Jun 20 2011
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My Sugar Obsession

Najaf Ahmad, M.P.H., is a Communications Associate with the Robert Wood Johnson Foundation's Human Capital Portfolio. She has contributed to RWJF’s efforts in the areas of health insurance coverage and nursing since joining the Foundation in 2004, and is currently working on initiatives to build capacity in the health and health care workforce.

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I’m obsessed with sugar and so is my husband. It wasn’t always this way; we used to spend many evenings sharing a pint of Ben & Jerry’s curled up in front of the TV.

That was until we became neurotic new parents.

In our quest to become good—and healthy—parents, nutrition became a new-found obsession. Our determination to model healthy behaviors for our child meant, among other things, reassessing our diet. To guide our efforts, we spent many evenings voraciously reading up on diet and nutrition–this time without Ben & Jerry.

It was right around then that I first heard of award-winning science journalist Gary Taubes. He had just published Good Calories, Bad Calories, his magnum opus examining the relationship between carbohydrates and obesity. A Robert Wood Johnson Foundation Investigator in Health Policy Research, Taubes has rediscovered the relationship between excess consumption of sugar, chronic health problems, obesity and food policy. He is one of only a few journalists that the Investigator program has funded.

Good Calories, Bad Calories challenged conventional wisdom by asserting that carbohydrates—not dietary fat—are driving surging rates of obesity. It also identified a strong link between diet and chronic diseases, such as diabetes, heart disease and even Alzheimer’s and cancer. Taubes documented a substantial body of research supporting this conclusion in his book. He noted that the medical community and federal government have relied upon misinterpreted scientific data to determine what healthful eating entails. More recently he came out with Why We Get Fat, a more succinct, digestible version of his first book on the issue.

The New York Times Magazine recently published a continuation of Taubes’ analysis of sugar’s impact on health in his article “Is Sugar Toxic?”. Taubes observed that the marked increase in our consumption of sugar coincides with our unprecedented epidemics of obesity and diabetes.

Taubes’ work is generating a groundswell of debate on nutrition and obesity. This debate has earned him his fair share of critics. Prominent among them is Mehmet Oz, aka Dr. Oz, a cardiothoracic surgeon, author, and host of The Dr. Oz Show. Dr. Oz recently challenged Taubes’ assertions on his popular daytime TV show. I couldn’t help but cringe as Oz challenged Taubes to a surprise on-air cholesterol test. Taubes politely refused.

Taubes fired back through his own personal blog, following up on Oz’s challenge by posting the results of his cholesterol test taken following the show. It is on his blog that Taubes has noted:

My message and the message of Why We Get Fat was not that we should all be eating nothing but animal products—and certainly not the unappetizing meat and eggs that Oz’s crew prepared as props—but that carbohydrate rich foods are inherently fattening, some more so than others, and that those of us predisposed to put on fat do so because of the carbs in the diet.

Related to this last point, Taubes does note that not everyone responds to insulin and carbohydrate in the same way. Some are more tolerant of refined and easily digestible carbs and sugars than others.

Another critic of Taubes is Dr. David Katz, Director of Yale Prevention Research Center and one of my own grad school professors. He countered Taubes’ article with an emphatic rebuttal in “Sugar Isn’t Evil” in which he said that while excess sugar is harmful, he finds it “far-fetched at best to suggest that the native composition of, say, berries is ‘evil.’”

Upon reading Katz’s rebuttal I couldn’t help but wonder if he may have missed the point of Taubes’ New York Times Magazine article. Taubes notes that isolating sugars found in fruit—fructose—and combining it with glucose and consuming it in concentrated quantities is what harms health:

Consuming sugar (fructose and glucose) means more work for the liver than if you consumed the same number of calories of starch (glucose). And if you take that sugar in liquid form—soda or fruit juices—the fructose and glucose will hit the liver more quickly than if you consumed them, say, in an apple (or several apples, to get what researchers would call the equivalent dose of sugar). The speed with which the liver has to do its work will also affect how it metabolizes the fructose and glucose.

Interestingly, my course with Katz was notable for the junk food we poor students eagerly passed around—junk food that Dr. Katz steadfastly refused.

Critics aside, I have my personal experience here. Taubes’ work has struck a chord with my husband and me, guiding a change in our food choices over the past few years. We’re hoping our new way of eating will help us lead healthier lives.

Since sugar is rife in many products lining our store shelves, our dietary changes have led to more home cooking. I’m often finding interesting ways to cut back on sugar while keeping what we eat delicious. This means throwing frozen berries and cream in the blender and freezing them into popsicles, rather than buying the “full sugar” brands of frozen confections. It means baking with nut flours instead of refined white flour, and drinking seltzer instead of soda. While some friends balk at the time and effort I spend in food preparation, to me it’s worth it, and I use it as an opportunity to engage my daughter in a fun activity that teaches her about healthy eating.

I can’t say that I’ve eliminated refined sugar entirely from my diet. But when I do muster up enough strength to go several days without it, I notice a marked difference in how I feel both mentally and physically.

My husband has taken a more hard-core approach –eliminating virtually all refined sugar and processed carbs from his diet—and even limiting “natural” sugars (fruits, honey, etc.). In the process he’s maintained a 40-pound weight loss over three years and refuses to look back. Ironically, he considers himself the last person who would have adhered so strictly to what many consider a radical diet, since it defies everything he’d been taught in medical school.

I don’t know how Taubes’ dietary theories will play out long term; he notes himself that the evidence is “not conclusive.” But my personal experience following his advice has convinced me. And I think most of us can agree that cutting back significantly on sugar consumption offers great benefits.

Tags: Nutrition, Childhood obesity, Research, Human Capital, Investigator Awards in Health Policy Research, Research & Analysis, RWJF Leaders