
Is Sugar Toxic? - px
http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?pagewanted=all
======
JonnieCache
Toxicity as a concept is entirely defined by dose. Bleach is not toxic if you
take a small enough dose. Conversely, water is toxic if you drink too much of
it.

Unfortunately toxic, like so many other of our perfectly good scientific
words, has been hijacked by quacks trying to deprive the credulous of their
money.

~~~
Splines
True enough, but people should know how much bleach and water is needed to
hurt themselves; death and/or pain provides immediate feedback. The problem
with sugar is that the benefits are so immediate and the drawbacks so distant
that it requires a strong will to avoid.

~~~
JonnieCache
The problem is that the question "Is sugar toxic?" is inherently meaningless.
Bandying the word around like this in a publication like the NYT dilutes
public understanding of the issue.

Scientifically responsible journalists would have chosen an accurate term to
discuss the issue rather than shooting for maximum emotional impact.

~~~
jsdalton
The thesis of the article is pretty obvious: Sugar is toxic in the amounts
found in a typical western diet.

~~~
JonnieCache
Hmmmm. You're right. That is pretty obvious. I feel kinda silly now.

I tend to be on a bit of a hair trigger over the use of words like toxic by
nutritionists, because so often they turn out to be graduates of degree mills,
pedalling patent medicines via press release reprinting churnalists.

This guy seems to check out however, even if he is a bit absolutist.

~~~
jsdalton
That's cool; I actually appreciated your insight in the top comment. It _is_
meaningless to say sugar is toxic or not toxic. The important question is at
what level does it become toxic, which is almost certainly less than what we
consume now but surely greater than zero (I hope so anyway -- zero strikes me
as both impractical and not very tasty).

------
bgentry
For those who haven't watched the video lecture referenced early in the
article, I highly recommend checking it out:
<http://www.youtube.com/watch?v=dBnniua6-oM>

Lustig does a fantastic job explaining the cellular processes at work, which
appealed to my engineering side. I'm not usually passionate about biochemistry
and this lecture is definitely long, but if you make it through the first 15
minutes you will be hooked.

~~~
nikcub
I am one of those people who is hard to convince to watch something, so if
there is anybody else out there reading this comment thread and wondering if
you should watch that video - please do.

It is informative in parts, and his style is excellent, but watch if with an
open mind and a pinch of skepticism

~~~
g_lined
Thanks. I watched the video only after reading your comment. I found something
new about fructose so it was worth it. I personally am turned off by his
presentation style. He tries to hard to convince me of his conclusion, too
rhetorically and indeed before he had presented his reasons. Nevertheless I
feel that the theory of what he presented is pretty much right and the only
question appears to be to what degree you agree with his conclusions.

------
rflrob
_"In Lustig’s view, sugar should be thought of, like cigarettes and alcohol,
as something that’s killing us."_

I don't smoke, but I do drink alcohol in moderated amounts, and I'd disagree
that alcohol is "killing us" [1], and feel that even if it were proved beyond
a doubt that alcohol monotonically decreases lifespan, it helps make life
enjoyable enough to be worth it. The same is true for processed sugar, in
moderate amounts (though I'd take a ripe honeycrisp apple over a twinkie any
day).

[1][http://www.wired.co.uk/news/archive/2010-09/09/why-
alcohol-i...](http://www.wired.co.uk/news/archive/2010-09/09/why-alcohol-is-
good-for-you)

~~~
kenjackson
I think all addictive drugs that decrease lifespan seem worth it to the person
doing it. Ask a crackhead if crack is worth dying for and he'll say "hell yes"
-- then rob you.

~~~
jacoblyles
The same description applies to following a sedentary lifestyle, participating
in risky sports (like skiing), living in a city, and being single. All the
more reason to let adults with free will do what they want with their lives.

------
sp332
I can't find a link now, but I remember some research being done that had
runners in a lab swish a sucrose solution in their mouths and then spit it
out. They ran longer than the control group who got artificial sweetener. So
something happens to your metabolism before the sugar is digested, and no one
has studied how tasting sucrose might be different from tasting HFCS. It's
just weird and complicated :)

Edit: here's a quick explanation of some of those studies:
[http://www.theglobeandmail.com/life/health/fitness/exercise/...](http://www.theglobeandmail.com/life/health/fitness/exercise/fitness-
research/how-long-can-i-go-before-refuelling-with-carbs/article1878842/)

Edit2 I found the research, but it's behind a paywall.
[http://journals.lww.com/co-
clinicalnutrition/Abstract/2010/0...](http://journals.lww.com/co-
clinicalnutrition/Abstract/2010/07000/Oral_carbohydrate_sensing_and_exercise_performance.18.aspx)

~~~
larrik
Artificial sweetener doesn't strike me as solid enough for a control. How
could you know the effect wasn't in fact the artificial sweetener negatively
affecting the "control"? Or some combination of the two?

Your link doesn't actually mention what the placebo was, though.

~~~
sp332
A different study, but I think it's similar:
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2683964/> "The placebo (PLA)
mouth rinse solution was made from 150 ml of a commercially available non-
caloric concentrate sweetened with aspartame and saccharin (Robinsons Soft
Drinks Ltd, UK) diluted to 1000 ml with water. The GLU mouth rinse contained
64 g glucose (Roquette, France) per 1000 ml of the same solution. The MALT
mouth rinse contained 64 g maltodextrin (Roquette, France) per 1000 ml of the
same solution. The strong artificial sweetness reduced any sensory clues that
subjects might use to consciously differentiate between the GLU, MALT and PLA
mouth rinses."

------
pdx
I used to pop Rolaids for heartburn like crazy. I did this for years, until I
was actually developing a toxic reaction to the Rolaids and I began trying
other ways to control my heartburn.

I finally discovered that sugar (and alcohol) were my biggest contributors. So
for me, sugar is definitely toxic. Now that I limit my sugar, I go weeks
without heartburn, and when I do get it, it's usually because I had some beer
or wine the previous day.

Based on this experience, I was interested that he talked about the fructose
being removed by the liver (as alcohol is). I probably have some liver issue.
This article has led me to a new avenue of research. In the meantime, I am a
believer in limiting sugar intake.

~~~
tygorius
You might be interested in Lustig's lecture on YouTube then. About 2/3 of the
way through he goes into how HFCS is processed in the brain. In short, you get
many of the disadvantages of alcohol, without the pleasant side-effects.

------
teach
"Because each of these sugars ends up as glucose and fructose in our guts, our
bodies react the same way to both, and the physiological effects are
identical."

I find this statement, as written, to be almost willfully misleading. In
sucrose, the glucose and fructose molecules are bound by an acetal bond, which
must first be broken. The bond is broken with water, which donates a hydroxide
to the fructose molecule (and a hydrogen to the glucose, of course).

With HFCS 55, the fructose and glucose are unbound, so the fructose molecule
can be absorbed without first being "broken off" and slightly changed via
hydrolysis.

This almost certainly affects the metabolization of the fructose.

Source: my wife, who has a PhD in nutrition.

~~~
hcurtiss
I suspect Lustig knows that (notwithstanding the fact he says something
similar in his lecture, and Taubes repeats it), but decided it's not important
for his thesis. Or, at the very least, he doesn't want to wade into the
sucrose/HFCS debate. Evidently, he thinks the fructose is sufficiently
available in both to be problematic. I'd be super interested in your wife
thought something different. I suspect Lustig would too.

~~~
hcurtiss
. . . IF your wife . . . !!

------
fanboy123
Anyone who has questions has the option of posing them directly to Gary
himself. The NYT has a Q&A that's open for a few days. Looks like he has
already started responding.

[http://community.nytimes.com/comments/well.blogs.nytimes.com...](http://community.nytimes.com/comments/well.blogs.nytimes.com/2011/04/13/talk-
to-gary-taubes-about-sugar/?sort=oldest&offset=1)

------
pradocchia
_In animals, or at least in laboratory rats and mice, it’s clear that if the
fructose hits the liver in sufficient quantity and with sufficient speed, the
liver will convert much of it to fat. This apparently induces a condition
known as insulin resistance, which is now considered the fundamental problem
in obesity, and the underlying defect in heart disease and in the type of
diabetes, type 2, that is common to obese and overweight individuals. It might
also be the underlying defect in many cancers._

I've seen this liver-cancer connection in other places, such as Chinese
Traditional Medicine and Italian folk medicine. Interesting to see it cropping
up here.

------
Jun8
Here's my (somewhat childish and _Bioshock_ -ish) response along the lines of
Shaw's "The reasonable man adapts ..." idea: Why are we still bound by our
body mechanisms that were determined by our cavemen ancestors millions of
years ago? Rather than cutting back sugar, maybe we should find a way to re-
engineer our cellular structure to avoid the metabolic syndrome, mentioned in
the article. Why work towards healthy, rather than bend "healthy" towards our
will?

~~~
bluekeybox
> Rather than cutting back sugar, maybe we should find a way to re-engineer
> our cellular structure to avoid the metabolic syndrome

We could also reengineer our taste buds to like sugar less, which would be a
more optimal solution (no need for a sugar supply chain). Or we could just
trick ourselves into eating less sugar for a while, and then after a few
months we will find we don't crave it as much (believe me, it works).

------
yread
According to <http://en.wikipedia.org/wiki/Median_lethal_dose> it is: Sucrose
(table sugar) - 29,700 mg/kg (LD50)

~~~
pak
I'm not sure if you're being sarcastic and pointing out that anything is
"toxic" in high quantities. In case you aren't, or for people that did not
catch it, 29g/kg is about 2.4kg of sugar for the average 80kg male, which
comes out to about 12.5 cups or 3 liters. It should be obvious to most people
that filling a two-liter bottle with pure granulated sugar and consuming it in
one sitting would have severe health consequences (if you can even manage to
get it all down).

What's probably toxic about it at this dosage is that it cannot be eliminated
by your kidneys or stored in your liver quickly enough, so it accumulates in
the blood and shifts the osmolality causing neurological symptoms, osmotic
diuresis and cardiac arrhythmia.

~~~
yread
I was being sarcastic. But I also wanted to post to point to the fact that
scientists believe that 50% of the people who ate this much sugar would in
fact _survive_!

~~~
smhelp
I was severely depressed a month or two ago, and I went ahead and bought two 2
pound chocolate rich cakes in succession and ate them over a period of 24
hours. Though it didn't kill me, but it was definitely not too upsetting. I
still have the urge to just eat huge quantities of sugar, and I am not sure
how to control it, but yea it definitely did not kill me or make me sick.

I am otherwise an extremely fit individual (can run 5k in 16 minutes)

~~~
Saavedro
Incidentally there are some studies with rats showing that sugar/sweet
addicted + cocaine addicted rats prefer their sugar hit over their cocaine
hit, and plain sugar-addicted rats when removed from sugar/sweet had opiate-
withdrawal like symptoms.

~~~
smhelp
I guess I will need to get this sorted out sooner rather than later then.

~~~
getpost
Eating sweets does improve mood. There are several known mechanisms. e.g.,
carbs facilitate amino acid transport across the blood-brain barrier [1], and
wheat stimulates endogenous opiate receptors [2]. But, if you want to
influence brain chemistry therapeutically, eating sweets is probably not the
best approach. Good luck!

[1] <http://www.ncbi.nlm.nih.gov/pubmed/3527063> [2]
[http://www.heartscanblog.org/2011/01/heroine-oxycontin-
and-w...](http://www.heartscanblog.org/2011/01/heroine-oxycontin-and-whole-
wheat-bagel.html)

------
trustfundbaby
I'm actually curious about what this says about consuming fruits in large
amounts ... since they are pretty much all fructose.

Some folks I know (I did for a bit) consume fruits with gusto, erroneously
thinking they don't have effects close to what refined sugars have on the body

~~~
bromley
I wonder this as well. Lustig seems to say that fruit is fine - the sugar in
fruit is nature's way of getting you to eat the healthy fibre or some such -
but I've yet to see a scientific explanation of why sugar is bad but sugar in
fruit is OK. Sure there are good things in fruit, but if sugar is bad then
surely you'd be better off getting those good things from other sources, like
vegetables.

~~~
count
Sugar isn't 'bad', too much sugar is bad. Lustig says that the sugar in fruit
is fine, and is the same sugar found elsewhere. It's fine in fruit because
it's wrapped up in a fiber package, that prevents your body from absorbing
most of it.

------
mkross
Maybe sugar is toxic. I don't know (and there seem to be some pretty
reasonable opinions both ways). However, there is a line in the article that
really stands out to me:

"If Lustig is right, it would mean that sugar is also the likely dietary cause
of several other chronic ailments widely considered to be diseases of Western
lifestyles — heart disease, hypertension and many common cancers among them."

I can't tell if this is the author of the article extrapolating sugar's
toxicity to explain the root of all ills, or whether Lustig makes that
assertion. Either way, there doesn't seem to be anything more than postulation
on that front. I'm hoping the purported science behind this theory is actually
sound and not just fluff so that we get into arguments about sugar based on
incorrect assumptions.

------
hirenj
So, according to the wiki, HFCS contains about 55% Fructose, 45% Glucose.
Regular sucrose is at a 50-50 split. Given your stomach splits sucrose into
the respective monosaccharide units anyway, you're going to end up with
roughly the same amount of glucose and fructose floating around.

The big issue then is just having a large amount of fructose (from whatever
source) in your diet. Since excess fructose is shunted off to be stored as
fat, this is what's causing all the problems.

What would be kind of interesting is whether we can just go about engineering
corn so that we block off the fructose pathway, and just produce glucose. This
also has the nice side-effect that it's also much more delicious for bacteria
to eat, meaning a greater yield of things like biofuels.

------
timedoctor
This validates my diet: Zero added sugar (essentially means no processed
foods) Zero deep fried food

------
DanielH
I just recently stumbled upon it, so for those who wanted a more compact
version of Robert Lustigs talk: <http://www.youtube.com/watch?v=14ZIKOQkTiM>

------
neworbit
I see that this article cites "fatty liver = insulin resistance" and
correlates that directly to sugar ingestion. Well and good - I don't want to
be foie gras. But this article also suggests that going off sugar quickly
causes the fatty liver to remediate itself - or at least so in lab animals,
such problem "promptly goes away". How prompt is this effect in people?
Failure rates on commonplace diets seems to make me think it isn't all that
swift a process. Anyone have any good stats/links/refs?

------
wnoise
How can one buy bulk glucose to use as a sweetener instead of fructose or
sucrose?

~~~
Sapient
Try Xylitol rather, my wife switched me over to this about a year ago, and I
could barely tell the difference.

 _Possessing approximately 40% less food energy, xylitol is a low-calorie
alternative to table sugar. Absorbed more slowly than sugar, it does not
contribute to high blood sugar levels or the resulting hyperglycemia caused by
insufficient insulin response. This characteristic has also proven beneficial
for people suffering from metabolic syndrome, a common disorder that includes
insulin resistance, hypertension, hypercholesterolemia, and an increased risk
for blood clots._

~~~
neworbit
But be careful with table scraps, Xylitol can kill Fido.
[http://www.healthypet.com/petcare/PetCareArticle.aspx?art_ke...](http://www.healthypet.com/petcare/PetCareArticle.aspx?art_key=8ca80d3f-69db-43e5-8838-f1010746fd0d)

------
pessimist
"Officially I’m not supposed to worry because the evidence isn’t conclusive,
but I do."

Wow, that was a content-free article, borderline scare-mongering, eg. "when
you bake your children a birthday cake or give them lemonade on a hot summer
day, you may be doing them more harm than good". There's no information about
what sort of doses are really bad at all, and so nothing useful to learn from
it. I have 2 kids who will eat as much sugar as we give them, so this is a
serious issue for me, and I'm disappointed by such articles.

~~~
pg
Being tentative about drawing conclusions is not the same as being content
free. Considering how often past dietary advice has been wrong, it seems like
this topic could use a little more tentativeness.

~~~
burgerbrain
_"Considering how often past dietary advice has been wrong"_... ...I would
argue that writing news articles about things with no conclusive evidence is
_worse_ than irresponsible journalism. It's downright harmful, in the most
literal sense of the term.

~~~
3am
There is conclusive evidence of a problem. The rise in diabetes, heart
disease, and obesity are all out there and free to anyone with a web browser.

One might say that given a health crisis, sitting back not saying anything
would be irresponsible. Ben Goldacre chronicles bad science journalism, and
this is not an example of it.

(edited)

~~~
skunkworks
1\. We all agree there is conclusive evidence of a problem with diet and
obesity. 2\. Author inconclusively argues that sugar is the cause of the
problem. 3\. Someone says this is irresponsible journalism (scaremongering).
4\. In response, you say that that this is not irresponsible journalism
because doing nothing in a crisis is irresponsible, even if doing something
involves a little bit of misdirection.

As someone that believes in accurate science and honest journalism, I would
call that irresponsible.

~~~
3am
"In response, you say that that this is not irresponsible journalism because
doing nothing in a crisis is irresponsible, even if doing something involves a
little bit of misdirection."

Did I say that?

~~~
skunkworks
At some point -- and I'm not saying you've reached that point -- if enough
people misread you, maybe you need to communicate more clearly. (Not trying to
be rude.) Anyway, here are some fun refutations of Mr. Taubes body of dietary
advice: <http://reason.com/archives/2003/03/01/big-fat-fake>
[http://www.proteinpower.com/drmike/wp-
content/uploads/2008/0...](http://www.proteinpower.com/drmike/wp-
content/uploads/2008/07/bray-review-of-gcbc.pdf)

I guess the big issue I have with his advice is that obesity is really most
strongly correlated with increased intake of calories, and less so with the
macronutritional source of those calories.

~~~
allwein
But as always, correlation != causation.

In his books, Gary Taubes makes an argument that the causal relationship is
reversed. It's not that eating too much causes your body to store the excess
as fat. Rather it's that your body is storing necessary energy as fat before
your body can use it, so you need to eat more to make up the deficit.

------
msluyter
Dr. William Davis, a cardiologist who runs the "Track Your Plaque" program and
the Heart Scan blog (<http://www.heartscanblog.org/>) has identified sugar as
one of the primary factors contributing to heart disease. He advises his
patients to generally eliminate all sugars, grains (they break down into
glucose in the bloodstream), and anything else raises blood glucose levels.

~~~
fhars
But all the evidence presented in the article seems to point in the direction
that glucose is mostly harmless (see the discussion of the Japanese diet that
contained mostly rice). So Davis' recommanedation cannot be justified along
these lines.

~~~
matthennigan
Davis absolutely hates wheat, on very justifiable grounds. And he strongly
recommends anyone with heart problems get off it immediately. But I dont think
he has anything against rice.

~~~
msluyter
Actually, if you read his blog, you'll find lots of articles that, at least
indirectly, indict rice (and basically anything that spikes your blood sugar,
which includes all grains). For example:

[http://www.heartscanblog.org/2010/07/what-increases-blood-
su...](http://www.heartscanblog.org/2010/07/what-increases-blood-sugar-more-
than.html)

Generally, he advocates close postprandial monitoring of blood sugar as a sort
of proxy for triglicerides/ldl and often notes that some people may have
higher tolerances for certain foods than others. If rice doesn't raise your
postprandial blood sugar much, then I'd imagine he'd be ok with it.

------
mast
I'm not a nutritionist, biologist, or doctor, but I have a huge sweet tooth,
and I actually tried to answer this question on my humble little blog
(<http://foodconstrued.com/2011/02/sugar-cravings/>) back in February.

My answer: It is not the sugar, but the empty calories leading to obesity and
then to further health complications.

~~~
jerf
So, the article addresses that point, goes into extensive detail as to why it
may not be true, with scientists, biochemistry, and all sorts of other stuff,
and I'm supposed to believe your "Nuh-uh"? Why is this article wrong? Why is
the conventional answer right? At least cite something that directly addresses
these arguments and discusses why they are wrong, this makes it looks like
you're taking the metaphorical ostrich approach to the argument.

------
jalada
tl;dr?

~~~
AlexC04
<http://www.youtube.com/watch?v=dBnniua6-oM>

Go to 57:00 and you should get to the bit where he explains why Fructose is a
poison. Loses a bit in translation without the hour leading up to it, (which
is absolutely fascinating).

However, that should cover your TL;DR.

Even shorter version: Fructose can only be processed by the liver. That means,
by definition it is a poison.

~~~
AlexC04
More TL:DR for you.

At 1:08:00 (ish)

The effects of long term Fuctose use is virtually identical to long term
alcoholism (8 out of 12 effects)

(at 1:09:00 ish) Intervention:

1) Remove all sugared drinks from your diet. Water & Milk _only_

2) Eat carbohydrates with fibre.

3) Wait 20 minutes before a second portion.

4) "Buy" your screen time, minute for minute with physical activity. (holy
crap! I've got an eight hour work day to buy back!)

------
tmcw
Journalist who hasn't done any research on sugar agrees with doctor who hasn't
done any research on sugar. And this happens to be great linkbait.

Tell me why I should pay for the New York Times, again?

~~~
fanboy123
Dr. Lustig is a nationally-recognized authority in the field of
neuroendocrinology, with a specific emphasis on the regulation of energy
balance by the central nervous system. He is currently investigating the
contribution of biochemical, neural, hormonal, and genetic influences in the
expression of the current obesity epidemic both in children and adults. He has
defined a syndrome of vagally-mediated beta-cell hyperactivity which leads to
insulin hypersecretion and obesity, and which is treatable by insulin
suppression. This phenomenon may occur in up to 20% of the obese population.
He is interested in the hypothalamic signal transduction of insulin and
leptin, and how these two systems interact. He is studying the cardiovascular
morbidity associated with hyperinsulinemia, and developing methods to evaluate
and prevent this phenomenon in children. He is also analyzing the contribution
of the autonomic nervous system to insulin secretion and insulin resistance in
obese children, and the utility of assessing insulin dynamics in targeting
obesity therapy.

~~~
oconnor0
Which means?

~~~
oconnor0
Why was I downvoted for asking for clarification?

~~~
jon_dahl
Probably because the parent was a detailed, well-researched answer, and your
request for clarification didn't explain what sort of clarification you were
looking for.

The second one, on the other hand, was downvoted for asking why you were
downvoted. ;)

