Are Natural Sweeteners Healthier Than Sugar Title

Are “Natural” Sweeteners Healthier than Sugar?

The health impact of consuming too much sugar is big news, and many people are looking for alternatives. What about so-called “natural” sweeteners? Food marketers want you to think they are healthier, and labels boasting terms like “naturally sweetened” or “honey-sweetened” are a common fixture.

This line of thinking has made its way into cookbooks, recipe blogs, and many home kitchens. One of my cake recipes wasn’t “healthy,” a reader commented, because it used sugar instead of a more “natural” sweetener like honey.

Are these “naturally” sweetened options really better for you than foods sweetened with sugar?

Honey Sweetener2What Are “Natural” Sweeteners?

When it comes to foods, the term “natural” is ill defined.  When people use the term “natural” sweeteners, they typically mean sweeteners that aren’t refined granulated sugar (pure sucrose from sugar cane) or high fructose corn syrup.

Popular “natural” sweeteners include agave nectar, brown rice syrup, coconut sugar, date sugar, honey, maple syrup; molasses, organic cane sugar, sucanat, turbanido sugar (raw sugar).

The Claims

Some of the claims attributed to natural sweeteners include that
“natural” sweeteners are . . .

  • less processed
  • full of minerals, vitamins, and antioxidants
  • lower on the glycemic index scale (may not raise blood sugar as much as other sweeteners)
  • lower in fructose/glucose
  • much healthier for you than sugar

The Evidence

Less processed

A popular argument for “natural” sweeteners is that they are less processed than sugar.

sugarsFor example, some people consider Turbinado (raw) sugar and Organic Cane Sugar healthier and less processed than sugar.  Similar to refined sugar, turbinado sugar is refined cane juice, but a little darker with hints of molasses since it contains more impurities. Organic cane sugar is from organically grown sugar cane.  Both of these sugars are highly refined and very similar to table sugar in terms of nutrition and how your body metabolizes them, so you’re out of luck if you’re choosing these sugars for superior nutrition.  However, choose turbinado sugar if you like its depth of flavor, or organic cane sugar if you value that it is free of pesticide residues and potentially better for the environment (soil, health of workers exposed to pesticides).

Agave syrup is another popular “natural” sweetener that some consider less processed. Initially, natural health enthusiasts recommended agave nectar because it was “natural,” and low on the glycemic index scale.  Also, because agave is sweeter than sugar, the thinking was that people would use less of it. The high fructose content responsible for the lower glycemic index of agave might be a concern. Most fad health gurus who recommended agave enthusiastically (e.g., Dr Oz or Dr. Weil) changed their tune when they found out that agave has a very high fructose content compared to other sweeteners (much higher than high fructose corn syrup,  the much vilified sweetener in soft drinks).

Although agave syrup is from the agave plant, it is actually highly processed to deliver a refined and clear syrup, so it’s hard to argue that it is less processed.  Sugar is processed out of “natural” sugar cane, but no one calls sugar natural.  In both cases, the processing removes fiber and concentrates sugars.  Use agave nectar in small quantities if you like the taste of it, or if it truly benefits your recipe, but don’t fool yourself into thinking it’s healthier than other sweeteners.

READ  Is agave nectar a healthy sweetener?

What About the Minerals in Many Natural Sweeteners?

Some “natural” sweeteners are less processed than sugar and do retain some minerals and other substances. Does this make them a better choice than refined sugar?  Here are a some sweeteners touted for their mineral content that you may be wondering about . . .

Honey

Honey IsolatedHoney is another sweetener many choose over sugar for health reasons, and claimed benefits range from preventing cancer and heart disease to regulating blood sugar. Honey does contain trace amounts of minerals and antioxidants. Darker honey has a stronger flavour and contains more antioxidants, but the amount is negligible compared to other foods like fruits and vegetables that offer many health benefits.  As one of the oldest sweeteners on earth, and the product of honeybees foraging nectar from flowers, honey is truly amazing and offers wonderful flavors.  But despite terrific tastes that vary with the seasons and flowers, and diverse culinary uses, your body treats honey pretty much like refined sugar, and you shouldn’t consume honey for health reasons.

Coconut Sugar

Coconut sugar is promoted as a good source of magnesium . . . but has only 1 mg of magnesium per teaspoon. Compare that to ½ cup of cooked spinach (80 mg magnesium); ½ cup black beans (60 mg magnesium), or one medium banana (30 mg magnesium).  So, you shouldn’t be eating coconut sugar for the magnesium. . . If coconut sugar makes your recipe taste great, go for it. But keep in mind that coconut sugar has the same calorie and carbohydrate content as regular sugar and is mostly sucrose.

Maple Syrup

Maple Syrup In Snow CroppedMaple syrup, a product of the boiled sap of maple trees, is my all-time favourite sweetener (owing to being Canadian, or maybe the fact that my grandmother used to drink it out of a shot glass during maple syrup season . . . ). Maple syrup contains small amounts antioxidants and minerals (calcium, potassium, and iron), and a moderate amount of potassium and zinc. It is a good source of manganese, but, you would be better off getting your manganese from nuts and seeds, leafy greens, unrefined whole grains, or legumes.

Researchers at the University of Rhode Island have isolated potentially beneficial compounds in maple syrup, and the media picked up with “superfood” type headlines. And a recent laboratory study found that a concentrated extract of maple syrup positively influenced a protein common in the brains of people with Alzheimer’s: though intriguing, these preliminary findings involve isolated compounds that don’t necessarily translate to human consumption and health, and shouldn’t be interpreted as health advice to consume more maple syrup! You can read more about Sweet Hype for Maple Syrup by McGill’s Joe Schwartz here.

Brown Rice Syrup

Brown rice syrup sounds healthy and is a popular ingredient on “health guru” food blogs that lack scientific evidence. You’ll see it in many commercial granola, cereal, and fruit-and-nut type bars. Many well-intentioned vegan food bloggers use brown rice syrup as a “glue” to bind ingredients in unbaked cookies and bars: I liked the dried fruit and nut combinations, but rice syrup makes the bars too sticky and crumbly to be practical. Using eggs to bind ingredients and baking bars/cookies offers much better nutrition than adding more brown rice syrup to help ingredients bind! And similar to all sweeteners, your body breaks down brown rice syrup and treats it like other sweeteners, whether it is organic or not, part of a “healthy” cookie, or poured on pancakes.

Molasses

molassesMolasses is the dark liquid that remains after sugar is extracted from sugar cane. It comes in several varieties depending on the level of processing. Blackstrap molasses is the least refined and a notable exception for getting nutrition beyond calories from sweeteners, because it has a high enough iron content (7 mg in 2 tbsp.) to be considered beneficial. But because of its bitter flavor people don’t typically substitute it for sugar. Light molasses is more palatable, but it does not contain as much iron as blackstrap molasses or other minerals (1.8 mg of iron in 2 tbsp.).

Even though many “natural” sweeteners provide more minerals than white sugar, it does not make them “healthy.” And even if these sweeteners contained significant amounts of minerals, you’re better off getting these minerals from foods that don’t provide empty calories and influence your hormones or metabolism.

Glycemic Index

The glycemic index is a way of measuring the effect of a food on blood sugar. Although some “natural” sweeteners may have a lower glycemic index than others, many question the influence of this measure on health.  This study suggests that a low glycemic index diet didn’t improve insulin sensitivity, cholesterol, or other heart disease risk factors for people who are already following a healthful diet. Another recent study calls into question the reliability of this measure. In general, judging whether a food is nutritious or not based on one measure, like the glycemic index, is not a good idea!

Is Fructose poison?

Beyond taste and texture, sweeteners do vary in the number of calories, sweetness, chemical composition, and how your body breaks them down. Much of the confusion and championing of certain sweeteners comes from exaggerating the influence of how your body breaks down sugars on health. For example, some call fructose poison and blame it for the obesity epidemic, but the evidence doesn’t support this sweeping statement.  Your body metabolizes fructose differently than other sugars, and studies suggest that high intakes could raise triglycerides, predisposing individuals to fatty liver disease, insulin resistance, and heart disease.  But researchers conducted these studies mostly in animals, and looked at very high doses of 100% fructose: this is not how fructose is consumed in a typical diet. Most sweeteners are a combination of glucose and fructose. More recent studies in humans show no evidence that fructose influences metabolic syndrome or cardiovascular disease risk factors compared to glucose.   Blaming fructose for health problems overshadows more important factors like body weight, overall calorie intake, and inactivity. Choosing a sweetener based on fructose content isn’t the best strategy for health.

Health Halo Donut SmallBeware the health halo . . . sugar is sugar!

Considering “natural sugars” as healthy can have a health halo effect, meaning that if you think something is good for you, you feel better about eating it, and may end up consuming more of it. Researchers have documented the health halo effect in several studies, like this one.

In fact, simply adding the word “fruit” to the word sugar makes people think it is healthier. In this recent study published in the journal Appetite, consumers looking at cereal ingredients perceived the cereal with “fruit sugar” as healthier than the cereal with “sugar,” although the nutrient profiles of both cereals were the same.  Fruit juice concentrate is a common sweetener in many foods, but it is no healthier than sugar, and organic fruit juice gummy bears with no artificial flavours are not better for you than jujubes.

Bottom Line

Despite marketing claims and labels that suggest otherwise, “natural” sweeteners are not better for you than refined sugar. Most people would be better off consuming less sugar from all sources, “natural” and refined.

Use “natural” sweeteners because you like their flavour or they work well in your cooking/baking.  But they are not better for you  nor will they improve your health.  Treat them as you would sugar and consume judiciously.

Sugar has made its way into many foods, and even commonly consumed foods and beverages contain surprisingly high amounts of sugar. For example, 1 cup of flavoured yogurt contains about 11 teaspoons (42 g) of sugar. It’s not just “added” sugars that is an issue:  most fruit juice contains almost as much sugar as the same amount of soft drink (1.5 cups = 8-10 teaspoons of sugar; and 15 teaspoons for grape juice). Yes, the sugar is from fruit, but your body will metabolize it in a similar way.

Mediterranean Diet FoodsSugar is not toxic

This post is not intended to vilify sugar, but to clarify the confusion around the term “natural” sweeteners. Plenty of misinformation demonizes sugar. Excess sugar intake is not healthy, but sugars are not toxic, sugars do not feed cancer,  and sugars are not the cause of the obesity epidemic or other chronic diseases.

You do not need to “quit sugar.” Trying to eat “sugar free” or obsessing too much about specific foods or food components isn’t necessary for health. In fact, it is a strategy that could backfire.  You are better off focusing on a dietary pattern that helps you maintain a healthy weight and includes plenty of whole, minimally processed foods. Also, being physical active is important as it influences how your body deals with sugar, in addition to other countless health benefits of physical activity.

You’ll find more “Healthy or Hype?” articles and resources here.

Healthy Or Hype General

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Chocolate Pecan Tart Website

Chocolate Pecan Tart

I love pecans and chocolate. They are wonderful on their own, and pair together beautifully. In this light dessert they add intense and decadent flavours without overwhelming.  If you’ve ever indulged in too much pecan pie (or pecan-chocolate pie) and felt full for hours later (yes I’m speaking from experience!), you’ll welcome this healthier dessert.

This pecan crust is easy to make and more flavourful than traditional pie crusts, and the ingredients provide important nutrients: pecans lend a buttery taster with healthy unsaturated fats,  and the oats provide a nice texture while providing cholesterol-lowering fiber.  In contrast,  traditional pie crusts contain unhealthy fats, refined flour, and offer few important nutrients. . . not to mention that they can be tricky to prepare!

Pecan Crust

The filling in this pie is protein-rich Greek yogurt, that you can sweeten a little or a lot depending on your preferences. I thicken it up with gelatin, which may have the added bonus for some with nagging tendon injuries, as preliminary research suggests gelatin may help tendon repair by promoting collagen production.

Ingredients

Pecan Crust
  • 1 1/3 cup oats
  • 1 cup pecans halves
  • 2 tbsp. sugar
  • 1/8 tsp. salt
  • 1 egg
Yogurt Filling
  • 1 carton (500 g/about 2 cups) Greek Yogurt (I used nonfat vanilla)
  • 3 tbsp. cold water
  • 1 package unflavored gelatin (2.5 tsp.)
Chocolate-Pecan Topping
  • About 1/2 cup pecan halves (for garnish)
  • 1/2 cup semi-sweet chocolate chips or chopped dark chocolate
  • 2 tbsp. milk

Directions

Pecan Crust
  1. Preheat oven to 350 deg F. Place the oats, walnuts, sugar, and salt, in food processor and process. Add the egg and process until well mixed.
  2. Press mixture into a 9- or 10-inch tart dish lightly greased with butter (consider lining bottom with circle of parchment paper – sometimes the crust sticks without it). Use your fingers to spread the dough and press it evenly all over the inside of the tart pan (it helps if you wet your fingers with water).  Poke the crust in a few places with a fork.
  3. Bake for 10-15 minutes (until lightly browned) and cool on a wire rack.
Yogurt Filling and Chocolate-Pecan Topping
  1. Put cold water in a 2-cup microwavable measuring cup or medium-sized glass bowl. Sprinkle with gelatin; stir and let stand for 2 minutes (gelatin will expand and solidify).
  2. Microwave on High for 30 seconds (gelatin will become liquid).
  3. Add gelatin mixture to yogurt, stir or whisk well, pour into baked crust.
  4. Combine chocolate and milk in microwave safe bowl or cup. Microwave until chocolate is barely melted – about 15-25 seconds.  Remove from microwave and stir vigorously. With a spoon “paint” the top of your yogurt filling with chocolate (if chocolate mixture is too thick add a little milk (just a few drops – a little goes a long way). Garnish with pecans and put tart in refrigerator for 1-2 hours to set.
READ  Healthy Baking Tip: Use Nut & Seed Butters Instead of Oils

Preparation Tips & Variations

  • Don’t have a tart pan? Neither did I (until recently – I”m pretty happy with the purchase, and delighted with the fluted edges and removable bottom!)  You can also make this in a glass pie plate.
  • Use another nut instead of pecans.  I’ve tried walnuts and results were great. I imagine cashews would work as well.
  • If you want something more decadent, use a higher fat yogurt and add a little maple syrup or other sweetener to it before adding the gelatin (this will be higher in calories and fat, but will still be much healthier than most tarts and pies).
  • Have an abundance of fresh fruit? Turn this into a fabulous fruit tart – you’ll find the recipe here.

Nutrition Notes

  • Pecans IsolatedPECANS are rich in healthy unsaturated fats associated with favorable lipid profiles.  Like most nuts they also contain important vitamins (notably vitamin E) and minerals, as well as fiber.  And these nutrients may benefit health, as eating nuts can lower cardiovascular disease risk, according to a recent meta-analysis.   In this analysis, researchers looked at 61 studies that examined the effect of tree nuts on blood lipids (tree nuts include walnuts, pistachios, macadamia nuts, pecans, cashews, almonds, hazelnuts, and Brazil nuts).  They found that tree nut consumption was linked to blood markers associated with lower heart disease risk (lower total cholesterol, triglycerides, LDL cholesterol, and ApoB). The greatest effect was linked with consuming 60 grams of nuts or more daily (60 g nuts is equivalent to about 40 pecan halves).
  • GREEK YOGURT is exceptionally rich in protein and a good source of calcium.  High yogurt Oats (with Path)consumption (> 7 servings/week) is linked to lower weight (especially in people who eat more fruit), and lower risk of diabetes.
  • OATS are well-know for their cholesterol lowering properties, and recent research shows that they contain antioxidant compounds called avenanthramides that help decrease chronic inflammation that can lead to disease.
  • DARK CHOCOLATE is rich in flavanols that have potential disease-fighting properties.

Nutrition Per Serving

1 serving = 1/8 tart

  • 330 calories
  • 10 g protein
  • 31 g carbohydrate
  • 20 g fat
  • 26 mg cholesterol
  • 3 g fiber
  • 72 mg sodium
  • 150 mg potassium

muesli oatsMore recipes with OATS

More recipes with CHOCOLATE

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What Happens When the Media Misinterprets the Findings of Scientific Studies?

Media Reporting of Nutrition Research

The media has a tremendous influence on our health decisions, and unfortunately good health and science reporting is often overshadowed by attention-grabbing headlines.  Nutrition and health studies are quite popular in the news media, and often poorly reported.

The general public does not have a good understanding of the scientific process, research design, or nutrition epidemiology.  So it is critical for health reporters to help readers understand what the research means to them. They can do this by interviewing the right experts in the field, putting the research in context, and considering the cumulative scientific knowledge in the area.

Here is a hilariously funny and well-researched piece on John Oliver’s Last Week Tonight. Oliver explains how the media misinterprets the findings of scientific studies, providing real examples. His clever delivery informs, educates, and will certainly make you laugh.

A consequence of poor reporting is confusion. How many times have we heard

“researchers keep changing their minds”

about what to eat for good health.  Because expert consensus is important to foster trust in science,  poor reporting can fuel this distrust. And this is worrying because such distrust can have serious consequences; for example, distrust or poor understanding of science is the reason some people question the efficacy or safety of vaccines, putting the health of many at risk.

More Reading:

Healthy Or HypeHealthy or Hype?

Along these lines, I’ve been working on a section of my website to help point readers to trusted sources of nutrition information (and highlight sources you should steer clear of).

Here are some of my resources to help you find information based on the best available scientific evidence.

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Carbs Vs Fat No Text

Fats vs Carbs: Clarifying Conspiracies, Controversies, and Confusion

Are you confused about how much fat you should eat? You have good reason! Many journalists and “internet experts” skillfully weave convincing stories about a large body of research.  We are often told to ignore academic experts and decades of nutrition research. What’s going on here?

A recent example is journalist Ian Leslie’s “The Sugar Conspiracy.” This was indeed a good story and quite persuasive.  Leslie provides a historical account of the research on the role of fat intake and heart disease. He states that the current recommendations of nutrition experts are wrong, and explains that nutrition researchers are biased and discount studies that don’t fit with their thinking.

Leslie has many convincing arguments, relying heavily on work of popular journalists Gary Taubes (Good Calories Bad CaloriesWhy We Get Fat) and Nina Teicholz (Big Fat Surprise), but he ignores a large body of evidence that would support any counter-arguments. Is he, and other sugar conspiracy proponents, guilty of the biased thinking for which they accuse nutrition researchers?

I’ll will examine Leslie’s arguments below, and summarize the following topics to help you understand the current nutrition debates.

John Yudkin vs. Ancel Key’s: Does Fat or Sugar Cause Heart Disease?

Leslie provides a fascinating account of how in the 1970’s, prominent nutrition researchers ridiculed the work and destroyed the reputation of a scientist (John Yudkin) who proposed that sugar was responsible for heart disease, diabetes, and obesity. Good story material for sure – bad guys, a good guy, and a conspiracy.

Did this really happen?  A nutrition scientist has scrutinized Leslie’s account of the story and provides an evidenced-based interpretation of Ancel Key’s research here. (Spoiler alert: Not really). Have a look! You’ll also figure out how to interpret the graph below: 

Ancel Keys Seven Countries Study
Ancel Keys Seven Countries Study

Does the research of good guy John Yudkin stand up to scrutiny? Kevin Klatt has reviewed his research here, and concludes that “there were significant limitations of Yudkin’s work and of the hypotheses surrounding sugar at the time.”

Did Americans Get Fat Because of Dietary Guidelines?

Scientists have to reckon with the fact that the obesity epidemic basically began with the first dietary guidelines. You can’t look at that and not think we’ve done something terribly wrong” – Nina Teicholz

O.K., the first set of guidelines weren’t perfect. But, did they cause the obesity epidemic? Maintaining an ideal weight is critical to good health, and featured prominently in Guideline #2.  Only 2/7 guidelines relate to Teicholz’s concerns (#3 and #4 to limit fat and eat adequate starch), but even then they emphasized whole foods. And don’t miss guideline #5 (I think Nina may have) – Avoid Too Much Sugar.

1980 Dietary Guidelines Fat Carbs

Contrary to stories of Leslie, Taubes, and others, these guidelines show there has been longstanding and prominent advice to limit sugar and refined carbohydrates. And, as I wrote in this article, contrary to what Teicholz, Leslie, and others allude most people did not follow the guidelines.

BIG Food = BIG Bodies

Did Americans Follow the Guidelines? While the 1980 Guidelines discouraged too much sugar and refined carbohydrates, Americans increased their intake of these foods: importantly, they also increased total calories and did not follow the low-fat recommendations, and they got fatter. Was eating this way an unintended consequence of the Guidelines to reduce fat intake? Doubtful.

The "Snackwell Effect" People eat more foods labeled as healthy/low fat
The “Snackwell Effect” People eat more of foods they believe to be healthy

Although nutrition experts emphasized vegetables, fruits, beans, and fiber-rich grains, the food industry latched onto “low fat,” and replaced fat in junk food with less healthful ingredients (more sugar/refined carbohydrates).  Food giants like Pepsico and Nabisco (Snackwell’s) produced low-fat cookies, chips, and other snacks and cleverly marketed it as healthy, because it was low in fat. And this was quite profitable.

The food industry has large budgets, powerful marketing, and their bottom line is money, not public health.  Consumer confusion and distrust in nutrition experts and evidence-based guidelines can actually be good for their bottom line. The food industry’s influence is far-reaching: consider also that they have a big say in Dietary Guidelines.  James Hamblin’s How Agriculture Controls Nutrition Guidelines is a good example of the industry sowing distrust in science.

So, clever food marketing and not nutrition experts convinced people that anything labeled “low fat” was healthy (even cookies . . . so why not eat two?). And it worked! Research now confirms that simply seeing the words “low fat” on a label encourages consumers to eat more.

Mammoth MuffinPortion sizes have increased dramatically and we eat more when served larger portions, another factor that has contributed to the obesity epidemic and chronic disease. Consider that an average restaurant meal contains almost a day’s worth of calories. The fact that we are simply eating too much shouldn’t be ignored or misconstrued while debating the merits of fats vs carbs in the diet.

Beyond the food industry, sedentary behavior, our obesogenic environment, and other influences have contributed to rising rates of obesity and preventable diseases. It is deceptive to blame these conditions on nutrition recommendations.

The 2015 Guidelines were generally well received by the nutrition community –  see a review by Marion Nestle and my interpretation, which I summarized in the graphic below. The scientific committee also recommended a goal of environmental sustainability, but lobbying power was strong and this was not included in the final guidelines.

DietaryGuidelines
How I interpreted the 2015 Dietary Guidelines Report

Ms. Teicholz launched a full-fledged campaign against the 2015 Guidelines.  Her criticisms are explained in this article.

Making Sense of Nutrition Science

Making dietary recommendations requires considerable expertise to interpret research from various fields, put it in context, and consider the cumulative scientific knowledge in the area. Many have criticized Teicholz’ ability to objectively critique research. According to Teicholz

“Americans have been the subjects of a vast, uncontrolled diet experiment with disastrous consequences.”

But how much weight should you give to individual studies? Just because a study was conducted in mice, or because a human study was “observational” doesn’t mean it should be discounted. And even the results of long-term well-designed clinical trials need to be carefully interpreted. (If you’re curious about how to weight various evidence, here’s a good primer).   Nutrition researchers do recognize the limitations of dietary data and implications for making evidence-based recommendations.  Importantly, experts often have strict methodologies for examining the scientific literature (see examples below). Unfortunately, the same can’t be said for many popular books and news articles, as is evident in a critical review of the Big Fat Surprise.

WCRF Colorectal Caner RiskEven Experts Disagree. . . But That’s O.K.! People complain that findings of research studies contradict each other. But, as explains epidemiologist Michael Marmot, who chaired the WHO World Cancer Research Fund’s examination of the evidence of diet and lifestyle influences on cancer, “That is the nature of science and a source of its strength.” For example, the World Cancer Research Fund review has a panel of expert scientists who examine and debate the scientific evidence to come up with recommendations to guide new research, prevention guidelines, and policy. They categorize the evidence as (1) convincing; (2) probable, or (3) substantial effect on risk unlikely. For example, this graphic shows how they categorized lifestyle risks on colorectal cancers.

The Scientific Committee for the Dietary Guidelines reports also follow a detailed protocol to interpret the literature, as explained here.

Do you think authors of newspaper articles and popular books or “internet experts” have such rigorous protocols or methodologies when they interpret the scientific literature?  It’s something to think about before you trust their stories.

Fats or Carbs?

What’s All the Fuss About FATS?

The 1980’s Guidelines advised avoiding too much fat or saturated fat. Now more evidence shows that certain fats are beneficial and should be part of a healthy eating pattern. These “healthy’ fats include monounsaturated and polyunsaturated fats found in nuts, seeds, fatty fish, and some vegetable oils. Trans fats – found primarily in processed foods – are considered unhealthy and should be avoided.

The role of saturated fat in health is a topic of much debate (and confusion!). Years of research have associated saturated fat with heart disease, some cancers, and diabetes. But more recent studies suggest that some types of fats may not be as harmful to some conditions as once thought. However, the evidence isn’t strong enough to disregard research showing saturated fat intake is harmful.

Red Meat And Poultry MED Public Domain Nci Vol 2402 150Are Meat and Butter Good for You? Many headlines interpret the emerging research on saturated fats as meaning that certain foods are good for us. While the role of saturated fat in heart disease needs more study, saturated fat intake is linked to other diseases. In terms of cancer, there is still considerable evidence linking high consumption of meat and/or processed meat with an increased risk of cancer mortality and an increased risk of incident cancers, particularly colorectal cancer.  Just because something is not as bad as once thought, doesn’t mean it’s beneficial, especially in copious amounts.  Replacing cookies with cheese might be a good swap, but replacing cookies with nuts is likely better.

CARBOHYDRATES Can Be Confusing, but That Doesn’t Make Them Bad

The type of carbohydrate you eat is likely more important than the amount. Carbohydrate critics tend to lump all carbohydrates into one category (somewhat like equating candy to broccoli). Vegetables, fruits, whole grains, and legumes are carbohydrate-rich foods, and affect the body differently than the refined and processed carbohydrates found in many popular foods.

Certain people may be more susceptible to the influences of carbohydrates on insulin (but again, eating lentils will influence the body differently than cake . . .). And how we metabolize carbohydrates has a lot to do with how active we are: though some studies do account for physical activity, even those participants categorized as “active” do not move much.

Kenyan Runners-Berlin_marathon_2012The world’s fastest distance runners have very high carbohydrate diets (about 75% carbs for Kenyans and 65% carbs for Ethiopians): and good evidence shows carbs are the preferred fuel for endurance athletes. New research recommends tailoring carbohydrate consumption to activity intensity and duration.  Some athletes seem keen to try High Fat Low Carb (HFLC) diets, despite the fact that carb restriction compromises the effectiveness of high intensity interval training and no evidence shows performance benefits.  The research is quite limited: an expert in this area, Louise Burke, provides a good evidence-based summary of the state of research on HFLC diets for athletes here.

Dietary Patterns Matter More than Nutrients

Mediterranean Diet FoodsExperts agree that it’s critical to consider the overall dietary pattern: eating less saturated fat won’t be helpful if the rest of your diet is full of highly processed foods. Though there are many healthy ways to eat (low carb and low fat), a large body of research shows that the most disease-protective dietary patterns are Mediterranean, DASH (Dietary Approaches to Stop Hypertension), or patterns assigned by studies as “Prudent” “High Quality” or “Healthy Eating” – they all contain healthful carbohydrates.

Examining the Credibility of Two Popular Anti-Carb Crusaders

Nina Teicholz and Gary Taubes are journalists with a disturbing degree of influence.  Should we be trusting them to interpret nutrition research?

Nina Teicholz

Big Fat Surprise “Painstakingly Researched?” While Leslie calls Teicholz’s book “painstakingly researched,” most evidence-based reviews show that Teicholz lacks the appropriate nutrition expertise to critique studies and put decades of research in context.  Many experts question her credibility and you should too.

Here is a detailed scientific critique that fact checks Teicholz’s text that outlines the many errors and biases (see The Big Fat Surprise: A Critical Review (Part 1; Part 2). Here are a few examples:

Big Fat Surprise Critique

Big Fat Surprise Critique Atkins 2

Gary Taubes

Gary Taubes argues that the main cause of obesity is eating too many carbohydrates. Many talk about the insulin-carbohydrate hypothesis of obesity as if it is fact. In reality, numerous studies don’t support this hypothesis. Obesity researcher Stephan Guyenet does a nice job explaining the insulin-carbohydrate hypothesis and outlines why you should question this reasoning.

The latest study to refute this hypothesis, published in Cell Metabolism, showed that for the same number of calories, a low-fat diet was better than a low-carb diet to lose body fat.  This was a “feeding study” – one of the most rigorous forms of studies that I summarize below:

Study participants received two diets in random order (a low-carb diet and low-fat diet) and spent part of the study in a “metabolic chamber” that captured all the air they inhaled and exhaled. Urine and body gases collected allowed researchers to determine the number of calories participants were burning and whether those calories came from carbohydrates, fat, or protein. Calories were restricted, so, as expected, participants lost weight and body fat on both diets. The low-fat diet seemed to have a metabolic advantage, and the low-carb diet slowed metabolism. A low-fat diet didn’t slow metabolism, and had increased fat burning and fat loss compared to the low-carb diet.

Do these results mean that “low-fat diets are best to lose fat” or “low-carb diets don’t work”? No, although this type of interpretation is common. The study authors caution that they conducted the research to better understand metabolism and energy balance, and not to form the basis of dietary recommendations. Here’s a good interview with the lead author explaining the study results, and if you’re interested in how this study relates to the carbohydrate-insulin hypothesis of obesity, obesity researcher Stephan Guyenet explains that here.

The insulin-carbohydrate hypothesis is an important theme in Taube’s anti-carb campaign and his books “Good Calories/Bad Calories” (you’ll find an excellent critical review here) and “Why We Get Fat.”  Obesity expert Yoni Freedhoff provides an excellent and detailed review of the book.  Among many other criticisms . . .

Taubes seems to have decided to abandon journalistic and scientific integrity in place of observational data, straw men and logical fallacy.”

“Taubes doesn’t just rely on non-scientific argument, he also appears to be comfortable in ascribing his beliefs to other people and to omitting facts when it’s convenient.”

Bottom Line

Should we trust the work of nutrition scientists? Critics claim that their diet recommendations led us to eat more sugar and refined carbohydrates, but this is not true.  On the contrary, the first recommendations issued in 1980 recommended limiting sugar and refined carbohydrates.  Obesity is a complex problem and it does not have a single cause.  Put simply, people eat too much, likely due to a variety of influences, including the food industry, sedentary behavior, and our obesogenic society. Understanding the multiple factors that influence obesity and preventable chronic diseases is critical, and undermining the public trust in nutrition research is not helping progress.

Some Key Points:

  • Nutrition science is difficult to conduct and interpretation can be complicated. Experts in the field are the best ones to interpret this research, not clearly biased journalists
  • Conspiracies make for a good story, but typically don’t represent good science
  • Nutrition experts never recommended increasing sugar intake or intake of refined carbohydrates, and it is doubtful that this was a direct consequence of nutrition guidelines
  • Food industry marketing is more persuasive than the advice of nutrition scientists

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Photo of Kenyan runners in Berlin Marathon By Dirk Ingo Franke (Own work) CC BY 3.0  via Wikimedia Commons

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