Sugar and Scare Tactics

Recently, Israel’s Channel 2 television broadcasted an investigative report about the numerous damages which excessive consumption of sugar and processed food could cause children and adults. The report included many inaccuracies that are not consistent with the existing scientific literature, and which ultimately provoked unnecessary fear. It is important to emphasize that excessive consumption of sugar and processed foods is indeed bad for one’s health and may cause disease. The report, however, used scare tactics that were, at times, disproportionate and riddled with inaccuracy. In this article, we review the scientific arguments raised by the televised report and try to put things in better perspective.

Let’s start with the basics. Sugars are carbohydrates, and carbohydrates are essential to us as they are our main energy source. Current health organizations’ recommendation is that 45-55% of our daily calories would come from carbohydrates.

“Added sugar” (simple sugars such as white and brown sugar, sugar syrup, etc.) is the sugar added to food and drinks during industrial processing; the term refers to sugars that are not naturally found in the food. While there is currently no specific upper limit for added sugars, the World Health Organization recommends limiting the amount of added sugars to 10% of the total caloric intake per person, and even states there are health benefits in limiting consumption to 5% or less. In other words, 3-6 teaspoons of sugar per day for women and about 4.5-9 teaspoons for men.

A sugar cube | Wikipedia

Added sugar and obesity

It is estimated that in the United States, an average person’s added sugar intake reaches 15.8% of the total calories consumed, mostly from sweetened beverages. In one can of a cola drink, for example, there are about 8-10 teaspoons of added sugar.

Studies have shown that excessive sugar intake, particularly from sweetened beverages, is linked to obesity and the development of diabetes. In 2013, the World Health Organization (WHO) surveyed all studies on added sugars and their effect on body weight. It was found that a high intake of added sugars or sugary beverages did indeed increase body weight and obesity. These results were less consistent in children than in adults.

Obesity arises from the fact that sugar consumption increases caloric intake, so the body is consuming more calories than it uses, which disrupts the energy balance. Sweetened beverages are less satisfying than a meal containing similar calories, and added sugar is absorbed more quickly than solid food.

However, the researchers noted that obesity results from many factors, and that no direct link was found between reducing added sugar consumption and weight loss. They also mentioned there is still no justification for making sweeping recommendations to the public based on the connection observed in their research. However, there is no doubt that, in light of the findings, the consumption of added sugar and sweetened beverages should be reduced as much as possible.

Let us look at the main points of the arguments raised in the televised report and what scientific literature has to say about them:

It is very difficult to isolate variables and identify a single dietary component that contributes to health or is harmful to it. There is little doubt that a diet based on a large quantity of fruits and vegetables is indeed good for one’s health and there is now scientific consensus regarding this. However, to date, there are no high-quality studies indicating that there is a definite benefit to adding antioxidants or a distinct advantage in their increased consumption, except for vitamin C, which gives a slight advantage in relieving, but not preventing, colds.

A fat man. The Tuscan General. Painted by: Alessandro Del Borro, 17th century | Wikipedia

Ritalin is a drug that treats, among other things, ADHD. In an article published in the journal Pediatrics in 2012, the latest information on the role of dietary treatments in ADHD was reviewed in comparison with publications from previous years. The study revealed that most of the controlled trials in the field failed to show a statistically significant negative effect of sucrose (white sugar) or aspartame (artificial sweetener) on symptoms of ADHD.

Studies claiming that there was such a link were conducted in the 1980s on a small number of children, so it is rather difficult to deduce any information regarding the general population. Therefore it was summarized that a high intake of sugar at a specific point in time does not affect ADHD, but there might be some cumulative effect. In addition, it was found that a protein meal consumed either before or with the sugar blocks the effect of symptoms of ADHD.

The relationship between sugar intake and hyperactivity may be due to a sharp drop in blood sugar (hypoglycemia). Children are more sensitive than adults to low levels of sugar in the blood, which causes a relatively sharp decline in their cognitive functions when their blood sugar decreases. It is possible and desirable to prevent these negative effects by reducing the intake of foods containing sugars that are quickly absorbed in the body (especially white sugar).

For example, children who ate a breakfast containing slow-absorbing sugars (low glycemic index) demonstrated higher performance in memory tests than those who ate breakfast with a high glycemic index. High levels of blood sugar (hyperglycemia) had no adverse effect on cognitive function.

In conclusion, it should be noted that even though sugar does not usually influence cognitive behavior and performance, the possibility that there is a limited population of children who may be affected by it cannot be entirely ruled out.

The molecular structure of Methylphenidate, the active substance of Ritalin | Wikipedia

There is indeed a clear link between excessive sugar consumption and obesity, which affects a variety of ailments such as heart disease, hypertension, etc. The relationship between sugar consumption and other risk factors is much less distinct.

A paper reviewing the relationship between sugar intake and the risk of cardiovascular disease was published this year. The study indicated that a high intake of added sugars moderately affects blood pressure and levels of triglycerides, total cholesterol and LDL (the “bad cholesterol”).

In another study, high sugar intake was associated with an increased risk of type 2 diabetes, as well as hypertension, cardiovascular disease, and lipid profile disorders. Another review published this year found that sweetened beverage consumption is mainly related to the increased risk for cardiovascular disease rather than directly to the disease itself. In other words, there may be other factors, such as the fact that people who consume high amounts of sweetened beverages tend to lead an unhealthy lifestyle in general, which is raising their risk factors.

The link between bone health and sugar consumption seems very simple: children and teenagers consume sweetened beverages at the expense of milk. Since milk is a good source of calcium, its reduced consumption may affect bone health. However, there is currently no conclusive evidence for this hypothesis, as there are also studies showing that drinking sugary drinks has a negligible effect on the dietary calcium balance.

Drinks from the cola family are associated with a negative effect on bone health, possibly due to their high phosphorus content. High levels of phosphorus may disrupt the calcium-phosphorus balance in the diet, leading to bone depletion. These findings, too, are not only inconsistent, but there are studies contradicting them.

The main reference to sugar in scientific literature is in relation to obesity and health-endangering excess weight, as well as eating disorders. The subject of food addiction is beginning to attract attention in the treatment of obesity and eating disorders. It has been found that in some cases of obesity, high-carbohydrate intake may impair brain mechanisms, just as in drug addiction.

Neurobiological studies have found similarities in brain processes in situations of extreme obesity and drug and substance abuse. However, it cannot be ignored that there is considerable difference between the two situations and that health-endangering food consumption is the main cause of the obesity epidemic and of chronic diseases associated with poor nutrition.

Processed food additives

E621 – Monosodium glutamate (MSG) is a “flavor enhancer,” which means it causes an increased arousal of the Umami (“taste of protein”) taste buds. The substance is made of a mixture of sodium and glutamate. Glutamate is one of the protein building blocks the body uses on a regular basis and we add it to foods to emphasize protein taste, which our body prefers. Studies have found no risk in MSG or an association between MSG and the adverse effects attributed to it, such as ADHD, asthma, and headaches.

Hydrolysate – A degraded compound. In our case, this is a protein that has been broken down through heating or enzymatic digestion. A similar process occurs in our digestive system.

E452 – Polyphosphates. Substances containing a chain of phosphate groups. A phosphate group is one of the building blocks of our DNA and the body's energy currency – ATP – in our case, it is a polyphosphate salt, an emulsifier designed to aid the mixing of fatty and watery substances.

E500 – Sodium carbonate and sodium bicarbonate. These substances are designed to control the acidity of foods and are an important component in baking powder as well.

E551 – Silicon dioxide is a substance designed to absorb fluids and prevent lumps, thus giving food a uniform appearance. It is considered safe to eat, although the powder itself is dangerous to inhale.

Cellulose fibers – Dietary fibers derived from plants.

E1420 – Starch acetate – Starch that has been chemically modified to make it more stable as a thickening agent.

E407 (Carrageenans) – A gelatin-like substance produced from red algae that is edible and serves as a food stabilizer.

E461, E456 – Methyl cellulose and methyl ethyl cellulose, substances produced from plant cellulose and go through minor chemical adjustments to be used as stabilizing agents.

The televised report showed how industrial schnitzel is prepared, and as part of the demonstration, powders of the additives mentioned above were added – in exaggerated amounts and without measurement. Industrial food is prepared and measured meticulously to eliminate the addition of any excessive amounts, as misrepresented in this report.

Thus, processed foods contain additives designed to improve their taste and appearance and create a uniform product. Some of them don’t necessarily add to our health, and clearly homemade schnitzel is better than processed schnitzel, but here, too, it is important to present things as they are without trying to create panic.

A schnitzel | Photo: Aviad Bublil, Wikipedia

In recent years, there has been an increase in the consumption of phosphates in food, mainly due to an increased consumption of processed foods. High phosphate consumption may lead to the secretion of circulatory hormones that can damage tissues in the body and ultimately disrupt the body's balance of minerals and cause cardiovascular disease, kidney disease, and bone loss.

Epidemiological studies have found a link between a slight rise in phosphate levels and an increased risk of cardiovascular disease. Calcium levels are also associated with the harmful effects of phosphates, so if calcium levels are maintained properly, the hormonal effect of phosphates is eliminated.

The hypothesis of a link between food coloring and preservatives and ADHD was introduced in the 1970s by a researcher named Feingold. He showed that when dietary supplements were omitted, symptoms improved in more than 50% of hyperactive children. Since then, controlled studies (1, 2) have failed to replicate the efficacy of this diet, known as the “Feingold Diet”, on a scale similar to that reported in the original study.

It is important to remember that there is a group of children who are sensitive to dietary supplements in the general population, and they demonstrate a negative response to dietary supplements. In any case, it is indeed recommended to reduce the intake of food additives and the law requires identifying them clearly on food packaging. In some countries, certain artificial food colors have been removed from the shelves.

The televised report demonstrated on oil extraction procedure from snacks, resulting in cloudy, unappetizing oil. The reason is that this oil had already been fried and contained a few other snack-derived ingredients. A similar result would also be obtained from a home-cooked schnitzel. However, it is clear that the amount of oil used is excessive overall, and therefore unhealthy.

There are few examples in the medical history of a consumer product that has caused such great and substantial damage as cigarettes, to the point that their effect was clear across parameters that distinguish among individuals. Cigarettes cause a wide variety of diseases in humans, and no other consumption item is known today whose detrimental effects are even close to those of smoking. The argument that the food we eat is more dangerous than cigarettes is an injustice to the victims of smoking.

To summarize

There is no doubt that an excessive consumption of processed foods, especially added sugars, does not benefit one’s health. It can cause a variety of effects, such as obesity, diabetes, heart disease, etc. None of this does detracts from the fact that research conducted on a topic of with health implications, must ensure accuracy and reliability and always present things as they are. There is no paucity of research and reliable data to illustrate the importance of this point, and there is no justification to present incorrect or inaccurate information just for scare tactics.

This article is part of the “Leave room for doubt” section dealing with failures in the media dealing with scientific issues. It should not be regarded as expressing any position on the subject from the original report, but only on how it relates to science.