Over the past half-century, Taiwan’s eating and drinking habits have evolved. In the past, cooking oil was made from animal fats and many have childhood memories of fried lard and crisp, deep-fried onion rings. Granulated sugar made by Taiwan Sugar Corp is made into syrup and added to cold drinks and sweet soups. In the past, the average Taiwanese was not very heavy, despite a cultural preference for fat children, because it implies good fortune and wealth. A love of fatness is deep and it does not exist only in Han Chinese societies, but also among some Austronesian cultures.
Who would have thought that today, half a century later, obesity and heart disease would become a Taiwanese epidemic?
These eating and drinking habits are part of a global culture and are influenced by the US in particular. Taiwanese today eat little animal fat and avoid cholesterol-rich foods, but instead eat a lot of carbohydrates, and almost every dish contains sugar and is accompanied by sweet drinks and desserts.
These changes are closely related to the US’ Sugar Association. In 1965, the association’s predecessor paid Harvard scientists to write a skewed study making a connection between heart disease and saturated fats, while playing down the relationship between sugar and heart disease. The report was published in the New England Journal of Medicine.
In the early 20th century, few people died from heart disease, but by the middle of the century it had become very common. In 1955, then-US president Dwight Eisenhower had a heart attack and donations to the American Heart Association increased by 40 percent. After recovering, Eisenhower became a board member and honorary chairman of the association.
By the early 1960s, doctors and nutritionists successfully showed a connection between heart disease, saturated fats and cholesterol. They made it onto the cover of Time magazine and dominated the US National Institutes of Health’s food and beverage guide. Animal fats and cholesterol had become the main culprits behind heart disease.
Last week, JAMA Internal Medicine published an article claiming that researchers had cooperated with the sugar industry to distort the facts, citing historical internal sugar industry documents. The article said that, based on today’s research standards, the study was unethical and involved conflicts of interest.
Cholesterol and saturated fats have been wrongly accused for 50 years.
Today, the main suspect behind obesity and heart disease is sugar. It is addictive and akin to a legalized drug. It has been tolerated for half a century in a historical political, scientific, social and medical context.
In the 1970s, the US began to produce corn in large quantities and the excess has been used for animal feed, cheap vegetable oil and promoting the prosperity of fast food chains. The cheap concentrated fructose (corn syrup) refined from corn has been hidden in Taiwanese food and beverages ever since.
Half a century later, the Taiwanese gut has been drawn into the perfect storm of US-style food and beverages, obesity and cardiovascular disease.
New medical evidence has weakened concern over animal fats and raised warnings over sugar. It is alright to eat food in a natural, unprocessed state, but we should stay away from processed foods containing sugar.
Chiang Sheng is an attending physician in the department of obstetrics and gynecology at Mackay Memorial Hospital.
Translated by Perry Svensson
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