Food and Behaviour Research

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15 Jan 2013 - BMJ - Sugar and the Heart - Old Ideas Revisited

Geoff Watts

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


After 40 years, the tide finally appears to be turning back in favour of the idea that sugar - not dietary fat - is more important as a contributor to heart disease (and obesity, and a huge array of other related health problems - including many mental health disorders).

Largely ignored by public health experts at the time, Professor John Yudkin's classic book 'Pure, White and Deadly' seems at last to be coming into its own as the evidence against sugar has continued to mount.  

See also the editorial 'Science Souring on Sugar' from the same issue of the BMJ, and details of two upcoming events with Professor Robert Lustig MD, at which John Yudkin's son - Professor Michael Yudkin - will be speaking on the legacy left by his father's work.

Sugar, Fat and the Public Health Crisis
12 March 2013 - Church House Conference Centre, London

Sugar and the Brain: Food Choice, Addiction and the Mental Health Crisis
13 March 2013 - MSTC, Oxford

“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 to the amount of dietary fat, or of a particular sort of fat. In support of these beliefs, we are presented with evidence of an epidemiological nature . . . From time to time, however, it becomes evident that some of the epidemiological data do not fit . . . As more and more of these awkward facts turn up, one begins to have the uneasy feeling that both the proponents and opponents of a dietary hypothesis are quoting only those data which support their view.”2