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Soda and sugar

A study in the British Medical Journal publication, Open Heart, highlights and validates one of the major topics regarding the detrimental health effects of the highly processed modern Western diet that is discussed in great detail in both, The Fallacy of the Calorie: Why the Modern Western Diet Is Killing Us and How to Stop It and Food Shaman: The Art of Quantum Food.

I long railed against the ill-advised campaign for dietary sodium restriction (see these articles: the Atlantic; the Pacific Standard) that seems more based in politics than facts. Research also suggests that sugar, not salt, appears to correlate with the majority of the hypertension risk associated with processed food. Richard Krasuski, MD, from the Cleveland Clinic in Ohio, acknowledged that he should have anticipated it. He and other cardiologists have noticed that the recommendations to increasingly lower salt intake have not resulted in the expected positive cardiovascular outcomes. This topic is also discussed at length in the book but remains a tale for another day.

One of the key points of the study and one the books focus on is the data linking the consumption of significant amounts of sugar, and particularly fructose, with the development of a number of pathologies and diseases. Since the introduction of high fructose corn syrup in the 1970s, an increase in total sugar consumption, including fructose, is a trend that has been observed in the United States and other industrialized nations.

This ubiquitous sweetening agent has found its way into a plethora of processed foods that run the gamut of dietary selections; from the obviously sweet to the subtly savory. The vast majority of the foodstuffs consumed in the modern Western diet come from such highly processed items. And unfortunately, the bulk of the modern Western diet is built upon these products.

The researchers of the study find themselves drawn to the same important conclusion as the readers of the books; for good health people need to “eat less processed food.” As recommended in The Fallacy & Food Shaman, The authors suggest that future dietary guidelines recommend that highly refined processed foods be replaced by natural whole foods.

As I could not have said it better myself, here are the study’s conclusions:

Thus, while there is no argument that recommendations to reduce consumption of processed foods are highly appropriate and advisable, the arguments in this review are that the benefits of such recommendations might have less to do with sodium—minimally related to blood pressure and perhaps even inversely related to cardiovascular risk—and more to do with highly-refined carbohydrates. It is time for guideline committees to shift focus away from salt and focus greater attention to the likely more-consequential food additive: sugar. A reduction in the intake of added sugars, particularly fructose, and specifically in the quantities and context of industrially-manufactured consumables, would help not only curb hypertension rates, but might also help address broader problems related to cardiometabolic disease.


DiNicolantonio, J. J., & Lucan, S. C. (2014). The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart BMJ, 1:e000167.doi:10.1136/openhrt-2014-000167.