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Interesting. I think folks in the comments here maybe missed this paper is way more about the beverages part making it important. The research is around sugar sweetened beverages (SSBs). If I'm reading it right, the SSBs have a differentmetabolic effect.
"Due to their liquid form, SSBs are rapidly consumed and digested, resulting in lower satiety, higher caloric intake and weight gain. High doses of rapidly digested glucose also activate insulin and other regulatory pathways, which can result in visceral fat production, hepatic and skeletal muscle insulin resistance and weight gain. High doses of rapidly digested fructose directly activate hepatic fat synthesis, leading to ectopic fat deposition and metabolic dysfunction in liver and muscle"
Unfortunately I can't find where they define high dose, but if you look at what they say is high elsewhere, it seems to be around 9 servings a week of "any beverage with added sugars and >50 kcal per 8 oz serving, including commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch, lemonade and aguas frescas." - A can of coke is 12oz I believe?
About 15 years ago, I stopped drinking soda. Not out of a desire to be healthy or loose weight but simply because it dawned on me that for the same amount of sugar in one soft drink that I drink without any afterthought, I could enjoy a really good pastry that I can slowly savor.
I do the same for fats. The way I look at it, I want to maximize the "enjoyment per kcalorie". :)
More recently, I'm starting to apply this to meat as well. I really enjoy meat, but I'm not one for quantity since I'm on the skinnier side. So I'm trying to enjoy meat more, and in doing so, get better quality, prepare it better, etc. while at the same time eating less of it. This is still a work in progress, and eating in restaurants can be challenging as they usually favor quantity over quality—except for the very high-end & costly places.
"Sugar: The Bitter Truth" (https://robertlustig.com/sugar-the-bitter-truth/) is a pretty long watch, but it's incredibly eye-opening in terms of explaining in detail exactly why our current dietary sugar intake is so damaging to our bodies.
Note: Robert Lustig is a professor of pediatric endocrinology at UCSF, I promise I wouldn't ask you (the reader) to watch a long-ass youtube video unless it contained extremely relevant science about how you (the biological machine) work.
Orange juice is high in sugars. Drinking any alternative beverage with a lot of sugar is bad for your health. I believe a 12 ounce glass of orange juice is 100% of maximum sugar intake for one day. If you drank orange juice the same way you drank soda with added sugar, the health effect would be equally detrimental.
So taking myself as an example: I drink 12 oz of coffee daily (7 days per week), and I add exactly 12 grams of table sugar to my coffee each day (equivalent to 3 sugar packets), which is 45 calories. Seems like I don't have much wiggle room and should continue avoiding soda and juice.
I'm always glad for more hard evidence, but this exact reasoning has been "common sense", or something to that tune, my entire life. Maybe not every individual resulting issue, but that liquid sugar absorbs more rapidly and as such is worse that an equivalent amount of sugar in a more solid meal.
I'm curious what is the number of added sugars and above 50kcal peer 8 oz serving. You can get away with saying fruit drinks have no added sugar and still be insanely sugary.
Soft drinks tend to be much higher in sugar per ounce, roughly double. A 12 ounce can of coke has 39 grams, so you blow past that at around 4 ounces.
All carbohydrates eventually break down into sugars. Some quite a bit faster than others.
What people and scientists haven't been saying in any meaningful way is the truth that carbohydrate poisoning is a real thing. If you eat too much, its harmful.
Its common knowledge that medicines may become poisons when taken in too high amounts. This applies to most things in this area.
Protein poisoning is fairly easily discovered in the scientific literature, why isn't carbohydrate poisoning? Its a conundrum.
My father was Type 2 and for decades drank sweet tea; sweet tea that progressively became sweeter and sweeter. If you were to let it settle, you would see a thick layer of sugar sitting at the bottom of the glass. Eventually, he lost both of his legs beneath the knee due to infections that festered. He spent his last few years in a wheelchair and then eventually died of a heart attack.
Bad habits, bit by bit, over the course of years.
As a photojournalist, he won a Pulitzer for earthquake footage in 1989, saw the shuttle take off and land countless times, and took an incredible photo at a NASCAR event of a car, engulfed in flames, flying directly at his lens. (He got the shot and then dove out of the way.)
Which I guess is to say... life is ups and downs. Be wary of sugary stuff.
Your father sounds similar to mine: high-achiever, running every which way. Question: how was his sleep? My father's career was in a field that required annual physical fitness certification; his diet probably could have stood to include less salt and sugar when I was very young, but he cleaned it up, especially by the time he was diagnosed with T2. Something his job also required, however: early mornings. Late nights. And, evidently, not enough time to stop for a moment and determine if he might have sleep apnea (he did).
So, I think it's a three-part issue. Diet (sugar), obviously. Exercise, too, and whether or not you're getting it regularly throughout the day, every day. But I think it all goes to shit if you're getting bad sleep, especially if that "bad sleep" is "miniature bouts of asphyxiation." It completely screws with your body's ability to regulate itself, hormonally, and to recover from the day's damage.
That sounds like an epic photo, indeed.
> Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries
https://www.nature.com/articles/s41591-024-03345-4.pdf
The data and the code used for the analysis appears to be available.
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One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold. Afterall, it would benefit not only the receivers of care but also the people funding the healthcare system. The sellers of those things will fight (to their death) to prevent that environment from existing.
Not allowing something to be mass produced, marketed and sold is different than banning it outright.
I personally think mass scale tobacco and soda should not be sold, at the same time I think people can hand roll and pack a pipe into the grave. Same for their at home bathtub soda.
> One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold.
For the most unhealthy class of people that are most affected by things like T2 diabetes, we have universal healthcare. At 65 you get Medicare which covers diabetes treatment.
We have yet to ban sodas despite the added cost to the taxpayers.
> I personally think mass scale tobacco and soda should not be sold, at the same time I think people can hand roll and pack a pipe into the grave. Same for their at home bathtub soda.
For tobacco, the age restriction has been the thing that has limited use more than anything. People don't tend to pick up smoking once they hit 21. Millennials by and large do not smoke and the anti-tobacco legislation in the 90s is a large part of that.
Unfortunately, because the legislation didn't target all nicotine products that left the door open for vape companies to come in and get Gen Z and Alpha addicted to nicotine all over again.
A broad ban on the sale of nicotine products to minors should be in place. It certainly shouldn't be sold over the internet.
Soda is trickier. I don't think an outright ban would be right (though it would have a fair number of positive health benefits). A sin tax would likely be ineffective and age checks seems like it would be somewhat burdensome.
> One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold. Afterall, it would benefit not only the receivers of care but also the people funding the healthcare system. The sellers of those things will fight (to their death) to prevent that environment from existing.
Perhaps you’re implying something unique about the US, but those products are still sold in other countries that have state-funded universal health care.
I think you strike a good balance between personal freedoms and health of the population.
You’re right in that availability is the problem.
If I go across the road to the store, there’s a whole WALL covered in hundreds, maybe thousands, of sugar drinks, all very very cheap.
You know what there isn’t any of in the whole store? Something healthy and low sugar / high protein.
I have the luxury of time and a little bit of money so I can choose, but what about the busy parent who just needs energy? The busy office worker with a bunch of projects due, or just the poor individual with not much money, I don’t think it’s fair to setup these kind of situations and then blame the individuals for their choices, we have to step in at a governmental level
I don't think people realize the scale of soda consumption that needs to happen to have health issues. By and large the people in these affected studies are not drinking water at all. They are getting all their thirst needs met by a sugary drink. That is so overboard. You can have a can of coke every now and then and not have your enamel slough off.
Can you not buy more or less as unhealthy products in countries with universal healthcare as in US?
e.g. smoking rate is considerably higher in France or even in Spain
Sugar consumption isn't relatively that high either compared to most European countries:
https://www.who.int/data/gho/data/indicators/indicator-detai...
> One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold.
Counter argument: Pretty much every other nation has socialized healthcare and still allows sugary beverages and tobacco products.
>I personally think mass scale tobacco and soda should not be sold, at the same time I think people can hand roll and pack a pipe into the grave. Same for their at home bathtub soda.
I'd be fine with that to be honest. I'd drink soda water going forward just to not have to smell cigarettes, but be fine with people backyarding some tobacco to make their own cigars.
It would probably even be healthier to force people to make their own syrup for soda at home vs the ease of obtaining it now.
Canada has universal healthcare and they drink plenty of sugary drinks there too.
Before we go here, what is the alternative. If restrict soda and people switch to beer even if they will be driving that could be much worse. (I don't otherwise know how the effects of alcohol vs soda come up but that too is a question worth asking)
> One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold.
Yeah that not it boss. Never did I come across something getting banned in France because of healthcare costs.
I don't know that that's true. Most healthcare is subsidized. And so is the sugar. There's very little movement to restrict the sugar. There are profits to be made on both ends (selling the sugar and the insulin for example) by those who have captured the relevant parts of the government.
It's good to see more studies come on this but it's not exactly news. Researchers have known for quite some time now that there's an entire constellation of diseases (diabetes, stroke, certain cancers, fatty liver disease, heart disease, etc, etc) known as metabolic syndrome that are all caused by diet and lifestyle.
Also good that GLP-1s have been found to help people patch the reward center around unhealthy diet demand signals. We know these things are bad, we know will power isn't a solution, and we have a fix we can deploy at scale relatively inexpensively.
https://news.ycombinator.com/item?id=41988285 ("HN: GLP-1 for Everything")
https://news.ycombinator.com/item?id=42579445 ("HN: Weight loss drugs seem to be driving down grocery bills")
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5073929 | https://dx.doi.org/10.2139/ssrn.5073929 ("The No-Hunger Games: How GLP-1 Medication Adoption is Changing Consumer Food Purchases")
That is true but I think emphasizing liquid sugar is particularly important. When I was young I tried to bulk (for sports) several times and ate an obscene amount of carbohydrates and protein, think like 8 hot dogs and half a gallon of milk for lunch... roughly 4k calories a day of carbs/protein/fat.
I never got past 220. I would get terrible heartburn and bloating and be too full to eat enough, 220 seemed to be about the max my body could obtain without severe discomfort. It always made me wonder how people get up into the 300+ range. Liquified sugar seems like the only food that your body can process efficiently enough to get you into those massive weight categories.
Just to clarify metabolic syndrome isn't the umbrella term for all of these things.
Metabolic syndrome is when you have 3 or more of: central adiposity, high blood pressure, high blood sugar, high triglycerides and low HDL.
You can have any of these independently, it becomes metabolic syndrome when you hit the bingo.
I'd bet a dollar per gram additive sugar tax in excess of 5g would immediately flatten the chronic disease curve. Maybe double that if it's marketed towards kids. There are a lot of problems besides sugar/HFCS but it's easily towards the top of the list.
Tangentially related: a while ago i used to drink aspartame-sweetened drinks (sugarfree coke) but I did quit that as well after reading thst the sweet taste is still going go stimulate insulin production.
Speaking with a relative eho is a medical doctor they told me that yes, that’s a thing.
I’m not sure to what degree this might fit into the discussion, but just wanted to write this down.
Nowadays i just drink water.
I still have the occasional beer or the occasional glass of proper wine if i’m out with friends.
I drink 270g of pure sugar during a hard 3h bike ride. While allowing me to complete the hard work, it also helps with not feeling empty afterwards and eating uncontrollably. As long as I don’t gain weight It’s all good.
I'm from latam. I never saw anyone drink water growing up. Anytime you try to drink water, people label you as boring, even your parents. Whenever we go to a restaurant, the first thing you ask the waiter is "what sodas do you have?". If you're not feeling like drinking soda and want something "healthier", you ask what kinds of fruit juices they have. If you don't like the options, you settle on a hyper-sweetened tea.
I frequently ask my parents to drink more water, and they get defensive saying they drink a lot of water but I just don't see it. The truth is they only drink half a small cup in the middle of the night...
Fruit smoothies are an interesting case of a "sugar beverage" which doesn't quite act how you'd think. Intuitively, you'd think that speedy ingestion of that much fructose with all its fiber obliterated in a blender could potentially cause spikes in blood glucose. However this study showed that when the fruits had seeds, like blackberries and raspberries, the glucose peak was lower with blended fruit than whole.
I know several people who’ve undergone bariatric surgery.
One of the post-surgery ‘rules’ is … “Don’t drink your calories.”
It's "good" that this is in Nature, but does any health-aware person not already know this?
Our real problem is that most people aren't health-aware, and advertising (including the pharma-funded healthcare system) absolutely overwhelms common-sense truths about health.
Over the past few years I have improved my own health by greatly limiting my intake of sugars, including by cutting out "healthy" smoothies, but I learned all this from Dr Internet, and NOT from any physician who was being paid to treat me. US physicians' knowledge of nutrition is stuck at whatever they were taught in med school, which was probably 20+ years behind the research at that time.
There is almost nothing* like sugar drinks in the natural world our bodies evolved in. Sugar drinks are about as different as tea leaves and pure cocaine. It's is no coincidence that both are refined white powders.
*honey
Not a native English speaker but, isn’t the word “attributable” in the title at least misleading?
Shouldn’t it be “linked” instead?
The paper indicates correlation, not causality.
How did this article get past the sugar mafia? That too in nature!
Yudkin [1] must be chortling ;)
Warren Buffett, have your boys been slacking off? Somebody is gonna get really hurt...bad!
"Tendency to manifest consumption of sugar beverages attributable to predisposition to type 2 diabetes and cardiovascular disease."
Hm. I thought the "switcheroo test" would create an obviously false "what if" statement in this case, but not so sure.
Trying to attribute it to just one cause is always fallacious. In truth the modern Western diet is probably the worst of it.
Highly processed seed oils that are chemically extracted and used for frying and baking. I'm not one of those people who believes that they are genuinely toxic but they have too much omega-6.
Inexpensive sources of sugar everywhere.
Conditioners and preservatives in everything.
Most vegetables and fruits are sprayed with pesticides to some degree.
Low variety and diversity of vegetables in traditional diets.
Combine this with exceedingly high levels of misinformation both from the government and various dietitians, celebrities, medical journals, doctors, Facebook groups and users, conspiracy theorists etc. It's hard for people to know what is actually going to kill them and what isn't.
All I can tell you is is that I got a pair of 90-year-old grandparents who always eat eggs and bacon for breakfast, cook their food the old fashioned way, drink plenty of tea and always seek out the highest quality ingredients for their foods.
There is a classic book about the effects of sugar named "Sugar Blues" for the interested. I have a bad reaction to sugar so have to avoid certain foods -- e.g. bananas are a no-no for me.
Well this article scared me. Guess I will have to quit Mountain Dew. But what if I switched to the sugar free one? (Am I swapping diabetes and heart disease for cancer?)
What was hard to read from the article was if there’s a weekly or daily intake of sugar from SSB’s that’s “safe”?
Does this mean that soft-drink companies could be facing tobacco-company-style lawsuits?
I only ever drink coke when I'm mixing with whisky... not sure which one is worse...
What else will they find out, that sugar is sweet?
Yet another article implying causation from association. The theory that sugar CAUSES diabetes type 2 fails when you look at people that eat a ton of carbs but keep the fats low: low fat vegans, fruitarians. Find one that's diabetic. They should be dropping like flies. But look at people that eat high fat >40% of calories, and the rest in carbs, and there you'll find the population of the metabolically compromised.
Really?
I thought it was salad’s fault.
If A causes diabetes, then it causes C outcome of diabetes. It’s a tautology.
((A → B) ∧ (B → C)) → (A → C)