Sickeningly Sweet: Does Sugar Cause Type 2 Diabetes? Yes

Lustig, Robert H.

doi:10.1016/j.jcjd.2016.01.004

Cited by 24 publications

(25 citation statements)

References 37 publications

(32 reference statements)

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“…Most studies evaluating individual added sugar components examined the role of either fructose, glucose, or sucrose on T2D risk . However, a few studies explored how added sugar components (ie, fructose, glucose, and/or sucrose) contribute to changes in insulin resistance or glucose metabolism, indirectly influencing T2D risk …”

Section: Resultsmentioning

confidence: 99%

“…Specifically, dietary self‐report is associated with intentional misreporting; typically, under‐reporting of dietary intake . Diagnostic methods to determine added sugar's impact on T2D risk were typically measured using blood‐serum laboratory tests like glycosylated hemoglobin (HbA1c), fasting blood glucose, oral glucose tolerance testing, or the homeostatic model assessment for insulin resistance (HOMA‐IR) …”

Section: Resultsmentioning

confidence: 99%

“…These examples include words like sugar, sucrose, free sugars, dietary sugars, nutritive sweeteners, sugar‐sweetened beverages (SSB), high glycemic carbohydrates, high‐fructose corn syrup (HFCS), fructose, and fructose‐containing sugars . Several publications studied SSB consumption which was not always portrayed as an exclusive “added sugar product”, but rather as a product containing HFCS . A few publications described SSBs as caloric sweeteners instead of products containing added sugar …”

Section: Resultsmentioning

confidence: 99%

“…Other studies examining added sugars effect on T2D risk did not distinguish added sugar proxies as actual added sugar‐containing products (eg, sweets, HFCS) and alternatively referred to these products as simply, dietary sugars . Several review articles compared and contrasted sugar sources (eg, fructose sugars, total sugars, HFCS, sucrose, SSB) in the context of T2D risk, but did not refer to these sugars as “added” sugar sources limiting the conceptual clarity of the concept …”

Section: Resultsmentioning

confidence: 99%

“…12 Other researchers studied added sugar in the form of the sugar disaccharide sucrose (comprised of the two sugar components fructose and glucose), or examined individual added sugar components (ie, monosaccharides) such as fructose and glucose. 1,2,[33][34][35][36][37][38][39][40] Of these three forms of sugar evaluated, fructose was most commonly studied, typically as an individual sugar 34,35,37,38,40 or in combination with foods and beverages specifically containing HFCS. 1,2,33,36,39 Most studies evaluating individual added sugar components examined the role of either fructose, glucose, or sucrose on T2D risk.…”

Section: Literature Search Methodsmentioning

confidence: 99%

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Influences of added sugar consumption in adults with type 2 diabetes risk: A principle‐based concept analysis

Sneed¹,

Patrician

Morrison

2019

Nurs Forum

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Aim The aim of this study is to describe the concept added sugar in the context of type 2 diabetes (T2D) risk in adults. Background Dietary added sugars are associated with a greater risk for T2D; however, it is unclear if added sugars influence T2D risk directly or if their effects are mediated by excess caloric intake and weight gain. Design A principle‐based concept analysis following the PRISMA guidelines was conducted to clarify the concept of added sugar. A systematic search was conducted using PubMed and Embase. Multidisciplinary, empirical evidence was appraised using four guiding principles outlined by the principle‐based concept analysis method. Results Thirty‐five publications were included in this concept analysis. The concept, added sugar in the context of T2D risk, was found to be epistemologically immature and lacked conceptual clarity. Conclusions Added sugar is an immature concept warranting further refinement for conceptual advancement. To enhance conceptual clarity, the term “added sugar” should be used consistently in the scientific literature when discussing foods or beverages containing added sugars or caloric sweeteners. A clearer delineation of added sugar and its association with T2D risk in adults is critical to advance this concept within the scientific literature.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Literature Search Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Influences of added sugar consumption in adults with type 2 diabetes risk: A principle‐based concept analysis

Sneed¹,

Patrician

Morrison

2019

Nurs Forum

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Processed Food—An Experiment That Failed

Lustig

2017

JAMA Pediatr

Self Cite

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buy previously unaffordable luxuries for her grandson including toiletries, fresh produce, winter blankets, and a nightlight.Like Beatrice, single women making less than $10 000 yearly headed many of the families we served. The good news for these women and their children was 2-fold. First, these types of families are the EITC's target population and, as such, received thousands of dollars in tax credit. Second, for those who filed in prior years, StreetCred saved them money previously lost to the for-profit taxfiling industry by providing free services in the comfort of a trusted setting: their pediatrician's office. These women expressed both gratitude and practical impact as they reported their ability to not only more fully meet their children's basic needs, but also take a first step toward financial stability by paying off loans, which are stories consistent with national data on the ways taxpayers use EITC monies. 7 Moreover, StreetCred empowered families with EITC education. Some clients expressed enthusiasm about working more hours in the coming year to qualify for a larger EITC on their next tax return. Other single mothers learned that they, not their ex-husbands, should claim the children as tax-return dependents because they served as primary caretakers.StreetCred is another example of how the US health care system can be a gateway to the public benefits, community resources, and financial stability supporting low-income parents, like Beatrice, in one of the most important jobs in the United States: raising healthy children. The trust and regular contact between families and their children's medical professionals present a special opportunity to screen for and address the social determinants of health. Street-Cred aims to make accessing programs, such as the EITC, cheaper, faster, and easier to understand. The program's short-term goals are 2-fold: (1) expand free tax-preparation services to other clinics and hospitals serving low-income families with children and (2) expand its services portfolio with additional asset-building tools so families might truly break the cycle of poverty. Innovative programs extending beyond the traditional boundaries of pediatric health services remain an important approach to promoting the health and development of our patients growing up poor.

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Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetes

2016

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Fructose-containing sugars are a focus of attention as a public health target for their putative role in obesity and cardiometabolic disease including diabetes. The fructose moiety is singled out to be the primary driver for the harms of sugars due to its unique endocrine signal and pathophysiological role. However, this is only supported by ecological studies, animal models of overfeeding and select human intervention studies with supraphysiological doses or lack of control for energy. The highest level of evidence from systematic reviews and meta-analyses of controlled trials has not shown that fructose-containing sugars behave any differently from other forms of digestible carbohydrates. Fructose-containing sugars can only lead to weight gain and other unintended harms on cardiometabolic risk factors insofar as the excess calories they provide. Prospective cohort studies, which provide the strongest observational evidence, have shown an association between fructose-containing sugars and cardiometabolic risk including weight gain, cardiovascular disease outcomes and diabetes only when restricted to sugar-sweetened beverages and not for sugars from other sources. In fact, sugar-sweetened beverages are a marker of an unhealthy lifestyle and their drinkers consume more calories, exercise less, smoke more and have a poor dietary pattern. The potential for overconsumption of sugars in the form of sugary foods and drinks makes targeting sugars, as a source of excess calories, a prudent strategy. However, sugar content should not be the sole determinant of a healthy diet. There are many other factors in the diet—some providing excess calories while others provide beneficial nutrients. Rather than just focusing on one energy source, we should consider the whole diet for health benefits.

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Sickeningly Sweet: Does Sugar Cause Type 2 Diabetes? Yes

Cited by 24 publications

References 37 publications

Influences of added sugar consumption in adults with type 2 diabetes risk: A principle‐based concept analysis

Influences of added sugar consumption in adults with type 2 diabetes risk: A principle‐based concept analysis

Processed Food—An Experiment That Failed

Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetes

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