Sugar-Frosted Fat: What's to Blame for Disease and Poor Diets?

Our Fatuous Fixation on Picking a Dietary Scapegoat

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In case you are in a rush, here’s the bottom line right at the top: A healthful diet is high NEITHER in added sugar, nor saturated fat. Really.

We have been hearing a lot of noise about sugar in our diets, and frankly, a lot of it is sugarcoating history. We have also been hearing a lot of noise about fat in our diets, and most of that is just plain fatuous.

It’s true that a study published in JAMA Internal Medicine in September 2016 indicates that the sugar industry funded research decades ago in an effort to bolster the reputation of their product. Specifically, we are told in this important paper that the Sugar Research Foundation funded studies and researchers in an effort to shift blame for heart disease away from sugar and onto saturated fat.

This would be useful information if we approached the science of nutrition with something other than the tendency in Newton’s third law to replace every action with an equal and opposite reaction, no matter how silly both might be. It would be useful information if we approached diet with just a bit of common sense. Unfortunately, that response is anything but common.

One sensible response to this revelation about sugar, and the history of sugar-frosted research, would be concern about industry-funded research in general, and overt conflicts of interest in particular. Protections against such distortions, oversights, and standards can, and should, be put in place for food industry research as they have long been for the pharmaceutical industry.

Another sensible response would be to recall that the truth about sugar wasn’t very successfully shielded from us in the first place. Just ask yourself: Didn’t you already know, last week and the week before that, that an excess of added sugar in your diet (or the diet of your child) isn’t exactly good for you? Hadn’t you gotten that memo? Of course you had! Everybody has. There is prominent advice to limit sugar intake in the Dietary Guidelines for Americans all the way back to the very first such report in 1980.

Now, maybe you didn’t think to blame heart disease on sugar directly, and maybe that’s where sugar-funded research did its mischief. But again, ask yourself: Didn’t you know that excess added sugar was a risk factor for obesity and diabetes? And didn’t you already know that obesity and diabetes were, in turn, risk factors for heart disease? Again, I’m pretty sure the answers all around are yes.

Making Sense of the Blame Game

The truth, thank goodness, tends to be a lot bigger than any one shroud any one biased group tries to throw over it. And while lies tend to shrivel with exposure to time and light, the truth thrives on both. So, the 50-year-old mischief of the Sugar Research Foundation holds important lessons for us; but the reality is, we knew that excess sugar was bad for us in spite of it.

As for dietary fat, our muddled considerations of its role in our diets and health tend to come in four main flavors. First, we are often encouraged to think that if one nutrient indicted for crimes against the health of humanity is guilty, all others must be vindicated. That’s just silly.  Neither deli meats nor doughnuts do our health any favors. There isn’t just one thing wrong with our diets.

Second, the most emphatic recommendations to increase fat intake now, often in the form of popular diet books, fail to differentiate baby from bathwater. In very extensive literature quite independent of sugar industry mischief, saturated fat from meat, processed meat, fast foods, and processed dairy products is very decisively associated with more heart disease and worse health outcomes. Unsaturated fats from nuts, seeds, olive oil, avocados, seafood, and game are associated with health benefits. The idea that all fats are created equal is nearly as silly as the idea that all carbs, from lentils to lollipops, are created equal.

Third, we are invited to believe that we cut our intake of dietary fat over the past half century and got fatter and sicker as a result. The reality is that we never really cut our intake of dietary fat in the first place, but rather diluted down our percent calories from fat by adding ever more low-fat junk food. Not losing weight or finding health with this approach should surprise no one.

Finally, those arguing against limits on dietary fat intake now, and all too often exploiting that message to sell something, seem to have missed the notice that the war is over. The 2015 Dietary Guidelines for Americans do not recommend any particular limit on total fat, while—very appropriately—still recommending a limit on saturated fat.

Getting Back to Basics

We are never going to get healthy, but will surely get dizzy from going in circles, if every argument about the harms of sugar comes with an attempt to exonerate saturated fat, or vice versa. The reality is that on the basis of science, sense, and global consensus, a diet good for the health of people and planet alike is high in neither added sugar, nor saturated fat. Rather, across research methods, cultures, populations, and generations, all such diets share an emphasis on minimally processed or unprocessed vegetables, fruits, whole grains, beans, lentils, nuts, and seeds, and water to satisfy thirst. 

The bottom line about diet for health is that it really does come down to the overall diet and the foods that make it up, not substituting today’s scapegoat for yesterday’s. 

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