“It is important not to have the mind of the American public poisoned against an invaluable and almost indispensable food—sugar.” These words, penned in 1943 by Ody Lamborn, president of the Coffee and Sugar Exchange of New York, lie at the heart of The Case Against Sugar, Gary Taubes’ unflinching look at a food Americans eat an average 90 pounds of every year: sugar.
I picked up Taubes’ book just before New Year’s, thinking I might join my type-II-diabetic husband in drastically cutting my sugar intake, which got out of hand during the holidays. I hate diet books, but Taubes is an experienced investigative journalist, and that background makes The Case Against Sugar stand out among the piles of nutrition books crowding the shelves.
This isn’t a diet book, a how-to, or a miracle cure; its focus is on how, despite a wealth of evidence all pointing in the same direction, a century’s worth of medical research on the mysterious question of how the “Western diet” leads to elevated rates of diabetes, hypertension, cancer, and other health problems has apparently pursued every avenue but sugar.
The book, as its name suggests, is an “argument for the prosecution,” pointing the finger at sugar “as the principal cause of the chronic diseases that are most likely to kill us, or at least accelerate our demise, in the twenty-first century.” Fat, salt, and calories in general have all taken the blame, Taubes argues, yet somehow sugar has largely been “treated as little worse than a source of harmless pleasure.”
Like any good journalist, Taubes begins his research by following the money, and finds the sugar industry and major food corporations pulling many strings. Many troubling questions arise, such as: Who researches sugar, and where does their funding come from? Who runs the government agencies that make dietary recommendations, and how do lobbying and election donors affect their decisions? Is what’s good for General Mills really good for America?
For a book that deals with obesity, The Case Against Sugar is refreshingly critical of approaches that put all of the onus for health on individuals. In fact, Taubes is very clear that weight-shaming and diet advice like “calories in, calories out” are not only counterproductive but downright victim-blaming, noting the bizarreness of pumping a nation’s entire food system full of sucrose and fructose to the point where they’re nearly unavoidable and then telling individuals to “just avoid them.” He exposes the role of advertisers, corporate lobbyists, government agencies, and other major institutions in refusing to acknowledge that sugar is a serious public health problem.
Taubes traces this process from its earliest origins in the Atlantic slave trade, drawing from Sidney Mintz’s masterwork Sweetness and Power. He follows sugar’s path through the colonial arteries of the British Empire, looking at colonial doctors’ research to track the prevalence of diabetes and other health problems in traditional societies before and after the introduction of new, sugar-laden foods. (Spoiler: Increase the availability of sugar and you’ll see rates of such health problems increase dramatically in a generation or two.)
As for Big Food, we start with the introduction of soda around the turn of the twentieth century, when sugar took the place of wine and cocaine in Coca-Cola’s recipe (yes, really). As soda fountains and ice cream counters soared in popularity, so did the sugar industry. This was amplified by the Sugar Act, which “guaranteed that producing and refining sugar in the United States would always be profitable” by limiting domestic production, putting import quotas in place, setting prices, and subsidizing what sugar producers either didn’t produce or couldn’t sell. Franklin Roosevelt called the sugar lobby “the most powerful pressure group that had descended on the nation’s capital during his lifetime.”
During World War II, sugar was considered indispensable to war production: While it was rationed for civilians, 220 pounds of sugar were allotted per year for each soldier in the US Army—and both Coke and Pepsi took advantage of the war to spread their sales into new markets, following American service members wherever they went. After the war, the question was how to keep sugar consumption high. New products like sweetened breakfast cereals (some of them more than 50% sugar) did the job, though Taubes shows that company nutritionists at Kellogg’s and General Mills expressed strong reservations about their health effects on children.
The sugar industry knew there were problems (Taubes notes that “by 1950 the Sugar Association, Inc., was acknowledging in its internal documents that carbohydrates, including sugar, play a causal role in tooth decay”), but through its masterful public relations efforts, focused on how to limit the damage without cutting down on sugar consumption: advising dental patients to brush after every meal, for example, rather than simply to avoid sugary foods. Obesity entered the public consciousness as a public health issue in the 1950s, and sugar lobbyists argued that sugar would “stem the appetite” faster than other foods, thereby helping people lose weight.
Another fascinating section focuses on the tobacco industry. Tobacco leaves “sauced” in sugar, it turns out, were (and are) the secret ingredient that makes American-style cigarettes so palatable and easy to inhale—a huge win for R.J. Reynolds, but a massive loss for public health. “For those who immediately dismiss the possibility that sugar itself may be responsible for more premature deaths than cigarettes,” Taubes writes, “we have to consider the fact that cigarettes themselves would have been far less harmful and far less addictive had it not been for sugar.”
In the sometimes overly technical latter half of the book, Taubes dives deep into medical research, examining what studies were funded by sugar companies, why researchers who blamed sugar for health problems were called quacks, and what influenced policy makers to argue that “a calorie is a calorie.” Big Food, again, is behind the curtain. Despite that influence, though, there’s a mounting pile of evidence that sugar—and insulin resistance—are behind not only diabetes and hypertension but problems like breast cancer and Alzheimer’s disease, as well. There’s also a great deal of evidence, Taubes shows, that sugar is as addictive as alcohol or cocaine. His arguments are too complex for a short review to do them justice, but his approach is rigorous and at each step asks how outside interests sway researchers to stray from scientific principles.
So what’s an eater to do? Avoid sugar entirely, like we advise people to do with cigarettes, or eat it in moderation? Taubes points out that “moderation” is a slippery concept when it comes to substances that affect different people differently and take decades to do their full damage: We don’t know how much is “too much” until it’s too late. “Enough evidence exists for us to consider sugar very likely to be a toxic substance,” he concludes, and suggests that readers try living for a few months or years without sugar in order to make a fully informed decision.
As for me, I’m not sure I’m ready to go cold turkey just yet. I’ve spent the few weeks trying to—but when I found myself scarfing two candy bars in a row, I realized that Taubes might be right about the addictive nature of sugar. Staying healthy is a struggle in a country built on profiting from unhealthy foods, and overcoming that will take a lot more than just individual willpower.
Update: The post originally stated incorrectly that Gary Taubes is the author of Salt, Sugar, Fat. Michael Moss is the author of that book, and the reference has been removed.
Book cover image courtesy of Knopf Doubleday Publishing Group – Head shot of Gary Taubes by Kirsten Lara Getchell.