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We could try to reformulate all these foods so that they are made without sugar, but then they won't taste the same – unless, of course, we replace the sugar with artificial sweeteners. Our population randomised to consume as little sugar as possible is likely to lose weight, but we won't know if it happened because they ate less sugar, or fewer calories of all sorts. Indeed, virtually all dietary advice suffers from this same complication: whether you're trying to avoid gluten, trans fats, saturated fats or refined carbohydrates of all types, or just trying to cut calories – eat less and eat healthily – an end result of this advice is that you're often avoiding processed foods containing sugar and a host of other ingredients.
我们可以尝试改变所有食物的配方，在制作时不加糖。但如果这样，这些食物吃起来味道就不一样了——当然，除非我们用人造甜味剂来代替糖。我们随机抽取了一些人，结果表明吃糖少的人更容易瘦下来，但我们无法确定这是因为他们吃的糖少了，还是所有种类的卡路里都少了。事实上，几乎所有的饮食建议都存在同样的问题：无论是避免摄入麸质、反式脂肪、饱和脂肪或所有类型的精制碳水化合物，还是只是减少卡路里——吃得少吃得健康——这一建议的最终结果是，你避免摄入的是含糖和其他成分的加工食品。
Artificial sweeteners as a replacement for sugar muddy these waters even more. Much of the anxiety about these sweeteners was generated in the 60s and 70s by the research, partly funded by the sugar industry, that led to the banning of the artificial sweetener cyclamate as a possible carcinogen, and the suggestion that saccharin could cause cancer (at least in rats, at extraordinarily high doses). Though this particular anxiety has faded with time, it has been replaced by the suggestion that maybe these artificial sweeteners can cause metabolic syndrome, and thus obesity and diabetes.
糖的替代品“人工甜味剂”使得这一水域变得更加浑浊。对这些甜味剂的担忧主要来自六七十年代的一项研究，该研究部分由制糖业资助，导致人工甜味剂糖精作为一种可能的致癌物被禁用，并暗示糖精可能致癌(至少在老鼠身上，在极高的剂量下)。虽然慢慢地这种焦虑已经消退，但取而代之的是，这些人造甜味剂可能会导致代谢综合症，从而导致肥胖和糖尿病。
This suggestion comes primarily from epidemiological studies that show an association between the use of artificial sweeteners and obesity and diabetes. But it is likely that people who are predisposed to gain weight and become diabetic are also the people who use artificial sweeteners instead of sugar.
这一发现主要来自流行病学研究，研究表明，人造甜味剂的使用与肥胖和糖尿病之间存在联系。不过，那些容易发胖并患上糖尿病的人使用的可能是人造甜味剂而不是糖。
As Philip Handler, then head of the US National Academies of Sciences, suggested in 1975, what we want to know is whether using artificial sweeteners over a lifetime – or even a few years or decades – is better or worse for us than however much sugar we would have consumed instead. It's hard for me to imagine that sugar would have been the healthier choice. If the goal is to get off sugar, then replacing it with artificial sweeteners is one way to do it.
正如时任美国国家科学院院长的菲利普·汉德勒在1975年提出的那样，我们想知道的是，与不管摄入多少糖相比，吃几年、十几年甚至一辈子的人造甜味剂对我们的健康是好是坏。我很难想象糖会是更健康的选择。如果我们的目标是不吃糖，那么用人工甜味剂代替糖就是一种方法。
The research community can certainly do a much better job than it has in the past of testing all these questions. But we may have a very long wait before the public-health authorities fund such studies and give us the definitive answers we seek. What do we do until then?
在测试所有这些问题时，研究界肯定能做得比过去好得多。但在公共卫生当局资助此类研究并给予我们想要的明确的答案之前，我们可能还要等很长时间。在那之前我们应该怎么做？
Ultimately, the question of how much is too much becomes a personal decision, just as we all decide as adults what level of alcohol, caffeine or cigarettes we'll ingest. Enough evidence exists for us to consider sugar very likely to be a toxic substance, and to make an informed decision about how best to balance the likely risks with the benefits. To know what those benefits are, though, it helps to see how life feels without sugar. Former cigarette smokers (of which I am one) will tell you that it was impossible for them to grasp intellectually or emotionally what life would be like without cigarettes until they quit; that through weeks or months or even years, it was a constant struggle. Then, one day, they reached a point at which they couldn't imagine smoking a cigarette and couldn't imagine why they had ever smoked, let alone found it desirable.
最终，摄入多少才算过量的问题变成了个人决策，就像我们成年后都会决定自己摄入多少酒精、咖啡因或香烟一样。足够的证据表明，糖很可能是一种有毒物质，我们要在“如何最好地平衡可能的风险和好处”时做出明智的决定。不过，要想知道这些好处是什么，就得看看没有糖的生活感觉如何。曾经吸烟的人(我就是其中之一)会告诉你，在他们戒烟之前，他们不可能从智力上或情感上理解没有香烟的生活会是什么样子，要经历几周、几个月甚至几年的持续战斗。直到有一天，他们到达了一个临界点，变得连吸烟想都不敢想，也无法理解过去自己为什么吸烟，更别谈吸烟可不可取了。
A similar experience is likely to be true of sugar – but until we try to live without it, until we try to sustain that effort for more than days, or just a few weeks, we'll never know.
糖也是如此。但除非我们试着不吃糖，除非我们试着几天或几周不吃糖，否则我们永远都不会知道。
