The dilemma of the low-hanging fruit has plagued mankind since the beginning of time. But history has proven that while it is tempting to address a problem by focusing on the most attainable goal, rather than the most appropriate, it just doesn’t pan out in the long run.
We would be well-advised to remember this as we search for solutions to the ongoing obesity epidemic.
Currently, many purported health advocates are targeting all-natural sugar as public enemy number one in the fight against obesity. And while this tactic might result in a quick win, especially given the negative coverage of all-natural sugar in recent years, it’s an oversimplified approach to a complex problem and simply not supported by scientific evidence and solid data.
Take for example, the World Health Organization’s recent guidance on “added sugars.” The WHO recommends “free sugars” (“added sugars”) intake be less than 10 percent and ideally 5 percent of caloric intake. Similar guidance for 5-7.5 percent of calories from “added sugars” was put forth by the American Heart Association in 2009.
The primary driving force for these intake recommendations is the current obesity epidemic and the assumption that “added sugars” play a significant role in the cause and solution to obesity.
But the data tell us otherwise.
In fact, using National Health and Nutrition Examination Survey (NHANES) data, researchers observed the highest body mass indexes (BMIs) in persons consuming 0-5 percent of calories from “added sugars.” Also of note, the lowest BMIs are seen when “added sugars” intake is between 15 and 35 percent of calories. Additionally, for each 5 percent increase in “added sugars” above 15 percent, the authors observed a lower prevalence of overweight and obese individuals, with the exception of more than 35 percent energy from “added sugars” (only 2.9 percent of population were in this range). By no means are we suggesting that if you eat more “added sugars” you will have a lower BMI. We are simply reporting these data as provided by NHANES.
Given that the highest BMIs are seen in those consuming the least amount of “added sugars,” clearly there are other dietary and lifestyle factors that should be considered.
It is important to point out that this study was not designed to distinguish between the different caloric sweeteners, and instead addressed the broad category called “added sugars.” The human body reacts differently to different types of sugars. Of note, based on USDA availability data, sugar/sucrose consumption is less than half of all “added sugars” intake.
Despite these NHANES findings, and the fact that comprehensive reviews of published science have failed to support a causal link between sugar consumption and lifestyle diseases, the inaccurate targeting of all-natural sugar continues.
The Dietary Guidelines Advisory Committee recently made it clear “added sugars” is the newest dietary target, with over 300 mentions in their report. The 2015 Committee, despite weak science, is now telling the American public that many of our health woes are caused by “added sugars” intake.
This targeting of sugar is not only misguided, but problematic at its core. A hyper-focus on one nutrient without thinking about what calories will replace that nutrient is shortsighted. Were any lessons learned from the low-fat reformulation of foods in the 1990s? Did we see improved health outcomes? No. In fact, obesity increased dramatically over the same time period.
When it comes to sugar-free or “less sugar” products, the same holds true. Many sugar-free products have similar carbohydrate content and calories as the regular sweetened versions. Furthermore, the prevalence of obesity has increased substantially at the same time as the consumption of artificial sweeteners has increased.
Over the past several decades, foods once considered staples of the American diet such as eggs, milk, and butter have come under attack.
Now sugar is being targeted, despite the overwhelming science that simply restricting sugar does not work.
Also of note, Department of Agriculture data show that U.S. per-capita consumption of real sugar is lower now than it was 40 years ago by about one-third, just as rates of obesity, diabetes and other metabolic diseases have risen.
The cause of obesity is multi-factorial and in reversing this trend, there needs to be a focus on evidence-based solutions so that real progress can be made. The science on sugar is clear: All-natural sugar in moderation can be a part of a balanced diet and healthy lifestyle.