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Feature Public Health

Sugar and the heart: old ideas revisited

BMJ 2013; 346 doi: (Published 15 January 2013) Cite this as: BMJ 2013;346:e7800
  1. Geoff Watts, freelance journalist, BMJ
  1. 1London, UK
  1. geoff{at}

Forty years after he first put them forward, John Yudkin’s warnings on sugar are finally being recognised. Geoff Watts reports

“Diets high in added sugar raise heart disease risk”; “One soft drink a day raises heart attack danger”; “Added sugars increase heart disease risk.” Few things are more prey to fad and fashion than alleged dietary influences on health. So the word “sugar” in headlines where, for 30 years, we’ve been accustomed to expect the word “fat” may be little more than a caprice. Alternatively it may indicate a more substantial change. Which is perhaps why Penguin Books is reissuing Pure, White and Deadly, John Yudkin’s valiant, 40 year old attempt to warn us against our lust for sucrose.1

Born in 1910, Yudkin studied physiology and biochemistry at Cambridge University, embarked on a career in microbiology, but then switched to medicine and nutrition. In 1945 he was appointed professor of physiology at Queen Elizabeth College, London, and set about creating a department with an international reputation in nutrition. He died in July 1995.

His book Pure, White and Deadly is about the uses of sugar, who consumes it, in what amounts, and how it’s handled by the body. But most of all it’s about what he saw as sugar’s deleterious effects on health. As he points out, carbohydrates have always been part of our diet and, until 50 years ago, the general view was that the form in which you consumed them was neither here nor there. But the more he thought and read, the more doubtful he became—about this, and also about the role of fat in heart disease.

Back in 1957, commenting that much had been said on the role of diet in coronary thrombosis, he wrote: “In particular, many believe that the disease is related …

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