All cultures exposed to sugar and refined carbohydrates have adopted them. Dr Elliot Blass has elucidated a likely reason. Rat pups jump off a hot plate after 8 seconds, but if they're given sugar, they jump off after 20 seconds: the sugar more than doubles their pain tolerance. The opiate antagonist naltrexone (which brings addicts out of heroin coma in the emergency room) reverses the effect, which means the rat pups higher pain threshold is because sugar makes them secrete endorphins.

Endorphins are "endogenous opiates" which modulate physical and emotional pain in people, and have subtle behavioral effects. One study involving naltrexone could not be completed because although the experimental group noticed no effect consciously, almost all of them dropped out for one reason or another. No such dropouts occurred in the matched control group. Having the effect of your endorphins annulled is so deeply uncomfortable at a subconscious level that you'll do whatever it takes to stop it, and then you'll make up a phony reason that even you believe! Endorphins are one reason why sugar is so deeply seductive.

Why on earth would evolution have favored a taste for sugar? I think that fat made from the meager quantities of sugar in wild fruit were vital for survival during harsh winters, so endorphins - among the most addictive substances known to man - rewarded efforts to seek it out, and the trait boosted survival. Most who didn't have this trait didn't survive, so almost all of us have a taste for sugar.

Unfortunately, agriculture and food refining has allowed us to indulge this taste, but sugar and refined flour and so forth are so different from the foods of our evolution that they cause damage. This is not conjecture, but observation. Decades ago, dentist Weston Price saw tooth decay and physical deterioration in every culture which used refined sugar and flour, but almost no decay (and considerably better physiques) in those that did not.


Dr G.D. Campbell wrote in The South African Medical Journal in 1960 that urban-dwelling Zulus had many times the incidence of diabetes of country-dwelling Zulus, and that the most likely culprit was a diabetogenic factor (sugar) acting on them for long enough (20 years) to produce the disease.

Similarly, Dr Aharon Cohen showed that immigrants to Israel (where sugar consumption is very high) from the Yemen (where it is very low) caused the same thing after about the same incubation period. Since then, some aspect of this effect this has been demonstrated in at least twenty populations: Eskimos, Pima and Cherokee Indians, Pakistanis and on and on. Dr T.L. Cleave ably summarized what was known in 1975 in The Saccharine Disease:- twenty years after refined carbohydrates are adopted, there is dramatic rise in dental caries, obesity, diabetes and heart disease, as well as in the diseases associated with low fiber intake including diverticulitis, varicose veins and hemorrhoids.

Cohen demonstrated that rats secreted more insulin to control their blood sugar after three weeks of a diet containing 67% sugar, after six weeks at 40% sugar and 13 weeks at 33%. The rats regained normal glucose tolerance after some time on a normal diet, but permanent damage is done because it takes only days for impaired glucose tolerance to develop when sugar is given once more. In people, this effect causes the blood sugar to fall too low, leading to "reactive hypoglycemia." Although the American Medical Association has said this condition is rare, almost 50% of survey respondents reported symptoms which could be attributed to hypoglycemia.

How Sugar Does Its Damage

Syndrome X and the deadly quartet research efforts are converging on the insight that refined foods which increase insulin rapidly probably cause insulin resistance and its sequelae, overweight, hypertension, high blood fats, coronary artery disease and heart attack, but the researchers tiptoe about this elephant in the lab. The awful truth is that if they address the real issue, they will lose their funding. Everybody knows that university nutrition departments depend on food industry funding, and it's a certainty that such funding would vanish if the research knocked the sponsor's products. Some call this a conspiracy on the scale of the tobacco industry's attempt to counter the awareness of the health risks of tobacco, others maintain it's legitimate business practice. Either way, the result is ...

Silly Research

When it emerged that many "complex carbohydrates" such as potatoes which were permitted in the American Diabetes Association diet actually have higher glycemic indexes than sugar, a spate of studies comparing the effect of sugared foods (such as chocolate cake!) and potatoes concluded that diabetics need no longer avoid sugar. If sugar is the cause of most diabetes as Weston Price and Cleave observed to be the case, this is the height of idiocy. While the glycemic index research actually suggests that any diabetic who wants a future should avoid both potatoes and sugar, the American Diabetes Association added sugar to its carbohydrate exchange list!

Similarly, a 1986 government report exonerates sugar of everything but causing dental caries. Ideas in the "popular press" (including Cleave's epidemiology) were dismissed and contrary studies were disregarded for reasons such as not having control groups (very difficult in dietary studies) or being "controversial." It's quite easy to fund a study which causes an earlier, unequivocal finding to become "controversial." For example, when it was suggested that high-sugar diets caused hyperactivity in children, several studies appeared which compared children on diets with commonplace amounts of sugar with children eating larger amounts of sugar; unsurprisingly, no differences emerged.

So ... How Do Refined Carbohydrates Cause Damage?

When sugar is eaten ... "what strains the pancreas is what strains any other piece of apparatus - not so much the total amount of work it is called upon to do, but the rate at which it is called upon to do it." TL Cleave, The Saccharine Disease

From the time we were squid until the advent of agriculture, sugar was packaged with fiber, vitamins and minerals in, for example, fruit. Fiber slows the absorption of sugar dramatically, and the vitamins and minerals necessary for the sugar's metabolism were to hand.

When an apple is eaten, the sweet taste forewarns the pancreas and stored insulin granules are released in anticipation. As the blood sugar begins to rise, more insulin enters the bloodstream stimulated by the glucose to counter it. This mechanism is so precise that the blood sugar level barely moves. The insulin joins with receptors on the surfaces of muscle, fat and liver cell, and the insulin-receptor complex passes into the cell where the insulin is broken down while the receptor is recycled to the surface. This event stimulates the glucose transport system to move glucose into the cell, where it may be used to power the cell, burned for heat, stored as glycogen ("animal starch"), or used to fuel muscle contraction; any excess is made into triglycerides and passed to the fat cells for storage.

But when, say, a cola is drunk, five times the amount of sugar in a single apple may be consumed in a gulp. The blood sugar rises rapidly and stays elevated until insulin brings it back to normal. This transient hyperglycemia causes cells to take up calcium ions and lose magnesium ions. Elevated calcium has tissue-specific effects: in muscle and fat, it lessens responsiveness to insulin; in the blood vessels, there may be vasoconstriction which elevates the blood pressure; in the kidneys, calcium is lost to the urine; and in the pancreas, the beta cells over-respond to glucose, secreting extra insulin. With each cola drink, these effects advance by some tiny increment until eventually there may be hypoglycemia, hypertension, osteoporosis, obesity and/or diabetes in the genetically susceptible.

In short, eating refined sugar causes higher blood sugar, which causes higher intracellular calcium, which causes both insulin resistance in the tissues and too much insulin secretion from the pancreas. This is syndrome X! The first abnormalities are tooth decay and the hypoglycemia caused by the over-secretion of insulin.

Interestingly, the anti-seizure drug Dilantin normalized disturbed GTT curves in five hypoglycemics who failed to respond to dietary measures, causing insulin secretion to drop to young-person levels (which could mean it reversed insulin resistance, if insulin resistance was present). Dilantin is called a membrane stabilizer, which means it calms over-excited cell membranes. This has an anti-seizure effect in the hippocampal region of the brain, preventing neural discharges from proliferating out of control. Apparently, it has the same effect in the pancreas and liver, and perhaps also in the muscles and fat tissue. This is an old drug, long out of patent, but data indicating its effectiveness in some cases of hypoglycemia are in the literature.

Reactive Hypoglcemia: More Common Than I Thought

Dr Seale Harris made the observation in 1924 - a few years after insulin was introduced - that some people had insulin reactions without taking any insulin. He called this reactive hypoglycemia and prescribed a low carbohydrate diet without coffee or alcohol to correct it. This became the diagnosis du jour and hundreds of thousands of people used the diet. Dr Harris received an award from the American Medical Association for innovation in medicine in1949.

Symptoms of hypoglycemia include some combination of anxiety, depression, sleep disturbance, angst, irritability, nausea, headaches, tears for no reason, existential doubts, dizziness, purple spots before the eyes, tension and weakness. Actually, the full list of possible symptoms is considerably longer, and these are just the symptoms I've personally experienced when my blood sugar was low. Dr Harris's remedy was a high protein diet without refined carbohydrates, alcohol or caffeine.

Since starting the ketogenic diet, I have had very few insulin reactions. I have gained much more so-called "hypoglycemic awareness", so that I feel hungry and out of sorts on the rare occasions when my blood sugar gets low. From this new, more stable platform, I see other peoples' hypoglycemia much more clearly. One patient of mine ate pasta all the time and couldn't seem feel good. Another had panic attacks with terrible feelings of depersonalization. When I asked him what he'd eaten, it turned out the common factor was that he hadn't eaten anything at all for at least twelve hours before each attack. A third seemed to fall back into feeling bad each time he managed to get out of his depression, and he was eating breakfast cereal and bananas when he remembered to eat at all. The most dramatic case of all had exhaustion with fainting spells whenever he exerted himself. A doctor told him there was nothing wrong with him. He had to carry a gallon of orange juice with him and drink from it every fifteen minutes or so to avoid collapse. All his symptoms disappeared within 24 hours of starting a high-protein diet without fruit.

The rate of incidence of this new disease entity (established with 5 to 8-hour Glucose Tolerance Tests in which the blood sugar is measured every half-hour or hour after taking a 100 gram glucose drink) was about 10% of the population, 70% of patients in psychotherapy, 85% of schizophrenics and 95% of alcoholics. One can infer two things: first, that those sufferers who are not incarcerated seek help, and second, that this may be an underestimate as a government survey revealed that 49.2% of respondents reported some symptom of reactive hypoglycemia without prompting.

Reactive Hypoglycemia Falls From Grace

Then the diabetologist Samsum demonstrated that glucose tolerance depended worsens with increasing dietary fat, and that abnormal Glucose Tolerance Tests become normal if fat is reduced and carbohydrates increased. Another diabetologist, Himsworth showed that feeding a high fat diet for a week before the test produced a diabetic curve in normal people, while feeding a high sugar diet produced a normal curve. They made the defective conclusion that a high carbohydrate diet is the appropriate treatment for diabetics because they did not know that the hyperinsulinism inevitable on such a diet causes complications, or that exercise lowers the insulin resistance they demonstrated, or that lowering carbohydrate into ketogenic territory reverses these objections completely.

However, although these observations are not relevant to "reactive hypoglycemia", they seemed to convince the AMA to change its mind and repudiate the diagnosis, reeducating the profession that "spontaneous hypoglycemia" is vanishingly rare (which it is, being the consequence of insulin-producing tumors and the like). Hypoglycemia became the province of quacks and faddists. Orthodox physicians refused to consider glucose tolerance tests, or misinterpreted them as normal. Alternative health people such as Adelle Davis and Carleton Fredericks kept the concept alive, along with a core of maverick researchers and physicians like Linus Pauling, Carl Pfeiffer and John Yudkin.

Where are we going with this?

Hypoglycemia is real in my experience. This knowledge has helped me help five people who had crippling emotional difficulties which were of dietary origin. Hypoglycemia is caused by hyperinsulinism, which is behind the deadly quartet of hypertension, high blood fats, insulin resistance and diabetes, and heart disease. The remedy for hypoglycemia is avoiding refined carbohydrates. Is the converse true? Is eating refined carbohydrates the cause of hypersinulinism, and by extension, the cause of a large part of the psychological malfunction, disease and mortality in Western civilization?  I think so.

An increase in fat consumption has been the prime suspect since Ancel Keys published his seven countries study in 1971, but his hypothesis hasn't held up. Indeed, therapeutic measures based on the fat hypothesis such as reducing fat in the American diet have been spectacularly unsuccessful, with increased obesity, little change in heart disease etc. Refined carbos and fat both increase with affluence and we've tried lowering fat intake, so what's left?

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