The mighty armies of academia have once again come together to combat the common enemy — sugar. Having consumed plenty of the sweet stuff of late, feasting, merry-making, vacationing and celebrating, perhaps we should take notice of what they have come up with now. It seems that once again, they have had a change of heart. For decades we have followed their instructions to cut down on our fat intake, to exercise and eliminate carbs. The result is that we have become even fatter, according to the World Health Organisation. Globally, we reached a peak in 2020, with 83 per cent of men and 72 per cent of women either overweight or obese. What went wrong? They come up with a variety of theories that conflict and confuse: eat eggs, do not eat eggs, eat carbs, avoid carbs, exercise vigorously, exercise mildly. No milk, no flour, no salt, and it went on season after season, and the result is disastrous. The latest and most popular was to avoid saturated and/or unsaturated fat. It made sense. If you consume fat it will inevitably make you fat. Nothing worked, we are as fat as we ever were, just more so, despite all our efforts. A common complaint is "I have been dieting all my life and I am still fat." Now a fresh voice rings loud and clear and everyone, including scientists, nutritionists, endocrinologists, and doctors, are paying close attention. The voice is that of Dr Robert Lustig, whose credentials could fill volumes. He has been studying and researching, and he concluded that we are all on the wrong track. A professor emeritus of paediatrics, the Division of Endocrinology at the University of California in San Francisco, Lustig has been treating obese infants and children. Through no fault of their own, they developed obesity. They cannot be blamed of laziness, gluttony, or all the other guilt-laden accusations we hurl on fat people. He came to the conclusion that the main culprit is sugar. Perhaps not an earth-shaking discovery, but it was always in the back rather than the forefront of our minds. There is simply too much sugar in milk, in fruit juices, without fibre, it is immediately absorbed by our cells. It is a question of metabolism, not calories. How often have we been told to count calories, and what goes in must come out by running around the block or spending hours at the gym. Counting calories really became the standard. Even doctors treating diabetics would instruct them to do just that, plus a daily walk or so. Today it seems it has little to do with the number but the quality of calories. What is a calorie, exactly? Few of us know. A calorie is a unit of physics. It is how much energy you have to add to a glass of water to raise it one degree centigrade. It has unique bio-chemical reactions and in addition, it is measured at the mouth. In fact you should not care about how many calories you eat, but how many you absorb. When you consume food with fibre you only absorb 70/80 calories of what you eat. The rest get metabolised by the bacteria in your intestine, but you counted them anyway. So when you consume your calories with fibre, those calories were not for you but for your bacteria. Different foodstuffs are metabolised at different rates. Therefore, "a calorie is not a calorie" said Lustig. From a metabolic perspective (as opposed to a weight management perspective) not all calories are created equal. For years, Lustig has been arguing that sugar causes health problems unrelated to calories and unrelated to weight gain. Besides, it is possible to be overweight and healthy. Really? Indeed. Apart from the big butt-fat, they do not seem to harbour any metabolic perturbations. Their telomeres seem as healthy as those of normal weight people, so obesity is not harming them in any way. Science has a name for them: metabolically healthy obese (MHO). However only 20 per cent of obese people are MHO. Lustig's popularity has grown by leaps and bounds. His famous UC documentary has been viewed by five million people. His books, particularly Fat Chance, are fast bestsellers, and his lectures around the globe are attended by scientists and laymen alike. His quarrel is with processed food that we consume in big quantities, frozen foods, crackers, chips, cornflakes, granolas, candies and most specifically, colas and juices. The food industry together with the soft drink industry are fighting him tooth and nail. He is fighting back and we are listening. Consumers read labels, discard whatever high sugar content, but the industry is smarter. It has 56 names for sugar making it hard to discern. The "inconvenient truth" is that sugar is killing hundreds of thousands of us, while they are getting richer. The "Fog of Food" is reminiscent of the wars with the tobacco industry of half a century ago. Sugar is not dangerous because of the calories, or because it makes you fat, but because it is not nutritious, it is toxic and addictive. The problem is metabolic dysfunction and anyone can get it. Obesity is the result of the problem, not the cause. We have come full circle to what is real food, like grandma used to make. Cut down on eating out, you save money and health. When it comes to a slice of birthday cake, do not hesitate to partake, those are not calories. "Sugar, not fat, is now considered the devil's food. It is a fact." Robert Lustig (1957-) *A version of this article appears in print in the 27 May, 2021 edition of Al-Ahram Weekly
