Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA,
Nestle Nutr Inst Workshop Ser. 2020;95:100-111. doi: 10.1159/000511524. Epub 2020 Nov 9.
Over the course of evolution, Mother Nature preserved the ability of humans to make every sugar they need for metabolic functions. Glucose is the almost exclusive fuel preferred by the human brain. Human infants are born with sweet taste receptors, sugars are a significant energy source in human milk, and mammals have a direct gut-to-brain sugar-sensing system that enhances development of a preference for sugars. If sugars are as toxic as many postulate, what species advantage was conferred by this evolutionary progression? Observational studies have reported that sugar consumption is associated with various adverse health risks. However, observational studies can never prove causality, dietary intake records are known to be highly problematic, and the huge number of correlation interdependencies among environmental "exposome" variables makes it impossible to attribute causality to individual dietary components. Additionally, these studies overall have been graded as low quality, and many reported the small effect sizes are likely within the propagated methodological "noise." With several exceptions, data from randomized controlled trials that ensured isocaloric energy intakes have failed to confirm the causal implications of the observational data. Likewise, the comprehensive UK Scientific Committee on Nutrition Report on Carbohydrates and Health also failed to confirm the vast majority of widely postulated detrimental effects of sugar consumption per se. Current data on intakes of sugar-sweetened beverages and on the risks associated with high intakes of dietary fructose remain under debate.
在进化过程中,大自然母亲保留了人类制造新陈代谢所需的每一种糖的能力。葡萄糖是人类大脑几乎唯一首选的燃料。人类婴儿天生就有甜味感受器,糖是人类母乳中的重要能量来源,哺乳动物有一个直接的肠道到大脑的糖感应系统,增强了对糖的偏好的发展。如果糖像许多人假设的那样有毒,那么这种进化进展赋予了哪种物种优势?观察性研究报告称,糖的消耗与各种不良健康风险有关。然而,观察性研究永远不能证明因果关系,饮食摄入记录众所周知存在很大问题,环境“暴露组学”变量之间的大量相关性相互依存使得不可能将因果关系归因于个别饮食成分。此外,这些研究总体上被评为低质量,并且许多报告的小效应大小可能在传播的方法学“噪声”内。除了几个例外,确保等热量能量摄入的随机对照试验的数据未能证实观察数据的因果关系。同样,英国营养科学委员会关于碳水化合物和健康的全面报告也未能证实糖消耗本身所带来的绝大多数广泛假设的有害影响。关于含糖饮料摄入量以及高摄入量与饮食果糖相关的风险的当前数据仍存在争议。