Is sugar poison? 

After I was diagnosed with cancer in 2023, I pretty much eliminated almost all white sugar from my diet. I ended up losing about 40 lb through chemo and just dietary changes. No love loss because I was overweight anyway. The biggest takeaway for me is I feel better physically without the sugar and I've been able to maintain my weight loss just by not eating things that are loaded with sugar or anything processed for that matter. My oncologist doesn't seem to think that diet makes a difference with cancer, but who knows. I keep doing what I need to do to feel better and healthy and eliminating sugar was one of those things.

Here are the key takeaways from Peter Attia's discussion on whether sugar is poison: 1. **Contextual Definition of Poison:** Attia emphasizes that the term "poison" depends on dose, frequency, and context of consumption. He argues that many substances, including sugar, can be toxic in excessive amounts but not inherently poisonous in moderate quantities. 2. **Comparative Analysis:** By comparing sugar to other substances like acetaminophen and alcohol, Attia illustrates that even commonly used substances can become toxic if misused, suggesting that toxicity is more about usage patterns than the inherent properties of a substance. 3. **Sugar's Biochemical Impact:** The effects of sugar, specifically different types such as sucrose or fructose, should be assessed based on their biochemical impacts at varying doses and metabolic conditions, rather than simply labeling them as poisonous. 4. **Misinterpretation and Overstatement in Data:** Attia points out that data regarding sugar consumption often get misrepresented or overstated, particularly concerning its impact on overall calorie intake and metabolic health. 5. **Controlled Intake Experiments:** Reference to experimental studies, like the mouse study, shows that under controlled calorie intake, sugar in different forms does not significantly affect body weight, though the impact on other metabolic parameters might vary with higher doses. 6. **Personal Experience and Activity Level:** Attia shares personal anecdotes to demonstrate that high sugar consumption may not be detrimental in the context of high physical activity, highlighting the importance of lifestyle context. 7. **Dietary Patterns Over Isolated Nutrients:** He advises focusing on overall dietary patterns rather than obsessing over single nutrients like sugar. This broader perspective helps in understanding and managing health more effectively. 8. **Individualized Nutritional Advice:** Attia advocates for nutritional recommendations that are tailored to individual metabolic health, body composition, and lifestyle factors, rather than one-size-fits-all advice. 9. **Ongoing Research:** The podcast hints at ongoing research into the specific roles of different types of sugar, like fructose, in conditions such as non-alcoholic fatty liver disease (NAFLD), indicating a nuanced and evolving understanding of sugar's health impacts. These takeaways underscore a nuanced view of sugar, advocating for a balanced and informed approach to dietary sugar rather than categorical demonization.

The thing that is often missed in this discussion is the amounts. One cup of blueberries has about 5g of fructose. An orange has 4g. A 12oz bottle of soda has almost 20g of fructose. In fruit, that fructose is bound up with fiber, minerals, vitamins. In soda or candy, it's immediate released and unless you are currently running, biking, or swimming hard to use those sugars in your muscles, those sugars then float around causing problems

Pretty sure that alcohol is a poison, regardless of the amount.

Dose determines the answer.

Seems like he’s saying if you eat a healthy well balanced diet, then a sugary dessert won’t hurt you so long as your total caloric intake is kept in check. Just common sense!

Thanks for this info Doc.

Like so many things in life, I think the problem with sugar is as much behavioral as biochemical. Anecdotally, there definitely seems to be a portion of the populace who needs to avoid sugar at all costs the way some people need to avoid alcohol or gambling - and while there probably is less overall harm in avoiding sugar than not, it's still a mistake to make blanket statements like "sugar is poison" or "sugar is fine".

Is there anything that is not toxic if over-consumed?

What an honest and refreshing answer

What I'm getting from this is that things looked at as generally unhealthy for you, aren't necessarily inherently bad, but it's the moderation and/or frequency with which you supply your body these foods/substances etc. that contribute to your overall well-being. So a cookie here and there is fine, but a whole box of Samoa's, and then cake for desert, not a great idea. Moderation control is something I've struggled with my whole life. Good luck everyone!

I’m pretty low carb and eat little sugar . Fasting insulin 1.7 - I recently ate unconsciously xxlarge amount of Swedish fish . Following a shoulder surgery in which I was fasted and on pain meds . The next day I was water logged -my weight went from 185 to 205lbs. Most of water was concentrated to my lower extremities especially lower back and feet . I looked like the elephant man. Freaked me out - I noticed I wasn’t urinating I was drinking a gallon of water with electrolytes added to it. I didn’t have carbs for the next few days. Water disappeared and I got back to normal. Was it over consumption of Swedish fish? I’m assuming it was I’ll never touch them again. Lesson learned.😮

"We're gonna very simplify it" killed me. Come on.

It’s a nuanced response from Peter and refreshing to listen to. As he says, over consumption of sugar clearly isn’t desirable but show us the data that points to sugar being the culprit in isolation when calories are in fact equated. I cannot find a single RCT which demonstrates this. There are many doctors in the podcast space these days, including the likes of Lustig, demonzing sugar for being the single main cause of health issues when in reality the problem has always been the overconsumption of calories. The problem with sugar is its association with highly palatable caloric dense foods/drinks that enable us to easily over consume calories. But statements like sugar is poison and addictive are both grossly misguided and misleading

Short version….discussion is very much context dependent.

My bet is that the biggest risk from sugar (whether sucrose or fructose) is not really from the sugar itself but from the fact that it's a highly "processed" food, and by "processed", I mean it's been isolated as a single molecule, and especially has no accompanying minerals or fiber...it's a non-whole food-energy source. When we consume too much of such foods as a percentage of our total calories, we are very likely to be in a mineral and fiber deficit, maybe fatty acids and proteins as well, let's say all the non-carb stuff...all nutrient intake should follow along proportionately to our total daily calorie intake needs...to be on the safe side. So, I'd say sugar is a fine fuel but must be accompanied by enough other non-carb nutrients to keep us in total balance, not just in energy balance. Balance is not balance unless it's total.

Doctor Attia has a point : if you exercise a lot ,like I do, glucids intake is not an issue , you have to burn the energy that glucids provides. I am happy to hear him, he is excellent, not like these keto diet gurus....

My father-in-law who's 97, always says about sugar. "That stuff is dynamite!" I laugh but he's damn right.

Im glad i saw this since im eating donuts atm

The clinical studies have been done for NAFLD, but in isocaloric overfeeding studies. saturated fat is the worst, carbs middle, unsaturated fats are the best in terms of adding less hepatic fat when overfed. Look up Ching Jian et al. Clin Nutr. 2021 Jan.

I rarely crave sugar these days. Every now and then, I love a Mexican Coke. I have to have sugar when I participate in endurance events, and I try to use gels that are tart or a little salty because I just loathe that sticky sweet flavor and texture. It makes my teeth ring in pain. I'm much more of a salt enthusiast. Sugars are needed, but like the Doc said, fruit (and complex carbohydrates) are a much more sustainable option. Also, I think another part of the equation is that we're pretty neglectful of dietary fiber in this country.

I still remember watching a Chris McCormick interview(a 6 time iron man champion), said he drinks Coke after the race

OK, a limited calorie, iso-caloric diet of glucose vs fructose didn't produce different metabolic states. But if they could all eat ad libitum, would the fructose mice swell up more?

I think it was John Yudkin who said that there is no substance that is absolutely toxic. Everything is a matter of dosage. Whether or not it was a good idea Doctors used to prescribe small amounts of Arsenic as medicine. People have been known to die from consuming too much water. Having said that, fructose is like crack-cocaine to me and I've had to struggle to avoid it in processed foods. My tolerance for fructose has diminished with each decade of life, as has my activity. Since fructose is only processed by the liver (and kidneys), IMO it is best to avoid it, especially if you are overweight. In many ways asking young healthy Doctors their opinions on sugar and fructose is like asking a teenager what they feel about aging. I would put more stock in their opinions if they were 70 years old and had regained a healthy BMI after recently having been obese.

Would have been great if he touched on insulin resistance. If sugar has the potential to spike insulin more severely, wouldn't that be a reason to avoid it for longevity purposes?

What if the question was rephrased as 'is sugar that comes in a pack (not fructose in fruits or lactose in dairy products) poison?

Can you elaborate on the diff between acute health and fitness in young ppl using bmi and metabolicly optimal health for overall life heath... oh, you just did. Thx!!

I think he was saying why eat empty calories with refined sugar treats when fruit are sweet and they are full of fiber and helpful vitamins.

If you listen to Peter, it's his opinion when he says "I think" he is not referring to any studies, just his biases. I have noticed this in his Red Meat vlog. Please be aware that Peter has changed his dietary patterns and his training along side other stuff

The bigger problem is people don't know how to think, so they want everything to be whittled down to fun catchphrases. There are some good ones- "everything in moderation" for example- but figuring out what's useful requires some effort and thought.

I limit sugar intake as well for the same reason but maybe it's worse for me because I have a family inherited thing that is thicker saliva than usual so the saliva doesn't clean as well as people that have typical saliva density. I also saw a video about sugar being fuel for cancer and that also makes me limit it. I'm surprised you didn't call it poison because of the cancer thing.

I found out in May, 2022 that i am allergic to cane sugar. It is so hard to avoid, but i am doing it.

Is it poison for people with type 2 diabetes or again, not if they are in calorie controlled situations?

Sugar and fat together is definitely delicious and quite unnatural, apart from milk, natural foods that have one, don’t usually have the other.

Maybe a better way to ask this question, what is our single most significant national health threat? I would say from a medical and dental standpoint, it has to be excess sugar. We likely spend more as a national health issue on excess sugar in our diet, than any other single entity.

Calorie and protein equated low carb and low fat diets show little or no significant change during weight loss periods. As a single data point I am a 32 yo very active male athlete who regularly consumes "poison" I eat at calorie maintenance, have been same body weight for 13 years ±2lbs. Around 12-13% BF. Have seen no negative side effects physically, biochemicall, or mentally. Sugar for me is another macro nothing more nothing less Idk that is helpful to someone but the fear mongering over sugar should be taken with an entire salt shaker IMO

This discussion here adds value to this topic but the two I rely on when it comes to 'everything about sugar' are Lustig and Jamnadas. Lustig has specifically said he thinks desert should be limited to once a week. Hell I WISH I could only eat it that seldom lol.

Do you consider the trials involving metabolically unhealthy children that Dr. Lustig had referenced to several times, that under iso-caloric conditions, without weight loss and not changing food quality. substituting glucose for fructose did change the bio markers and NAFLD in less than two weeks?

Sounds like its mostly behavioral. Sugar makes you consume more other calories than you need rather than outright risk of eating sugar.

Omg any chance you guys could go on a Circe to study brevity

Refined fats devoid of micronutrients are a much bigger issue than sugars

It’s the only way he can really answer this, given who he is. For all intents and purposes, avoid sugar if you want to be healthy, not least because of its addictive properties.

I come from western UP in India and abrout 30 yrs back most farmers are loads of suger and ni one has heard of diabetes and they all had athelete like bodies. The secret...they worked very hard in the fields. So it depends on how much calories one spends

Processed food manufacturers need to hear from consumers that less sugar is wanted in their food products. Why is there so much sugar in everything, even bread. That's just crazy Email, text, tweet or phone your favorite producer of poison and let them know consumers want less salt, oils and sugars in their products. Let their customer service department know that all the extra added salt, oil and sugar is not necessary or desired and is causing health issues.

I wouldnt say its poison, unless u eat sugar laden foods every day. I eat very little. Nobody needs to add sugar to already sweet foods.

Is pugar soison?

Rob lustig will not be afraid to answer your question straight up

Water can be toxic as well. You retain too much for too long.

only if you eat it.

Nuance is Nuance.....😊

As an ultra-runner, I utilize Dextrose all the time. Great way to get those carbs right to the blood!

A simple yes or no would of been sufficient

Where does pass to being a dose of

Yes, I have seen the damages of diabetes, especially when they saw peoples hands and feet off from consuming all these foods in the U.S.

Bro the mental gymnastics 😂

So many words for a: Yes, no but actually yes.

Nope.

According to today’s knowledge, scientific evidence and anecdotal information, moderate sugar intake, accompanied by a very well rounded diet (fiber , protein, fat) and active lifestyle, does not negatively affect a person’s health or weight whatsoever. Sugar alone is not the culprit for anything. Like with everything else is the how much of something and who is consuming it that makes the difference. I am always ready to learn from new scientific discoveries but for now… the sugar is poison is not my motto 😅

8:37 It was a very sugary waffle. The question was "Is sugar poison?", your response was "I ate a lot of sugar when I was a kid but I don't eat much now because of my teeth". Plus I'm not sure what the point is of being an MD that does videos almost exclusively on nutrition, but then acting annoyed by the most common and obvious questions

It's wild how constantly off the mark Peter is. Something is either a poison or it's not. If you're body doesnt require it for function or health, and triggers a detoxifying response in the body, it's a poison/toxin. Sugar and hemlock both fit this paradigm. Anything you do need but over/under consume becomes an imbalance. If you overconsume water, or salt, you cause imbalances, this doesnt mean they're poisonous. You dont need exogenous carbs to function at all, your body stores fat and has gluconeogenesis for a reason, when fat adapted it can turn its own fat into glucose faster that you can eat and metabolise exogenous carbs. Just like the oxalates in leafy greens, your body goes to great effort to detoxify exogenous glucose in the blood and excrete and store it temporarily. If your body needed it, it wouldnt burn it off before butning off its own fat stores. You dont need carbs kr plants, just meat.

Love the common sense.

If you do a lot of endurance sport you have to Take some product with sugar like gel or énergétique drink with sugar to perform but the rest of the time protéines it's better😊

yes it is

they can show using brain scans, that sugar activates the same parts of your brain that cause addiction, as someone who has quit both sugar and drugs, i can definitely say sugar is MAJORLY addictive and was even harder to quit than actually recognized addictive drugs... regardless of whether its a poison, you cannot deny all the addictive behaviors that we observe in people just for sugar.

Sugar is like nitrous in cars. If you’re about to drag race, it can be very beneficial. It increases performance. But if you’re driving to the grocery store and soccer practice on nitrous, you’ll destroy your engine. Sugar can increase performance in the gym / athletics. It can help you recover faster from those activities and build muscle too. But lots of sugar when you have been sedentary and aren’t going to do anything athletic any time soon isn’t a good idea.

Poison as in creating AGE's

i'm surprised that Attia does not recognize the fact that fructose is metabolized by a different pathway than glucose. This increases the risk of fatty liver and metabolic syndrome. The fact that low fat/high sugar diets resulting from the low fat diet craze resulted in a massive increase in obesity (Lustig) trumps his anecdotal evidence about sugar having a less toxic effect on athletes than sedentary individuals.

As everything in life: it depends In the amount is the poison Dont demonize it

Common sense 🤷

Yes. I know it's poison 😢

Sugar is sugar

GOOGLE RAY PEAT!

I have a hard time listening to a guy who says he drinks diet pepper twice a month to protect his teeth. lol. Huh… cmon, if the dose is the poison , will two sodas a month toy your teeth? Nope.

Stupid question, and pretentious answer by Attia. You might as well ask if fructose (fruit sugar) and glucose are both poisons, because they are the only 2 molecules in sugar (a disaccharide). Of course sugar is not a poison. It's no worse than other refined carbs like bread, pasta or rice, and even has a lower glycemic index than they do (about 60 vs about 75). The dosage is the poison. Eating too much all the time is poisonous.

I gave up sugar and the biggest difference is in my tooth health! Only one cavity in 12 years.

Hormiosis

What is nafuld?? I'm learning here, guys. I'm learning.🤸‍♀️

If he had rotten teeth though?

Sugar can be addictive just like alcohol. Too much of it could eventually kill you.

I feel like i wasted 5 mins of my life listening to someone (who i highly regard) not get to the point. Plenty of research on the topic, and it can be context dependent, but treating it as a 'molecule' and not something that is in nearly absolutely everything and is absolutely a huge problem - for someone with such a large following, a poor answer.

Fun fact: Refined sugar is more addictive than cocaine in laboratory animals studies

Peter: "No evidence that iso-caloric substitution of fructose for glucose is demonstrably worse for health outcomes if total energy intake is preserved. Does that mean that eating sugar in an unrestricted way in a free living environment is of no consequence? No, it doesn't mean that at all." Also Peter: [Describing consuming 200g+ of sugar per day while training] "Was I unhealthy? No chance, I had 4% body fat" ???

All that sugar he ate as a kid aged him regardless of 4 percent bodyfat

I think Peter is unclear on the chemistry of metabolizing glucose vs. fructose. To be specific, fructose metabolism results in a disproportionately high amount of reactive oxygen species that interfere with healthy cell growth and division.

Yes

Calories in and calories out. Plain and simple.

Sugar is poison.

I was done at Tylenol

YES. Slow, sweet poison. But a resounding yes.

My mom always said that after a meal 🥘 sugar helps with digestion of the food. With all do respect to the doctor, in moderation you can partake of sugar just don’t overdo the amount of sugar. lol

Wow he likes making things complicated to impress people. Repeated acute fructose overconsumption causes insulin resistance it's proven. Insulin resistance causes over eating so it's causal in the obesity epidemic. Peter Attia is being outdone by Jason Blaha on this it's kind of crazy. As for Attia's personal anecdote about his youthful exercise regimen, low bodyfat and overconsumption of orange juice, yes exactly thats how most likely gave himself insulin resistance which caused his high bodyfat only a few years later which he has described at length, and had to use keto to solve by reversing his insulin resistance. The science on fructose causing insulin resistance is very well established there are Royal Society papers on it detailing the causal pathways. Attia talks a good talk but i can't help but think this is all a novelty yuppy brain flex type brand. The science on this is mainstream but you don't hear it plainly discussed on youtube which seems more concerned with trends and brands. And with over complicating big public health issues like this purely for self-differentiation. Nuance is great when it's appropriate but here it's being applied inappropriately just to have a more interesting pseudo intellectual sound bite. A bit like telling the average person doing a few deadlifts when they are weak will do the same damage to their back that an elite lifter hitting a PR will. This is content for entertainment and flattery it's very disappointing.

This guy just talks and talks about nothing and it always winds up with him talking about how great he is or was.

Flip, flop. How many positions can Attia take? I'd like to see Attia and Lustig debate whether sugar is poison. Longevity is just as relevant as dose.

To me it sounds like all glucose and fructose and sucrose are empty calories with no value added. Just some endorphins for you brain.

The simple answer is 'yes, it's a poison' no ifs or butts.