Is Objective Dialogue About Sugar Even Possible?

For the Dietary Guidelines Advisory Committee, this was a relatively easy question. Americans typically consume too much added sugar. So the committee recommends a lower limit. In the 2015, the limit was ten percent of total calories from added sugars. But now the committee says that limit should come down to six. Not so fast, say Edward Archer and Bahram Arjmandi. “Anti-sugar policies are not merely unscientific, but are regressive and unjust,” they write. Such divergent views make us wonder. How objective is the dialogue about sugar? Are we talking past each other?

A Marker for an Unhealthy Diet

With the 2015 dietary guidelines, the focus on sugar shifted. Consumption of total sugars had been dropping since the turn of the millenium. Nutrition Facts labels had focused on total sugars. But lots of very nourishing food contain sugar. Starting with breast milk. One cup has 17 grams. Nature’s perfect food.

So policy shifted toward a focus on added sugars. This is sugar that goes into food in the manufacturing process, mostly to make it more delicious and irresistible. A body of research built up to document a correlation between more added sugar and worse health outcomes. Dietary cognoscenti rallied behind the idea of cutting back on added sugars. The concept seems perfectly reasonable.

Just a Doggone Minute

Archer and Arjmandi beg to differ. Biologically, intrinsic sugar in food and added sugar are identical:

The striking contradiction between the passionate prescription of breast-feeding and the puritanical proscription of dietary sugars is due to the failure to acknowledge that, despite its political expediency and marketing potential, the distinction between “added” and “intrinsic” sugars is biochemically and scientifically meaningless.

From there, they have an easy time progressing to argue that anti-sugar rhetoric and policies “provide no clear health benefits while harming people already burdened by stigma, poverty, and prejudice.”

Dialogue About Sugar?

Thus we have two extremes. Some folks who falsely claim “sugar is toxic.” Meanwhile, Archer and Arjmandi argue that policies to curb added sugar are “regressive and unjust.” Does this dogma leave room for dialogue about sugar, nutrition, and health?

Michelle Cardel tells us that we should focus on what we really know and what we don’t:

Sugar detox rhetoric is nothing but pseudoscience. But people can often benefit from avoiding added sugars in their diets because it can lead to eliminating a great deal of ultra-processed foods. Research by Kevin Hall has convincingly demonstrated the value of shifting one’s diet toward whole foods. Yet it doesn’t give us definitive answers about what’s sustainable and practical for the long term. We need more data for that.

In a similar vein, Emily Dhurandhar offers caution about dietary absolutism:

It can be important to keep food privilege in mind when we are making food policy. With sugar, for example, we can certainly see harmful effects in controlled experiments when it is consumed at high doses, chronically. But translating that to policy to reduce intake is complicated when those who have the highest intake depend at least in part on shelf stable, sugar rich foods for their food security. Increasing the price through taxes may reduce consumption of sugar. But it can introduce a whole new stressor of worsening food insecurity. We want to make sure food policy isn’t improving one issue at the cost of creating another.

Stay Curious

All of this reminds us to be curious and objective about seeking the truth in nutrition. And likewise be very cautious about people who are so certain they have found it.

Click here for Archer and Arjmandi’s article and here for more on food privilege. For perspective on how dietary guidelines might not respect diversity, click here.

Dialogue, photograph © Kačka a Ondra / flickr

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August 18, 2020