Critiquing Gary Taubes, Part 3: Did the US Government Give Us Absurd Advice About Sugar?

Pre­vi­ously: Main­stream Nutri­tion Science on Obe­sity, Atk­ins Redux

Here’s where I start talk­ing about the thing that ini­tially drove me to write this post se­ries: Taubes’ re­peated mis­rep­re­sen­ta­tion of the views of the main­stream nu­tri­tion au­thor­i­ties he at­tacks. I’ll start by go­ing back to Taubes’ 2002 ar­ti­cle. Im­me­di­ately af­ter the dis­cus­sion of Atk­ins, it con­tains an­other set of claims that stood out to me as a huge red flag:

Thirty years later, Amer­ica has be­come weirdly po­larized on the sub­ject of weight. On the one hand, we’ve been told with al­most re­li­gious cer­tainty by ev­ery­one from the sur­geon gen­eral on down, and we have come to be­lieve with al­most re­li­gious cer­tainty, that obe­sity is caused by the ex­ces­sive con­sump­tion of fat, and that if we eat less fat we will lose weight and live longer. On the other, we have the ever-re­silient mes­sage of Atk­ins and decades’ worth of best-sel­l­ing diet books, in­clud­ing ″The Zone,″ ″Su­gar Busters″ and ″Protein Power″ to name a few. All push some vari­a­tion of what sci­en­tists would call the al­ter­na­tive hy­poth­e­sis: it’s not the fat that makes us fat, but the car­bo­hy­drates, and if we eat less car­bo­hy­drates we will lose weight and live longer.

The per­ver­sity of this al­ter­na­tive hy­poth­e­sis is that it iden­ti­fies the cause of obe­sity as pre­cisely those re­fined car­bo­hy­drates at the base of the fa­mous Food Guide Pyra­mid—the pasta, rice and bread—that we are told should be the sta­ple of our healthy low-fat diet, and then on the sugar or corn syrup in the soft drinks, fruit juices and sports drinks that we have taken to con­sum­ing in quan­tity if for no other rea­son than that they are fat free and so ap­pear in­trin­si­cally healthy. While the low-fat-is-good-health dogma rep­re­sents re­al­ity as we have come to know it, and the gov­ern­ment has spent hun­dreds of mil­lions of dol­lars in re­search try­ing to prove its worth, the low-car­bo­hy­drate mes­sage has been rel­e­gated to the realm of un­scien­tific fan­tasy.

I’ll start with the ob­vi­ous: We thought sug­ary soft drinks were in­trin­si­cally healthy? To quote an old joke, who do you mean we, ke­mosabe? Given wide­spread sci­en­tific illiter­acy, I wouldn’t be sur­prised if some peo­ple have be­lieved that low-fat is a suffi­cient con­di­tion for be­ing healthy, but if so, they didn’t get this idea from main­stream nu­tri­tion sci­ence.

Taubes makes it sound the main­stream view and the view Atk­ins pushed are mir­ror images of each other: on the one hand, “ev­ery­one from the sur­geon gen­eral on down” told us “if we eat less fat we will lose weight and live longer.” On the other hand, Atk­ins et al. told us “if we eat less car­bo­hy­drates we will lose weight and live longer.”

This rhetoric ig­nores a cru­cial dis­tinc­tion: as I showed in my pre­vi­ous post, Atk­ins re­ally did claim eat­ing less carbs was a suffi­cient con­di­tion for weight loss, and that no amount of fat could pos­si­bly make us fat. Main­stream nu­tri­tion ex­perts, on the other hand, did ar­gue low fat diets were bet­ter for us, all else be­ing equal. But they never, so far as I’ve been able to find, claimed a low-fat diet was a suffi­cient con­di­tion for los­ing weight, or that no amount of sugar could pos­si­bly make make us fat.

Taubes seems un­aware of this—or else he chooses to hide it from his read­ers. In Good Calories, Bad Calories (p. 342), for ex­am­ple, he at­tempts to re­but the sug­ges­tion that low-carb diets are re­ally low-calorie diets in dis­guise that this idea “seems to con­tra­dict the un­der­ly­ing prin­ci­ple of low-fat diets for weight con­trol and the no­tion that we get obese be­cause we overeat on the dense calories of fat in our diets.” This re­sponse would only make sense if main­stream nu­tri­tion sci­en­tists were say­ing eat­ing less fat is the be-all, end-all of weight loss.

In these ini­tial para­graphs, Taubes only cites one source for what main­stream nu­tri­tion ex­perts were sup­pos­edly tel­ling us: the USDA’s Food Guide Pyra­mid. This is an un­for­tu­nate choice, be­cause as any­one who’s ac­tu­ally seen the chart knows, sweets get put right up at the top with fats and oils un­der the “use spar­ingly” cat­e­gory. At this point in the ar­ti­cle, I won­der how any­one read­ing it could avoid sus­pect­ing some­thing was. (The same goes for the refer­ences to the Food Pyra­mid in Taubes’ books on nu­tri­tion, both of which quote the “use spar­ingly” recom­men­da­tion in re­gard to fats and oils, while care­fully omit­ting the fact that it said the same thing about sweets.)

But then again, the Food Pyra­mid was first pub­lished the year I en­tered kinder­garten, so I’m at ex­actly the right age to have had it drilled into my head hard in school. And maybe main­stream nu­tri­tion mes­sag­ing was much cra­zier in the 70′s and 80′s. So what about the other sources Taubes cites as sup­pos­edly show­ing main­stream nu­tri­tion­ists giv­ing giv­ing us ter­rible ad­vice about fat vs. sugar?

Farther down in the ar­ti­cle, Taubes talks about how the de­bate over the 1977 Se­nate com­mit­tee re­port “Die­tary Goals for the United States” sup­pos­edly tried to set­tle the de­bate over what Taubes calls the “low-fat-is-good-health dogma” with poli­tics rather than sci­ence. Yet a quick look at the re­port re­veals it’s state­ments to the effect that fat is dan­ger­ous and we should eat less of it are con­sis­tently paired with par­allel state­ments about sugar, in­clud­ing a recom­men­da­tion to cut our sugar in­take by 40 per­cent. In­stead, the re­port recom­mends, we should be eat­ing more fruits, veg­eta­bles, and whole grains.

Okay, what about the sources Taubes cites in his books? Three im­por­tant ones are sum­ma­rized in the chap­ter on sugar in Good Calories, Bad Calories:

In 1986, the FDA ex­on­er­ated sugar of any nu­tri­tional crimes on the ba­sis that “no con­clu­sive ev­i­dence demon­strates a haz­ard.” The two-hun­dred-page re­port con­sti­tuted a re­view of hun­dreds of ar­ti­cles on the health as­pects of sugar, many of which re­ported that sugar had a range of po­ten­tially ad­verse metabolic effects re­lated to a higher risk of heart dis­ease and di­a­betes. The FDA in­ter­preted the ev­i­dence as in­con­clu­sive. Health re­porters, the sugar in­dus­try, and pub­lic-health au­thor­i­ties there­fore per­ceived the FDA re­port as ab­solv­ing sugar of hav­ing any dele­te­ri­ous effects on our health.

The iden­ti­cal mes­sage was passed along in the 1988 Sur­geon Gen­eral’s Re­port on Nutri­tion and Health and the 1989 Na­tional Academy of Sciences Diet and Health re­port.

Let’s start with the FDA re­port. If you read the ex­ec­u­tive sum­mary (which I ob­tained thanks to a gen­er­ous in­di­vi­d­ual on r/​scholar), a cou­ple things stand out. They con­tinu­ally em­pha­size that they were in­ter­ested in whether sugar was harm­ful at cur­rent lev­els (i.e. in 1986, more than 25 years ago), and whether sugar had a unique role in the cause of obe­sity. There’s noth­ing to sug­gest that in­creas­ing our sugar con­sump­tion (which we in fact did, along with in­creas­ing our in­take of calories in gen­eral) would be harm­less.

The 1988 Sur­geon Gen­eral’s re­port is even less im­pres­sive as an ex­am­ple of sup­posed offi­cial sanc­tion for sugar con­sump­tion. The sum­mary of recom­men­da­tions (p. 3) recom­mends that peo­ple “Re­duce con­sump­tion of fat (es­pe­cially sat­u­rated fat) and choles­terol,” but recom­mends re­plac­ing high-fat foods not with just any car­bo­hy­drates, but with whole grains, fruits, and veg­eta­bles. It also recom­mends, on the sub­ject of weight con­trol, that peo­ple “limit con­sump­tion of foods rel­a­tively high in calories, fats, and sug­ars, and to min­i­mize al­co­hol con­sump­tion.” Similarly, the 1989 Na­tional Academy of Sciences Diet and Health re­port (p. 18) ex­plic­itly recom­mends re­plac­ing fat with whole grains rather than food and drinks con­tain­ing added sug­ars.

One other ex­am­ple bears men­tion­ing. In Why We Get Fat, Taubes claims:

[Low-fat] logic may have reached the pin­na­cle of ab­sur­dity in 1995 (at least I hope it did), when the Amer­i­can Heart As­so­ci­a­tion pub­lished a pam­phlet sug­gest­ing that we can eat vir­tu­ally any­thing with im­punity—even candy and sugar—as long as it’s low in fat: “To con­trol the amount and kind of fat, sat­u­rated fatty acids and dietary choles­terol you eat,” the AHA coun­seled, “choose snacks from other food groups such as… low-fat cook­ies, low-fat crack­ers… un­salted pret­zels, hard candy, gum drops, sugar, syrup, honey, jam, jelly, mar­mal­ade (as spreads).” (p. 162)

The pam­phlet Taubes is refer­ring to can be found here. The two halves of the above “quote” (“To con­trol the amount and kind of fat, sat­u­rated fatty acids and dietary choles­terol you eat” and the sec­ond part that be­gins “chose snacks from other food groups...”) are sep­a­rated by a dozen pages of bor­ingly main­stream ad­vice which closely re­sem­bles that of the Food Guide Pyra­mid: no more than 6 ounces of lean meat per day; 5 or more serv­ings of fruits and veg­eta­bles a day; 2 or more serv­ings of dairy; and 6 or more serv­ings of bread, ce­re­als, pasta, and starchy veg­eta­bles.

The part that Taubes ridicules about low-fat cook­ies and so on comes from a sec­tion on snacks that doesn’t come with a recom­mended num­ber of daily serv­ings. I sup­pose if you read the AHA pam­phlet know­ing noth­ing else about nu­tri­tion, you could take that as a sign that the listed snacks are won­der­fully healthy and you should eat as much of them as you like. But any­one fa­mil­iar with the stan­dard nu­tri­tion ad­vice of the time would un­der­stand that the in­tended mean­ing is “if you snack, choose the low-fat op­tions”—not that you should nec­es­sar­ily be snack­ing much at all. That may or may not have been good ad­vice, but it’s not nearly so ab­surd as Taubes makes it out to be.

It’s pos­si­ble there’s room here to crit­i­cize not the un­der­ly­ing sci­ence, but the sci­ence com­mu­ni­ca­tion; not what the offi­cial re­ports and said, but how well that in­for­ma­tion was con­veyed to the gen­eral pub­lic, few of whom are likely to have read the origi­nal re­ports care­fully. If a sig­nifi­cant num­ber of peo­ple re­ally did be­lieve eat­ing less fat was all they needed to do to lose weight and that Coca-Cola is “in­trin­si­cally healthy” (as Taubes claims “we” be­lieved), we’d have an ex­am­ple of a se­ri­ous failure of sci­ence com­mu­ni­ca­tion.

Any such crit­i­cisms of sci­ence com­mu­ni­ca­tion side of things would need to be tem­pered with recog­ni­tion that sci­ence com­mu­ni­ca­tion is re­ally freak­ing hard. If you haven’t seen the amount of hand-wring­ing that’s gone on in the sci­ence and skep­ti­cism blo­go­sphere over how to do sci­ence com­mu­ni­ca­tion bet­ter, trust me: sci­en­tists have thought a lot about this stuff, and it’s not ob­vi­ous what the solu­tions are. Yet if bad sci­ence com­mu­ni­ca­tion were re­ally, say, a ma­jor con­tribut­ing fac­tor in the obe­sity epi­demic, it would un­der­line the need for sci­en­tists to do their ab­solute best in com­mu­ni­cat­ing with the gen­eral pub­lic.

But a failure of sci­ence com­mu­ni­ca­tion isn’t how Taubes frames his at­tack on main­stream nu­tri­tion au­thor­i­ties, nor is it the mes­sage most peo­ple seem to take away from read­ing his work. Taubes’ ir­re­spon­si­ble rhetoric doesn’t help the prob­lem of bad sci­ence com­mu­ni­ca­tion—it adds to it.

Next: What Causes Obe­sity?