What A Swedish Tradition Can Teach Us About American Sugarphobia

healthier

Mar 6

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Takeaway Points:

A surprising Swedish tradition of eating a metric crap-ton of candy seems at odds with the American belief that sugar is uniquely damaging to our health.
Interestingly, many countries have high sugar consumption, yet have better life expectancy than the US.
I dig into some of the reasons why sugar alone is likely not the sole culprit for negative health outcomes.

(Author’s note: I originally wrote this post a few years ago, and have struggled to hit publish on it, largely because I think the sources and data in it are a bit weak in comparison to some of the stronger conclusions I drew from it. However, I think it’s still worth discussing, so I’ve done a lot of mental back and forth about whether it’s worth rewriting, if rewriting it will really fix the problems with it, and so on. Ultimately, I’m just going to hit publish now , rip off the band-aid, and get on with it.)

Sugar. Love it or hate it, it’s one of the staples of modern diets in many countries. We put sugar in everything: coffee, candy, cakes, desserts, cereals, and so on.

The United States of America has the highest per capita consumption of sugar in the world. At 126.4 grams per person per day, we have a significant lead on the competition: the next highest per capita consumption is Germany with 102.9 grams per person per day. That means that Americans consume, at minimum, about 20% more than everyone else.

For comparison, in 2015 the WHO recommendations for sugar intake were halved, from 10% of daily overall calories to 5% of daily overall calories. For a person with a 2000 calorie per day diet, this amounts to a reduction from 200 cal of sugar to 100 cal of sugar - from 50 grams per day to just 25 grams per day. Americans consume about 5 times that recommendation.

This has naturally led to the demonization of sugar in the American health and fitness communities. Despite the resurgence of the popularity of junk food via the recent popularization of flexible/IIFYM dieting styles which enable you to eat anything you want so long as you hit certain macronutrient targets, the overall trend has been to minimize sugar intake.

Some have gone a step further, blaming sugar for every ailment under the sun. Numerous documentaries (in most recent memory, Fed Up comes to mind) have attempted to pin the blame for general health issues solely on sugar, or at least significantly on sugar. Attempts have been made to tax sodas in order to artificially raise prices and discourage consumption, or to render the poor incapable of purchasing sodas with food stamps. CrossFit has championed a sustained war with Coca Cola over the past few years as a result of their position as a sponsor of the ACSM, one of the largest sport research and advocacy groups in the United States. Across the board, the opinion seems to be that sugar is significantly dangerous to one’s health.

It is also true that for all its sugar consumption, the United States is one of the heaviest overall countries (around the 20th) and perhaps the heaviest of developed countries. Often, a direct line is assumed between these two facts: that higher sugar consumption equals heavier and less healthy people. I don’t really think it’s that simple.

Outside Perspective

Recently I had the opportunity to move out of the United States. My wife was offered a job in Denmark, and I work from home, so I didn’t mind - I’ve lived abroad twice before, and I was excited by the chance to live somewhere new. This left us with plenty of opportunities for cheap travel around Europe. One weekend, we took a train over the bridge to Sweden to meet some friends who had recently moved there.

From our friends, we learned about the Swedish tradition of lördagsgodis - “Saturday candy”. Under this tradition, Swedes only eat candy on Saturdays. It’s not a hard and fast rule, but it is a tradition - and it would seem that many Swedes use Saturday as an opportunity to eat candy with friends, or in other social settings. In fact, Swedes consume a LOT of candy - while it’s harder to find accurate data since candy consumption isn’t as well-tracked by the World Health Organization as more iconic figures like sugar consumption, they’re generally ranked among the highest in the world, along with other Scandinavian countries.

As the story goes, children in Sweden began to spend an inordinate amount of money on candy in the early 1900’s as it became cheaper and as pocket money became more plentiful. This reached massive levels, with children eating candy regularly every day of the week and everyone coming down with tons of cavities. At the time, science was a bit less developed, and there was no evident link between the sugar consumption and the cavities.

In response, medical and dental organizations in Sweden funded a series of controversial experiments called the Vipeholm Experiments. In these experiments, patients of the Vipeholm Mental Hospital were force fed candy to see what happened - what would today certainly be considered a flagrant violation of medical ethics. Within a couple years, the patients’ teeth were completely destroyed, confirming the link between sugar consumption and poor dental health. Its effect on their overall health probably remains to be seen - I’d assume that it’s unlikely that the experimenters bothered to track overall health outcomes in their subjects.

In response, the Swedish government ran a massive campaign to cut back on sugar consumption. Seemingly aware that outright prohibition would lead to failure, they instead focused on minimizing consumption - by suggesting that candy should only be consumed on one day of the week, Saturday. This campaign was surprisingly successful, and led to the tradition of lördagsgodis as it is today.

This likely minimized candy consumption in the longer run, but again, Swedes still have some of the highest candy consumption in the world. Their sugar consumption per capita is 86.1 grams - 12th highest in the world and about ⅔ of the United States’ 126.4 grams.

I was astounded by this tradition. After all, it seems absurdly counter to so many American dietary recommendations. It also has such an oddly perfect ring to it - it makes a neat, attention grabbing story and has a colorful history. So I decided to dig deeper.

It seems that Denmark has a similar tradition - fredagsslik, or “Friday candy”. For the Danes, a central concept of their identity is that of “hygge”, a word that refers to a certain kind of experience. Hygge refers to a psychological state in which you are warm, cozy, and relaxed - often in the company of close friends or family in the home. Things that are hygge include warm blankets, fireplaces, companionship, delicious meals, things you’ve made by hand, and many staples of the introvert’s repertoire - anything can be hygge, but these common trends tend to emerge. It’s no surprise that hygge is often associated with sweets as well, particularly homemade ones like cakes. Danes are also highly ranked in sugar consumption (17th, 75.1 grams) and candy consumption.

All of this is interesting, but it’s far more interesting when you take into account other statistics, like the life expectancy of these countries. When you examine the list of the highest sugar consumers in the world, yes, America tops it by a surprising margin. But when you examine the rest of the list, an odder trend emerges: that these other countries, despite having high sugar consumption, also have generally higher life expectancy. In the top 10, the only country with a lower life expectancy than the United States is Mexico. Germany, the second highest sugar consumer per capita in the world, ranks much higher on life expectancy.

In short - it seems that while Americans’ high sugar consumption may be alarming, it probably isn’t very purely predictive of health outcomes. Other countries around the world consume large amounts of sugar, even several times the WHO guidelines, and yet seem to have leaner bodies and longer life expectancy than Americans. It seems unlikely that sugar consumption alone tells us much about what’s going on.

The Science

While the hypothesis of sugar as uniquely detrimental to health has surged in recent years, so has research on the topic. Most importantly, the findings seen above in an analysis of sugar consumption compared to overall life expectancies is not too surprising when seen in conjunction with recent research, which suggests that there is little to no particularly harmful effect to sugar when controlling for total calories. While weight in the United States has continued to rise, some figures say that sugar consumption has actually decreased since 2000.

It also doesn’t really make sense that sugar alone would be an issue - after all, people have been consuming sugar for thousands of years. Maybe we weren’t consuming it to the same extent, but it’s been a dietary staple for a huge part of human history.

So why does it continue to get such a bad reputation?

While sugar may not be particularly detrimental to health, it may simply be demonized as a result of its unique position as a sweet and delicious food. Sugar is a particularly delicious and minimally satiating food. It is a refined food, so it often adds empty calories without any corresponding micronutrients. This means that, while it may not be particularly damaging calorie for calorie, sugar makes it easy in a psychological sense to overeat. Overconsumption can lead to weight gain, or to the crowding out of other, more nutrient dense foods in the diet. If you get 50% of your calories from sugar, for instance, you’ve got a lot fewer opportunities to get in your daily micronutrient intake from the other 50% of your calories. This doesn’t make sugar particularly “bad” - just that it's a bit easier to get out of a balanced diet the higher your consumption becomes.

So why is it that other countries, despite having high sugar consumption, can seemingly get away with it? Ultimately, there’s a lot of possible factors.

One possibility is that in the long run, diet doesn’t mean that much. Sure, huge overconsumption can lead to weight gain and health complications, but otherwise, it seems that what we eat is probably less important than how much we eat. This is supported by looking at native diets all over the world, which vary widely and cover pretty much every position on the spectrum of dietary possibility.

Another possibility is that other health events matter more than those that can arise from poor diet. No matter what you eat, if you get shot or run over by a car, you’re going to die without proper medical attention. Genetic predisposition can also lead to the early onset of certain diseases and cancers that diet is powerless to stop. Since these factors aren’t controlled by diet, they confound the overall issue.

Then there’s the issue of environmental factors - war, poor resource distribution, lack of adequate employment, and poor infrastructure, can all lead to artificially shortened lifespans. A global map of life expectancy shows a clear trend for high life expectancy in those areas which provide more resources, more stability, and more opportunities to the people who live there.

Another glaring possibility: health care. The Scandinavian countries are known for their high tax rates, heavy welfare, and socialized medicine, leading to strong health care for all citizens. This leads to a better ability to treat unexpected health events such as the ones mentioned above, helping greatly alleviate the effects. Since these events can often trump diet in terms of life expectancy, it makes sense that a better ability to treat them would generally lead to longer life spans.

I’ve written previously about the topic of environmental factors and why they often matter a lot more for health than just diet and exercise, so I’d highly recommend checking that out if you’re interested.

There’s also the possibility of higher activity levels. In Denmark, for example, cars are heavily taxed, leading to high prices. In response, many Danes use public transportation or bicycles to travel to work, leading to higher activity levels. Since activity level is a clear indicator of health and generally leads to some weight loss or weight stabilization, it would make sense that a higher activity level may be a part of the equation for the success of other countries despite their relatively high consumption of empty calories such as those seen in sugar and candy. Activity also leads to greater movement quality and recovery from injury, leading to greater quality of life. I always highly recommend consistently high activity levels, as this is a net positive for virtually everyone.

One fact which does run counter to the above evidence is the fact that the addition of the typical western diet to indigenous cultures which previously relied on their own native diets, has historically led to poor health outcomes. However, this seems unlikely to be directly related to the sugar, per se, as my entire argument here is that it’s not just about the sugar, but instead about the whole dietary approach, taken in context.

Tying It All Together

Health is a complex subject and involves the interaction of a great number of different variables. Ultimately, no single variable is solely responsible for the overall health of any particular person. Rather, clusters of negative variables tend to lead to overall reductions in health and life span, and clusters of positive ones tend to lead to overall increases. Variables are often interlinked: for example, if one lives in a poorly developed area, this dictates a great number of other variables including dietary options, health care options, prevalence of political unrest or stability, and so on. Attempting to focus solely on any single variable is unlikely to cause significant improvement for this reason: because the development of health and the extension of your lifespan is a holistic and complicated politico-social process.

In the same way, the human diet is amazingly complex. People eat different foods, in different proportions, all over the world. Identifying individual variables in a specific diet that are “solely” or “completely” responsible for health issues is doomed to failure because your success or failure in any dietary goal is a result of the interaction of genetics with the totality of every single piece of food in your diet. To reduce the human diet solely to “sugar is evil” or “sugar is killing you” is a very simplistic view of things. Instead, it is best to accept that diet is complicated, and this means that big picture solutions have to aim to make piece by piece improvements to the whole rather than isolating and blaming small pieces of that whole.

Is sugar healthy? Not really. But is sugar something to be afraid of? Not really. Is it likely to be a contributing factor in unhealthiness? Probably.

I consume some amount of sugar everyday in my coffee and tea, in addition to the sweets I consume periodically. However, I also try to keep a generally solid diet reliant on protein and fiber, avoid excess calories, and am very active on a daily basis.

I would highly recommend reading my recent post on the topic of the environmental factors which play a (surprisingly large) role in your overall health.

About Adam Fisher

Adam is an experienced fitness coach and blogger who's been blogging and coaching since 2012, and lifting since 2006. He's written for numerous major health publications, including Personal Trainer Development Center, T-Nation, Bodybuilding.com, Fitocracy, and Juggernaut Training Systems.

During that time he has coached hundreds of individuals of all levels of fitness, including competitive powerlifters and older exercisers regaining the strength to walk up a flight of stairs. His own training revolves around bodybuilding and powerlifting, in which he’s competed.

Adam writes about fitness, health, science, philosophy, personal finance, self-improvement, productivity, the good life, and everything else that interests him. When he's not writing or lifting, he's usually hanging out with his cats or feeding his video game addiction.

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