Building a case on the harm of sugar

An in-depth, readable account of the history of sugar and how science and understanding of the metabolic effects of sugar have been identified over the years.

Cover of the book ‘The case against sugar’

Fat has been demonised for decades as the cause of obesity and other health ailments. But, as this book suggests, the case is building against sugar as the bigger enemy.

For the past 50 years, we have been advised to avoid eating too much fat and to reduce our intake of the saturated variety, focusing instead on eating plenty of wholegrain carbohydrates, fruits and vegetables. But recently the tirade against fat has lessened, with many researchers switching their attention to sugar, with some believing that this white, crystalline substance is a greater health hazard.

In this book, Taubes presents the case against sugar, detailing how it is a highly likely suspect responsible for the huge increase in obesity and type 2 diabetes that has occurred over the past 30 years. The author even indicts sugar as a cause of cancer, hypertension and Alzheimer’s disease.

The rise in type 2 diabetes seems inexorable, with figures for the UK suggesting that 1 in 16 people have type 2 diabetes. But what is the evidence that sugar is responsible for the rise in the prevalence of this condition? Perhaps it is the greater availability of sugar-laden products, such as confectionery, soft drinks, and ice cream. Certainly there is some evidence to show that, once peasant farmers across the globe migrate to towns and cities and increase their consumption of sugar-containing products, they, too, will develop diabetes.

Nevertheless, the problem for researchers is that it is extremely difficult to prove that, if consumed over many years, sugar is some kind of toxin that is responsible for a whole host of conditions. As Taubes describes in some detail, this fact did not go unnoticed by the sugar industry, which went to great lengths to highlight how it was impossible to extrapolate with the available information, that sugar was uniquely harmful to health.

Furthermore, a major pillar of nutritional research, which was ultimately a gift to the sugar industry, is that obesity, and the consequent increased risk of diabetes and heart disease, is a result of over-consumption of calories. It was perceived as a simple case of energy balance: put in more calories than you expend and the excess is stored as fat. This nutritional mantra is still quoted today and was used to great advantage by the sugar industry. Following this logic, if three teaspoons of sugar contains less calories than an apple, sugar is at best harmless and, as the industry would later argue, an ideal substance to help with weight loss.

Taubes provides an in-depth, very readable account of the history of sugar and how the science and understanding of the metabolic effects of sugar were identified over the years.

Many pharmacists will find this book interesting. In the end, there are no definitive conclusions as to whether or not sugar is the villain it is made out to be, which is more a failure of the science than anything else. However, the weight of circumstantial evidence is both compelling and convincing.

In 1972, John Yudkin wrote ‘Pure, white and deadly’, which argued that sugar was, in fact, more harmful than fat. Perhaps in the fullness of time, we will all come to see that he was right.

Rod Tucker




The case against sugar, by Gary Taubes. Pp 286. Price £14.99. London: Portobello Books; 2016. ISBN 978 1 84627 6378

Last updated
The Pharmaceutical Journal, PJ, April 2017, Vol 298, No 7900;298(7900):DOI:10.1211/PJ.2017.20202292

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