About this Resource
Sugar, which is the generic name for sweet-tasting, simple carbohydrates, has been linked with many conditions, including obesity, dental caries (cavities), and type 2 diabetes. In 1972, the book Pure, White and Deadly by John Yudkin highlighted these purported dangers of excess sugar consumption and beliefs that sugar is especially harmful and/or addictive have become more widespread over time. This handout reviews whether sugar is as ‘deadly’ as Yudkin suggested in the early 1970s.
Grounded in the Research
The suggestion that sugar might have adverse health effects has been a recurring theme for decades, with claims that high intake may be associated with an increased risk of conditions as diverse as dental caries, obesity, cardiovascular disease, diabetes, gout, fatty liver disease, some cancers, and hyperactivity.
Excerpt from: Te Morenga, L., Mallard, S., & Mann, J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ. 2012; 346: e7492.
References
[1] Yudkin, J.S. (1972). Pure, White, and Deadly. Viking Penguin.
[2] Malik, V. S., & Hu, F. B. (2022). The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases. Nature Reviews Endocrinology, 18(4), 205-218. https://doi.org/10.1038/s41574-021-00627-6
[3] Chandel, N. S. (2021). Carbohydrate metabolism. Cold Spring Harbor Perspectives in Biology, 13(1), a040568.
https://doi.org/10.1101%2Fcshperspect.a040568
[4] Campos, V., Tappy, L., Bally, L., Sievenpiper, J. L., & Lê, K. A. (2022). Importance of carbohydrate quality: what does it mean and how to measure it?. The Journal of Nutrition, 152(5), 1200-1206. https://doi.org/10.1093/jn/nxac039
[5] Kelishadi, R., Mansourian, M., & Heidari-Beni, M. (2014). Association of fructose consumption and components of metabolic syndrome in human studies: a systematic review and meta-analysis. Nutrition, 30(5), 503-510. https://doi.org/10.1016/j.nut.2013.08.014
[6] WHO (2015). Guideline: sugars intake for adults and children. Geneva (Switzerland).
[7] Huang, Y., Chen, Z., Chen, B., Li, J., Yuan, X., Li, J., … & Liu, L. (2023). Dietary sugar consumption and health: umbrella review. BMJ, 381. https://doi.org/10.1136/bmj-2022-071609
[8] Nguyen, M., Jarvis, S. E., Tinajero, M. G., Yu, J., Chiavaroli, L., Mejia, S. B., … & Malik, V. S. (2023). Sugar-sweetened beverage consumption and weight gain in children and adults: A systematic review and meta-analysis of prospective cohort studies and randomized controlled trials. The American Journal of Clinical Nutrition, 117(1), 160-174. https://doi.org/10.1016/j.ajcnut.2022.11.008
[9] Calcaterra, V., Cena, H., Magenes, V. C., Vincenti, A., Comola, G., Beretta, A., … & Zuccotti, G. (2023). Sugar-Sweetened Beverages and metabolic risk in children and adolescents with obesity: a narrative review. Nutrients, 15(3), 702. https://doi.org/10.3390/nu15030702
[10] Imamura, F., O’Connor, L., Ye, Z., Mursu, J., Hayashino, Y., Bhupathiraju, S. N., & Forouhi, N. G. (2015). Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ, 351. https://doi.org/10.1136/bmj.h3576
[11] Khan, T. A., & Sievenpiper, J. L. (2016). Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetes. European Journal of Nutrition, 55(Suppl 2), 25-43. https://doi.org/10.1007/s00394-016-1345-3
[12] Valenzuela, M. J., Waterhouse, B., Aggarwal, V. R., Bloor, K., & Doran, T. (2021). Effect of sugar-sweetened beverages on oral health: a systematic review and meta-analysis. European Journal of Public Health, 31(1), 122-129. https://doi.org/10.1093/eurpub/ckaa147
[13] Ryan, B. J., Schleh, M. W., Ahn, C., Ludzki, A. C., Gillen, J. B., Varshney, P., … & Horowitz, J. F. (2020). Moderate-intensity exercise and high-intensity interval training affect insulin sensitivity similarly in obese adults. The Journal of Clinical Endocrinology & Metabolism, 105(8), e2941-e2959. https://doi.org/10.1210/clinem/dgaa345
[14] Egli, L., Lecoultre, V., Theytaz, F., Campos, V., Hodson, L., Schneiter, P., … & Tappy, L. (2013). Exercise prevents fructose-induced hypertriglyceridemia in healthy young subjects. Diabetes, 62(7), 2259-2265. https://doi.org/10.2337/db12-1651