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GIFFORD-JONES: Sugar, not fat, responsible for heart attack

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Dr. John Yudkin, professor of nutrition at Queen Elizabeth College of London, made headlines in 1972 when his book, Pure White and Deadly, was published. 

Yudkin’s research convinced him it was not fat that caused heart attack, but sugar. So, has history proved him right? And is sugar the main reason for today’s epidemic of cardiovascular disease and other health problems?

Damning sugar obviously did not win Judkin popularity with the sugar industry. It’s sad that great efforts were taken, even by academic colleagues, to discredit his work. In fact, one researcher labelled his studies science fiction.

But Robert Lustig, professor of endocrinology at the University of California, has hailed Yudkin’s research as prophetic. He says that everything Yudkin wrote was “God’s honest truth” and that sugar should be labelled as a toxic substance just like tobacco and alcohol.

It was Ancel Keys who claimed his research showed that saturated fat was the major culprit of coronary attack. This sent the message that everyone should eat a low-fat diet. And it also presented food companies a golden opportunity to provide customers with a host of low-fat yogurts, desserts and biscuits.

But Yudkin believed there was a greater association with heart attack by the increase in sugar consumption in several countries than in the consumption of fat. After all, people had been eating butter for centuries without seeing an increase in coronary artery deaths.

Yudkin, however, faced a major problem. His research was observational, not the hard evidence of laboratory research. So, it was not until the 1980s that several discoveries gave credence to Yudkin’s theories. 

Studies revealed that fructose, one of the main carbohydrates in refined sugar, and present in many products, is primarily metabolized by the liver. And that excessive amounts of fructose are converted into fat. Glucose, the other component of sugar, found in bread and potatoes, is burned up (metabolized) by all cells. 

History shows another major trend. In the 18th century, sugar was considered an expensive luxury. In fact, so much so that sugar boxes were provided with a lock and key. As sugar has become affordable, its use has dramatically increased over the years. 

Two hundred and fifty years ago the British consumed four pounds of sugar a year. In 1972 it had increased to 50 pounds annually. The same is true for the rest of the world. In North America the average person consumes about 19.5 teaspoons of sugar daily or 66 pounds a year. Today it’s estimated that 68 percent of packaged foods contain added sugar.

Years ago, I labelled sugar the “white devil”. The sugar industry was again not amused and demanded the College of Physicians and Surgeons discipline me. I was required to defend my views before the college, a time-consuming, stressful process. But I was not disciplined.

I have not changed my views about sugar. Added sugar has become a part of so many products that North Americans are unaware of the amount of sugar they’re consuming. And according to Robert Lustig and other nutritional experts, it has addictive qualities like alcohol and tobacco. 

Sugar also contains calories. But sugar is unlike fibre in apples which has a filling effect. One normally does not desire a second apple. A can of cola loaded with sugar does not satisfy our hunger reflex.  

But as much as I blame sugar for being a significant factor in nutritional problems, it’s excess calories of all kinds that are responsible for the epidemic of obesity, Type 2 diabetes and coronary deaths. Remember the Gifford-Jones Law that stresses one bad problem leads to another and another.

In the end we are all architects of our own follies. Shakespeare was right when he wrote centuries ago, “The fault, dear Brutus, is not in our stars, but in ourselves.” 

So, although history redeems Yudkin’s work over Keys, it’s human nature that is guilty. Obesity is often self-inflicted. So, I’ve often said, the scale is the answer. Step on it every day. If it keeps going up, realize you are eating too much of everything. Then get smart.


Dr. W. Gifford-Jones is a syndicated columnist whose medical column appears in The Guardian every Tuesday. Check out his website, www.docgiff.com, which provides easy access to past columns and medical tips. For comments, readers are invited to email him at info@docgiff.com. He can also be found on Twitter @GiffordJonesMD.

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