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Table 3 The Sugar Association’s Key Counterclaims to Anti-Sugar Claims in Media, with Supporting Reasoning [53]

From: In defense of sugar: a critical analysis of rhetorical strategies used in The Sugar Association’s award-winning 1976 public relations campaign

Topic: Role of Sugar in Modern Nutrition
Anti-Sugar Claim SA Counterclaim
Sugar consumption is rising in the United States Sugar consumption has not changed over the last 50 years
  Reasons: “Harvard’s Dr. Fredrick Stare reports that of the roughly 100lbs. of sugar consumed each year by an average American only some 80lbs. are actually eaten. This amount has scarcely changed in half a century. So claims that sugar consumption is rising in the United States are untrue. Industrial sugar use has grown, but direct consumption of sugar by the consumer has declined proportionately.”
Sugar is not a nutrient or a food Our primary nutrition need is energy. The bulk of our energy has to come from carbohydrates. Sugar is a compact, economical carbohydrate energy source.
  Reasons: “Such charges [against sugar] are disturbing, for we use sugar not as a sweet extra but as a basic of our food supply. In the United States last year, slightly over 100 lbs. of sugar disappeared from the market for each living American, about 15 to 20% of our total calories. If sugar were removed from the market, all the calories needed to feed at least 36 million Americans would be lost.” “Worldwide, many nations—such as Great Britain, the Netherlands, Denmark, Australia and Israel—use as much or more sugar per capita than the United States. And consumption is rising in other lands, especially in developing nations. The U.N. reports an increased use of sugar unmatched by any other food for humans, predicting that by 1980 the world will consume some 186 billion lbs. a year.” “About 15 to 20% of a typical American’s calories come from sugar—about 12% for adults and 20% or more for teenagers. That sugar is seen by scientists as a compact source of energy, our primary nutrition need.” “Energy, Dr. Stare points out, can come from any of three food sources—proteins, fats or carbohydrates. Protein is expensive and scarce; it provides only about 15% of our calories. Excess fats may offer health hazards. So the bulk of our energy has to come from carbohydrates.” “So, Dr. Stare concludes that in the absence of a compact carbohydrate energy source, such as sugar, it could be hard to give youngsters enough calories without giving an unhealthful excess of fat.” “This energy compactness, coupled with high agricultural yield, makes sugar a solution to some world hunger problems. No other major crop yields so many calories from so little soil—about 1 million calories from an eighth of an acre. To produce so much energy, potatoes take four times as much land, beef 125 times. And energy, fertilizer and refining costs for sugar are relatively low.”
Sugar is an unhealthy carbohydrate Sugar is no different than any other carbohydrate
  Reasons: “(Many people are unaware that virtually all carbohydrates in our food are either sugars, or, as in the case of starches, are chains of sugars. Sucrose, the scientific name for table sugar, is one of the most common sugars found in plant foods.)” “The energy we get from sugar is scientifically no different from that in any other food. But most other carbohydrate-containing foods, such as fruits and vegetables, have much bulk with few calories.”
Sugar is empty calories Americans would not consume a healthy balanced diet full of vitamins, minerals without sugar to make foods palatable
  Reasons: “Though they carry with them no vitamins, minerals or protein, Dr. Stare notes that sugar is rarely eaten alone. And often it makes more palatable many foods such as cereals and fruits that supply other valuable nutrients.”
Topic: Sugar and Cardiovascular Disease
Anti-sugar Claim SA Counterclaim
Coronary Heart Disease (CHD) deaths are higher in countries where more sugar is eaten Some countries with high CHD mortality do not have high sugar consumption rates
  Reasons: “Finland and Sweden use similar amounts of sugar, but the Finns have far more CHD. And a number of nations—such as Venezuela, Cuba, Colombia, Costa Rica and Honduras—consume much sugar but have a low incidence of CHD.”
Increases in heart disease-related deaths can be accounted for by rising sugar use Sugar consumption has not changed in the U.S. over the last 50 years
  Reasons: “Dr. Grande finds that the increase of CHD deaths in the United States during the last 50 years occurred while sugar use stayed constant.”
Emerging evidence links sugar to CHD Dr. John Yudkin’s work is the primary source linking sugar to CHD, and his work has been discredited
  Reasons: “Dr. John Yudkin (author of nearly all the medical papers linking sugar to CHD) says that 20 of his heart patients ate more sugar than the usual. But nine other studies controvert this finding. In two of them the heart patients ate less. In one, Canadian veterans with CHD averaged 47 g of sugar a day; but a matched group of healthy veterans ate 65 g!”
Sugar increases blood lipids, such as cholesterol and triglycerides, indicating a higher risk of CHD Sugar does not increase blood lipids
  Reasons: “Reviewing scores of studies—in some of which sugar was the source of 75% or more of calories—Dr. Grande can document no such effect. The only indicators have been a few experimental studies of people who already had high levels of blood fats and who were fed huge amounts of sugar in a special dietary far different from any normal eating pattern. Such anomalies can hardly explain a disease so common that it is our worst killer.” “When large amounts of carbohydrates replace large amounts of fat in the diet, there is a rise in some people of certain fats in the blood (triglycerides). But this rise is temporary. And people who regularly eat much carbohydrate prove to have lower levels of such fats in their blood.”
Current sugar consumption levels are a causative factor in CHD Sugar consumed at current levels does not cause CHD
  Reasons: “To conclude,” says Dr. Grande, “the evidence available does not support the view that sugar, in the amounts present in diets such as those consumed in this country, is a causative factor in the development of CHD.”
Topic: Sugar and Obesity
Anti-Sugar Claim SA Counterclaim
Sugar causes obesity Sugar does not cause obesity
  Reasons: “Three University of Pittsburgh teachers of medicine—Drs. Thaddeus Danowski, Sean Nolan and Thorsten Stephan—review the evidence and conclude it does not.” “The stage seems to be set for obesity when some of us are either born with more of the storage cells that hold body fat or increase them by overfeeding in infancy. Even if one loses weight, these fat cells are not destroyed.” “The fat cells can be filled or emptied depending on how many calories of energy we get in food and how many we burn with exercise. It does not matter which food the calories come from. Any excess is stored as fat.” “Most such excesses seem small and steady. The experts conclude that often they result from learning to deal with emotional stress by eating more. Conversely, excesses may result from declines in activity, as with aging.” “Two other possibilities are suggested to account for individual tendencies to fatten. One is that while some of us stir and bustle more others are more economical of energy. Also, some of us may use fuel more efficiently, like cars that get more miles from a gallon; In either case tiny excesses can add up. Even a 1-per-cent-more efficient use of fuel could mean a gain of 40 lbs. over 20 years!”
Diets restricting sugar will lead to weight loss Diets restricting sugar will not lead to weight loss
  Reasons: “Because only total calories matter, it does not help weight control to restrict only starches or sugars. Like protein, they provide some four calories to the gram. Some restriction of fats may be useful, however, for they have nine calories to a gram.” “Unhappily, most people who want to reduce tend to limit their diets to a few foods and eliminate many others. This leads to boredom and failure and to poor nutrition.” “For example, low-carbohydrate diets are pointless and may be hazardous. And when such diets emphasize meats they prove to be very high in fat. Although they seem to work for some people, they can cause nausea, loss of appetite, and the loss of body fluids (dehydration). The AMA has warned doctors of their medical dangers.” “Even skipping meals is self-defeating. For the body tends to deposit more fat with only one or two meals a day then with several, although the caloric intake is the same.” “The most successful programs of caloric restriction,” say the authors, “deviate least from ordinary eating... Any excess of calories, be it from food, alcohol or inactivity, is inevitably stored as body fat. It is this excess of calories, and not the type or amount of sugars, starches, protein or fat in foods... that results in obesity.”
Topic: Sugar and Diabetes
Anti-sugar Claim SA Counterclaim
Diabetics should restrict their carbohydrate intake Diabetics do not need to restrict their carbohydrate intake
  Reasons: “In 1971 the American Diabetes Association surprised many with a statement that: “There no longer appears to be any need to restrict disproportionately the intake of carbohydrates in the diet of most diabetic patients.”” “Explaining this statement, Drs. Edwin Bierman (who chaired the committee that wrote it) and Ralph Nelson note that today patients rarely die of the direct effect of diabetes. They are lost to ills of the heart, blood vessels and kidneys, all of which may be related to high-fat diets. And a diet low in carbohydrates, such as the traditional diabetic diet, is high in fat. As the ADA statement observes: “A liberalized carbohydrate intake…will necessarily be associated with a decrease in dietary fat and cholesterol.””
Carbohydrates are harmful to diabetics Carbohydrates are not harmful to diabetics, and may help diabetics live longer
  Reasons: “Newer studies indicate that carbohydrates seem not only to stimulate the body to produce insulin, but also to trigger enzymes that put sugars in the blood to work. Experiments using diets up to 80% sugar actually improved the glucose (blood sugar) tolerance of both normal people and diabetics.” “Bierman and Nelson cite evidence that total calorie control is the main nutritional need of diabetics. If there is such control, diabetics can eat as much carbohydrate as the normal American—45% or more of the calories they consume.” “Will more carbohydrate and less fat help diabetics live longer? No one is yet sure. But in Japan, where diabetics eat more carbohydrates than their Western counterparts, they show less glucose intolerance and suffer less the complications of gangrene, while other functional disturbances are similar for both groups.” “Regulating the diabetic’s diet is still important. It must be adjusted to medication, activity and, above all, to calorie needs. And sudden surges of blood sugar (as can be caused by large amounts of sweets) must still be avoided. For the obese diabetic total calorie restriction (calories from all sources, not just sugar) is not relaxed.”
Sugar causes diabetes Excess sugar consumption does not cause diabetes
  Reasons: “There is no evidence,” the researchers emphasize, “that excessive consumption of sugar causes diabetes.”
Topic: Sugar and Hypoglycemia
Anti-Sugar Claim SA Counterclaim
Hypoglycemia is a widespread condition The prevalence of hypoglycemia is overstated
  Reasons: “Low blood sugar” (hypoglycemia) is a new way to explain many discomforts, especially emotional ones. “We may find it easier,” say the experts who studied the data, “to say, ‘My blood sugar is low,’ rather than, ‘I can’t cope.’”
All cases of hypoglycemia require treatment Not all cases of hypoglycemia require treatment
  Reasons: “But contrary to popular belief, not all of those people who show somewhat low blood sugar levels in tests are ill and need special care. Indeed, Pittsburgh’s Drs. Danowski, Nolan and Stephan find that 20 to 30% of normal people can show such readings in glucose tolerance tests.” “Low blood sugar is simply a sign—one that should be checked to eliminate the possibility of serious underlying disease. This is especially true if the hypoglycemia is moderate or marked.” “In most cases of mild hypoglycemia (blood sugars of 45 to 60 mg per cent) there is nothing more than a variation of normal. But even such patients should be followed for a time.” "In moderate hypoglycemia, however (30 to 45 mg. per cent), the low blood sugar may signify a prediabetic state. In a Public Health Service survey, within 10 years over 50% of those with moderate hypoglycemia progressed to actual diabetes. All cases showing very low blood sugars (zero to 30 mg. per cent) are unusual. And blood sugar at this level may be the indicator of poorly controlled diabetes mellitus or of some rare and serious diseases, such as disorders of the nervous system, the liver, certain glands and the life."
Hypoglycemia causes psychological disorders Hypoglycemia does not cause psychological disorders
  Reasons: “These slightly low blood sugars are not, as some claim, the cause of psychological disorders.”
Hypoglycemia is caused by too consuming much sugar Hypoglycemia is not caused by consuming too much sugar
  Reasons: “[Low blood sugars are not] the result, as some popular writers insist, of too much carbohydrate, especially sugar, in the diet.” “Whatever the reason for low blood sugar, it is the result of either an individual quirk or a disease state, not of eating starches and sugars. A diagnosis of “low blood sugar,” the authors’ studies of research suggest, is not a diagnosis at all. In many cases it is meaningless. In some others it is a signal to look for what could be an underlying disease.”
Topic: Sugar and Dental Caries
Anti-sugar Claim SA Counterclaim
Sugar is the cause of tooth decay Sugar only causes decay if it is consumed between meals and in sticky form
  Reasons: “the facts [supporting the claim that sugar causes tooth decay] are not so simple” “For example, in a five-year study at a Swedish mental institution patients were divided into seven groups. The first group got no sugar but still developed some cavities. Two other groups received sweet drinks at meals but had no increase in decay.” “Four other groups received between-meal sugars—as beverages, chocolate, caramels or toffee. The beverages and chocolate had no significant effect on decay, but the sticky candies did increase decay markedly when taken between meals.” “From this and many related studies, Drs. Sidney Finn and Robert Glass conclude there is not a one-to-one relationship between total sugar consumption and decay. But there is strong association between cavities and between-meal eating. It seems to be long and frequent exposure to certain foods in certain forms that does the damage.”
Foods should be ranked based on their cavity-causing potential Foods cannot be ranked by their cavity-causing potential
  Reasons: “Which foods? Nearly all sugars tested cause about equal decay. “Natural” sugars, such as honey, are as decay-producing as table sugar. The common sugars of grains, fruits, vegetables and even milk may produce decay. And cooked starches can be as troublesome. For two years 979 children were given as much unsweetened or presweetened cereal as they wanted; regardless of the kinds or amounts of cereal consumed, the amount of decay was similar.”
Dental caries should be controlled by reducing sugar consumption Reducing sugar consumption is not practical. There are other effective means of dental caries control.
  Reasons: “Why? Drs. Finn and Glass describe decay as an infectious disease. For mouth bacteria, which flourish on carbohydrates, produce an acid waste that eats into tooth enamel. Good hygiene helps to reduce tooth-adhering plaque and bacteria harbored by the plaque but never eliminates them entirely.” “Many other factors enter into decay—heredity, the shape, alignment and hardness of teeth, the chemistry of the saliva and so on. But there are few of these factors we can control. We cannot keep our mouths bacteria-free or go without all the foods on which the bacteria can feed.” "We can practice good dental hygiene, including regular visits to the family dentist. We can avoid sticky foods containing sugar, particularly between meals and at bedtime, and opt for sweets in liquid or quick-dissolving forms. But above all, we can add fluorides to school and community water supplies to harden young teeth early. It is estimated that for about 25 cents per person annually community water supplies can be fluoridated and some 60% of dental decay (and hence dental bills) can be eliminated."
Topic: Other
Anti-sugar Claim SA Counterclaim
Sugar has been linked to health problems beyond obesity, heart disease, diabetes, and dental caries, including addiction. Claims that sugar is addictive are not credible
  Reasons: “Many other human ills have been charged to sugar. But in these evidence is either non-existent or so slight that the scientific reviewers saw no reason for further study.”
The FDA should ban sugar Sugar is safe for the general public at current consumption levels
  Reasons: “In 1973 a team of noted scientists all of whom were either physicians or dentists—aware both of such threats and of sugar’s mounting importance as a food—began to study what was actually known about sugar’s effects on health. Working independently, at medical centers and universities across the nation, they combed the archives of scientific research. This is a summary of the six recently published papers in which they report their findings (World Review of Nutrition and Dietetics, Vol. 22, pp. 237–326, 1975).” “In general they conclude that sugar, like any other widely used food, is harmless when eaten in reasonable amounts.” “Considering all that science has learned of sugar and health, Dr. Stare sums up: "Sugar, a pure carbohydrate, is an important nutrient and food in the U.S. diet when used in moderation... Studies of actual intake suggest that the percentage of calories taken as sugar are higher during the growing and adolescent years when energy demands are high, and lower during adult and later years... There being no valid evidence to the contrary, this rate of intake (between 10 and 30% of total calories, with the average at 15 to 20%) may be considered moderate.” “Discussing the conclusions of the investigating team, Dr. Stare concludes, simply "At these levels sugar contributes to good nutrition, to the enjoyment of our meals; and it is safe.”