42
" When populations underwent Westernization, chronic diseases emerged with it, whether rapid or not, and typically in the same order, beginning with periodontal disease (tooth decay), gout, obesity, diabetes, and hypertension, and eventually encompassing all of them. "
― Gary Taubes , The Case Against Sugar
47
" Artificial sweeteners (noncaloric sweeteners, as the USDA calls them) as a replacement for sugar muddy these waters even more. Much of the anxiety about these sweeteners was generated in the 1960s and 1970s by the research, partly funded by the sugar industry, as we’ve seen, that led to the banning of cyclamates as a possible carcinogen, and the suggestion that saccharin could cause cancer (at least in rats, at extraordinarily high doses). Though this particular anxiety has tapered off with time, it has been replaced by the suggestion that maybe these artificial sweeteners can cause metabolic syndrome, and thus obesity and diabetes. This conjecture comes primarily from epidemiological studies that show an association between the use of artificial sweeteners and obesity and diabetes. But whether this means artificial sweeteners cause obesity and diabetes is, again, impossible to say. "
― Gary Taubes , The Case Against Sugar
48
" Ultimately and obviously, the question of how much is too much becomes a personal decision, just as we all decide as adults what level of alcohol, caffeine, or cigarettes we’ll ingest. I’ve argued here that enough evidence exists for us to consider sugar very likely to be a toxic substance, and to make an informed decision about how best to balance the likely risks with the benefits. To know what those benefits are, though, it helps to see how life feels without sugar. Former cigarette smokers (of which I am one) will tell you that it was impossible for them to grasp intellectually or emotionally what life would be like without cigarettes until they quit; that through weeks or months or even years, it was a constant struggle. Then, one day, they reached a point at which they couldn’t imagine smoking a cigarette and couldn’t imagine why they had ever smoked, let alone found it desirable. A similar experience is likely to be true of sugar—but until we try to live without it, until we try to sustain that effort for more than days, or just a few weeks, we’ll never know. "
― Gary Taubes , The Case Against Sugar
51
" The diet and lifestyle changes for the Tokelauans who immigrated to New Zealand were abrupt and even more dramatic. Bread and potatoes replaced breadfruit in their diets; meat replaced fish; they hardly ate any coconuts. Sugar consumption skyrocketed, as did physical activity: the men went to work as manual laborers in the forest service or on the railway, and the women got jobs in electrical assembly plants or clothing factories, or they cleaned offices during the evening hours, walking miles to and from work. In both populations, a similar pattern of chronic diseases erupted with the Westernization of the diet. Between the late 1960s and early 1980s, diabetes prevalence shot upward, particularly among the immigrants. By 1982, almost 20 percent of the immigrant women and 11 percent of the immigrant men—one in five and one in nine, respectively—were diabetic. Hypertension, heart disease, and gout also increased significantly, particularly in the migrant population (the migrants were nine times as likely to get gout as those remaining behind on the atolls). Obesity, unsurprisingly, also increased: Both men and women gained, on average, between twenty and thirty pounds. Children, too, got fatter. "
― Gary Taubes , The Case Against Sugar
56
" In 2003, epidemiologists from the Centers for Disease Control, led by Eugenia Calle, published an analysis in The New England Journal of Medicine reporting that cancer mortality in the United States was clearly associated with obesity and overweight. The heaviest men and women, they reported, were 50 and 60 percent more likely, respectively, to die from cancer than the lean. This increased risk of death held true for a host of common cancers—esophageal, colorectal, liver, gallbladder, pancreatic, and kidney cancers, as well as, in women, cancers of the breast, uterus, cervix, and ovary. In 2004, the CDC followed up with an analysis linking cancer to diabetes, particularly pancreatic, colorectal, liver, bladder, and breast cancers. Cancer researchers trying to make sense of this association would later say that something about cancer seems to thrive on the metabolic environment of the obese and the diabetic. One conspicuous clue as to what that something might be was that the same association was seen with people who weren’t obese and diabetic (or at least not yet) but suffered only from metabolic syndrome and thus were insulin-resistant. The higher their levels of circulating insulin, and that of a related hormone known as insulin-like growth factor, the greater the likelihood that they would get cancer. "
― Gary Taubes , The Case Against Sugar
58
" as the University of Toronto cancer researcher Vuk Stambolic would later describe it, these breast-cancer cells seemed to be “addicted to” insulin, and when weaned off it in the laboratory they responded by dying. This kind of phenomenon was seen also in cancers of adrenal and liver cells. As one 1976 report put it, insulin “intensely stimulated cell proliferation in certain tumors”; another, by researchers at the National Cancer Institute, described one particular line of breast-cancer cells as “exquisitely sensitive to insulin.” By then, researchers had established that malignant breast tumors had receptors to insulin, which were absent in healthy breast tissue, and that the more they had, the more insulin-sensitive they were. "
― Gary Taubes , The Case Against Sugar
