Introduction
At some point in our lives, most of us have resolved to eat healthier. What are the first few changes you would make to your diet? Chances are that eliminating sugar sprung to mind. Although diet culture has demonized this ingredient, we must be wary of the ideas propagated by our communities. Since Dual Perspectives is all about the intersection of science and culture, let’s examine how both diet culture and scientific studies are communicating questionable conclusions.
Hence its name, diet culture is, in fact, a culture, for it influences societal behaviors and outlooks on thinness and food. All cultures, despite the capacity of most to inspire pride and creative expression, may cause shame and confinement when their belief systems are rigid and forcefully imposed. The crippling pressure diet culture creates is largely universal, so as you read, I urge you to consider how the culture manifests itself in your daily life and attaches stigma to sugar consumption.
Is Eating Sugar Good or Bad?
. . . you may ask. Let’s avoid framing questions like this; there is no such thing as “good” or “bad” foods, so we should not elevate or disparage an entire type of ingredient. No evidence suggests that you should completely eliminate sugar from your diet, and the research on the effect of added sugars on health is varied and self-contradictory. Thus, we cannot claim that increased consumption causes diseases. Attempts to draw associations–suggestions that there are other catalysts of increased risk but that sugar consumption is often present alongside them–have yielded different conclusions as attempts to draw causal links have; in fact, some studies imply no associations.
Some of you may be dissatisfied with this response. I know that when I tried to alter my diet, as I pondered which foods to eliminate, I grew tired of researching the nutritional benefits and downsides of certain foods. Rather, I wished that a manual simply listed which I should and should not eat. The truth is that nutrition is not this black and white. Not only should I have avoided completely eliminating foods, but I also should have accounted for factors besides nutrition as I weighed their pros and cons. Consider your enjoyment and focus on healing your relationship with food, for reducing disordered eating can, in turn, reduce risk of cardiovascular disease, diabetes, and other health problems.
Why Should We Be Wary of Nutrition Research?
Self-Reporting
Most nutrition research is not conducted in labs with randomized controlled trials, in which participants are randomly sorted into experimental or control groups. Such research is rigorous and difficult to run, especially when scientists must keep track of participants’ diets over a long duration. Participants are often unwilling to sacrifice such a significant amount of time, and scientists often lack sufficient money. Instead, participants are asked about their diets, and while researchers may look at their blood, other samples, and medical records, they heavily rely on these self-reports. Then, they sort individuals into groups based on the amount of added sugars, in this case, they consume. Researchers compare the likelihood of those in various groups, with various levels of consumption, contracting certain diseases, so the conclusions of these studies are associations; they do not indicate causation.
Disregarded Factors: Looking Beyond Sugar Consumption
Recent studies have shown that those in the lowest group for added, not natural, sugars have a lower risk of heart disease, an observation that appears to support cutting out the ingredient. However, other studies have not obtained the same results, and the research methods are controversial.
In assessing the accuracy of findings, we must also know the cut-off points for the groups involved. In the nutrition studies, those in the lowest group still ate some added sugars while those in the highest group consumed an egregious amount daily. The latter behavior suggests that they may be facing hardships or have a strained relationship with food due to an eating disorder or history of chronic dieting, for instance. Nevertheless, researchers typically do not ask participants about their eating history to discover potential disorders.
Individuals may also consume large amounts of added sugars because of diet culture, which sometimes encourages the opposite behaviors as what it promotes, for severe restrictive eating can be unsustainable and simply engender overconsumption. Alternatively, participants may be subject to weight stigma in the experimental setting and thus eat more sugar out of shame. These factors are all independently associated with cardiovascular health, so diseases may have little to do with added sugars themselves and more to do with underlying issues.
A Swedish Study’s Findings
In contrast to the studies described above, a 2020 Swedish study found that those who consume the least added sugars are at a higher risk of certain cardiovascular diseases and other conditions. However, as others are, this study is purely observational, so we cannot claim that too few added sugars lead to cardiovascular issues either. Yet again, disordered eating could cause this link, for it heightens susceptibility to cardiovascular diseases. This explanation is likely because researchers found that individuals with the lowest added sugar intake were more likely to share that they consumed less food overall, had drastically changed their diets in the past, and were more active, all of which point to disordered or restrictive eating.
The Link Between Sugar and Diabetes
Cardiovascular diseases have a stronger correlation than diabetes to added sugar consumption. Despite the lack of evidence, diet culture often claims that eating more sugar increases the risk of diabetes. Some studies show a link between the consumption of sugar-sweetened beverages, in particular, and the development of type 2 diabetes, but others, including the aforementioned Swedish study, have found no connection. A few investigations even suggest that a higher consumption is correlated to a lower risk.
The Swedish study did pick up on a subtle u-shaped trend that indicated that the risk of type 2 diabetes was lowest in the middle group, whose members consumed some added sugars at each meal, through snacks, and through daily dessert. The risk peaked in the lowest and highest groups, or amongst those who had likely omitted sugar from their diets and those who consumed an excessive amount due to other conditions, such as binge eating. However, this trend was not statistically significant and thus could have been coincidental. Overall, how much added sugars you consume does not clearly affect your risk of developing type 2 diabetes.
Regarding sugar-sweetened beverages, consumption is higher amongst certain demographics, such as Black people, Mexican American adults, and lower-income individuals. These marginalized groups also experience a higher risk of diabetes but due to other aspects of their lifestyles, such as stress, low-quality healthcare, lack of social support, employment and housing insecurity, racism, heightened exposure to air pollution, etc. Without controlling these variables, we cannot draw definitive conclusions.
What About Those Who Already Have Type 2 Diabetes?
Is cutting out sugar justified in this case? Despite the common belief that sugar is harmful to those who already have type 2 diabetes, evidence suggests that the opposite is true. Eliminating or severely limiting sugar intake is unnecessary and could encourage restrictive eating followed by binges. These cycles may put an individual’s health at greater risk than a balanced approach to sugar consumption would.
A recent study demonstrated that the blood glucose of those with type 2 diabetes responds to perceived sugar intake more than actual sugar intake. When participants received a beverage labeled as high in sugar, their blood glucose levels rose more than when they were given one labeled as low in sugar although the beverages were the same. These results were especially evident in those who relied on external rather than internal cues when making eating choices, a group that includes dieters. The labels had no effect once the researchers conducted the experiment on intuitive eaters. Thus, relying on external cues by fixating on nutrition labels, for instance, (although you should remain educated on your food intake) may complicate type 2 diabetes by creating expectations that could affect your blood sugar. Other research shows that intuitive eating is associated with better management of type 2 diabetes regardless of individuals’ weight.
Conclusion
Wow. Science is complicated. I understand the confusion and frustration that may result from sifting through contradictory scientific findings. Although accepted scientific and cultural beliefs are reliable to an extent, you must consider what your own body tells you, especially as you ponder how to nourish it. Thus, if you are thinking about revising your diet, moderation is essential to improving your health. Avoid extreme, rash decisions that will not only undermine your physical health but also emotional well-being. Diet culture takes shape all around us. The media has perpetuated rebukes of sugar. Your community members may comment on your food choices. Just remember that you should largely look inward as opposed to outward to determine your bodily needs.
Sources
1. https://christyharrison.com/foodpsych/9/sugar-and-your-health
2. Feature image: https://medium.com/illumination/diet-is-a-dangerous-word-b3a76b54e325
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