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Science souring on sugar

BMJ 2013; 346 doi: (Published 15 January 2013) Cite this as: BMJ 2013;346:e8077
  1. Walter C Willett, professor and chair1,
  2. David S Ludwig, professor of pediatrics2
  1. 1Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA
  2. 2New Balance Foundation Obesity Prevention Center, Boston Children’s Hospital, Boston
  1. walter.willett{at}

Accumulating evidence points towards a role for sugar and other refined carbohydrates in the development of overweight

Sugar—most importantly sucrose (table sugar) and high fructose corn syrup—has long been thought to have adverse health effects, such as contributing to dental caries, overweight, diabetes, and heart disease. A linked feature (doi;10.1136/bmj.e7800) comments on the 40th anniversary of the publication of the popular book—Pure, White and Deadly—written by the British physiologist John Yudkin, which claimed that high sugar consumption was associated with heart disease.1 2

The association between sugar and poor health has remained contentious over the past few decades. This is partly because of weaknesses in the data (Yudkin’s conclusions were largely based on comparisons of sugar intake and disease rates among different populations, which is generally considered a weak form of evidence) and because powerful economic interests are invested in the production and sale of sugar based products. The tension between industry and scientists can be illustrated by a 2003 recommendation from the World Health Organization that sugar intake be limited to 10% of energy intake,3 which was heavily attacked by the sugar industry and many governments, but was ultimately sustained. Because WHO plans to update its recommendations, a systematic review of the literature on the association between sugar consumption and body weight was commissioned, the findings of which are presented in …

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