Full Transcript Sugar Guidelines and Industry Pressure 0:00 Doesn't it seem like when it comes to nutrition, there are more opinions than 0:04 [music] facts to go around? Every day we hear new theories about 0:08 diets and supplements and >> [music] 0:10 >> best foods to eat. Well, my role is to take the mystery out of good nutrition 0:15 and look at the science. Welcome to the NutritionFacts Podcast. I'm your host, 0:20 Dr. [music] Michael Greger. Public health authorities continue to 0:24 drop the upper tolerable limit of daily [music] added sugar intake, and that's a 0:29 good thing. Here's our first story. Dating back to the original dietary 0:34 goals for the United [music] States in 1977, the so-called McGovern report, 0:39 leading nutrition scientists were not only calling for a reduction in meat and 0:43 other sources of saturated fat and cholesterol like dairy and eggs, but 0:47 also sugar. The goal was to reduce America's sugar intake down to 0:53 no more than 10% of the daily diet. The final conclusions would hang sugar, 0:59 reported the president of the Sugar Association. The McGovern report has to 1:04 be neutralized. Don't worry though, we have the National Cattlemen's 1:07 Association on our side, and like big sugar, they appealed to the Senate 1:12 Select Committee to withdraw the report. The sugar industry empire striking back 1:18 appeared to work when the official dietary guidelines were released in 1980 1:23 and then again in '85, no specific limit like 10% just a vague avoid too much 1:30 sugar, whatever that means. By '95 it got even vaguer, choose a diet moderate 1:35 in sugars. In 2000, they were at least back to limit, but even that was too 1:40 strong. Under pressure from sugar lobbyists, they went back to a moderate 1:44 your intake of sugars before the 2005 guideline committee dropped the S word 1:50 completely, encouraging Americans to choose carbohydrates wisely, whatever 1:55 that means. If only there were some kind of dietary guidelines committee that 2:00 could give us guidance. The Sugar Association expressed optimism about 2:05 that 2005 committee. The Sugar Association Incorporated is 2:10 committed to the protection and promotion of table sugar consumption, 2:14 and they will not allow for the disparagement of sugar. 2:18 And they're not kidding. In 2003, the World Health Organization released a 2:21 report on diet, nutrition, and the prevention of chronic disease, which for 2:26 the first time since the McGovern report, called for reduction in sugar 2:30 intake to under 10%. The Sugar Association responded by threatening to 2:35 get the US to withdraw all funding from the WHO. 2:39 Here it is in black and white. The Sugar Association threatening to 2:44 pressure Congress to withdraw funding from the World Health Organization. You 2:48 know, polio vaccinations, AIDS medications, be damned. You just don't 2:53 mess with the candy man. The threat was described as tantamount 2:59 to blackmail and worse than any pressure they had experienced from big tobacco. 3:04 But now, 15 years later, and 40 years after the first proposed McGovern 3:08 report, the current 2015 to 2020 dietary guidelines lay out as a key 3:13 recommendation the 10% limit, currently exceeded by every age bracket in the 3:19 United States starting at age one, with adolescents averaging 87 g of sugar a 3:25 day, meaning the average teen is effectively eating 29 sugar packets a 3:30 day. The Sugar Association describes the 10% 3:33 limit as extremely low. I mean, only like up to a dozen spoonfuls a day. 3:39 But of course, there's no dietary requirement for added sugar at all, and 3:43 every single calorie you get from added sugar is a wasted opportunity to get 3:48 calories from sources that actually provide nutrition. To the American Heart 3:53 Association's credit, they went further, trying to push added sugar intake down 3:57 to about 6% of calories, for which a single can of soda could, you know, send 4:03 you over the limit. An added sugar limit exceeded by 90%
Sugar, Obesity, and Weight Gain 4:08 of Americans. In 2017, the American Heart Association released their 4:12 guidelines for children, recommending they get no more than about, you know, 4:15 six teaspoons per day, which means there's, you know, nearly 100 cereals on 4:21 the US market for which a single serving exceeded the entire recommended daily 4:25 limit. And the Heart Association recommends no added sugars at all under 4:29 age two. Small toddlers are to avoid added sugars 4:33 altogether, a recommendation that's violated in up to 80% of toddlers. The 4:39 US is one of at least 65 countries that have implemented dietary guidelines or 4:44 policies to curb sugar consumption. In the UK, the Scientific Advisory 4:50 Committee on Nutrition made new recommendations to reduce added sugars 4:53 down to 5%, which is the direction the World Health Organization is headed as 4:58 well. They always seem to be kind of ahead of the curve. Why? Because their 5:01 policy-making process is at least partially protected from industry 5:06 influence. Unlike governments, which may have competing interests in commerce and 5:10 trade, the World Health Organization is exclusively concerned with health. 5:17 In our next story, we look at the sugar industry's response to evidence 5:21 implicating sweeteners in the obesity epidemic. 5:24 The obesity epidemic may just be the tip of the iceberg in terms of excess body 5:29 fat. It's been estimated that 91% of adults, 5:33 nine out of 10 of us, and 69% of children in the United States are, quote 5:37 unquote, over fat, defined as excess body fat sufficient to impair health. 5:44 That can occur even in normal weight individuals, often due to excess 5:49 abdominal fat. The way you tell if you're over fat is if your waist 5:53 circumference is more than half your height. What's causing this epidemic? 5:58 One primary cause may be all the added sugars we're eating. A century ago, 6:03 sugar was heralded as one of the cheapest forms of calories in the diet. 6:07 Just 10 cents worth of sugar could furnish 6:10 thousands of calories. Harvard's sugar-pushing nutritionist 6:15 bristled at the term empty calories. The calories in sugar were not empty, but 6:20 full of energy. In other words, full of calories, which we are now getting too 6:24 many of. The excess body weight of the US 6:28 population corresponds to about a 350 to 500 calorie excess daily caloric intake 6:35 on average. So, to revert the obesity epidemic, that's how many calories we 6:40 have to reduce. Okay, so which calories should we cut? 6:45 That's just how many calories the majority of Americans who failed to meet 6:48 the dietary guideline sugar limit get in added sugars every day, 25 teaspoons, 6:53 about 400 calories. Even the most die-hard sugar defenders like James 6:58 Rippe, who is reportedly paid $40,000 a month by the high-fructose corn syrup 7:04 industry on top of the 10 million they paid for his research, even Dr. Rippe 7:09 considers it indisputable that sugars contribute to obesity. 7:14 It's also indisputable that sugar reduction should be part of any weight 7:18 loss program. And of all sources of calories to limit, 7:22 since sugar is just empty calories, contains no essential nutrients, 7:27 reducing sugar consumption is obviously the place to start. And again, this is 7:32 what the researchers funded by the likes of Dr. Pepper and Coca-Cola are saying. 7:38 The primary author, Richard Kahn, is infamous for his defense of the American 7:42 Beverage Association, the soda industry. He was chief science officer at the 7:47 American Diabetes Association when they signed a million-dollar sponsorship deal 7:51 with the world's largest candy company. Maybe the American Diabetes Association 7:56 should rename itself the American Junk Food Association. But what do you expect 8:01 from an organization that was started with drug industry funding? 8:05 The bottom line is that randomized controlled trials show that increasing 8:08 sugars intake increases calorie intake, and this leads to body weight gain in 8:12 adults, and sugar reduction leads to body weight loss in children. For 8:16 example, when researchers randomized individuals to either increase their 8:20 intake of table sugar or decrease their intake, the added sugar group gained 8:24 about 3 and 1/2 lb over 10 weeks, whereas the reduced sugar group lost 8:29 about 2 and 1/2 lb. A systematic review and meta-analysis of all such ad libitum 8:34 diet studies, meaning real-life studies where sugar levels were changed, but 8:38 people could otherwise eat whatever they wanted, reduced intake of dietary sugars 8:43 resulted in a decrease in body weight, whereas increased sugars intake resulted 8:48 in a comparable increase in weight. The researchers conclude that, considering 8:52 the rapid weight gain that occurs after an increased intake of sugars, it seems 8:56 reasonable to advise people to cut down. Findings from observational studies have
Vinegar and Blood Sugar Control 9:03 been more ambiguous though, with the association found between obesity and 9:08 sweetened beverage intake, but failing to show consistent correlations with 9:12 sugary foods. Most such studies rely on self-reported 9:16 data, however, and obese people tend to underreport sugar-rich foods. 9:21 One can measure trace sucrose levels in the urine, however, to not only get an 9:26 objective measure of actual sugar intake, but to exclude contributions 9:30 from other sweeteners such as high-fructose corn syrup. When 9:33 researchers have done this, they discovered that sugar intake is indeed 9:37 not only associated with greater odds of obesity and greater waist circumference 9:41 on a snapshot in time cross-sectional basis, but in a prospective cohort study 9:47 over time. Using urinary sucrose as a measure of 9:50 sucrose intake, those in the highest versus lowest fifth for sucrose intake 9:54 had more than a 50% greater risk of being overweight or obese. Denying 9:59 evidence that sugars are harmful to health has evidently been at the heart 10:03 of the sugar industry's defense. But when the evidence is undeniable, like 10:07 the link between sugar and cavities, they switch from denial to deflection, 10:11 like trying to switch attention from restricting intake to coming up with 10:15 some kind of vaccine against tooth decay. 10:19 We seem to have reached a similar point with obesity with the likes of the sugar 10:22 bureau switching from denial to deflection by commissioning research 10:26 suggesting obese individuals would not benefit from losing weight, a stance 10:31 contradicted by hundreds of studies across four continents involving more 10:36 than 10 million participants. Finally today, how vinegar can help with 10:42 blood sugar control. A double-blind, placebo-controlled, randomized study 10:46 found that body weight and belly fat were significantly reduced adding just a 10:51 single tablespoon of vinegar to one's daily diet. 10:54 But is there any benefit to vinegar consumption if you're not overweight? 11:00 Well, their triglycerides normalized and on the two tablespoons a day dose, there 11:04 was a dip in blood pressure. But those effects may have just been because of 11:08 the weight loss. Other than taste, is there any benefit to normal weight 11:13 individuals sprinkling vinegar on their salad? What about vinegar for blood 11:18 sugar control? If you feed people a massive amount of sugar, half cup of 11:22 table sugar, as their blood sugar spike, their artery 11:26 function can become impaired. And the higher the blood sugars go, the more the 11:31 arteries take a hit. There's a drug though that can block 11:35 sugar absorption and by blunting the blood sugar spike with a drug, you can 11:40 prevent the arterial dysfunction demonstrating it's probably good for 11:44 your heart if you don't have big blood sugar spikes after meals. And indeed, 11:47 how high your blood sugar spike after a meal is a predictor for cardiovascular 11:52 mortality. So the people who eat lots of high glycemic foods like sugary foods 11:57 and refined grains tend to have more heart attacks and strokes. Yes. 12:02 And they appear more likely to get diabetes, but maybe people who eat lots 12:06 of frosted flakes and Wonder Bread also have other bad dietary habits. 12:12 The diets that have been put to the test in randomized controlled trials and 12:16 proven to prevent diabetes are the ones focusing on cutting down on saturated 12:21 fat and ramping up the consumption of fiber-rich whole plant foods such as 12:25 fruits, vegetables, and whole grains without specific regard to lower or 12:29 higher glycemic loads. The drug has been put to the test though in blunting one's 12:35 mealtime blood sugar spikes does seem to reduce the risk of developing diabetes. 12:41 As well as reduce the risk of heart attacks and high blood pressure. 12:45 So is there any way to prevent these blood sugar spikes without having to 12:49 take drugs? Well, one way would be to not sit down to have 12:54 a cup of sugar. Yes, the drug can slow the progression 12:58 of your atherosclerosis, but wouldn't it be better to eat a diet 13:01 that actually reverses heart disease, reverses diabetes? The healthiest diet 13:06 to prevent the meal-related blood sugar and fat spikes, the oxidation, 13:10 inflammation, is a diet centered around whole plant foods. 13:14 But what if you really want a bagel? Instead of spreading drugs on it, 13:19 spreading on some almond butter may help blunt the blood sugar spike from refined 13:24 carbs. And another option is to dip your baguette in some balsamic vinegar. 13:31 The consumption of vinegar with meals was evidently used as a home remedy for 13:35 diabetes before drugs came along, but wasn't put to the test until 1988. After 13:42 all, how much money can be made from vinegar? 13:45 Well, according to the Vinegar Institute, millions of dollars, but a 13:50 single diabetes drug like Rezulin can pull in billions 13:56 before it was pulled from the market for killing too many people by shutting down
NutritionFacts Resources and Closing 14:00 their livers. The drug company still made off like a 14:04 bandit having to pay out less than a billion to the grieving families for 14:08 covering up the danger. No liver failure from a peanut 14:13 butter-smeared bagel though, cutting the blood sugar response in half. And the 14:18 same with vinegar, if you chug down four teaspoons of apple cider vinegar diluted 14:23 in water, you get that same blunting of the spike and you get the additional 14:27 advantage over the nuts of lowering insulin levels in the blood, something 14:32 peanut butter apparently can't do. But presumably better than a bagel with 14:37 lox as fish causes triple the insulin response or red wine, which also 14:44 increases insulin levels, though not as much as the fish. 14:47 And also shoots up triglycerides, though dealcoholized 14:53 red wine, non-alcoholic wine, doesn't have the same problem. 14:58 Okay, but what about vinegar? Not only may a tablespoon a day tend to improve 15:02 cholesterol and triglycerides over time, vinegar 15:06 can drop triglycerides within an hour of a meal along with decreased blood sugars 15:12 and the insulin spike potentially offering the best of all worlds. 15:19 Visit nutritionfacts.org/audio to see all the podcast episodes with 15:23 descriptions that include links to the associated videos. Sources cited and 15:28 other details are available on each video's page. Information about my 15:32 books, How Not to Die, How Not to Diet, and How Not to Age is at 15:36 nutritionfacts.org/books. All proceeds of [music] which I get are 15:40 donated directly to charity. And I've got a new book in the publication 15:45 pipeline, the manuscript for How Not to Hurt, a diet lifestyle approaches to 15:50 pain management. It's been handed in and will be published December 15th. 15:55 >> [music] >> Going to be doing a series of webinars 15:57 to feature some of the new research I discovered. Sign up for our free 16:00 newsletter at nutritionfacts.org/subscribe 16:05 to stay updated on when those will be. Nutritionfacts.org is a science-based 16:11 nonprofit and everything on the website is free. There are no ads, no corporate 16:14 sponsorships, no kickbacks. We're strictly non-commercial, not selling 16:18 anything, just put up as a public service, as a labor of love, as a 16:22 tribute to my grandmother whose own life is saved with evidence-based nutrition. 16:27 We just have like a a Wikipedia-type nonprofit model where 16:31 everything's free and we just hope maybe, you know, one in a thousand 16:33 people will find it so viable that they'll kick in a few bucks so we can 16:37 continue to churn out new content >> [music] 16:39 >> to help you and your family be healthier. Thanks for listening.
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