来源: https://www.nytimes.com/2017/01/13/opinion/sunday/big-sugars-secret-ally-nutritionists.html

The first time the sugar industry felt compelled to “knock down reports that sugar is fattening,” as this newspaper put it, it was 1956. Papers had run a photograph of President Dwight D. Eisenhower sweetening his coffee with saccharin, with the news that his doctor had advised him to avoid sugar if he wanted to remain thin.

正如本报所述，制糖业第一次被迫“打压糖肥胖的报道”，这是1956年。论文中有一张照片显示总统德怀特·艾森豪威尔用糖精将咖啡加糖，有消息说 如果他想保持瘦身，他的医生建议他避免糖。

The industry responded with a national advertising campaign based on what it believed to be solid science. The ads explained that there was no such thing as a “fattening food”: “All foods supply calories and there is no difference between the calories that come from sugar or steak or grapefruit or ice cream.”

该行业的回应是基于它认为是坚实科学的全国广告活动。 广告解释说，没有“增肥食品”这样的东西：“所有的食物都能提供卡路里，而来自糖，牛排或葡萄柚或冰淇淋的卡路里之间也没有差别。”

More than 60 years later, the sugar industry is still making the same argument, or at least paying researchers to do it for them. The stakes have changed, however, with a near tripling of the prevalence of obesity in the intervening decades and what the Centers for Disease Control and Prevention figures reveal to be an almost unimaginable 655 percent increase in the percentage of Americans with diabetes diagnoses. When it comes to weight gain, the sugar industry and purveyors of sugary beverages still insist, a calorie is a calorie, regardless of its source, so guidelines that single out sugar as a dietary evil are not evidence-based.

60多年后，制糖业仍在提出同样的论点，或者至少付钱给研究人员为他们做这件事。 然而，风险发生了变化，在几十年间，肥胖患病率几乎增加了三倍，而疾病控制和预防中心的数据显示，美国糖尿病患者的百分比几乎难以想象增加了655％。 当涉及到体重增加时，制糖业和含糖饮料的供应商仍然坚持认为，卡路里是一种卡路里，无论其来源如何，因此将糖作为膳食邪恶的指导方针不是以证据为基础的。

Surprisingly, the scientific consensus is technically in agreement. It holds that obesity is caused “by a lack of energy balance,” as the National Institutes of Health website explains — in other words, by our taking in more calories than we expend. Hence, the primary, if not the only, way that foods can influence our body weight is through their caloric content.

令人惊讶的是，科学上的共识在技术上是一致的。 它认为肥胖是由“缺乏能量平衡”引起的，正如美国国立卫生研究院网站所解释的那样 - 换句话说，我们摄入的卡路里比我们消耗的更多。 因此，食物可以影响我们体重的主要方式（如果不是唯一的方式）是通过它们的热量含量。

Another way to say this is that what we eat doesn’t matter; it’s only how much — just as the sugar industry would have us believe. A 2014 article in an American Diabetes Association journal phrased the situation this way: “There is no clear or convincing evidence that any dietary or added sugar has a unique or detrimental impact relative to any other source of calories on the development of obesity or diabetes.”

另一种说法是我们吃的东西并不重要; 这只是多少 - 正如制糖业让我们相信的那样。 2014年美国糖尿病协会期刊上的一篇文章以这种方式表达了这种情况：“没有明确或令人信服的证据表明任何饮食或添加的糖相对于肥胖或糖尿病发展的任何其他热量来源都具有独特或有害的影响。”

The absence of evidence, though, as the saying goes, is not necessarily evidence of absence. If the research community had been doing its job and not assuming since the 1920s that a calorie is a calorie, perhaps we would have found such evidence long ago.

然而，正如俗话所说，缺乏证据并不一定是缺席的证据。 如果研究界一直在做自己的工作并且自20世纪20年代以来没有假设卡路里是热量，那么我们很久以前就会找到这样的证据。

The assumption ignores decades of medical science, including much of what has become textbook endocrinology (the science of hormones and hormone-related diseases) and biochemistry. By the 1960s, researchers in these fields had clearly demonstrated that different carbohydrates, like glucose and fructose, are metabolized differently, leading to different hormonal and physiological responses, and that fat accumulation and metabolism were influenced profoundly by these hormones. The unique composition of sugar — half glucose, half fructose — made it a suspect of particular interest even then.

这种假设忽略了几十年的医学科学，包括已成为教科书内分泌学（激素和激素相关疾病科学）和生物化学的大部分内容。 到了20世纪60年代，这些领域的研究人员已经清楚地证明了不同的碳水化合物，如葡萄糖和果糖，代谢不同，导致不同的激素和生理反应，脂肪的积累和新陈代谢受到这些激素的深刻影响。 糖的一种独特成分 - 半葡萄糖，半果糖 - 使其成为特别令人怀疑的嫌疑人。

The takeaway is that we should expect the consumption of different macronutrients to have differential effects on the hormonal milieu of our cells and so, among myriad other things, on how much fat we accumulate. These effects may be very subtle, but subtle effects can accumulate over a few years or decades into the anything-but-subtle phenomena of obesity and diabetes. In light of this research, arguing today that your body fat responds to everything you eat the exact same way is almost inconceivably naïve.

需要注意的是，我们应该期望不同的常量营养素的消耗对我们细胞的激素环境产生不同的影响，因此，在无数其他事物中，我们积累了多少脂肪。 这些影响可能非常微妙，但微妙的影响可能在几年或几十年内累积到肥胖和糖尿病的任何 - 但微妙的现象。 根据这项研究，今天争论说你的身体脂肪对你吃的所有东西的反应完全相同，几乎是不可思议的天真。

But don’t blame the sugar industry for perpetuating this view. Blame the researchers and the nutrition authorities.

但不要责怪制糖业使这种观点永久化。 责怪研究人员和营养当局。

The industry is in a perverse position: defending the core beliefs of nutrition and obesity research while simultaneously being accused by some of the prominent experts in these disciplines of following the tobacco-industry playbook and so acting as “merchants of doubt.” If this sounds like cognitive dissonance — well, it is.

该行业处于一个不正常的位置：捍卫营养和肥胖研究的核心信念，同时被这些学科中的一些着名专家指责遵循烟草业的剧本，因此充当“怀疑的商人”。如果这听起来 像认知失调一样 - 嗯，就是这样。

I am a fierce critic of sugar and believe that it, in fact, may have prematurely killed more people than tobacco. The disorders for which it is the prime suspect — obesity and Type 2 diabetes — in turn elevate our risk of virtually every major chronic disease, from heart disease to cancer and Alzheimer’s. And yet on this issue, I think the sugar industry has a fair point in rejecting the comparison.

我是对糖的激烈批评者，并且相信它实际上可能过早杀死了比烟草更多的人。 它是主要嫌疑人的疾病 - 肥胖和2型糖尿病 - 反过来又提高了我们几乎所有主要慢性病的风险，从心脏病到癌症和老年痴呆症。 然而在这个问题上，我认为制糖业在拒绝比较方面有一个公平的观点。

Cigarette companies are notorious for having worked to undermine the scientific consensus on tobacco, which was backed by compelling evidence. Tobacco executives knew as well as public health officials that nicotine was addictive and that smoking caused lung cancer. But the evidence implicating sugar as a unique cause of chronic disease has never been nearly so convincing. More to the point, the consensus among nutrition and obesity authorities has been completely aligned with sugar industry interests: Sugar advertisers have had to remind people only that what nutrition authorities believe to be true of all foods is therefore true of sugar as well.

卷烟公司以破坏科学的烟草共识而臭名昭着，烟草公司得到了令人信服的证据支持。 烟草公司的管理人员以及公共卫生官员都知道尼古丁会使人上瘾，吸烟会导致肺癌。 但是，将糖作为慢性病的独特原因的证据从未如此令人信服。 更重要的是，营养和肥胖当局的共识已经完全符合制糖业的利益：糖广告商不得不提醒人们，营养当局认为所有食品的真实性也适用于糖。

So can we really blame sugar companies for seeking to rebut the contention of some nutrition researchers — that sugar might be a unique cause of diabetes and heart disease — by commissioning other mainstream nutritionists to make the opposite case? In the 1970s, when the industry paid Fred Stare, founder of the nutrition department at the Harvard School of Public Health, to exonerate sugar in a lengthy journal supplement, “Sugar in the Diet of Man,” all Mr. Stare had to do was enlist as authors some of the very influential researchers who were convinced that dietary fatwas the real enemy (the conventional wisdom of the time that has now been largely overturned). No confusion needed to be sown. Their task was simply to reinforce the consensus.

那么，我们真的可以责怪糖公司试图反驳一些营养研究人员的争论 - 糖可能是糖尿病和心脏病的一个独特原因 - 委托其他主流营养学家做出相反的案例吗？ 在20世纪70年代，当业界向哈佛大学公共卫生学院营养系的创始人弗雷德斯塔尔（Fred Stare）支付费用以在一份冗长的期刊补充品“人类饮食中的糖”中免除糖时，斯塔尔先生所要做的就是 作为一些非常有影响力的研究人员，他们确信饮食中的脂肪是真正的敌人（当时的传统智慧已经在很大程度上被推翻）。 不需要播种混淆。 他们的任务只是加强共识。

“The method of science,” as the philosopher of science Karl Popper once put it, “is the method of bold conjectures and ingenious and severe attempts to refute them.” In nutrition, the conjectures (their boldness is debatable) are that obesity is caused by lack of energy balance, and so a calorie is a calorie. But they have been accepted with such faith that attempts to refute them have been anything but ingenious and severe. That the attempts have failed may speak more to the quality of the science than the validity of the conjectures. To fully understand the dangers of consuming sugar, we need experiments, in humans, that can unambiguously test these 100-year-old conjectures. No matter how time consuming or expensive these studies are.

正如科学哲学家卡尔波普尔曾经说过的那样，“科学的方法”是大胆猜想的方法，也是反驳它们的巧妙而严厉的尝试。在营养方面，猜想（它们的大胆是值得商榷的）是肥胖是 由缺乏能量平衡引起的，因此卡路里是卡路里。 但是他们已经被这样的信仰所接受，以至于试图反驳他们并不是巧妙和严厉的。 尝试失败可能更多地说明科学的质量而不是猜想的有效性。 为了充分了解消费糖的危险性，我们需要在人类中进行实验，这些实验可以明确地测试这些具有100年历史的猜想。 无论这些研究多么费时或昂贵。

To the sugar industry, the nutritionists’ dogmatic belief that obesity is a calorie overconsumption problem and a calorie is a calorie has been the gift that keeps on giving. So long as nutrition and obesity authorities insist that this is true, then the sugar industry can rightfully defend its product on the basis that the calories from sugar are no better nor worse than those from steak or grapefruit or ice cream — perhaps even kale or quinoa. We can’t have it both ways.

对于制糖业来说，营养学家的教条主义认为肥胖是一种卡路里过度消费问题而卡路里是一种卡路里，一直是不断给予的礼物。 只要营养和肥胖当局坚持认为这是真的，糖业就可以合理地保护其产品，因为糖的卡路里并不比牛排或葡萄柚或冰淇淋更好也不差 - 甚至可能是羽衣甘蓝或藜麦。 我们不可能两种方式。