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The obesity epidemic may just be the tip of the iceberg in terms of excess body fat. It’s been estimated that 91 percent of adults—9 out of 10 of us—and 69 percent of children in the United States are quote-unquote “overfat,” “defined as excess body fat sufficient to impair health” that can occur even in “normal-weight” individuals, often due to excess abdominal fat. The way to tell if you’re “overfat” is if your waist circumference is more than half your height. What’s causing this epidemic? One primary cause may be all the added sugars we’re eating.

A century ago, sugar was heralded as “one of the cheapest [forms of calories] in the dietary.” Just ten cents’ worth of sugar could furnish thousands of calories. “Harvard’s sugar-pushing nutritionist” bristled at the term “empty calories.” The calories in sugar were “not empty but full of energy.” In other words, full of calories, which we now are getting too many of. “The excess body weight of the US population corresponds to [about a] 350–500 [calorie] excess [daily caloric] intake on average.” So, to revert the obesity epidemic, that’s how many calories we have to reduce. Okay, so which calories should we cut? That’s just how many calories the majority of Americans who fail to meet the Dietary Guidelines’ sugar limit get in added sugars every day. 25 teaspoons is about 400 calories.

Even the most diehard sugar defenders, like James Rippe, who was reportedly paid $40,000 a month by the high-fructose corn syrup industry, on top of the $10 million they paid for his research. Even Dr. Rippe considers it indisputable that sugars contribute to obesity. “It is also [indisputable] that sugar reduction should be part of any weight loss program.” And, of all sources of calories to limit, since sugar is just empty calories, contains no essential nutrients, reducing sugar consumption is obviously the place to start. And again, this is what the researchers funded by the likes of Dr. Pepper and Coca-Cola are saying. The primary author, Richard Kahn, is infamous for his defense of the American Beverage Association—the soda industry. He was chief science officer at the American Diabetes Association when they signed a million-dollar sponsorship deal with the world’s largest candy company. “Maybe the American Diabetes Association should rename itself the American Junk Food Association.” What do you expect from an organization that was started with drug industry funding?

The bottom line is that “randomized, controlled trials show that increasing sugars intake increases calorie intake,” and this leads to “body weight gain in adults, and…sugar reduction leads to body weight loss in children.” For example, when researchers randomize individuals to either increase their intake of table sugar or decrease their intake, the added sugar group gained about three and a half pounds over 10 weeks, whereas the reduced sugar group lost about two and a half pounds. A systematic review and meta-analysis of all such “ad libitum diet” studies (meaning real-life studies where sugar levels were changed but people could otherwise eat whatever they wanted) showed that reduced intake of dietary sugars resulted in a decrease in body weight, whereas increased sugars intake resulted in a comparable increase in weight. The researchers conclude that “considering the rapid weight gain that occurs after an increased intake of sugars, it seems reasonable to [advise people to cut down.]”

Findings from observational studies have been more ambiguous, though, with an association found between obesity and sweetened beverage intake, but failing to show consistent correlations with sugary foods. Most such studies rely on self-reported data, however, and obese people tend to under-report sugar-rich foods. One can measure trace sucrose levels in the urine, however, to not only get an objective measure of actual sugar intake, but to exclude contributions from other sweeteners, such as high-fructose corn syrup. When researchers have done this, they discovered that sugar intake is indeed not only associated with greater odds of obesity and greater waist circumference on a snapshot-in-time cross-sectional basis, but in a prospective cohort study over time. “Using urinary sucrose as the measure of sucrose intake,” those in the highest versus the lowest fifth for sucrose intake had more than a 50 percent greater risk of being overweight or obese.

“Denying evidence that sugars are harmful to health has [evidently] always been at the heart of the sugar industry’s defense.” But when the evidence is undeniable, like the link between sugar and cavities, they switch from denial to deflection, like trying to switch attention from restricting intake to coming up with some kind of “vaccine against tooth decay.” We seem to have reached a similar point with obesity, with the likes of the Sugar Bureau switching from denial to deflection by commissioning research suggesting obese individuals would not benefit from losing weight, a stance contradicted by hundreds of studies across four continents involving more than ten million participants.

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