Is sugar a ‘fundamental cause of diabetes’ beyond adding empty calories, BMJ author asks

By Elizabeth Crawford contact

- Last updated on GMT

Is sugar a ‘fundamental cause of diabetes’ BMJ author asks

Related tags: Nutrition

While the jury is still out on what role, if any, sugar plays in the development of diabetes, recommendations to restrict consumption should be strengthened and research should be redoubled until a clear determination is found, according to an essay in The BMJ today.

Gary Taubes, cofounder of the non-profit Nutrition Science Initiative, argues in the essay​ that for more than 100 years doctors have suspected that refined sugar – namely sucrose – is a likely cause of the ongoing diabetes epidemic, as illustrated by early trends data that tracked the rise and fall of the disease with consumption levels of the nutrient.

He notes, this data was bolstered by additional research that hypothesized “sugar has deleterious effects on the human body independent of its calorific content,”​ in the form of a “distinct causal pathway” ​revealed in the metabolism of fructose primarily in the liver, which could lead to increased hepatic fat. From there, he added, it contributed “to the insulin resistance that is the fundamental biochemical disturbance in type 2 diabetes.”

However, Taubes points out,“the idea that sugar could be a fundamental cause of diabetes, not just a source of empty calories, fell out of fashion over the years,”​ as the health community instead focused on the role of fat and overconsumption of calories in the development of obesity, for which diabetes was considered “a penalty.”

While this led to recommendations to strictly limit the consumption of sugar to reduce the intake of “empty”​ calories and the development of dental caries, Taubes says this is not enough to balance the potential health dangers of the nutrient.

Pointing to the “present dire situation”​ with diabetes impacting one in 11 people in the US and costing the American healthcare system as much as $1 billion a day, Taubes argues that the idea that sugar could fundamentally lead to diabetes – as well as obesity – “should be considered seriously again.”

Taubes acknowledges that the evidence connecting sugar to diabetes is “far from definitive,”​ but, he also says it is growing. He points to animal studies that connect high-sugar diets with metabolic syndrome and insulin resistance.

The only way to know for sure whether sugar is connected to diabetes development is to fund additional research, including randomized controlled studies looking at hard endpoints such as mortality and cardiovascular events – similar to the research looking at the relationship between dietary fat consumption, blood cholesterol levels and chronic disease development.

“Given the scale of the obesity and diabetes epidemics … a concerted program of research to establish reliable knowledge on this subject should be among our highest priorities,”​ Taubes said. At the same time, he concluded, “we can acknowledge the uncertainties while still recommending strongly against consumption.”

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4 comments

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SUGAR is NOT the BAD GUY!

Posted by s leonard,

I do not agree with the premise of this article! The obvious connection between the increase in diabetes other than genetics is OBESITY! The people who are obese usually eat way too much red meat, FAT, and snack foods /drinks. I have a diabetic sister who has done this all her life and has been in denial the entire time. I am over 70 and have drunk more sweet tea than just about anybody and I love sweets, too! The difference has been the rest of my diet and my active lifestyle. I burn off the calories of sugar both physically and mentally so fast that I have to worry about hypoglycemia. I don't sit much even now after I have had a severe spinal degenerative event and now chronic pain and sciatica issue, but have gained ~ 8 lbs without any diet change and only a limited decrease in activity over the last 2 years. The difference I see in people (and my animal patients) between diabetics and non-diabetics is overeating and under activity. Animals don't typically eat more sugar in their "balanced" diets - they just eat too much of everything and are often not active (all due to the owner's forcing these conditions on the pet). Decrease the food, the animal loses weight and often becomes more active, even in an indoor lifestyle. Increase the activity level and you have a faster weight loss. AND a plus, probably more positive bonding between pet and owner (then stress decrease, less time for binge eating, etc). A win, win.
Before blaming sucrose, research the entire diet components! I love my iced tea even in the cold of winter! and baking. My diet is vegetarian, by the way! Thanks for the listen; I hope you hear me, as well!

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Sugar is not the reason diabetes & obesity.

Posted by Manikandan Kumar,

Yes, you read it right. It is lack of physical activity in your body that leads to obesity and eventually diabetic. Primary cause is genetic. Secondary cause is not burning of calories.

You can consume any amount of candies, chocolate, ice creams, cookies etc, but be sure you go out & play or do some physical activity every morning.

In rural areas in India, people consume only rice along with sweets. They are not affected by obesity & diabetes. They only reason being they indulge in physical agricultural activity.

The present generation of people, mainly younger generations, are glued to TV's, iPads & iPhones. Then it is natural for them to put on lot of weight which leads to obesity & ignorantly people end up blaming sugar as the root cause.

For the past hundreds of years sugar has been doing its duty perfectly well. It gives calories when consumed. Sugar has not changed its behavior. It is we who have changed our lifestyle over the years and the mistake clearly lies with us.

Hope the world realizes soon that sugar is not the cause for obesity & diabetes.

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Bad cause.

Posted by sara,

I was diagnosed with type 2 Diabetes and put on Metformin on June 26th, 2016. I started the ADA diet and followed it 100% for a few weeks and could not get my blood sugar to go below 140. Finally I began to panic and called my doctor, he told me to get used to it. He said I would be on metformin my whole life and eventually insulin. At that point i knew something wasn't right and began to do lots of research. Then I found Lisa’s diabetes story http://mydiabetesday.com/i-finally-reversed-my-diabetes/ I read that article from end to end because everything the writer was saying made absolute sense. I started the diet that day and the next morning my blood sugar was down to 100 and now i have a fasting blood sugar between Mid 70's and the 80's. My doctor took me off the metformin after just three week of being on this lifestyle change. I have lost over 30 pounds and 6+ inches around my waist in a month. The truth is we can get off the drugs and help myself by trying natural methods

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