They warned us about the dangers of sugar 70 years ago (Why didn’t we listen?)

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| By Dr. Ronald Hoffman

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Faced with some downtime for the holidays, I undertook the task of excavating my basement. Having moved my office to more compact quarters a couple of years ago, I had shipped my legacy book collection to New Jersey. Boxes sat unopened there for a couple of years.

There were plenty of discards. Among the first to go was “Cooking Without Fat”, a 1992 best-seller that purports that “Fat-free products represent a real breakthrough in food.” The author, George Mateljan, founder of Health Valley Foods, is depicted on the book jacket. It seems to work for him, because after selling his company in 1996, he appears to be alive and continues to promote a healthy eating initiative. But fat-free cheesecake and fruit juice-sweetened granola with raisins as the basis for a healthy diet? Ummm . . .

After reluctantly tossing dozens of dated tomes into the throw out box (I channeled my inner Marie Kondo), I discovered a lost gem: Body, Mind, and Sugar by Emanuel Maurice Abrahamson MD. It was written in 1951, one year prior to my birth! And I had a rare first edition.

I’m not sure how I got hold of it, but it was probably thrust into my hands during an appointment with a well-meaning patient who may have discovered it while sorting through a departed parent’s book collection.

It was a revolutionary book, perhaps the first to highlight the pervasive health problems associated with refined carbohydrate consumption. It was prescient in mainstreaming the concept of hypoglycemia—long scorned as a “fad” by the medical establishment.

It’s also the earliest popular reference I can find to hyperinsulinism—an idea central to our understanding of the majority of preventable diseases that now threaten Americans’ longevity.

And the sad fact is that during my lifetime, Americans’ consumption of sugar and refined carbohydrates has nearly tripled, speeded by the introduction of cheap, corn-derived sweeteners in sodas, “fruit drinks” and processed foods. Obesity rates have soared, to a point that would astonish readers of Abrahamson’s book in the 1950s, when overweight afflicted a minority of Americans.

Abrahamson was no mere health journalist or science writer. He received his doctorate in chemistry in 1922 and was author of authoritative textbooks. He performed extensive research on diabetes, and published papers on the then-novel concept of hyperinsulinism.

In 1951 he teamed with a professional writer, A. Z. Pezet, with the stated aim of producing a book “ . . . written in language understandable to the layman . . . It is hoped, however, that those physicians who may read this will be impressed to consult our sources and to investigate further the theses which we present.”

After a long introduction into the physiology of diabetes, Abrahamson declares of hyperinsulinism: “We know now that there are many sufferers from this ‘newest’ disease, or condition, than there are diabetics.” The problem, he argues, is not one of too little insulin, but too much! Hyperinsulinism drives blood sugar too low, resulting in the constellation of symptoms encompassed by the term hypoglycemia.

And here’s a surprise: Abrahamson reported that, in 1945, he received an invitation to collaborate by a U.S. psychiatrist, Dr. Richard Horace Hoffmann (no relation, although my father dropped the 2nd “n” from our last name after emigrating from Germany). Hoffmann had noticed that many “neurotic” patients were suffering from low blood sugar. They exhibited “depression, phobias, and compulsions”. A six-hour glucose tolerance test—only then coming into vogue—revealed profound hypoglycemia. After a diet modification (“AVOID ABSOLUTELY—Sugar, candy and other sweets, cake, pie, pastries, custards, puddings and ice cream.”) their psychological symptoms abated. Abrahamson recorded numerous remarkable case studies of remission of mental conditions with sugar elimination.

Fast forward to this year—almost 70 years later—and the Wall Street Journal featured an article entitled “Foods That Battle Stress During the Coronavirus Pandemic” as if it’s “news”. They highlight the work of nutritional psychiatrist (!) Uma Naidoo, author of the new book This Is Your Brain on Food (An Indispensible Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD, and More). Dr. Naidoo, the founder and director of the Nutritional & Lifestyle Psychiatry clinic at Boston’s Massachusetts General Hospital, “specializes in helping people cope with mental illness through nutritional strategies”.

Nutritional psychiatry—what a concept!

It took the discovery of more efficient ways to measure insulin by Rosalyn Yalow at my alma mater, Albert Einstein College of Medicine, via radioimmune assay (RIA), to further clarify the role hyperinsulinism plays in promoting disease.

It was Gerald Reaven of Stanford who later popularized the term “Syndrome X”—the process by which Metabolic Syndrome interconnects obesity, blood sugar dysregulation, hypertension, fatty liver, adverse lipid ratios, inflammatory and even certain cancers—all related to hyperinsulinism triggered by high-carb diets. Now, hyperinsulinism has been found to be a key risk factor for bad outcomes of COVID-19.

Many popularizers of the low-carb paradigm were influenced by Abrahamson. The late Carlton Fredericks, my predecessor on WOR radio, often quoted “Body, Mind and Sugar” during his 30-year tenure on the air. Collaborating with Fredericks, Dr. Robert Atkins popularized his trademark low-carb diet. William Dufty picked up on the theme of food-mood in his influential 1975 book “Sugar Blues”. Countless follow-up books have reprised the theme of refined carbohydrates’ pernicious effects.

They knew. Yet they were ignored by so-called authorities. Worse yet, they were reviled as dangerous purveyors of “hogwash”. Now they’re finally achieving redemption.

For a comprehensive discussion of why the mainstream medical establishment, the food industry, and dietary guideline writers misinterpreted nutritional science and promoted the low-fat mantra, listen to my recent podcast interview with Gary Taubes, author of The Case for Keto: Rethinking Weight Control and the Science and Practice of Low-Carb/High-Fat Eating His book provides lots of valuable historical perspective on the long-standing diet wars.

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