And Speaking of Sugar

Last Friday I flashed back to an entry from February 2012 where I showed how eager the media is to help us blame sugar for the obesity and the diabetes epidemics instead of the taking responsibility for our own choices.

Shortly after deciding to feature those comments I came across this related news report. “The Sugar Association is asking the Food and Drug Administration to require more detailed information about artificial sweeteners on packaging.”

The problem as they see it is that, because sweeteners do not provide nutrition or calories, they are not required to be listed on nutrition facts labels. Instead they are listed under ingredients in smaller print on the side of the package.

The industry argument is, “Consumers deserve to know what is in their food so they can make informed decisions for themselves and their families.” By making these changes, the FDA “will bring the complete transparency in sweetener labeling that we know consumers want, deserve and should expect.” 

They innocently portray themselves as merely calling for transparency by putting the information on food labels as “sweetener,” followed by the name. This is similar to the tactics of the anti-GMO crowd. By forcing producers to list an ingredient on the package, they hope that past misinformation will give shoppers the impression that a safe ingredient, because it is highlighted, is really dangerous. It’s a subtle scare tactic dressed up as transparency that they have pulled off elsewhere*, but it’s not based on science!

I referred to information sources I trust like WebMD and the Mayo Clinic rather than believing folks like Global Healing, Nutralegacy or Doctors Jocker and Axe. Here is what the real doctors at Mayo Clinic have to say. 

Under the heading of possible health benefits, they state, “Artificial sweeteners don't contribute to tooth decay and cavities. Artificial sweeteners may also help with: Weight Loss and Diabetes.”

As far as concerns: “according to the National Cancer Institute and other health agencies, there's no sound scientific evidence that any of the artificial sweeteners approved for use in the United States cause cancer or other serious health problems. Numerous studies confirm that artificial sweeteners are generally safe in limited quantities, even for pregnant women.”

So they are safe and sometimes beneficial, but the Sugar Association has for a long time believed, “Consumers Are Confused: Decoding Artificial Sweeteners,” as that headline from ten years ago stated. The article goes on to say, “August marks the five-year anniversary of the Food and Drug Administration’s (FDA) receipt of a petition to help clear up some of the confusion...." So this has been going on for 15 years, and they are taking another run at it. Why? Before you start feeling bad for the Sugar Association, follow the money.

“The U.S. Sugar program is the federal commodity support program that maintains a minimum price for sugar, authorized by the 2002 farm bill....” It was designed to “protect the incomes of the sugar industry-growers of sugarcane and sugar beets, and firms that process each crop into sugar.”

This Reason Magazine article from last year calls it welfare for the rich, saying that it costs Americans as taxpayers and consumers about $4 billion per year. It does this in several ways: 

1. “Subsidies when sugar prices fall below a certain level;
2. Protection from foreign competition (a limit on imports); and
3. A guarantee that prices stay high (the sugar program imposes quotas on how much sugar may be produced in America).”

They are willing to spend a lot of money lobbying to maintain this sweet deal.

This Market Watch story from 2018 confirms the $4 billion cost while pointing out, “On average, U.S. sugar prices are about twice as high as world prices.” 

So, Big Sugar is trying to subtly frighten more people into buying their product at twice the price, based on a false (but popular) notion that the alternatives cause cancer and other problems, while downplaying the truth about the health concerns around sugar itself. They are counting on only a tiny minority of critical thinkers to figure it out.

*Note how successful they have been in giving high fructose corn syrup an undeserved bad rap.

Flashback – Why So Much Bad Advice

[This message was originally posted over six years ago, but since then the dynamic of bad information driving out the good has only gotten stronger with more fake news, advertising weasel words, political spinning, echo-chamber exchanges, media bias and health fads without any scientific basis.]

Why do bad ideas and bad advice seem to persist in a society with easy access to good science? One reason may be the tendency to cling to beliefs then look for evidence to support them, instead of accepting the conclusions of well-designed experiments. In his book The Righteous Mind Jonathan Haidt proposes that feelings and emotions come first, and that most reasoning works to justify rather than to test beliefs, that our “intuitions tend to drive our later reasoning.”  John Stuart Mill presented the same thought more than 150 years ago:  (paraphrasing) the more you argue, even while making clear, rational points, the deeper others dig in to protect long-held beliefs. Adding to the sad situation are the effects of scientists and doctors who would rather become famous as authors or TV stars by promoting popular beliefs than risk challenging them, as they should, with the truth.

One case that comes to mind is the persistent belief that artificial sweeteners are dangerous. Simple research is reassuring, but the belief is ingrained in our culture. The National Cancer Institute states clearly and unequivocally: “There is no clear evidence that the artificial sweeteners available commercially in the United States are associated with cancer risk in humans.” The Mayo Clinic’s view is that “there's no sound scientific evidence that any of the artificial sweeteners approved for use in the U.S. cause cancer or other serious health problems.” So who do Americans trust, these authoritative sources or a Facebook friend who watched some guy in a halloween costume on YouTube with scary stories?

Likewise folk remedies of all kinds continue to circulate. One longstanding belief is that magnetism has magical healing powers, leading people to buy bracelets, insoles and other magnetic devices. This is odd because over the past 15 years the FTC has ordered Magnetic Therapeutic Technologies, among others, to stop advertising magnets as a cure for numerous diseases or even as a pain reliever. No credible evidence exists of healing powers, and none can be claimed in their advertising. One recent well-designed test of such devices confirms this fact concluding: “Wearing a magnetic wrist strap or a copper bracelet did not appear to have any meaningful therapeutic effect, beyond that of a placebo, for alleviating symptoms and combating disease activity in rheumatoid arthritis.” Does that slow the sale of magnetic shoe insoles? – Not for people who don’t let the facts get in the way of a good story, a persuasive ad or a celebrity endorsement.

It’s your money to use as you please. You can save it for college and retirement, give it away to companies selling you magnetic health devices, or even flush it down the toilet. Two of those choices make the same amount of sense, but as Paul Simon sang, “A man hears what he wants to hear and disregards the rest."

Diet Soda Still Under Attack

People using social media too often read headlines and don’t look at the rest of the story or, perish the thought, do a little research to find out the truth. We see articles posted where an event happened in another country but the comments read as if it happened right next door. (I highlighted an example of some of the dangers of this kind of behavior, blindly reposting stuff, earlier this month.)

That is why I wasn’t surprised to run across another condemnation of diet soda being spread on Facebook a few weeks ago when the original news story came out last February 14. (Does the American Heart Association (AHA) always release a story on Valentine’s Day or was that just a coincidence?) This story presented a good example of how a headline can be very misleading, and how 15 minutes of research leads to a different conclusion.

Multiple news outlets reported it, but the Fortune headline was typical: “Drinking Two or More Diet Sodas a Day Increases Likelihood of Strokes, Heart-Attacks, American Heart Association Says.” Although they have been seen as a healthier alternative to sugary drinks, the study shows that “immoderate drinking of the low-calorie drinks is associated with a greater risk of strokes or heart attacks.” 

They go on to say that over 82,000 women participated, which is a very large sample, but it means the findings can apply only to women. Furthermore, and not mentioned in the Fortune article, they were post-menopausal women between the ages of 50 and 79.

Part of the findings correctly reported was that the women “who drank two or more artificially sweetened drinks had a 23% higher risk of strokes in general.”

A more thorough report came from Science Daily. They also report the 23% figure, but add near the beginning of the piece an important reminder for non-statisticians. “While this study identifies an association between diet drinks and stroke, it does not prove cause and effect because it was an observational study based on self-reported information about diet drink consumption.” Also researchers can determine no mechanism by which the ingredients in diet drinks could cause the associated ailments.

A further question arises: How bad is a 23% increase in risk? That depends not on the size of the sample, but on the size of the risk. If, for example, the overall risk of something bad happening is 60%, a 23% increase brings the risk up to almost 75% - a big difference. On the other hand, if the risk is small, say 2% such an increase brings the risk to less than 2.5%. Without specifying the original size of the risk, the unanswered question is: how much behavior should I change to try to avoid it?

The percentage increase says nothing about the real size of the increased risk. To find out how serious it was I went to the AHA Journal article cited in those news stories. I found the data in Table 2 of the study.

The data showed that the risk of a stroke over the twelve years of follow up was about 3% for the group that drank almost no diet drinks and 3.7% for those who regularly drank two or more. Remember, this very small risk applies only to post-menopausal women. And also mentioned in the conclusion of the AHA study, those women in the higher-risk group “were more likely to be obese, had lower levels of exercise, had … lower diet quality… [and] were more likely to be a current smoker.”

A different study with a smaller sample asking the same question was published two years earlier by Harvard Health. It concluded that the risk from diet soft drinks is small. They also referred to a larger study that “detected a slightly higher risk of stroke in people who drank more than one soda per day, regardless of whether it contained sugar or an artificial sweetener.” (That flies in the face of the aspartame urban myth that won't seem to go away.) And agreeing with the conclusion in the AHA study, for people drinking diet sodas, “heightened stroke risk may result from their health problems rather than their beverage choice.”

An honest headline should have read: "Postmenopausal women who drink two or more diet drinks a day seem to have a slightly higher risk of strokes but what they drink might have nothing at all to do with it" - not exactly click-bait.

It takes just a little critical thinking and research to uncover the misrepresentations in so many headlines. If you don’t care enough about the issue to do the research, ignore the headlines. If you do, don’t repost them on social media until you've looked into the matter.

How Sweet It Is!

A couple of things came together over the last few weeks that brought up some interesting questions. The first was this video from John Stossel using the sugar industry as an example of crony capitalism or corporate welfare. The second was the bold print on the side of a bread package announcing that the product contained no high fructose corn syrup (HFCS).

Most of the Stossel video, “Sugar’s Sweetheart Deal,” is about how the industry advertises that they are not subsidized, but government bailouts (using our tax dollars) when the price falls, keep them rich and happy. The government also helps keep the price up with artificial quotas on domestic production and imports. So much of our food costs more, because sugar costs more, and it’s in so many products. 

When I looked at the ingredients on that bread package, the one proudly proclaiming that it contained no HFCS, I was not surprised to see sugar near the top of the list. Perhaps the sugar industry also is behind the bad reputation that most people associate with the cheaper substitute. Is there something behind the halo-effect of “No High Fructose Corn Syrup” or is this another case of hype?

This source gave me a clue: “There isn't enough evidence to say that HFCS is less safe to eat than table sugar, according to the American Medical Association, which has stated that HFSC does not appear to be more harmful than other caloric sweeteners.”

The HealthLine site goes into more detail. “There are only tiny differences between HFCS 55. – the most common type of high-fructose corn syrup – and regular sugar. A major difference is that high-fructose corn syrup is liquid – containing 24% water – whereas table sugar is dry and granulated.” The differences in chemical structure between the fructose and glucose in HFCS and the sucrose in sugar is not significant and “do not affect nutritional value or health properties.” After they are broken down in the digestive system, they end up looking exactly the same.

In a discussion of recipes on howstuffworks.com, they point out that there is a small difference. The HFCS has slightly higher levels of fructose, but the difference is very small and not particularly relevant from a health perspective.

So the package posting no HFCS is not really a reassurance; it only means they used sugar instead. It’s just another advertising trick. Both are about the same thing, neither is particularly good for us, and both should be consumed in moderation.

But what of the packages that say “no sugar” or “sugar-free.” Therein lies another can of worms. Most of the time those products don’t contain HFCS either; they contain artificial sweeteners. But wait! Aren’t artificial sweeteners a kind of slow-acting poison? Some will tell you exactly that.

It turned into another research project. This time I went to Mayo Clinic's site. “Artificial sweeteners are synthetic sugar substitutes. But they may be derived from naturally occurring substances, such as herbs or sugar itself.” They can be “attractive alternatives to sugar” because they contain virtually no calories and do not contribute to dental problems. Artificial sweeteners may also help with weight control and diabetes.

They go on to say: “Artificial sweeteners have been scrutinized intensely for decades.”  Studies from the 1970s “that linked the artificial sweetener saccharin to bladder cancer in laboratory rats” led critics to claim that they are unhealthy and carcinogenic. “But according to the National Cancer Institute and other health agencies, there's no sound scientific evidence that any of the artificial sweeteners approved for use in the United States cause cancer or other serious health problems. Numerous studies confirm that artificial sweeteners are generally safe in limited quantities, even for pregnant women.” 

The sole choices left are the so-called natural sweeteners, such as honey, maple syrup, and molasses. These are popular among the health-conscious crowd, some even calling honey a miracle food. Back to Mayo for this information: "Natural sugar substitutes may seem healthier than sugar. But their vitamin and mineral content isn't significantly different. For example, honey and sugar are nutritionally similar, and your body processes both into glucose and fructose.”

Will all that information change minds? Probably not! Will “No High Fructose Corn Syrup” continue to sell, while people continue to warn their neighbors about the dangers of artificial sweeteners? Most likely! Will foodies be attracted to honey in recipes thinking it contains some health secret? That, too! Critical thinking and simple, solid research where are you?

Food Labeling

It’s interesting how many food items are being relabeled to take advantage of all the misinformation in the news and on social media. They label food as containing no high fructose corn syrup (HFCS). That simply means it contains sugar instead.  One is no better or worse for you than the other. If something is labeled as containing no sugar, it’s likely to contain an artificial sweetener. There are all kinds of rumors about how dangerous artificial sweeteners are. Some are labeled as no sugar added, but may have more natural sugar than a comparable product without the label. Everyone should easily be able to figure out that these special labels make little difference to the actual wholesomeness of the food. So why do the food companies make such an effort?

Apparently, it’s because most people don’t go to the trouble to figure this out.  The labels are shortcuts allowing them to follow their superstition of choice – yes, superstition. They are no different than the Salem Witch Trials except no one is killed, but they use the same tactics of mass hysteria.  Someone or some group pick up the chant of avoiding sugar or HFCS or artificial anything or GMOs or gluten (for most healthy people) and people choose to ignore evidence and climb on board the Superstition Express. 

One of the worst cases is the anti-GMO movement. The unreasonable opposition to GMOs starves people and adds to climate change. The promise of increased yields from smaller fields along with reduced reliance on pesticides and fertilizers supports the effort to reduce greenhouse gases and should be embraced by anyone concerned about climate change, but they pick and choose their cause. Mitch Daniels, president of Purdue University, calls the stance against GMOs both anti-science and immoral emphasizing the absence of evidence that these products have hurt anyone or have been a detriment to the environment –“no disruption of an ecosystem nor any adverse human health or even digestive problems, after 5 billion acres have been cultivated cumulatively and trillions of meals consumed.” It’s a distraction and political football that keeps good food from hungry people in less-developed countries.

The typical reaction is referred to in this article as the “healthy halo.” Food companies have found that certain labels elicit a positive response, regardless of logic, making consumers more likely to buy and more likely to pay more. To test this, researchers from Cornell University asked 115 shoppers to give their opinions of the value of snack foods based only on their labels. “People thought foods labeled ‘organic’ were more nutritious, lower in fat, and higher in fiber than the ‘regular’ foods, and were willing to pay up to 23.4 percent more for the food labeled as organic.” The difference was in the labels only: all the study participants were eating the same foods. The ink is cheap and the ability to increase the price by over 20 percent merely by adding one word to the label would be a marketing homerun for any company! And millions of superstitious Americans let them get away with it.

The manufacturers don’t care. And if it gives them an advantage in the market, they will even endorse any error or misconception their customers may have. It’s really sad.

Diet Coke is Killing Me!

If I were to believe everything I see on the Internet, I would fear that Diet Coke is killing me.  The most cited article comes from a website called Creative & Healthy Family where we are confronted with the headline:  “Drinking One Diet Drink A Day Can Triple Risk Of Dementia And Strokes.”  It is not dated, shows a picture of a can of Diet Coke and is written by a self-described mom blogger from Florida – so much for scientific credentials.  The scary thing is that it has been shared 410,000 times.

When I see any news like this I am inclined to put down my Diet Coke and investigate.  (It’s called critical thinking.)  I’m especially so inclined when I see the same posting recommending things like a detox bath and detox water recipes, knowing from my past investigations how questionable – no, that’s too polite – how bogus these types of recommendations are.

The site did provide this link to the original study.  It was sponsored by the American Heart Association and published in April of last year.  The first thing to notice is that it never mentions Diet Coke by name.  The summary in the Creative & Family Health page accurately reflects the study abstract, except the part where it states:  “Artificially sweetened soft drink consumption was associated with a higher risk of stroke and dementia.”  But we shouldn’t expect a mom blogger to understand that associated with does not mean causes – or should we?

But the abstract provides a link to the entire study.  One would hope that before jumping to conclusions, a responsible blogger would actually take that additional step.  If we do look further, here is what we find (with emphasis added and typos corrected):

“Limitations of the study include the absence of ethnic minorities, which limits the generalizability of our findings…. Second, the observational nature of our study precludes us from inferring causal links between artificially sweetened beverage consumption and the risks of stroke and dementia. Third, the use of a self-report FFQ [questionnaires] to obtain dietary intake data may be subject to recall bias [and other biases], thus, introducing error into our estimated models. Fourth, although we addressed confounding [outside influences] in numerous ways, we cannot exclude the possibility of residual confounding. Finally, we did not adjust for multiple comparisons meaning that some findings may be attributable to chance.”

They wrap it up with the usual wording that “future research is needed.”  This doesn’t sound as definitive as the mom blogger portrayed it.

The main issue is not whether Diet Coke is killing me; it's the rapid spread of misinformation. People look through the Internet for the latest study that reinforces their preconceptions, especially about health and wellness; and after doing a half-baked job of research, they print an attention-getting headline simply to get likes and re-posts.  Others aid them by passing the post along to their equally credulous friends and followers.  Then, instead of practicing moderation, they are inclined to totally replace artificial sweeteners with natural sweeteners.  And you don’t have to look far on the Internet to find faults with these, too, as this Economist story points out.  But natural sweeteners sound so much more natural than artificial sweeteners.

Wouldn’t it be more useful to focus on smoking, excessive alcohol, over-eating and high blood pressure, things that are really killing people; than to keep trying to invent new, more exotic nutritional enemies?  But those ordinary warnings don’t inspire the sense of panic needed to get likes and re-posts.  As a next step a few fanatics demand that everyone adopt their view, calling for product bans or boycotts or attacking opposite viewpoints and demeaning the people who hold them.

These half-truths, misrepresentations, misinterpretations and sloppy reporting cause people to make unnecessary changes and form false, negative opinions of products or people.  They can damage companies and individual reputations without any accountability on the part of the writer.  Without responsibility on one side and critical thinking on the other, social media can pose a serious threat to everyone.

Now Sugar Causes Cancer?

Eating healthy gets more and more difficult with so many warnings to heed.  Every other day someone is telling us that some other food may cause cancer.  Alternatively, we often find that the ones we were warned about last year are either less dangerous or actually good for us.

This report from the PBS News Hour is a good example.  “Scientists at the University of California, San Francisco, said they have uncovered documents demonstrating that members of the sugar industry called off a study, named Project 259, in the 1960s because it linked sucrose – a common sugar – to heart disease and bladder cancer in preliminary experiments.” 

Several questions spring to mind.  Is the science from 50 years ago as good as the science of today?  Is calling off a study that same as confirming that the unfavorable findings are true?  What was the objective of this Project 259 that they happened to stumble upon these findings – surely the sugar industry didn’t say, “Look into the health benefits of our product, but if you find anything scary, stop!”  Does PBS not understand that linked to is not the same as causes?  And, what are these scientists doing poking around into documents from studies done in the 1960s other than trying to stir things up and make headlines?  Finally, haven't we been told over and over that it's artificial sweeteners, like aspartame, not sugar, that supposedly cause cancer?

Back in the 1960s they were denying that sugar was the cause of obesity, pinning the blame instead on fat.  It took scientists and the government over 50 years to get that straight and still some want to argue.

A more recent source from a couple of years ago brings this sugar/cancer issue up to date:  “It’s true that sugar feeds every cell in our body – even cancer cells. But, research shows that eating sugar doesn’t necessarily lead to cancer. It’s what sugar does to your waistline that can lead to cancer.”

How do we keep these conflicting and confusing stories straight?  Another source provides some helpful information.

In 2013 the American Society for Nutrition reviewed 264 studies on cancer risk for “50 common ingredients from random recipes in a cookbook.”  They found at least one paper reporting a cancer risk for forty of those fifty ingredients.  In total, “191 (72%) of the studies concluded that the tested food was associated with an increased (n = 103) or a decreased (n = 88) risk.  It seems that if you look hard enough, you can find a study that confirms what you want to believe about the dangers or benefits of almost any food.

The conclusion of this wide-ranging review confirms that notion.  “Associations with cancer risk or benefits have been claimed for most food ingredients. Many single studies highlight implausibly large effects, even though evidence is weak.”

One writer put it into perspective with this comment:  “Perhaps the best example is processed red meat, which the WHO thinks will raise your relative risk of cancer by 18 percent. That sounds scary. That's still debatable, but even if it's true, then it would mean that if I declared today that I would eat an extra three pieces of bacon every day for the next 30 years, my absolute risk of colon cancer might go from 2.7 percent to 3.2 percent. That's… not that scary. And I'm not going to eat that much bacon, so it's likely much less.”

So, there we have it.  If sugar causes cancer, it’s in some good company.  It’s always important to put these reports in perspective, never counting on the news media to do it for us.  (But do take it easy on the Christmas cookies.)

Food For Thought

- Isn’t it much easier to find prejudice if you are always looking for it?

- Watching the Women’s World Cup games between teams from various countries with various commentators, I noticed that they use many of the same expressions as the men use:  “a two-man wall,” “separate the man from the ball,” “she beats her man,” and several others.  Since these commentators are former players, we must assume that players on the field likewise use these expressions.  Could it be that no one is offended by such sexist talk because first, it is a woman using these expressions and second, these women are confident enough in their abilities not to make themselves victims over something so petty?

- We have in the house three grocery items from same baking company.  The loaf of bread has on the package the reassuring label “Non – GMO.”  The package of English muffins says that there are “0g of transfats per serving.”  The hamburger buns’ claim to fame is:  “No high fructose corn syrup.”  This proves one thing.  There are so many different groups of food advocates trying to scare us about so many aspects of the food supply that labeling of packages is a grab bag of promotional choices.  Pick one scary thing that’s not in your food and post it proudly on the box or package to try to increase sales to a gullible public.

- Staying on the subject of food, for years people have been telling me that the daily Diet Coke is going to kill me.  The latest study on aspartame differs.  According to this recent video from the American Chemical Society that criticism is completely unfounded.  To come even close to an unacceptable level of consumption as set forth by the FDA, a person would have to ingest “97 aspartame sugar packets or more than 17 cans of diet soda in less than 24 hours.”  I think I’m safe.  (If taking 17 aspirins a day is dangerous, does that mean I should be afraid of taking aspirin?)

- That brings us back to the reality that everything, everything in the universe, is made of chemicals.  A synthetic chemical has exactly the same effect as the same chemical from nature.  (The tree doesn’t know if the nitrogen came out of a bag or the back end of a cow!)   Someone who is scared of chemicals or tries to avoid chemicals or thinks chemicals is a warning sign is playing a losing game.  It is fairly certain that critical thinking never killed anyone.