Sugar and the American Diet
Karen A. Witter
February 24, 2018
Disclaimer: This paper was written to share information with friends and colleagues about the harmful and addictive nature of sugar, which I learned more about through the Crossfit Instinct Longevity class in Springfield, IL. Books and web sites used as sources are listed at the end. Some, but not all, are cited in the text. The paper was initially prepared for a verbal presentation to a small group of women and not intended for publication.
Early History of Sugar
Sugar has changed the world, and the history of sugar is not all sweet. Its origins date back 10,000 years to New Guinea, which is located north of Australia, where sugar cane was first domesticated. Sugar cane reached the Asian mainland by 1000 BC. Indian alchemists discovered how to make a white powdered version of sugar by 500 BC. Sugar spread to the Middle East and then Europe, but it was initially only available to the wealthy.
Before modern chemistry, sugar cane was the sole source of the sweetener. Sugar cane needs hot, humid conditions, temperatures above 80 degrees, and lots of water through rain or irrigation. Thus, Europe is not a conducive environment to grow sugar cane. In addition, sugar mills needed large quantities of wood for fuel to process the sugar cane in vats, and timber was in short supply in Europe. Discovery of the New World had a huge impact.
Sugar cane is native to Southeast Asia and is not native anywhere in the Americas. Christopher Columbus first introduced sugar cane to the New World during his second voyage in 1493. He introduced sugar cane to the Dominican Republic where it grew well in the tropical environment. The Caribbean proved to be a perfect location to grow sugar cane and meet the growing demand for sugar in Europe. Many expeditions were commissioned to find suitable land to grow the sugar cane, and island after island in the Caribbean was converted into sugar fields with the native peoples doing all the labor. Many of the native peoples succumbed from diseases introduced by the European settlers, and the harsh working conditions took their toll. Soon the early settlers realized they lacked sufficient manpower to plant, harvest, and process the sugar cane. With a need for labor, the native peoples were replaced with slaves from Africa to do the backbreaking work. Sugar cane requires a lot of water to flourish. Island after island became depleted of its water table reserves, and when the crops dried up a new island was used for sugar cane production made possible by African slaves.
The first slave ships arrived in the Caribbean in 1505 and continued unabated for more than 300 years. Most came from western Africa, where Portuguese colonies had already established trading outposts for ivory, pepper, and other goods. European merchants considered the movement of slaves to the Caribbean simply an extension of the trading system already in place.
By the 1700’s, sugar was not simply a luxury spice. It had become a staple in high demand worldwide. British colonists called sugar “white gold”, and it was the engine of the slave trade. The history of every nation in the Caribbean, much of South America, and parts of the Southern United States was dramatically influenced by the sugar cane industry. By the middle of the 1800s, approximately 12 ½ million slaves had been forcibly transported to the New World to work on the sugar plantations of Brazil and throughout the Caribbean.
Slavery to support the sugar industry was the key component in what historians call The Trade Triangle, a network whereby slaves were sent to work on plantations in the New World, the product of their labor was sent to Europe to be sold, and other goods were brought to Africa to purchase more slaves.
Europeans consumed greater and greater quantities of sugar and depended upon the sugar produced in the Caribbean. In 1700, the average Englishman consumed 4 pounds of sugar a year. In 1800, 18 pounds. In 1870, 47 pounds, and by 1900 the average Englishman consumed 100 pounds per year.
From the 17th – 19th centuries, sugar was to world economies what oil was to the twentieth century economy. Profit from the sugar trade was so significant that it may have even helped America achieve independence from Great Britain. Many historians argue that Britain’s military was so busy protecting its sugar islands in the 1700s that it contributed to Britain losing the 13 American colonies. Africans on Caribbean sugar plantations (and the Caribbean islands themselves) outnumbered European owners. The British colonists lived in constant fear of revolt and demanded soldiers for protection. Several decisive battles of the Revolutionary War may have turned out differently had Britain thrown its full might behind the war, experts believe.
In 1747, a method was discovered to extract sugar from beets. Abolition of slavery by the English and collapse of the Caribbean sugarcane industry led to the increase of sugar beets contributing to the world supply of sugar. The USDA was founded in 1862, and a priority was to encourage sugar beet production and analyze different strains of beets for their sugar content.
Rise of Sugar in the American Diet
A number of factors have contributed to the increase of sugar in food products. Technology had a big impact. By the 1920s sugar refineries were producing as much sugar in a single day as would have taken a decade in the 1820s. Sugar became cheap and affordable to everyone. As technology enabled more and more foods to be processed, sugar was a prime ingredient for a variety of reasons.
The technology of flour milling was revolutionized in the 19th century, and flour was ground very fine. Sugar was the additive that enabled the yeast to rise. The sugar content in bread rose steadily. The sugar content of the Wonder Bread of American childhoods was more than 10% in comparison to 2% in European breads.
Dr. Pepper, Coca Cola, and Pepsi were introduced in the 1880s and there was a huge growth in foods and beverages in which sugar was a major ingredient…fruit juices, sports drinks, breakfast cereals, soda. Candy bars with names that are still prominent today were developed in the 1920s when technology changed how chocolate could be mass-produced.
Sugar also allows for preservation by inhibiting microorganisms that would cause spoiling, inhibits mold and bacteria in liquids, reduces harshness of salt used for preserving meat, reduces acidity, enhances flavor, and adds viscosity. Thus, sugar is added to nearly all processed foods, which constitute a huge part of the American diet. Pick up virtually any food product in a can, jar, or box and some form of sugar is listed in the ingredients.
There’s also a link between sugar and the alcohol and tobacco industries. Sugar can allay physical cravings for alcohol. Per capita consumption of candy in the U.S. doubled with the beginning of Prohibition as Americans turned from alcohol to sweets. In 1920 sugar consumption in the U.S. hit record highs. Breweries were converted to candy factories. Consumption of ice cream increased dramatically.
Sugar is a critical ingredient in the American blended-tobacco cigarette. The first was Camel, introduced in 1913.The marriage of tobacco and sugar, as a sugar industry report described in 1950, makes for the mild experience of smoking cigarettes in comparison to cigars and makes it possible to inhale cigarette smoke and draw it deep into lungs. The inhalability of American blended cigarettes made them powerfully addictive and potentially carcinogenic and drove the explosion of smoking in the U.S. and Europe in the first half of the 20th century.
Today, sugar is ubiquitous in the modern diet. On average, Americans consume 66 pounds of sugar per person per year (around 20 or more tsp. per day.) Studies show that Americans consume the most sugar per capita, followed by Germany, The Netherlands, Ireland, and Australia.
Harmful Effects of Sugar
The harmful effect of sugar is not new information.
“We are beyond question, the greatest sugar-consumer in the world, and many of our diseases may be attributed to too free a use of sweet food,” wrote the New York Times on May 22, 1857.
Gary Taubes in his 2017 book, The Case Against Sugar, presents a compelling case for eliminating sugar from your diet. He argues that sugars are fundamental causes of diabetes and obesity and they have unique physiological, metabolic, and endocrinological effects that trigger these disorders. Some highlights from his book: When sugar and sugary products spread around the globe, so did diabetes. When peasant farmers in undeveloped countries migrated to cities and changed dietary habits from locally grown products to sugar-laden foods, diabetes increased in those populations. Diabetes has increased in Native American populations, Eskimos, and Polynesians when they started consuming a Western sugar-laden diet. During WWI and a sugar shortage, diabetes declined.
Diabetes in America has increased 800 percent from 1960 to today.
Robert Lustig, a pediatric endocrinologist at the University of CA, San Francisco, says sugar is a toxin that does damage over decades. In 2012 he published “The Toxic Truth about Sugar”, suggesting sugar is addictive and should be regulated in the way alcohol and tobacco are regulated.
There is a great deal of research related to the addictive nature of sugar. For some people, eating sugar produces characteristics of craving and withdrawal, along with chemical changes in the brain's reward center, the limbic region. Using brain-scanning technology, scientists at the U.S. National Institute on Drug Abuse were among the first to show that sugar causes changes in peoples' brains similar to those in people addicted to drugs such as cocaine and alcohol. Sugar triggers dopamine receptors in the brain. These changes are linked to a heightened craving for more sugar. Dopamine has been called the “I gotta have it now” hormone. Due to the addictive nature of sugar, many people find it difficult to control what they are eating.
Food manufacturers have taken advantage of this addictive nature of sugar. Bliss point was a term coined in the 1960s. The bliss point of processed food is the point where food reaches the level of being as delicious as possible, yet not so satisfying that we don't want more. The bliss point is a ratio of fat, sugar and salt. These three compounds trigger all 10,000-plus of our taste buds and send a message to the pleasure receptors of our brains that makes us want to eat more. Natural foods also have these three nutrients, but not in the perfect bliss point ratio where we don't feel satisfied. Adding more sugar beyond the bliss point leads to a significant drop in desirability. That may explain why some desserts taste so sweet that you don’t want to keep eating more and more. Remember the “Bet you can’t eat just one” marketing strategy? Apparently, this is no accident and part of a well researched and designed strategy.
Dr. Craig Backs is a local doctor focused on the prevention of heart attacks and strokes. He explains that the key hormone in weight management is insulin. Insulin allows glucose to enter cells to be used for energy. It also causes unused glucose to be stored as fat for less plentiful times. When a person is resistant to the effect of insulin (due to a combination of genetics and obesity), insulin levels rise, storing more glucose as fat, leading to more insulin resistance in a vicious cycle.
There is strong evidence that consuming too much added sugar over long periods of time can affect the natural balance of hormones that drive critical functions in the body. Eating sugar increases levels of glucose in the bloodstream, which leads the pancreas to release insulin. Higher levels of insulin, in turn, cause the body to store more food calories as fat. Insulin also affects a hormone called leptin, which is the natural appetite suppressant that tells our brains we are full and can stop eating. Imbalanced insulin levels, along with high consumption of certain sugars, such as fructose, has been linked to a condition called leptin resistance, in which the brain no longer "hears" the message to stop eating, thus promoting weight gain and obesity.
Insulin resistance was a good thing when food was scarce. It allowed our ancestors to survive long periods of limited food supply by encouraging them to overeat during times of plenty and conserve more calories as fat. In the modern world, that's not a benefit. To make matters worse, people with insulin resistance also tend to feel sluggish, making it difficult to be active and contributing to further weight gain.
Recent studies have also suggested a relationship between long-term consumption of sugar and cognitive decline. An article published in the January 2018 issue of Diabetologia reported on a study of more than 5000 people followed over 10 years. People with high blood sugar had a faster rate of cognitive decline than those with normal blood sugar. Dr. Dale E. Bredesen published a book in 2017, The End of Alzheimer’s. He argues that there are several different types of Alzheimer’s and 36 different factors leading to cognitive decline. While there is no “cure”, he believes there are ways to prevent and reduce cognitive decline, especially when starting before the onset. He says high insulin and high glucose are two of the most important risk factors and calls sugar an ”addictive poison”. He, too, argues humans evolved to handle only a small amount of sugar in a daily diet, but now the typical American diet often leads to insulin resistance, which he says contributes to diabetes and also Alzheimer’s.
For many years there have been messages that weight gain is the result of consuming more calories than are burned. However, there is a lot of evidence that all calories are not equal Different types of foods are processed differently by the body. Sucrose, glucose, lactose, and fructose are natural forms of sugar, but the body processes them differently. Glucose and fructose, for example, are not processed the same way. Glucose is metabolized by every cell in the body, while fructose is metabolized primarily by the liver. Consuming 100 calories of table sugar will affect the body differently than consuming 100 calories of rice or potatoes. And, high fructose corn syrup contains more fructose than table sugar, which is a significant ingredient in soda and juices. Fruit juices often contain a similar amount of sugar as most soft drinks. There are now over 60 names for sugar on food labels, mostly ending in –ose.
The 2014 documentary, That Sugar Film, is a fascinating story and provides more evidence that all calories are not equal. An Australian man, Damon Gameau, used himself as a test subject. For two months, he changed his normal, healthy diet based primarily on whole foods with no refined sugar to a diet where he ate so-called healthy foods (yogurts, nutrition bars, fruit juice, cereal, low-fat products, and foods that were advertised as “healthy”). He shifted to eating a diet containing 40 tsp. of sugar daily, which was the amount consumed by the average Australian, and he avoided soda, ice cream, candy, and other obvious sources of sugar. He tracked calories and consumed the same number of calories as his previous diet, and he continued the same level of exercise. He gained weight, grew lethargic, and developed fatty liver disease. Following the experiment, he returned to his previous diet, and the ill effects were largely and quickly reversed. Gameau analyzed the composition of his diet. Prior to his experiment, his diet was 26% from protein, 50% from fats and 24% from carbohydrates. His experimental diet was 18% from protein, 22% from fats, and 60% from carbohydrates. He explains that there are nine calories per gram in fat and four calories per gram in sugar. But, he says he was eating more healthy fats (avocado, nuts, eggs, etc.) than sugar before the experiment so his calorie count was quite high. However, the healthy fats filled him up so he ate less, but with the sugar diet he was snacking more because he had removed the healthy fat and rarely felt full.
Interviews with experts suggest that fructose may be the main culprit. Dr. Robert Lustig explains that sugar is not just one chemical, but two – glucose and fructose. Glucose is the energy of life. Every cell in every organism on the planet can burn glucose for energy. Glucose is mildly sweet, but fructose is an entirely different animal. Fructose is very sweet, the molecule we seek. Both burn at four calories per gram. If fructose were just like glucose, then sugar or high-fructose corn syrup (HFCS) would be just like starch. But, fructose is not like glucose. Central to Dr. Lustig’s theory is that we used to get our fructose mostly in small amounts of fruit, which came loaded with fiber that slows absorption and consumption. After all, who can eat 10 oranges at a time? But, as sugar and high fructose corn syrup became cheaper to refine and produce, we started gorging on them. Lustig also says that practically there is no difference in the harmful effects of sucrose (table sugar) and high fructose corn syrup. Both are about 50% fructose. The key is that the liver processes fructose into stored fat to a greater extent than glucose. And, fruit juices are just as toxic as sugar-sweetened beverages.
Impact and Influence of the Sugar Industry
Sugar is big business, and it should come as no surprise that the sugar industry has been a powerful voice in promoting sugar as beneficial and contributing to the increase in consumption of sugar.
David Singerman is a science historian and graduate of MIT’s History, Anthropology and Science, Technology & Society program. He says labor, corruption, science, and politics all circulate around sugar. Singerman became interested in sugar while interning at the National Institute of Standards and Technology, where he learned that sugar accounted for a huge amount of tariff revenue coming into the United States in the late 1800s and early 1900s. The federal government’s involvement with sugar began based on money, not a dietary issue. By 1880, sugar accounted for a sixth of the federal budget. Singerman argues this revenue stream got the government and its people hooked on sugar. In the decades after the Civil War, Americans’ per capita consumption of sugar more than doubled, from 32 pounds in 1870 to 80 pounds in 1910.
With a glut of sugar on the market and decreased prices for sugar, the Sugar Institute was founded in 1928 to get the industry working together to promote the joys and benefits of eating and drinking sugar in order to increase sugar consumption. The Sugar Institute dissolved in 1936, after lawsuits went all the way to the Supreme Court accusing the industry of repressive methods to fix prices. When sugar was rationed during the war, the government helped to appease people’s concerns about rationing through marketing efforts asking the public how much sugar do you really need….to which the answer was none. At the same time the American Medical Association issued a report advocating limiting the consumption of sugar. The sugar industry was compelled to respond.
Companies in the U.S. sugar industry founded the Sugar Research Foundation in 1943 which was renamed the Sugar Association in 1947 and is still active today. It was created to respond to the growing public perception that sugar was unhealthy. Its focus was on educating the public on the merits of sugar and funding research as well as expanding the post-war markets for sugar.
The sugar industry also took advantage of the thinking that all calories are equal. A Domino Sugar ad in 1955 proclaimed that 3 tsp. of pure sugar contain fewer calories than one medium apple. Sugar was promoted as either harmless, or even an ideal food for losing weight and that obesity is caused by overeating and all calories are the same.
In the 1940s and 1950s, sugar coated cereals made their debut. The cereal industry justified adding more sugar to cereal, claiming it was a better alternative than kids adding their own sugar from their sugar bowl to unsweetened cereal. Companies saw that adding sugar to products increased sales. Ranger Joe was the first sugar coated pre-sweetened cereal sold in America. The company later became Nabisco in 1949. Post cereals produced Sugar Crisp. Kellogg’s came out with Sugar Corn Pops in 1950. Sugar Frosted Flakes was released in 1952. Other sugary cereals were Sugar Smacks and Cocoa Krispies. Over the next 20 years, dozens of sugar-coated cereals, some with half of their calories from sugar, were produced. And, marketing targeted at children went along with these sugary treats. Tony the Tiger, Mr. MaGoo, Yogi Bear, and Sugar Bear were mascots targeted at children, and they dominated the Saturday morning cartoon shows. In the 1960s the cereal companies spent 600 million dollars a year on marketing. Another justification used by the cereal industry was that it was a way to get kids to drink milk.
As mentioned earlier, the bliss point is the optimal combination of fat, sugar, and salt that triggers people to want to eat more. Fat gives foods like chips and crackers a smoother texture. Salt masks the chemical taste of processed food and is the cheapest spice around. Sugar hits the pleasure points in our brains and increases the shelf life of products. Food manufacturers tweak the ratios of fat, sugar and salt, and then exhaustively taste test products until they reach the right bliss point with consumers. Bliss points determine a food's crave level, which in turn determines sales and profit. One well-known example of bliss point research is Dr. Pepper soda. When attempting to formulate a new flavor, the company went through 61 formulas and 4,000 tasting events, which allowed their food scientists to continually tweak the recipe until they found the ultimate bliss point. The resulting soda was Cherry Vanilla Dr. Pepper, one of the company's most successful products ever.
In the 1970s, many doctors thought sugar contributed to diabetes and heart disease. Dentists were vocal about the adverse impact of sugar on teeth. In 1974 the sugar industry surveyed physicians, and most said they thought sugar consumption accelerated the onset of diabetes. As people responded and sugar consumption declined, the industry responded as well.
David Singerman wrote an article in the New York Times in Sept. 2016 citing that in the 1960s, the sugar industry funded Harvard scientists who published a study blaming fat and cholesterol for coronary heart disease while largely exculpating sugar. This study, published in the prestigious New England Journal of Medicine in 1967, helped set the agenda for decades of public health policy designed to steer Americans into low-fat foods, which increased carbohydrate consumption and exacerbated our obesity epidemic.
There are many examples of the sugar industry’s influence on governmental policy and promoting only the results of research that support the industry’s view.
At one point in time, sugar was under consideration by the USDA as part of a review of additives “generally recognized as safe”. The sugar industry weighed in on the issue. Ultimately sugar was included on the list of additives generally recognized as safe and as a result there are no limits on the amounts that can be added to any food.
By the late 1970s sugar vanished from the discussion, and dietary fat was implicated related to heart disease. When health professionals started blaming saturated fat for heart disease, people abandoned traditional fats like butter, lard and coconut oil in favor of processed vegetable oils. These oils are very high in Omega-6 fatty acids, which can contribute to inflammation and various problems when consumed in excess. These oils are often hydrogenated, which makes them high in trans fats. Many studies have shown that these fats and oils actually increase the risk of heart disease, even if they aren't hydrogenated. Today many professionals believe that this misguided advice to avoid saturated fat and choose vegetable oils instead may have actually fueled the heart disease epidemic. The anti-fat message essentially put the blame on saturated fat and cholesterol, while giving sugar and refined carbs a free pass.
Now there is much greater attention on the benefit of “good” fats, and the adverse impacts of sugar.
Americans are consuming vast amounts of ‘ultra-processed’ food, loaded with added sugars. Dr. Carlos Augusto Monteiro at Brazil’s University of São Paulo, examined the role of ultra-processed foods in the diets of over 9,000 individuals. Ultra-processed foods are defined in the study as industrial formulations, which besides salt, sugar, oils, and fats, include additives such as food dyes, sweeteners, emulsifiers and flavorings.
Monteiro’s team identified the main sources of added sugars among ultra-processed foods as soft drinks (17.1% of U.S. intake of added sugars); fruit drinks (13.9%); milk-based drinks (4.6%); cakes, cookies, and pies (11.2%); breads (7.6%); desserts (7.3%); sweet snacks (7.1%); breakfast cereals (6.4%); and ice creams and ice pops (5.9%).
Sugar in liquid form is particularly harmful. Studies show that the brain doesn't "register" liquid sugar calories in the same way as calories from solid foods, which dramatically increases total calorie intake. One study found that in children, each daily serving of sugar-sweetened beverages is linked to a 60% increased risk of obesity.
Added sugars are also in foods that consumers don't think of as sweet, including commercially sold pasta sauces, salad dressings, crackers, whole wheat bread, and prepared soups. The study found that added sugars accounted for 1 in every 5 calories in the average ultra-processed food product.
Added sugars in the American diet are a growing health concern. While whole foods like fruit and dairy products contain natural sugars, they are nutrient-dense. Added sugars in ultra-processed foods are considered empty calories. Organizations such as the American Heart Association, American Academy of Pediatrics, Institute of Medicine, and the World Health Organization recommend decreasing intake of added sugars. They also note that it is difficult to meet nutrient needs while staying within calorie requirements if you consume more than 10 percent of your total daily calories from added sugars. On average, Americans get about 13 percent of their total calories from added sugars, with the major sources being sugar-sweetened beverages (including soft drinks, fruit drinks, coffee and tea, sport and energy drinks, and alcoholic beverages) and snacks and sweets (including grain-based desserts, dairy desserts, candies, sugars, jams, syrups, and sweet toppings.)
Studies have found that excessive added sugar consumption increases the risk of obesity and type-2 diabetes, which in turn increases the risk of heart disease and stroke. High intake of added sugar has also been linked to high blood pressure, increased triglycerides, lower HDL (good) cholesterol, and insulin resistance. Researchers have recently been studying a possible link between added sugar consumption and non-alcoholic fatty liver disease. The researchers concluded that cutting back on the consumption of ultra-processed foods could be “an effective way of reducing the excessive intake of added sugars in the USA.”
Because of the growing concern over added sugars, regulations were put in place to require added sugars to be listed separately on food labels. Former first lady Michelle Obama championed this change. The new nutrition labels would add a special line for “added sugars”, as well as more prominently display calories per serving and serving size. As one example, a 20-ounce bottle of Coke could show 65 grams of added sugar, representing 130 percent of a recommended daily intake. They had been scheduled for rollout in July 2018, with a one-year extension for smaller manufacturers. Several advocacy groups cheered the FDA's move. Michael Jacobson, founder of the Center for Science in the Public Interest, released a statement saying that the new labels will allow consumers to make more informed choices and "should also spur food manufacturers to add less sugar to their products."
However, this was not popular with the food industry. After sustained lobbying from the packaged food and beverage industry, the Food and Drug Administration announced a delay in the launch of Nutrition Fact labels. Many food companies argued that from a health point of view, it doesn't matter whether sugar is added or is already present naturally in ingredients such as fruit. The existing labels already show the amount of total sugars in packaged food, and food manufacturers argued that this already tells consumers what they need to know. The Sugar Association called the FDA's original proposal to require added sugars to be listed separately a "dangerous precedent that is not grounded in science.”
On September 29, 2017 the FDA released a proposed rule to extend the compliance dates for the new nutrition labels rule from July 26, 2018, to Jan. 1, 2020 for manufacturers with $10 million or more in annual food sales. Manufacturers with less than $10 million in annual food sales would receive an extra year to comply—until Jan. 1, 2021.
People in Western countries are consuming massive amounts of refined sugars, way more than our bodies have evolved to handle. Everywhere modern processed foods go, chronic diseases like obesity, type-2 diabetes, and heart disease soon follow. The studies are clear that when people abandon their traditional foods in favor of modern processed foods high in sugar, refined flour and vegetable oils, they get sick. Of course, there are many things that can contribute to these health problems, but changes in the diet are the most important factor.
There is a lot of information and debate over the use of artificial sweeteners as a sugar substitute. This warrants a more in-depth review and is not addressed in this paper. However, anything that tastes sweet can trigger cravings and thus is better to avoid.
The best way to eliminate sugar from the diet is to avoid processed food and cook with whole foods, incorporating fresh vegetables and fruits. All calories are not equal. Experts recommend that meals should be balanced with 30 percent protein (meats, fish, chicken, eggs), 30 percent good fat (avocados, nuts, olive oil), and 40 percent low glycemic carbohydrates (vegetaables, some fruits, little starch). Many people are seeing positive results with their weight, blood-pressure, and energy levels by eating a diet with this mix of foods; avoiding processed food, sugar, grains, and dairy; drinking lots of water; avoiding snacking between meals; not eating two hours before bedtime; and fasting at least 12 hours before the next meal.
Elimination of sugar from one’s diet may be difficult to imagine. But, it would be hard to come away from reading Gary Taube’s book, The Case Against Sugar, without viewing sugar in a new light. And, that is likely the first step in deciding to reduce one’s consumption of sugar.
Gary Taubes, The Case Against Sugar, 2017
M.M. Eboch, Inside the Sugar Industry, 2017
Marc Aronson and Marina Budhos, Sugar Changed the World, 2010