Sugar versus fat
Over-consumption of sugar and fructose has ill effects with a wide wingspan
A scientific paper titled Sugar Industry And Coronary Heart Disease Research was published in the journal JAMA Internal Medicine in November. It has been making waves since. And justifiably so. Stantan A. Glantz and his colleagues from the Philip R Lee Institute for Health Policy Studies, San Francisco, US, wrote that in the 1960s, the Sugar Association (then called the Sugar Research Foundation) paid three Harvard scientists to write a biased review of the studies done on heart disease. In the review, the scientists concluded that saturated fat was the bigger and more critical player in the pathology of heart disease while sugar played a minor role. The study, conducted by the three scientists, was published in The New England Journal Of Medicine (NEJM).
Following the release of the NEJM paper, one of the Harvard professors went on to draft the US government’s dietary guidelines as head of nutrition. As a result, patients in the US and, eventually, the world over, have been told by doctors to watch their fat intake to prevent heart disease while no advice has been given to minimize sugar intake. In 2015, the UK’s scientific advisory committee on nutrition disputed the research on fructose, or fruit sugar, blaming it for causing metabolic diseases like heart disease.
The World Health Organization (WHO) issued a guideline in March 2015 recommending that adults and children worldwide reduce their daily intake of free sugars, like table sugar, to less than 10% of their total energy intake, stating that a further reduction to below 5% per day would provide additional benefits.
Evidence is accumulating to show that the overconsumption of sugar and fructose (a fruit sugar used to sweeten drinks and processed foods) has ill effects with a wide wingspan. It is linked not only to heart disease and diabetes but also cancer. Aashish Contractor, head, rehabilitation and sports medicine, at the Sir HN Reliance Foundation Hospital in Mumbai, says, “Excessive sugar can contribute to heart health in different ways—one by contributing to the development of diabetes; second, by reducing HDL, or good cholesterol, levels in the blood; and third, by increasing body weight. There are many studies showing this.” For example, a review of studies published in the British Journal Of Nutrition in March 2015 found that higher consumption of sugar-sweetened beverages increased the risk of heart disease.
However, this does not mean that we can consume large quantities of fat without worrying about its effects on heart health. Saturated fats are found in butter, ghee, cheese and poultry. Decades of research have shown that consuming large quantities of saturated fat increases “bad” cholesterol. Dr Contractor says: “We must be careful. While we need to consume sugar moderately, we must do the same with saturated fat too. There is a trend these days to vilify one while condoning the other, but the fact is there is plenty of research to support the ill effects of both saturated fat and sugar on the heart.” WHO recommends that total fat intake should not exceed 30% of energy intake and there needs to be a shift from saturated to unsaturated fats and towards the elimination of trans fats.
If, like me, you have eliminated processed foods from your diet and are eating food cooked in oils like olive and groundnut, then the American Heart Association recommendation also lets you know how much saturated fat you can have every day. It says getting 5% of your daily intake of calories from saturated fat, about 2 tsp ghee in a 2,000 calorie diet, is fine.
So let us enjoy both sugar and fat, but moderately.
Sujata Kelkar Shetty, PhD, is a wellness consultant, life coach, and a clinical scientist trained at the National Institutes of Health in Bethesda, US.