The American Heart Association has apparently issued new guidelines on sugar, urging everyone to cut their intake to 9 teaspoons a day, or a little more than one 12-ounce coke.
I'm not sure what to make of this. Pretty clearly, almost no one is going to cut their sugar intake that far, except people who already have cut their sugar intake. I suspect that the American Heart Association is hoping for some sort of anchoring effect: people hearing they should cut their sugar intake to 9 teaspo0ns will maybe bring it down to 18 or 27.
But I think that anchoring only works when people actually have to participate. When people have the option of ignoring you, making your goal too extreme may actually decrease its effectiveness.
You can think of it in terms of the real estate market. Sellers often insist on listing their house at an inflated price, on the off chance that someone will bite, and to enhance their bargaining position. But often it just means that buyers don't bother to look. Buyers can make the same mistake, lowballing their offer only to have the sellers conclude that they are not serious and refuse to negotiate.
So I suspect that where moderate guidelines might have done something, this will simply be ignored. Along with their recommendations on sodium intake and most other forms of dangerous deliciousness.
Copyright © 2009 by The Atlantic Monthly Group. All rights reserved.
Why is it unreasonable for the AHA to recommend an amount that's actually consistent with health? Advising too high a level for the sake of "moderation" misleads people who want to know what's actually healthy. Though I do wish the AHA and others carrying the story would put more emphasis on sugar-light alternatives to soda, candy and the like; that's more likely to lead people to make a change.
From the article:
I'd also note that the AHA's decision to state the recommended amount in calories -- instead of grams, which is the unit of measure available to people on the nutritional information -- seems designed to minimize impact.
Yes, but my comment was with regard to health, not obesity -- I don't wholly buy into Megan's dismissal of the connection between the two, but I do recognize they are distinct. And I don't think the calories/grams unit is terribly relevant, though both are preferable to "teaspoons", as they have the virtue of appearing on most food packaging.
Actually, the sugar recommendation is even worse than Megan says. The placebo effect doesn't just work one way. If you give somebody a sugar pill and tell them it's poisonous - then they'll feel sick and might even die sooner.
Right now, the AHA is telling everybody that eating sugar will kill them. Nobody is actually going to listen to the AHA and cut back on their sugar. But some people might listen enough to get a negative placebo effect. Getting yelled at by doctors all the time can actually be bad for your health.
Actually, it's my understanding that the placebo effect is largely confined to subjective symptoms like pain, depression, and stress. The effect on objective symptoms is minimal to nonexistent. Also, the technical term for the opposite of placebo is nocebo.
I've cut back on my sugar intake (though this was long before the AHA told me to), and would definitely recommend it to others, not just because it might potentially add a few months or years to my life, but because it's made me healthier now.
For the AHA to release information they know is INCORRECT just to improve the public acceptance of the information would be the corruption of science for political ends.
I didn't think people actually supported this. It seems I was wrong.
That's not so...placebo effects are relevant to all kinds of symptoms.
See for example:
http://www.scientificamerican.com/article.cfm?id=placebo-effect-a-cure-in-the-mind
Their recomedations are irrelevent. As long as ag subsidies are making cornsyrup artificaily cheap people will continue to over indulge.
But sugar is artificially expensive because of import tariffs and other protections, and we still use quite a bit of that. I'm all forgetting rid of the subsidies, but I expect it would have minimal impact on sugar consumption (especially if the sugar tariffs were lifted at the same time).
that should be "for getting" Darn non-sensitive spacebar.
May I offer an incoherent rant?
Alternatives to soda are rather hard to come up with in daily life. This problem seems to be uniquely American, too. As someone who quit drinking soda (cold turkey) awhile ago, I'm only too aware of it. To wit: you have a lunch at a fast food joint, or a roadside diner, or a cafe of your choice. Really, anyplace without an actual waiter serving you. What are your beverage options:
- Array of sodas, loaded with corn syrup.
- Another array of sodas, loaded with [unpalatable] sugar substitutes.
- Tap water, complete with local smells.
- Bottled water, if you're lucky. Then again, no guarantee the brand they stock in their fridge is actually an improvement on the item above.
- Maybe -- in certain kinds of eateries, such as BBQ or better hamburger joints -- Bud Light and Miller Light in bottles of indeterminate age. If you're having lunch with coworkers, they'll be sure to note (if not comment on) such an indulgence...
And now let me ask, W.T.F.??? For the price of soda, I'm sure anyone can make money serving decently filtered water. Beer (I don't mean *** Light either) is a staple table beverage in most Western countries, or so I was led to believe. So is red wine. Fruit juices are more expensive than sodas, true, but with current packaging technology surely even MickeyD's can afford to store some variety and sell it at a bit of a premium?
I know, supply and demand. What I don't understand is the lack of demand. After all, Americans are certainly in position to afford better variety.
PS. I have excluded the full service restaurants from my example, but they are not uniformly better in that respect, either. The establishments providing decent (and reasonably priced) house red and/or palatable draft beers tend to get noticed and remembered by yours truly... Otherwise it's that tap water again :(
Oh, how could I forget the muddy substance that is listed -- whether in arrogance or ignorance -- under the name of "coffee"? But I'm sure I've proffered THAT rant a few times already...
Well, there's usually tea, hot or iced or both. If it's from a soda dispenser it's still usually sweeter than I like, but it's often the most palatable choice.
and re blighter below, while I'm no doctor, I've read several who think sugar is the number-one "food" item to avoid, for health. While I'm not fanatical I find it easy to minimize my sugar intake; after a dew months not drinking soda or eating candy, I found the default sweetness of "sweet" items, at least in the US, to be cloying and pretty nasty.
Along the lines of what Megan wrote yesterday, if people will only replace a desirable thing with one that's more desirable, then something that has become less desirable is more easily replaced. When the sweet stuff tastes icky, you don't eat much sweet stuff. (I'm still a sucker for chocolate, and for fruit pies, though.)
Shelby: my thinking runs along the same lines. Except, with rare exceptions, the "tea" turns out to be even less palatable for me than "coffee". Damn the prohibitionist mindset that insist on lumping beer and wine into one category with booze!
I've yet to find a casual eating place that serves ice tea without heaps of added sugar.
However, when in San Diego recently I encountered "vitamin water" that was sugar free, and pleasantly dry in favour. When I went home to Sydney I ordered exactly the same brand, only to find that here it was heavily sugared and too sweet.
Almost every such fast food place that I've been in has a lemonade or fruit punch dispenser (not real fruit juice) in the row of drink dispensers, and that almost always has a little button so that you can get tap water. Also, almost all of these places have milk and orange juice available, though especially both for breakfast and as substitutes in kids' meals for parents who worry.
I'm sorry, it's hard for me to take you that seriously with your strident complaints about the tap water served at restaurants. I really should try, though.
One thing that's very common to American restaurants and rare elsewhere is the free refill.
I'm sorry, it's hard for me to take you that seriously with your strident complaints about the tap water served at restaurants.
You've got to be kidding me. Seriously. The way to escape is to ask for a bottle of water and a glass of ice -- and then you're subject to the brand issue. Ask for "water", and, in most cases, you get a glass full of ice and tap water and a [most welcome, of course] slice of lemon.
Milk is OK for those who drink it. "Orange juice" you mentioned fully deserves the scare quotes. I've already exhausted my rant quota on the topic of fruit juice availability though. The lemonade and fruit punch -- as served around here -- are just varieties of soda.
And while we are on the topic of water and seriousness: do you, personally, use tap water for your tea (or coffee)?
One thing that's very common to American restaurants and rare elsewhere is the free refill.
Which extends to the aforementioned sodas and tap water.
Let me ask again: is the near-universal exclusion of beer and red wine from the list of everyday table beverages reasonable?
Actually, that's not tap water. Beverage machines mix the drink at the tap, and as such, they source their water through a filter. Impurities or chlorination in the local water might alter the taste of the soda and even make it quite offensive, while the brand image is highly dependent upon consistent flavor. (The icemaker usually sources through the same filter for the same reason.)
Locally owned or out-of-the-way restaurants may use water directly from the tap for water service, or they may let the filter go too long, but any major chain restaurant will have well-maintained filtration for the entire beverage service. No special requirements are involved as they can get the replacement filters delivered along with their regular stock of syrups and CO2 from the soft drink distributor.
As a diabetic I've been dealing with that problem for years... and fruit juice isn't an option. If they offered a greater variety of diet sodas I'd take them, but most restaurants offer only a diet cola beverage with caffeine... so if you don't want caffeine you're stuck with water, coffee/tea (if they have decaf), or something alcoholic.
Exactly.
If "sugar" is an evil -- as it is for diabetics--then so are all fruit juices (even without added sugar).
Uh, yes. They are. Consumption of fruit juices contains just as much sugar and empty calories as non-diet soda. Now, it's not like smoking, so if you're non-diabetic and have ideal body weight there's no reason to avoid them, but fruit juices in excess are emphatically *not* health food.
I'd note that many of the mass distributed "fruit juices" contain just as much sugar as soda.
Willingness to drink tap water varies by location -- I live in the SF Bay Area and the tap water is just as good as anything bottled. Given decent tap water, you can train yourself to drink water instead of soda or anything else. It takes about a month of effort, after which time you'll find yourself no longer craving whatever it is you drank before. Staying hydrated throughout the day helps ease your craving for less healthy fluids. While I quit drinking soda not because of health but because I'm appalled by how much it costs, the principle works the same.
Now I only drink soda when it's mixed with alcohol. Other than a single cup of coffee in the morning and the occasional glass of milk when the mood suits me, I exclusively drink water.
The reason, I suspect, is that people have a powerful (and arguably irrational) aversion to paying for water. Water falls from the sky, so it ought to be free, even if served in a gold-plated, diamond-encrusted disposable cup at a restaurant built entirely out of unicorn ivory in the middle of the Sahara desert.
It occurs to me that the meaning of that last sentence might not be entirely clear. As unicorn ivory is a very thinly traded commodity, it may be difficult to find up-to-date price information. Trust me: It's expensive.
I'd be all for paying for water too, if it was served as you describe. But let's be clear here, it not really the water I'm paying for, its the container and the presentation. That's why I think bottled water is a rip-off - you're better off buying one (durable) container and refilling it versus having many containers that get thrown away on a semi-regular basis.
Juice is full of sugar too, even if it's all natural, and most has the stuff added. That juice is good for you is one of the top 20 health myths.
For what it's worth, heating water can remove some of the bad taste, since it forces dissolved gasses (hydrogen sulfide, for instance) to leave.
So a very low sugar diet is now to be aimed for? In addition to low sodium, low fat, etc., etc.?
It's a wonder that there are any humans left alive on the planet to recieve this dietary wisdom from these enlightened experts, what with the way people have been blithely feeding themselves whatever the heck they want all these many years.
Unlike a low-fat or low-sodium diet, cutting out sugar actually WOULD make a difference in most people's health. Fat is not bad in and of itself, but the glycemic response to sugar can be deadly in the long term.
Of course, after 30 years of "advice" from the AHA, I don't take anything they say seriously. Their recommendations to replace the saturated fats that humans have eaten for millenia with commercial vegetable oils and trans-fat laden lard substitutes - not to mention their advice to replace fat with carbs - has caused more damage to American health than any other thing I can think of.
Well, in their defense, the scientific information on appropriate diets has changed over the years, and guidelines are always going to lag the science by years (even without invoking conspiracy theories about corn syrup manufacturing lobbies). However, here's a reasonable synopsis of current recommendations:
-- limiting dietary sodium (as well as increasing dietary calcijm and magnesium) is useful in the treatment of hypertension and essential in the treatment of heart failure. If you have neither of those conditions, don't bother worrying about it.
-- limiting saturated fats is helpful in the treatment and prevention of all forms of atherosclerosis. That said, it's *not* helpful to replace saturated fats with trans-fats (like many margarines and processed foods) or with carbohydrates, complex or otherwise. A good case can be made that dietary recommendations to decrease fat intake and the associated explosion of "fat-free" foods is responsible for much of the ongoing epidemic of obesity and diabetes. Better to replace saturated fats with monounstaurated fats like olive oil, etc.
-- limiting all forms of carbohydrate intake, especially but not exclusively simple sugars, is crucial in the treatment and prevention of both obesity and diabetes.
A healthy diet consists of a wide variety of foods including meats (particularly lean meats), fish, plenty of fruits and vegetables, and far fewer carbohydrate and grain products than Americans are used to.
Fat is not bad in and of itself, but the glycemic response to sugar can be deadly in the long term.
Actually, recent research has found that the most harmful kind of sugar is fructose, which has a very low glycemic index. It appears that the harm done by sugar may in fact not be due to the short-term spikes in blood sugar it produces.
How sweet it is...Jackie Gleason
Wonder if he took sugar in his tea ? :)
Given his background and lifestyle,
one would guess yes:
Dum vivamus, Vivamus !
Everybody take speed and be done w/it.
Seems to me the takeaway is that a coke has nine teaspoons of sugar in it. That's just disgusting!
Would anybody just sit down and have a glass of water, a squeeze of artificial lemon, and start shoveling the sugar? Thought not. Whew!
That's how I make lemonade at least when life has given me artificial lemons.
I've actually made lemonade this way at restaurants that are generous with their lemon slices on glasses of water and have sugar on the table. And yeah, it's pretty much just water + lemon + sugar, preferably with a lot of #3.
And didn't your mother ever yell at you about the empty calories in pop? It's not exactly hidden.
It will cut down on health care costs to cut down on white sugar, a slow poison.
Oh, B.S.
The differences b/w white sugar, brown sugar, honey, and every other sweetener (including those in grapes, apples, etc.) are minimal in the long run.
The caloric equivalent of soda pop or juice have roughly the same long term effects.
These pronouncements border on faith-based initiatives. No salt, no fat, no sugar, eat organic, etc. Superstitious nonsense.
What about aquave as a healthy alternative to white/brown sugar?
After you've wheened yourself of the extra sweet taste of sugar, aquave, a natural sweetner, is a palatable -- and heathly choice.
caveat: Aquave is substantially more expensive than sugar.
Not sure what "aquave" is, but I believe maybe you are referring to agave, a.k.a. virgin tequila.
Here's a better idea: Watch for, and limit, your net intake of sugar, period. Instead of fighting over the specks in the diet, look for the beam, and remove that instead. What is the real difference between a carefully limited intake of sugar, and an equivalent amount of sweetener in corn syrup, honey, agave, or something else? For a healthy human eating a balanced diet, I would reckon somewhere between unmeasurable and zero.
IMO the problem is not the type of sugar and never has been. Rather, it is the vast quantity of simple sugar that a person can consume in a given day in the modern foods market, which is largely unprecedented in history outside of royalty and some narrow regions of the tropics.
@ aMouseforallSeasons,
Yes, I am referring to "agave." Please pardon the misspelling; it happens when you are typing on the fly at work.
Thanks for the idea, but I'll stick with agave over sugar. It has contributed to my weight-loss and my kicking of the sugar habit.
WTF = "natural"?
Sugar cane, sugar beets, corn, bees makin' honey -- they're all natural.
Superstitions are ruling your diet, Storm.
(BTW, salt is a naturally occuring rock -- so don't be all superstitious about that, too).
Agave syrup may be worse than white sugar. As I said upthread, fructose (the primary component of agave syrup) has a low glycemic index, but recent research suggests that it actually does far more to contribute to metabolic syndrome than glucose does. See, for example, this study, which found that consuming 25% of calories from fructose-sweetened beverages significantly impaired insulin sensitivity over 10 weeks, while consuming 25% of calories from glucose-sweetened beverages did not.
You may be better off switching to a glucose-based sweetener. Though the caveat there is that glucose isn't nearly as sweet as fructose, so you need more to achieve the same effect. So it's probably better just to cut back altogether.
Storm - If agave nectar has helped you reduce your overall sugar intake, then what is the argument? There's surely nothing wrong with using reasonable substitutes to to reduce or remove one's desire to overconsume something.
Point being, a person can go all day long trying to figure out which type of sugar is going to kill 'em first and then trying to remove that particular one from their diet, only to have each new pearl of wisdom overturned time and again with each new study...OR a person can stop staring at trees and see the forest, which is, too much simple sugar! -- and then cut back on net sugar consumption.
Club soda, with or without a squeeze of lemon? You can get it most places, it's sugar free, and it's not local water.
But mostly I drink coffee anyplace I'm out for a non-serious meal.
I have yet to taste any variety of tap water half as disgusting as club soda.
You're lucky. Maybe it's gotten better since, but in the early 1990s the water in Fredericksburg, Virginia was undrinkable, even coffee made from it was barely drinkable.
Of course, noramlly water isn't anywhere near that bad. The water in D.C.'s Maryland suburbs from WSSC is decent, and the water out here in Cumberland, MD is excellent.
Maybe you have a strong aversion to acidic tastes, which club soda will have (carbonic acid) but most tap water, regardless of whatever else is in it, will not?
Larry - Without government interference in food markets, we'd just be eating cheap cane sugar instead of cheap corn sugar. People like sweets, a lot, and they eat them because they like them, not because they're Just So Inexpensive.
On the main post, this is just further work by the AHA to dilute their impact and the meaning of any of their announcements. Telling us we all need to be thinner to save our hearts is hardly news - though I suspect they're not keeping up with the science as to the ill effects of moderate overweight, or the problems with "just eat less sugar" as a weight-loss regimen (or the problems of any such regimen having a serious effect on most people).
Just as they're actually pushing a scientifically unsupportable position on salt intake... increasingly anything they say should be taken with, well, a grain of salt. Or a small salt mine. (That said, people who already are hypertensive can demonstrably benefit from a low-salt diet. But that's nothing like most people, is it?)
A few points:
1. The supposed 'obesity paradox' that you're referring to, in which there does not appear to be a health penalty of being moderately overweight, is *probably* mostly an artifact. The data do indeed get a little slippery, but most analyses that appropriately control for chronic diseases (which produce low weight but are obviously not a healthy state), smoking (which is disproportionately present in lower-weight populations), and populations in which BMI is a poor measure of obesity (as, for example, highly muscular men) show that contrary to the above assertion, it is indeed healthier to maintain a lower body weight than the 'moderately overweight' cohort. Now, most but not all of the increase in risk is mediated by associated diseases like hypertension, glucose intolerance, and hyperlipidemia, so the case *can* be made that the person who has none of those things doesn't really need to lose weight for cardiovascular reasons. They still have higher rates of things like osteoarthritis, gout, sleep apnea, etc., though.
2. The prevalence of hypertension in American adults is about 30%. No, that's not 'most people,' but it's not a small amount either.
3. I actually disagree with you about the usefulness of 'eat less sugar' as a recommendation. If I'm given only ten seconds to impart useful dietary recommendations, "eat less sugar, flour, and processed foods and more fruits and vegetables" ain't half bad. Yes, one can be a whole lot more sophisticated than that, but as an overall recommendation it's about as useful as you can gets in twelve words or less.
But not all hypertension responds to lowering salt intake, but I don't remember what the fraction is.
People *like* sweets a lot, but they *eat* sweets a lot because they can afford them. Our Victorian-era ancestors liked sweets just as much as we do, but they couldn't afford nearly so many, and so ate fewer.
But I doubt the political will exists (or should exist) to make sweets (cane or HFCS) as expensive as they were in Victorian times.
Regarding diabetes, for Type II diabetics with *some* control over their diabetes, starch is just about as bad as sugar.
so what would you recommend? I agree that this is not ideal, but the fault does not lie with the AHA which is making a science-based recommendation, but with a food culture that is so far adrift from healthy. Wouldn't it be some sort of scientific or ethical malpractice to recommend a level that is not correct, just because it is a compromise between our crappy levels of sugar consumption and the ideal. Should they continually up the level of recommended sugar consumption up just b/c we start eating increasing amounts?
I really don't understand why you have a problem with this.
Megan has used a volume measurement, while the WSJ article measures it in calories: women should get 100 calories or less from sugar, while men should get no more than 150 calories.
Perhaps it's a good idea, but that's just a little silly. The very modest 1 cup of ice cream I have a night has ~140 calories from sugar.
How about just consume as little sugar as possible? I don't consume soft-drinks, I don't buy sugar-cereals, I don't add sugar to my coffee, I don't eat cakes, donuts or other baked goodies with sugar. I do add a bit of clover honey to my oatmeal, but at least that's a better form then just spooning in the refined white stuff. I've read that the average American consumption of sugar is 170lb/year. That's just horrific. I'm pretty sure my own annual consumption(with fruits) isn't more then 20-30lbs. No wonder America is gripped by an obesity & near-obesity crisis.
If that were distributed evenly among all Americans and three meals a day, that would be less than a half cup a day, or about 2.5 tablespoons per meal -- a bit much, perhaps, but hardly "horrific", especially considering the ten million ways that sugar can be divied up into different processed foods as well as many baked goods.
As with most averaged statistics, the real problem is that a responsible eater like you is being counterbalanced somewhere by someone who assembles their breakfast cereal from Pepsi and doughnut holes.
Oh and I stopped eating ice cream altogether about 2 years ago. I just can't stand the sickly sweet taste of it. Yuk.
The problem is that sugar consumption has nothing directly to do with heart disease. Nor does salt.
Yet if you do any study of the American Heart Association website you'll find a lot of nannying about salt, sugar etcetera. Sugar affects obesity and salt affects your blood pressure, both of which are bad for your heart, true, but if like me you have heart disease and are not obese and do not have high blood pressure then the AHA website is unreliable and/or difficult to use for what you'd think was it's main purpose.
You'd think a heart patient could go to the American Heart Association and get information that is spot-on regarding heart disease but you'd be wrong if you thought that.