Sugar Free Diet ?

Below is an article on sugar free dieting from The Conversation followed by some other diet related material:

Sweet enough? Separating fact from fiction in the sugar debate

By Chris Forbes-Ewan, Defence Science and Technology Organisation

Forget lemon detox diets and soup fasts, sugar-free was the fad diet choice of 2013. But while it’s wise to limit the foods and drinks you consume that contain added sugars, this doesn’t mean you need to eliminate sugars from your diet altogether.

In 2003 the World Health Organisation (WHO) considered recommending limiting intake of “free sugars” to 10% of total energy intake. Free sugars are sugars added to the food by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and fruit juices.

Although this recommendation was based largely on the well-established relationship between sugars and dental health, the evidence available in 2003 suggested that, at least when consumed in liquid foods, sugars may also contribute to obesity.

The US sugar lobby argued tenaciously against the recommendation, to the point where it was accused of adopting similar tactics to those used by the tobacco lobby a few decades previously. To its credit, the WHO held firm and the 10% limit was recommended.

A recent report in the UK press suggests that the WHO is considering halving its recommended maximum intake of free sugars to 5% of total energy. This is based on recent evidence that, it is claimed, implicates sugars in the onset of heart disease and strengthens the link with obesity, in addition to the previously demonstrated association with tooth decay.

So, how strong is the evidence that consumption of sugars causes (or is at least a major contributor to) obesity and heart disease?

In preparation for the proposed update, the World Health Organisation published a review of the effects of sugars on obesity was published last year.

One study found increasing sugar consumption led to a 0.8 kg weight gain. Flickr/foshydog

In summary, the report found that increasing intake is associated with a small, but statistically significant (around 0.8 kg) weight gain, while decreasing intake is associated with a similar level of weight loss. It also concluded that consumption of sugar-sweetened beverages is particularly likely to lead to increased body weight.

Sugars in liquid form are often attributed as a main cause of obesity and related chronic diseases. One study, for example, was reported to have found a direct link between consumption of sugary drinks and 180,000 deaths annually worldwide.

The relationship between consumption of sugars in liquid form and adverse health effects is reflected in the Australian Dietary Guidelines, which were revised by the National Health and Medical Research Council (NHMRC) last year. The new sugar guideline emphasises the importance of limiting intake of:

… sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks.

However, although the strength of the evidence that sugar-sweetened drinks are associated with weight gain was regarded by the NHMRC as grade B (meaning it can probably be trusted, but is not entirely convincing), no evidence of a direct link between intake of sugars and heart disease was found.

Even so, the NHMRC suggested a possible indirect link with heart disease through an association of consumption of sugar-sweetened drinks with type 2 diabetes and “metabolic syndrome”, a set of conditions that predisposes to both heart disease and diabetes.

In 2009 the American Heart Association (AHA) concluded that:

Excessive consumption of sugars has been linked with several metabolic abnormalities and adverse health conditions … evidence from observational studies indicates that a higher intake of soft drinks is associated with greater energy intake, higher body weight, and lower intake of essential nutrients.

The AHA report recommended an upper limit of approximately 400 kilojoules (six teaspoons) per day from sugars for a woman, and 600 kilojoules (nine teaspoons) per day for a man. These quantities constitute about 5% of total energy intake and are consistent with the reported potential revised WHO recommendation.

There will be little or no harm done if the recommended maximum level of sugar is decreased. Flickr/stevendepolo

One of the leading proponents of the concept that sugar is the major cause of obesity, heart disease and type 2 diabetes is Robert Lustig, a US professor of pediatrics. In an opinion piece published in Nature last year Lustig and colleagues argued that sugar is as dangerous as alcohol and tobacco, and that it’s fuelling a global obesity pandemic, contributing to 35 million deaths annually worldwide from diseases such as diabetes, heart disease and cancer.

It is important to note that “sugar” (the crystalline product commonly used to sweeten foods and beverages, and known scientifically as sucrose) consists of two components, glucose and fructose. Lustig (and colleagues) believe that it is the fructose component of sugar that is the culprit, while glucose is an “innocent bystander”.

However, other experts in the field remain unconvinced that moderate intakes of fructose-containing sugars (up to about 10% of total energy intake) are major contributors to heart disease or obesity.

An extensive review of the scientific literature published in 2010 found:

… no evidence that the consumption of normal levels of intake (of fructose) causes biologically relevant changes in triglyceride [a type of fat that is associated with increased risk of heart disease] or body weight in overweight or obese individuals.

John Sievenpiper, a world-renowned expert from the University of Toronto, came to the conclusion that far from being harmful, small doses (up to 36 grams) of fructose per day may reduce the risk of type 2 diabetes, while having no adverse effects on body weight or blood lipids.

Fruit also contains fructose. Matthew Kenwrick

This quantity of fructose equates to 72 grams of sucrose, which corresponds to about 10% of total energy intake for a typical man (the current maximum intake recommended by the WHO).

However, some of our ingested fructose should be coming from fruit, so this finding doesn’t constitute a suggestion that 10% of energy intake “should” come from sucrose, only that this level of intake may not be harmful.

So what can we conclude – from the current state of evidence – about the appropriateness of the reported proposal by the WHO to reduce recommended maximum sugar intake from 10% to 5% of total energy intake?

One prediction I can confidently make is that the sugar lobby will strenuously oppose any recommendation to further reduce sugar intake, as it did for the 2003 WHO recommendation.

I also believe that there will be little or no harm done if the recommended maximum level is decreased, while some good may come from such a revision.

However, it still remains to be seen if the WHO will go ahead with this recommendation. Watch this space.

Chris Forbes-Ewan received funding from the National Health and Medical Research Council in 2006 for his contribution to the development of Nutrient Reference Values for Australia and New Zealand. His contribution was in the area of estimated energy requirements.

The Conversation

This article was originally published at The Conversation.
Read the original article.


My response

As a psychologist I often talk about diet.  My post on the was:


My personal experience is that when I want to reduce my weight I cut my sugar intake. This has worked for me for many years. I am currently 7 kgs overweight and about to do this again. Last time was a 5kg weight reduction in 2012.

I have a “sweet tooth” with a particular weakness for cakes and biscuits. I drink minimal alcohol. When I go on this diet I get sugar cravings. I cope with these by distracting myself with fruit. I can therefore relate to the idea of sugar as an addiction. I find when I do this I become more conscious of my diet and portion size so I don’t think it is the sugar alone.

To me reducing sugar is a simple way to reduce calorie intake and it works for me.

My professional experience is that obese people often use food as a distraction from negative emotions. This is very similar to other addictions and this is core to the approach I take with those clients in terms of looking at alternative ways to deal with the emotions and looking at strategies to deal with the triggers for non-compliance with their diet.


Other Articles and links 

This article talks about psychological aspects of weight loss:


This article notes:  ”The first step in my weight-loss journey had little to do with food and a lot to do with changing the way I talked to myself. I was my own worst coach – trying to motivate myself with insult and abuse rather than empowerment. I was telling myself very damaging lies, which I had to address before I could make any sort of permanent changes in my life. The most harmful of these, I’ve already addressed: that my weight determined my value. But I also told myself things like “I’m too fat to be loved”, “everyone sees my fat first”, and “I’m too fat to eat in front of people”. Moreover, I began with the damaging mindset that gaining weight meant failure while losing weight meant success. This, I believe, is what kept me on the rollercoaster for so long.”


This article from the Guardian talks about dieting makes you fatter;


A new book The Diet Myth by Dr Tim Spector notes the importance of eating a variety of foods and the role of microbes:

  • The living cells in our bodies are 10 per cent human and 90 per cent microbe
  • Eating lots of fatty cheese or yoghurt can improve health and weight
  • A handful of garden soil holds more microbes than there are stars in the known universe
  • Sweeteners in ‘diet’ fizzy drinks have adverse effects on our metabolism and microbes and can make us gain weight
  • Cubans, despite eating on average twice the amount of sugar as Americans, are far healthier
  • We evolved from microbes millions of years ago, share their genes and still perform many tasks for them and they perform many more for us.
  • Foods advertised as ‘low-fat’ are actually making us fatter
  • Fasting diets such as the 5:2 diet work by beneficially altering our microbes and their metabolism
  • Skipping breakfast may be a healthy strategy for many people
  • The average twenty-year-old today will have already had eighteen courses of antibiotics and will have abnormal microbes increasing risk of obesity
  • The diversity of microbes in our bodies is 30 per cent lower than fifty years ago
  • Gut microbes, when disrupted, are a major cause of obesity and diabetes but they are also essential for health
  • Thousands of people are now having poo transplants – many with significant success (see link to ABC Catalyst below)
  • Microbes in your gut can affect your brain and mental health, and contribute to autism and depression and even the urge to eat more
  • Much of our food is contaminated with low levels of antibiotics used in farming, making us fat
  • A third of people have genes and microbes that prevent them getting fat
  • Microbes enjoy eating the polyphenols in dark chocolate which may keep us slim
  • Key nutrients and essential vitamins are extracted from our food only through our gut bacteria
  • Babies need microbes for development of their brains and immune systems
  • The success of the Mediterranean diet is due largely to providing fertiliser for our microbes
  • Unpasteurised cheese is one of the richest sources of living healthy microbes and fungi
  • Most probiotics in yoghurt don’t work well in humans and may need to be personalised
  • Olive oil and nuts are ultimate health foods that nourish our microbes
  • Living on a dirty farm or having pets helps microbes and protects you against allergies
  • Whether you like to eat salads, broccoli chips or garlic is partly genetic
  • Belgian Beer, garlic, coffee, leeks and celery are perfect foods to increase gut microbes
  • A diet of junk food can dramatically reduce healthy gut microbes in only two days
  • Increasing the diversity of our diet will increase our microbes, our health, happiness and lifespan


Here is an interesting 30 minute documentary on the role of fibre and the potential for high fibre diets to help various medical conditions including asthma, irritable bowel, and psoriasis:


If you have one and half hours to watch Dr Robert H. Lustig, UCSF Professor of Pediatrics in the Division of Endocrinology, he talks on the damage caused by sugary foods. He argues that fructose (too much) and fiber (not enough) appear to be cornerstones of the obesity epidemic through their effects on insulin;

Dr Robert Katz argues against fads including the sugar free diet here;
A well reasoned article but low fat diets are argued to be the fad here (with a low carb diet recommended);
Here is a fact sheet from the ABC on sugar:






Description:  There have been a number of articles on following a sugar free diet. Psychological strategies can help stay on a diet.

Keywords:  Diet Psychologist

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