Which Nonsugar Sweeteners are OK? An Insulin-Index Perspective

In my view, one of the greatest steps forward for public health would be for people to get the message that sugar is very bad—worse than many other foods that people worry about. (See “The Trouble with Most Psychological Approaches to Weight Loss: They Assume the Biology is Obvious, When It Isn't” and the posts listed below under the heading “Sugar as a Slow Poison.”)

Given the dangers of sugar, it is natural to ask whether any nonsugar sweeteners are OK. One part of the answer is that sweetness itself tends to make you think about food, and thinking about food can make you hungry. This is called the cephalic response. It is like the effect of walking past a restaurant. The cephalic response getting your body prepared for food is OK if you are just sitting down to eat anyway, but it could be a big problem if you are, say, drinking diet sodas between meals, since it will make you hungry when you weren’t otherwise going to eat.

Are there any nonsugar sweeteners that are OK other than the cephalic response of making you think about food and getting your body prepared for food? The excellent article flagged above, “The Skinny on Sweeteners” by Adam Nally, gives this answer, which accords with my own views:

I’ve been using ketogenic diets since 2005.  In that time, I have found personally, and clinically with the patients in my practice, that combinations of Stevia, chicory root and erythritol, when used in baking, seem to provide adequate texture and remove any aftertaste that may be found when using them individually.  These combinations also have no effect on weight loss, weight regain or adverse metabolic changes when used with a ketogenic lifestyle.

These sweeteners are equally OK when used in other ways than in baking.

Bad Sweeteners

Adam has a nice paragraph about insulin:

… weight gain and weight loss are controlled by 30 different known hormones, the master hormone being insulin, our overall goal is to lower the insulin levels in the blood stream. Glucose (a carbohydrate in its most simple form) stimulates insulin to rise.   A Low carbohydrate diet works because insulin levels are significantly lowered throughout the day.  Elevation in cholesterol, elevation in triglycerides and production of uric acid occur because of insulin surges. The presence of glucose  (from carbohydrates or sugars) is the most common stimulus for insulin to rise.

This is in line with what I say in “Obesity Is Always and Everywhere an Insulin Phenomenon.”

The following forms of sugar all raise insulin levels:

… white and brown sugar, fructose, succanat, corn syrup, high fructose corn syrup, honey, malt syrup, cane juice, cane syrup, rice syrup, barley syrup, maple syrup, molasses, turbinado, agave, monk fruit and fruit juice concentrate.

Adam has this additional useful caution:

Beware of products that contain “no added sugar” because they will often contain sugar concentrates in the form of concentrated grape or apple juice.

Fructose is sometimes promoted as a suitable sweetener for patients with diabetes or people who are wanting to follow a low-carb diet; however even though it does not cause a significant insulin rise on its own, it is rapidly absorbed by the liver and converted into glycerol which leads to increased insulin level a few hours later, as well as raising triglyceride and cholesterol levels. 

In addition, relying on the article above, experiments indicate that the following nonsugar sweeteners raise insulin levels:

  • acesulfame potassium (Ace-K™, Sunette™)

  • saccharine

  • maltitol

  • sorbitol

  • xylitol 

  • sucralose crystallized by being bound to dextrose or maltodextrin, as it is in Splenda™— sucralose is only OK in its liquid form)

Adam is not entirely clear about lactitol and hydrolyzed starch hydrolysates (HSH), but reading between the lines, he seems to be saying they are not as bad as maltitol, sorbitol or xylitol, but he doesn’t recommend them.

Cyclamate is banned in the United States because it causes bladder cancer in rats; otherwise Adam describes it as similar to sucralose: any dextrose or maltodextrin it is combined with will raise insulin.

Aspartame does not seem to raise insulin, but has a different downside:

… because of recent evidence demonstrating the effect of aspartame on the gut bacteria, changes in brain mitochondria with prolonged exposure, and stress responses effecting gluconeogensis (glucose regulation) in the liver, [Adam Nally] recommends avoiding this sweetener or using it with great caution in the short term only.  

If you think an effect on gut bacteria is no big deal, I hope you will think otherwise after reading my post “Anthony Komaroff: The Microbiome and Risk for Obesity and Diabetes.”

OK Sweeteners

Let me summarize by quoting short bits about the sweeteners that are OK—except for making you think about food because of their sweetness:

  • Fructooligosaccharides (FOS) … are actually short chain fibers derived from inulin. … They are commonly derived from chicory root, bananas, onions, garlic and the blue Agave. … A great option that Dr. Nally recommends for use in cooking is a combination of FOS with erythritol called Swerve.  

  • Erythritol is absorbed and excreted unchanged and appears to have no insulin response (Food and Chemical Toxicology, Dec 1998, Volume 36, Issue 12,  Pages 1139-1174). 

The Dispute about Stevia

In general, Adam’s article is an excellent article on nonsugar sweeteners. But on Stevia, what Adam says is in direct contradiction with what Jason Fung says in The Obesity Code about Stevia (See “Obesity Is Always and Everywhere an Insulin Phenomenon.”) Here are the two quotations:


Adam Nally: Stevia in the liquid form is a non-caloric natural sweetener which contains no carbohydrate. It is derived from a South American shrub and has been widely available for use in Asia for many years. 

… Stevia does not increase blood sugar and appears to improve insulin sensitivity in the pancreas (Metabolism, 2003 Mar;52(3):372-8.).

Jason Fung: The important question is this: Do artificial sweeteners increase insulin levels? Sucralose raises insulin by 20 percent, despite the fact that it contains no calories and no sugar. This insulin-raising effect has also been shown for other artificial sweeteners, including the “natural” sweetener stevia. Despite having a minimal effect on blood sugars, both aspartame and stevia raised insulin levels higher even than table sugar. 

This dispute should be possible to resolve with additional lab experiments with human subjects. I’d be glad for any references that illuminate the situation for stevia.

Stevia Update, January 19, 2019: In a study with what sounds like a good design, bringing 20 obese individuals in twice wasn’t enough to get great precision, but the effects of Stevia on insulin didn’t look that much different from the effects of a placebo. Here is the bottom line:

… between stevia and placebo (glucose, 15,285±4,531 vs. 15,101 ±3,955, p=0.89 and insulin 8,507 ±5,858 vs. 7,652 ± 5,020,p=0.62) Insulin sensitivity derived from OGTT using Matsuda index was not significant difference between stevia and placebo (4.74±1.86 vs. 5.84±2.96,p=0.09). Insulin secretion using Insulinogenic index was not significant difference between stevia and placebo (p=0.155).

Conclusions: Stevia does not affect in acute glycemic and insulin responses to OGTT in obese patients. This findings need to be determined in longer duration of ingestion study.

Note that this result was based on getting Stevia in a pill, so it doesn’t include the cephalic effect of sweetness itself. See below:

Less is More in Mormon Church Meetings

The degree of deference by other Mormon Church leaders to the President of the Mormon Church is great enough that the views and actions of a Mormon apostle who becomes President of the Mormon Church by seniority and so has no one above him to defer to can be surprising. My July 22, 2018 post, “New Mormon Prophet Russell Nelson Shakes Things Up” reported several big changes approved by Russell Nelson, who became President of the Mormon Church only in January 2018.

Major changes continue in the Mormon Church. The biggest is the reduction in the Sunday meeting schedule from three hours to two hours. Sunday School and the sex-segregated Priesthood Meeting/Relief Society period will now alternate Sundays, while the everyone-(including young children)-together Sacrament Meeting will continue to be held every week.

The official reason given for the change is to free up time for religious instruction and study at home: “It is time for a home-centered church,” Russell Nelson said.

The most intriguing aspect of the change is that it seems to have been spurred in part by social-science research. Quoting from the article flagged above:

Leaders also considered a study that found that individual scripture study and prayer did the most to help young Latter-day Saints feel the influence of the Holy Ghost, Elder Cook said.

Here, if I were a Mormon Church leader, I would worry that the research was based only on a correlation and was not causal. The sort of person who has the right psychological profile for feeling powerful subjective spiritual experiences might well be more attracted to scripture study and prayer to begin with. A broader range of psychological profiles might lead people to show up at church on Sunday. Making efforts to convince Mormons to spend more time on individual scripture study and prayer may get the desired effect more than having Mormons spend an extra hour in church on Sunday.

Intervention studies provided some evidence of satisfactory effects:

The church had been testing the new curriculum in congregations around the world with success, Elder Cook said. One pilot program was in Brazil and others were reported in Iowa and Tooele.

The big empirical issue here is the Hawthorne effect: doing an experiment that makes the people in the experiment feel special often gets a good effect, regardless of what the intervention is. Of course, many Mormon Church leaders have been businessmen who are used to changing things up in order to use the Hawthorne effect intentionally. (Russell Nelson himself was a heart surgeon rather than a businessman. He performed heart surgery on my grandfather.) But cutting the Sunday meeting times down to two hours from three is much bigger than the size of change one would make if one was only relying on the Hawthorne effect.

The other change is a continuing attempt to get those outside the Mormon Church not to call it the Mormon Church any more, but to use its official name, “The Church of Jesus Christ of Latter-day Saints.” The choir formerly known as “The Mormon Tabernacle Choir” is now officially “The Tabernacle Choir at Temple Square.” Despite these efforts, I plan to continue to refer to The Church of Jesus Christ of Latter-day Saints as the “Mormon Church” on this blog.

Don't miss these posts on Mormonism:

Also see the links in "Hal Boyd: The Ignorance of Mocking Mormonism."

Don’t miss these Unitarian-Universalist sermons by Miles:

By self-identification, I left Mormonism for Unitarian Universalism in 2000, at the age of 40. I have had the good fortune to be a lay preacher in Unitarian Universalism. I have posted many of my Unitarian-Universalist sermons on this blog.

The US Military Needs to Beef Up Its Artificial Intelligence and Cyberware Capabilities

                                                      Link to the article shown above

                                                      Link to the article shown above

Artificial intelligence is becoming more important to warfare. The US, China and Russia are all working on their military artificial intelligence capability and other computer capabilities. In their March 2, 2018 Wall Street Journal article "The New Arms Race in AI," Julian E. Barnes and Josh Chin give a very useful rundown of some of the things happening in this area. The sheer growth in computing power is a key driver:

Fueling the AI race is processing power, an emerging area of strategic competition between China and the U.S. Chinese state media reported in January that researchers with the National University of Defense Technology and National Supercomputer Center in Tianjin had made a breakthrough in building a conventional supercomputer at exascale—10 times faster than today’s supercomputers—scheduled for completion by 2020. “That’s a revolutionary, generational leap up,” said Dr. Cheung.

Distinct from raw processing power is the rise of quantum computing. For now, the low-hanging fruit from quantum computing is its value in breaking codes, and for itself enabling unbreakable encryption:

In the city of Hefei in eastern China, work began last year on a $1 billion national quantum-information-sciences laboratory. Slated to open in 2020, it will build on research already under way nearby in the lab of physicist Pan Jianwei, who led the team that launched the world’s first quantum communications satellite. The project propelled China far ahead of others in transmitting information with essentially unbreakable quantum encryption.

But quantum computing could be important in the long-run for sheer processing power. My intuition for the power of quantum computing comes from the many worlds interpretation of quantum mechanics. Quantum computing has the potential to harness a multitude of copies of a computer in close-by alternate universes that are still entangled and haven't fully separated yet. 

Here are some of the things artificial intelligence could do on the battlefield, as described by quotations from Julian Barnes and Josh Chin's article:

  • ... scan video from drones and find details that a human analyst would miss—identifying, for instance, a particular individual moving between previously undetected terrorist safe houses.
  • The F-35, one of America’s most advanced jet fighters, uses AI to evaluate and share radar and other sensor data among pilots, expanding their battlefield awareness. AI stitches together information and highlights what is likely most important to the pilot.
  • The U.S. Army is working on tactical augmented reality systems—sort of a Google Glass for war—using goggles or a visor that could display video from drones flying above, current position and enhanced night vision. AI-powered computing could add information about incoming threats, targets and areas that have to be protected.
  • AI also could vastly improve the effectiveness of airstrikes, ... launch a cluster of missiles at the target. ... China is developing similar technology. In January, the country’s military TV network broadcast footage of researchers testing such “swarm intelligence,” which could eventually link dozens of armed drones into an automated attack force.
  • AI could speed up warfare to a point where unassisted humans can’t keep up—a scenario that retired U.S. Marine Gen. John Allen calls “hyperwar.” In a report released last year, he urged the North Atlantic Treaty Organization to step up its investments in AI, including creating a center to study hyperwar and a European Darpa, particularly to counter the Russian effort. ... In hyperwar, the side that will prevail will be the side that is able to respond more quickly,” Gen. Allen said. “Artificial intelligence will collapse the decision-action loop in a very big and very real way.”
  • Russia is investing in AI as well. Moscow has focused on creating autonomous weapons powered by AI and hopes in the coming decade to have 30% of its military robotized, which could transform how it fights. Russia’s sophisticated drone development lags behind the U.S., but it has exceptional expertise in electronic warfare, and AI technologies could boost it further.

The US has great expertise in computer hardware and software in the private sector, but many private companies are leery of being involved in military research. 

In addition to the role of artificial intelligence and other computational capabilities in kinetic warfare, cyberespionage and cyberwar that attacks the internet itself or spreads computer viruses and worms is a great danger. I'd like to see the US government devote more resources to addressing all of these threats.

 

Don't miss these other posts on national security:  

 

Best Health Guide: 10 Surprising Changes When You Quit Sugar

Even clickbait can sometimes be on target. Here are the 10 points in the article above, “10 Surprising Changes When You Quit Sugar”:

  1. Your teeth improve.

  2. You feel more energetic.

  3. You lose weight.

  4. You reduce your diabetes risk.

  5. Food tastes better.

  6. You get smarter.

  7. You reverse a range of health problems.

  8. Your heart health improves.

  9. You sleep better.

  10. You extend your lifespan.

If you can quit sugar, it will be one of the best things you have ever done for yourself. I have some tips on quitting sugar in “Letting Go of Sugar.” And I have written about some of the arguments against sugar in many of the posts flagged below.

Don't miss these other posts on diet and health and on fighting obesity:

I. The Basics

II. Sugar as a Slow Poison

III. Anti-Cancer Eating

IV. Eating Tips

V. Calories In/Calories Out

VI. Wonkish

VIII. Debates about Particular Foods and about Exercise

IX. Gary Taubes

X. Twitter Discussions

XI. On My Interest in Diet and Health

See the last section of "Five Books That Have Changed My Life" and the podcast "Miles Kimball Explains to Tracy Alloway and Joe Weisenthal Why Losing Weight Is Like Defeating Inflation." If you want to know how I got interested in diet and health and fighting obesity and a little more about my own experience with weight gain and weight loss, see “Diana Kimball: Listening Creates Possibilities” and my post "A Barycentric Autobiography."

Noah Smith—The Replication Crisis in Economics: Even After Downloading the Same Data, Economists Don't Get the Same Answer →

John Locke: Defense against the Black Hats is the Origin of the State

In “The Social Contract According to John Locke” I write:

John Locke's version of social contract theory is striking in saying that the only right people give up in order to enter into civil society and its benefits is the right to punish other people for violating rights. No other rights are given up, only the right be be a vigilante.

But why would people give up even that right? John Locke explains in Section 123 of his 2d Treatise on Government: “Of Civil Government” (in Chapter IX, “Of the Ends of Political Society and Government”):

§ 123. IF man in the state of nature be so free, as has been said; if he be absolute lord of his own person and possessions, equal to the greatest, and subject to nobody, why will he part with his freedom? why will he give up this empire, and subject himself to the dominion and controul of any other power? To which it is obvious to answer, that though in the state of nature he hath such a right, yet the enjoyment of it is very uncertain, and constantly exposed to the invasion of others: for all being kings as much as he, every man his equal, and the greater part no strict observers of equity and justice, the enjoyment of the property he has in this state is very unsafe, very unsecure. This makes him willing to quit a condition, which, however free, is full of fears and continual dangers: and it is not without reason, that he seeks out, and is willing to join in society with others, who are already united, to have a mind to unite, for the mutual preservation of their lives, liberties and estates, which I call by the general name, property.  

Note here his definition of “property” as “lives, liberties and estates”; the ordinary meaning of property was enough different in the 18th century that the Declaration of Colonial Rights used the phrases “life, liberty, and property,” and the Declaration of Independence famously included close to the full range of things that enter people’s utility functions by the expansive phrase “life, liberty and the pursuit of happiness.” In the absence of some sort of mutual protection association, many things people care about are endangered by bad guys.

What does it take to restrain bad guys? Here is John Locke’s answer:

  • clearly stated rules

  • impartial judges

  • the brute force needed to enforce sentences

Why are these needed?

  • people are reluctant to admit they have transgressed

  • the desire for revenge makes people want to go too far in punishing offenses against themselves

  • lack of caring makes people not want to go far enough in punishing offenses against others they are not emotionally close to

  • punishing bad guys is hard.

Here is how John Locke makes those points:

§ 124. The great and chief end, therefore, of men’s uniting into commonwealths, and putting themselves under government, is the preservation of their property. To which in the state of nature there are many things wanting. First, There wants an established, settled, known law, received and allowed by common consent to be the standard of right and wrong, and the common measure to decide all controversies between them: for though the law of nature be plain and intelligible to all rational creatures; yet men being biassed by their interest, as well as ignorant for want of study of it, are not apt to allow of it as a law binding to them in the application of it to their particular cases. 

§ 125. Secondly, In the state of nature there wants a known and indifferent judge, with authority to determine all differences according to the established law: for every one in that state being both judge and executioner of the law of nature, men being partial to themselves, passion and revenge is very apt to carry them too far, and with too much heat, in their own cases; as well as negligence, and unconcernedness, to make them too remiss in other men’s. 

§ 126. Thirdly, In the state of nature there often wants power to back and support the sentence when right, and to give it due execution. They who by any injustice offended, will seldom fail, where they are able, by force to make good their injustice; such resistance many times makes the punishment dangerous, and frequently destructive, to those who attempt it.  

There remains the question “Why are people willing to subject themselves to actual, imperfect rulers?” The basic answer is that there are bad guys out there who are worse than the rulers:

§ 127. Thus mankind, notwithstanding all the privileges of the state of nature, being but in an ill condition, while they remain in it, are quickly driven into society. Hence it comes to pass, that we seldom find any number of men live any time together in this state. The inconveniences that they are therein exposed to by the irregular and uncertain exercise of the power every man has of punishing the transgressions of others, make them take sanctuary under the established laws of government, and therein seek the preservation of their property. It is this makes them so willingly give up every one his single power of punishing, to be exercised by such alone, as shall be appointed to it amongst them; and by such rules as the community, or those authorized by them to that purpose, shall agree on. And in this we have the original right and rise of both the legislative and executive power, as well as of the governments and societies themselves.

When the rulers become as bad as the worst of the bad guys, then people will often take their chances rejecting any authority of the state over them, or will try to form alternative dispute resolution mechanisms that can be seen as the rudiments of an alternative state.

For links to other John Locke posts, see these John Locke aggregator posts: 

On Guilt by Association

During the September 27 Senate Judiciary Committee hearings on Brett Kavanaugh’s nomination to the Supreme Court, Orrin Hatch said this:

Let's at least be fair and look at facts or the absence thereof," Mr. Hatch said. "Guilt by association is wrong. Immaturity does not equal criminality. That Judge Kavanaugh drank in high school or college does not make him guilty of every terrible thing that he's recently been accused of.

My reaction is that it depends on what “guilt by association” means. Certainly, you should be able to associate with any other human being, no matter how bad they are, without there crimes tainting you—unless through your association you gain knowledge of awful crimes it would be useful for the police or other constituted authorities to know, that you fail to share. If there was a rape culture at Georgetown Prep, and Brett Kavanaugh knew about it and did nothing, that is a serious black mark against him.

Note here that while attorney-client privilege is close to absolute, even therapists are required by law to report any suspicion of sexual abuse. So whatever privilege one thinks should extend to loyalty to what one’s friends tell one in confidence, it should not extend to helping one’s friends conceal sexual assault. Part of the test is whether someone could tell, and let themselves be moved by the fact, that sexual assault is an awful crime.

It seems it should be possible to determine by investigation whether there was such a rape culture at Georgetown Prep and whether Brett was in the in-crowd to such an extent that it would have been hard for him not to know about it. For a juvenile to know about and do nothing about such wrongdoing may not be worthy of jail time (whatever the statute says), but it should be disqualifying for a seat on the Supreme Court, even 35 years later, short of a forthright renunciation of such inaction in one’s past. We want to have on the Supreme Court folks who were straight arrows as kids—or who have admitted wrongdoing—whether by action or inaction—and turned over a new leaf.

Of course, Brett Kavanaugh may be guilty of worse than inaction. But even in that case it may be easier to prove that he didn’t lift a finger to stop the rape culture of friends.

John Ioannidis, T. D. Stanley and Hristos Doucouliagos: The Power of Bias in Economics Research

Unfortunately, I couldn't find an ungated version of this article. But the abstract above says a lot. In case it is hard to read the image, here it is:

We investigate two critical dimensions of the credibility of empirical economics research: statistical power and bias. We survey 159 empirical economics literatures that draw upon 64,076 estimates of economic parameters reported in more than 6,700 empirical studies. Half of the research areas have nearly 90% of their results under‐powered. The median statistical power is 18%, or less. A simple weighted average of those reported results that are adequately powered (power ≥ 80%) reveals that nearly 80% of the reported effects in these empirical economics literatures are exaggerated; typically, by a factor of two and with one‐third inflated by a factor of four or more.

Yes, Sugar is Really Bad for You

In a September 19, 2018 bbc.com article, journalist Jessica Brown acts as a defense attorney for sugar, while recognizing attacks that have been made on sugar. Here is the opening statement:

It’s hard to imagine now, but there was a time when humans only had access to sugar for a few months a year when fruit was in season. Some 80,000 years ago, hunter-gatherers ate fruit sporadically and infrequently, since they were competing with birds.

Now, our sugar hits come all year round, often with less nutritional value and far more easily – by simply opening a soft drink or cereal box. …

But so far, scientists have had a difficult time proving how it affects our health, independent of a diet too high in calories. 

Is it just calories?

One key way to cast doubt on the role of sugar is to say that it is really just total calories. Jessica quotes Luc Tappy:

Luc Tappy, professor of physiology at the University of Lausanne, is one of many scientists who argue that the main cause of diabetes, obesity and high blood pressure is excess calorie intake, and that sugar is simply one component of this.

“More energy intake than energy expenditure will, in the long term, lead to fat deposition, insulin resistance and a fatty liver, whatever the diet composition,” he says. “In people with a high energy output and a matched energy intake, even a high fructose/sugar diet will be well tolerated.”

Tappy points out that athletes, for example, often have higher sugar consumption but lower rates of cardiovascular disease: high fructose intake can be metabolised during exercise to increase performance. 

The trouble with this way of absolving sugar is that a key mechanism through which sugar can cause trouble is by leading people to eat more total calories—both through the insulin mechanism I emphasize in “Obesity Is Always and Everywhere an Insulin Phenomenon” and through making things tasty. So holding calories constant when thinking about the effects of sugar is ignoring one of the primary mechanisms through which eating sugar can cause harm. And to the extent athletes are harmed less by eating sugar, an interesting hypothesis is that exercise might reduce the effect of sugar in making people hungry a little while later.

Is it just correlational, not causal?

Some of the best evidence about the malign effects of sugar comes from data on soft drink and fruit juice consumption. Here Jessica confuses criticism of some studies as being only correlational with the status of research on soft drink and fruit juice as a whole. Indeed, there are some interesting studies that have to be taken with a grain of salt because they are only correlational:

Still, studies have demonstrated other ways in which sugar affects our brains. Matthew Pase, research fellow at Swinburne’s Centre for Human Psychopharmacology in Australia, examined the association between self-reported sugary beverage consumption and markers of brain health determined by MRI scans. Those who drank soft drinks and fruit juices more frequently displayed smaller average brain volumes and poorer memory function. Consuming two sugary drinks per day aged the brain two years compared to those who didn’t drink any at all. But Pase explains that since he only measured fruit juice intake, he can’t be sure that sugar alone is what affects brain health. …

One 15-year study seemed to back this up: it found that people who consumed 25% or more of their daily calories as added sugar were more than twice as likely to die from heart disease than those who consumed less than 10%. Type 2 diabetes also is attributed to added sugar intake. Two large studies in the 1990s found that women who consumed more than one soft drink or fruit juice per day were twice as likely to develop diabetes as those who rarely did so.

But there is a great deal of non-correlational evidence. Jessica writes:

Meanwhile, sugary drinks, which usually use high fructose corn syrup, have been central to research examining the effects of sugar on our health. One meta-analysis of 88 studies found a link between sugary drinks consumption and body weight. In other words, people don’t fully compensate for getting energy from soft drinks by consuming less of other foods – possibly because these drinks increase hunger or decrease satiety.

Following the link through to the meta-analysis, it reports:

… larger effect sizes were observed in studies with stronger methods (longitudinal and experimental vs cross-sectional studies). …

We found 7 studies that examined the connection between soft drink intake and body weight in an experimental or intervention context. Five reported a positive association. In 3 of these studies, participants who were given soft drinks to consume gained weight over the course of the experiment. Two intervention studies aimed at decreasing soft drink consumption among high school students showed that students in the intervention groups essentially maintained their weight over the treatment period, whereas those in the control groups exhibited significant weight gain. Two studies reported no statistically significant effect of soft drink consumption on weight gain. The average effect size for experimental studies was 0.24 (P < .001; Q7 = 24.57, P = .001).

Jessica never pulls this out.

Does sugar sometimes do something good?

There are so hundreds of effects of any one thing; so if one is looking for a good effect—as one might have an incentive to do—one is likely to find a good effect. For sugar, perking up old folks seems may be one:

One recent study found that sugar may even help improve memory and performance in older adults. Researchers gave participants a drink containing a small amount of glucose and asked them to perform various memory tasks. Other participants were given a drink containing artificial sweetener as a control. They measured the participants' levels of engagement, their memory score, and their own perception of how much effort they’d applied.

The results suggested that consuming sugar can make older people more motivated to perform difficult tasks at full capacity – without them feeling as if they tried harder. Increased blood sugar levels also made them feel happier during the task.

And of course, if you wait to eat sugar until your expected remaining life is only a couple of years, it may well be that death will interrupt any serious harm of sugar. It is young people—say anyone with an expected remaining life span of more than two years—who should quit eating sugar.

Is being against sugar crazy or cultlike?

One way to distract from the evidence against sugar is to shift the focus to other, less scientific reasons people might be against sugar. Jessica writes:

There is also a growing argument that demonising a single food is dangerous …

… dietitian Renee McGregor says it’s important to understand that a healthy, balanced diet is different for everyone.

McGregor, whose clients include those with orthorexia, a fixation with eating healthily, says that it isn’t healthy to label foods as ‘good’ or ‘bad’. And turning sugar into a taboo may only make it more tempting. “As soon as you say you can’t have something, you want it,” she says. “That’s why I never say anything is off-limits. I’ll say a food has no nutritional value. But sometimes foods have other values.”

Associate professor at James Madison University Alan Levinovitz studies the relationship between religion and science. He says there’s a simple reason we look at sugar as evil: throughout history, we’ve demonised the things we find hardest to resist (think of sexual pleasure in the Victorian times).

Today, we do this with sugar to gain control over cravings.

“Sugar is intensely pleasurable, so we have to see it as a cardinal sin. When we see things in simple good and evil binaries, it becomes unthinkable that this evil thing can exist in moderation. This is happening with sugar,” he says.

He argues that that seeing food in such extremes can make us anxious about what we’re eating – and add a moral judgment onto something as necessary, and as everyday, as deciding what to eat.

For well-adjusted folks, I think there is a good reason to cut out sugar almost entirely that they don’t give due credit to: after about three weeks off sugar, everything tastes sweeter, and the desire for sugar goes down, so it becomes much easier to avoid sugar. I talk about this in “Letting Go of Sugar.”

Will cutting out sugar lead to eating worse things or cutting out something essential?

One of the weakest arguments in defense of sugar is that cutting it out will lead to other bad dietary adjustments. Give me a break! Because sugar is in almost all processed foods, cutting out sugar leads to avoiding most processed foods—highly likely to be a step in the right direction. (See “The Problem with Processed Food” and the evidence discussed in “Why a Low-Insulin-Index Diet Isn't Exactly a 'Lowcarb' Diet.”)

While Jessica is doing her best to come up with pro-sugar arguments, she is cavalier in assuming that dietary fat is bad and that fruit is so wonderful, that eating fruit sparingly because of its sugar content is a bad thing. She writes:

Taking sugar out of our diets can even be counterproductive: it can mean replacing it with something potentially more calorific, such as if you substitute a fat for a sugar in a recipe.

… we risk confusing those foods and drinks with added sugar that lack other essential nutrients, like soft drinks, with healthy foods that have sugars, like fruit.

On fruit, see the section “The Conundrum of Fruit” in “Forget Calorie Counting; It's the Insulin Index, Stupid.” On dietary fat, see:

Also, see “Faye Flam: The Taboo on Dietary Fat is Grounded More in Puritanism than Science.” Here, as I noted above, “not science” is more important than “yes Puritanism.” But it is worth noting that if there is anything biasing non-scientists’ sense of the virtues and vices of different types of food, the fact that dietary fat uses the same word “fat” as body fat is highly likely to distort some people’s intuitions. (This could be tested by looking at attitudes toward dietary fat in countries where the word for dietary fat is fully distinct from the word for body fat.)

It may be surprising that one has to defend the idea that sugar is very bad, but that is the world we live in. In “The Trouble with Most Psychological Approaches to Weight Loss: They Assume the Biology is Obvious, When It Isn't” I give examples of things people will be saying when the serious harms of sugar really are conventional wisdom. We are not there yet. I am proud to be an anti-apologist for sugar.

Don't miss these other posts on diet and health and on fighting obesity:

Also see the last section of "Five Books That Have Changed My Life" and the podcast "Miles Kimball Explains to Tracy Alloway and Joe Weisenthal Why Losing Weight Is Like Defeating Inflation." If you want to know how I got interested in diet and health and fighting obesity and a little more about my own experience with weight gain and weight loss, see my post "A Barycentric Autobiography."