According to science journalist Gary Taubes, whose best-selling books include his latest, The Case Against Sugar,  the sweet stuff is even worse for you than you may think. In fact, as he documents, sugar is linked not only to obesity and type 2 diabetes, it also plays a significant role in heart disease, cancer, high blood pressure and even gout.

And the issue with sugar, he documents, is not that it contains "empty calories," as so many health experts have insisted, but that sugar is uniquely damaging to the human body.

In the past half century, "there has been a tripling of the prevalence of obesity … and an unimaginable 655 percent increase in the percentage of Americans with diabetes," he writes.

Yet for many years before the medical industry decided that fat in the diet was the real enemy, physicians counseled their overweight patients to avoid sweets and starches, in favor of meat (with the fat) and nonstarchy vegetables. Today, nutrition experts preach the virtues of "healthy fats," but lower-carbohydrate regimens like the one Taubes advocates (somewhat like the Atkins and South Beach programs) still remain controversial for long-term health management.

Taubes, who also wrote the bestselling Good Calories, Bad Calories and Why We Get Fat, recently spoke with the Inquirer about his work.

Do you consider this book journalism or advocacy?
In the book I indict sugar, but I don't convict it. I say it's the prosecution argument and I bring up holes in the evidence. So it's still journalism, not advocacy. The physicist Richard Feynman once said science isn't about proving what's true or false, but what's more or less likely. All science starts with telling stories about what might be true; the hard part is deciding what's likely to be true. By reading data and evidence on sugar, this is what's likely to be true.

Do you find that experts accept the idea that sugar is a catalyst for type 2 diabetes? For a long time diabetes experts advocated a balanced diet that included carbohydrates, including sugar. Do you see that changing?
Obesity is clearly a hormonal dysregulation of fat regulation and fatty acid oxidation. Sugar should be a prime suspect in these diseases. But research on this is hard to do. And I've lost faith in the research community to admit that they might have a wrong answer.  Despite the evidence, the idea that a very low carbohydrate diet should be recommended to people with diabetes is still not accepted. It's hard to say why. Maybe because diabetes is associated with heart disease, and there is still this belief that dietary fat or animal fat drives heart disease. And if you cut out fat, the logic goes that you will need to replace it with something, so you replace it with carbohydrates.

The American Diabetes Association now says that low carbohydrate diets are good for short term for weight loss, but it is still not the conventional thinking for long-term therapy. People and physicians still feel that a low-calorie diet is best way to lose weight.

What's wrong with a low calorie diet?
Well, the whole world of physicians knows that no one stays on a low-calorie diet and that the diets they've been putting people on don't work.  What I know is that diabetes is a burden and concern and if I give up carbs and live on fat, protein and green vegetables, I can be healthy.

And when it comes to sugar, I wrote this book because the empty calorie idea is naïve. As long as we discuss sugar in terms of empty calories we miss the point of the unique effects of sugar in the human body and how different carbohydrates, like glucose and fructose are metabolized differently, leading to different hormonal and physiological responses and that fat accumulation and metabolism are influenced profoundly by these hormones.

When we talk about sugar people act as though all that matters is the dose, but when you talk about it like any other drug you have a paradigm shift. For example: Why does Zoloft do something different than Lipitor? No matter what dose we give a patient of Lipitor it's never going to be an antidepressant. We keep talking about the dose rather than how sugar works in the body. We need to look at it differently.

Do you think that by advancing this argument you will make people feel guilty that they "gave themselves" a disease?
I worry about the idea that people think they gave themselves this disease by how they ate… I don't want to put this on people. There will be people who will give up carbs and sugars and still remain obese. The damage may have been done through generational effects, passed down from mother to child in the womb. I wonder how much of this obesity and type 2 diabetes was programmed two or three generations back, as mothers became more insulin resistant when they were pregnant, which gave rise to kids who are more likely to be insulin resistant and obese and diabetic. Research shows that such people are more likely to become more diabetic in any environment. They are going to be sicker and more insulin resistant than children not born to such parents.