Diabetes type 2 has become a serious epidemic and is only set to increase in the coming years. Yet this is one of the many lifestyle diseases that is highly preventable. So why aren’t we taking more initiative to prevent it? Why aren’t doctors and health professionals educating all of their patients about how easy it is to avoid this condition, as well as treat this condition, via diet and healthy lifestyle habits?

Touched by diabetes type 2 directly and via his family members, author Jeff O’Connell decided to explore these very questions himself. In his recently published book Sugar Nation: The Hidden Truth Behind America’s Deadliest Habit and the Simple Way to Beat It, Jeff offers some shattering awakenings that will force you to look at your lifestyle habits, your life and our medical industry in a whole new way.

In this review I wish to share with you a detailed account and analysis of this book to help you understand the full scope of the work presented and the impact it can have on you. Diabetes type 2 is a real threat to anyone who is sedentary and/or eating the Standard American Diet that is high in animal foods, processed foods, and refined carbohydrates. And so the more we learn, the more we can be empowered to make smart choices that do not sabotage the quality of our health and life.

About the Author

Sugar Nation: The Hidden Truth Behind America’s Deadliest Habit and the Simple Way to Beat It is written by Jeff O’Connell and newly released July 2011. Jeff is the editor-in-chief at BodyBuilding.com and has co-authored 4 other books. He was previously the executive writer at Men’s Health magazine and editor-in-chief at Muscle & Fitness.

To learn more about Jeff and hist work visit www.JeffOConnell.net

Book Content & Personal Commentary

From a general perspective, Sugar Nation proved to be a very interesting, although at times a bit “tough” to read book. I kept going back and forth between highly positive feelings towards it and some “disappointed” feelings as to the content and how it was being presented. The author has definitely done a great job on so many parts of the book, but there are some major pitfalls, which I will address below.

For starters I found the title to be a bit misleading. Sugar Nation is not a book about our consumption of sugar and its deleterious effect on all parts of our health. It is a book about the diabetes epidemic and promotion of a low-carb diet. It is written as part memoir and part expose, based on a journalistic research style.

The main messages that the author conveys through this book are that diabetes type 2 is a lifestyle disease and it can be prevented and managed, if not cured altogether, with diet and exercise alone. I couldn’t agree with him more on this general theme. Where our opinions differ is what dietary approach is needed to prevent and/or treat diabetes. The author takes a low carb, high protein, high fat approach with little consideration for the quality of those carbs, proteins and fats. My approach whether for diabetes, other conditions or overall health is a natural, whole, mainly raw and plant-based approach where every nutrient group is satisfied without needing to make numbers the main focus, or vilify entire nutrient groups.

Here is a summary of the chapters to present a more detailed analysis:

Chapter 1 – Ground Zero: Diabetes in the Delta was excellent and definitely had my attention. Based on this opening I thought I was going to love the book to pieces! Here a definite wake up call is presented for everyone to take note of the current diabetes epidemic, as well as the failure of major health agencies at guiding people properly when it comes to this disease.

Chapter 2 – Between the Devil and the DNA jumps into the personal memoir part where the author begins to share his personal journey with diabetes in more detail, his past eating and lifestyle habits, as well as his family history and challenges with his estranged father.

Chapter 3 – White Coats, White Flags shares a lot of statistics when it comes to diabetes numbers, diabetic test numbers as well as the different tests available. While there were many great and highly educational parts, this is the first chapter that turned me off a bit when the author labelled all carbohydrates as “bad” and to be avoided. No mention or differentiation was made between refined carbs versus vegetables for example, which are technically considered carbohydrates. The author only focused on carb percentages or gram amounts to be adhered to daily, and in fact shares that carbs are carbs, regardless of whether they are simple or complex carbohydrates.

Eating a diet of more than around 40% carbs is seen as “bad” for diabetics, or anyone really. So a diet for example, which consists of about 60-80% carbohydrates would be seen as an unhealthy choice, even though 80-90% of those carbohydrates could be from natural, raw, nutrient dense vegetables, without any refined sugars or highly processed grains as many raw, vegan foodists follow. In my opinion, diabetic or not, even a diet of only 20% carbohydrates is not going to be healthy if it is based on processed carbohydrates, not to mention processed proteins and fats. Anyhow, stuff like this isn’t taken into consideration and could be very misleading to the average person in terms of what they should be eating. (This applies to diabetics and non-diabetics alike.)

Chapter 4 – Metabolic Mysteries offers a great biology lesson on the inner body workings when it comes to the glucose-insulin relationship and more. Although even here a few facts shared are a bit misleading and not fully explained. By now also the theme of low carb/high fat/high protein as the dietary solution for diabetes is fully adopted. This is again troubling from a nutritional point of view especially when the author states things like “Part of the solution for America’s obesity and diabetes epidemics is a diet lower in carbs…” While it can be true, it does not tell the whole story. It is can therefore be confusing and misleading in that it does not specify “refined carbs”, with some people removing fruits, vegetables and even whole, unrefined grain options from their diet, in favor of meats, dairy, etc.

Chapter 5 – Come, Sweet Death was my most favorite chapter. It is supper valuable for everyone to read! The author compiled excellent research and presented the risks of diabetes in very sobering ways. He made excellent connections, like how much diabetes and heart disease really go hand in hand. He also detailed the dangers of both increased glucose and increased insulin that goes unchecked in terms of its effects, etc.

Chapter 6 – The Grave Consequence of Denial was another great chapter where the author provides an analysis of other cultures, their eating habits and the diabetes risk or prevalence. This chapter can greatly help bring awareness especially to Aboriginal or Native cultures who are more prone to developing diabetes type 2. In this chapter the author also shared an excellent finding, which unfortunately got no further coverage in the book. This being that not everyone needs to eat high fat, high protein, mainly animal food based diets. There are cultures like the Pima Natives who eat a mostly plant-based, high fiber diet and have virtually no diabetes in their population. This is huge, and should have been given at least some more exploration as it can be an option for many people who are not comfortable eating high fat, high protein animal-based diets. The presence of fiber would also help to explain why not all carbohydrates are equal, or can be treated equally, as fiber has a major effect in how a food is digested.

Chapter 7 – Reading Between the Lines was outstanding at exposing what is going on behind the scenes when it comes to medical establishments, health agencies and pharmaceutical companies when it comes to dealing with diabetes. It will be a shocker for some, and common news for those who know the manipulative ways our systems are run to keep pushing drugs and denying natural, lifestyle, dietary, non-pharmaceutical and preventative approaches for disease management. The author provides an excellent analysis, backed by research in how a diet change and exercise routine is more successful at dealing with diabetes type 2 and is almost never actively pursued. In fact, the average person is made to feel disempowered by national health agencies like the American Diabetic Association and doctors alike that in reality they won’t be successful at changing their diet and activity levels, so they might as well take the pills.

Chapter 8 – Prescriptions For A Disaster gave an excellent presentation of the deeper aspects of the pharmaceutical industry and an educational overview of the medications used to treat diabetes. This included various statistics, studies, side effects, lawsuits, their financial motivations and more.

Chapter 9 – Putting the “Die” In Diet was a mix of great facts, with some incomplete or misleading facts when it comes to low carb and high fat diets. There is too much generalization used that can be dangerous and again make people think that it is not okay to eat vegetables, or even fruits, while it is okay to eat processed protein shakes, or meat, or dairy of any quality. In my experience, both stances are erroneous because both don’t tell the complete story: society’s push for low fat, high carb diets and the author’s push for low carb, high fat diets.

Chapter 10 – Sweet Surrender was the hardest of all to read for me. There is an exploration of the glycemic index, glycemic load, high fructose corn syrup, supplements and the author’s tips on what to eat for diabetics, and for people in general who want to avoid diabetes. Some of the advice was nutritionally sound, but it is really hard to take seriously someone who promotes artificial sweeteners and diet soda in this day and age when we know so much about their dangers. I gave the author the benefit of the doubt for the approach he recommends on merits that he is honestly trying to help people with diabetes and not speaking from a personal bias given his career industry. I won’t even comment on the coffee and alcohol views because ultimately the author as everyone else, deserves to make their own decisions as to what they want to justify consuming. But in reality, we cannot be fixing diabetes, while harming other systems in our bodies and creating other health conditions. There is another way.

I think the saddest part of this chapter was that it is simply going to offer more confusion to the average consumer out there who is already lost and confused by the numerous media, doctors, authors and experts who are giving contradictory nutritional information.

Chapter 11 – Losing the Race To The Cure was very valuable in that it explores exercise (activity, movement) and its benefits for diabetics. In fact the author here states a very critical point that can be a life saver for diabetics:

“Type 2 diabetes is a lifestyle disease, one that can be prevented and maybe even reversed by exercising.”

But he says something else in this chapter that is perhaps the best thing he said in the entire book:

“…I realized how divorced I had been from the natural world for much of my adult life. Before I discovered that my survival hung in the balance, I’d had little connection with what I ate or where it came from.”

This revelation is brilliant! And it is this very thought—the disconnection from nature, others and ourselves on a deep heart level—that is at the main root of all of our diseases in society. We are so lacking in self love, we are so intent on holding grudges and past pain, and in a nutshell resistant to life itself. Is it any wonder insulin resistance is one of our main killers….if we only stopped to consider what our bodies are really trying to tell us.

Chapters 12 – A Sinking Feeling, and 13 – Barely A Shadow Cast present new awakenings and findings in the author’s life, when he goes for a follow-up, only to learn that things aren’t progressing as well as he had hoped. Here the author does a great job of analyzing the pros and cons of the some diabetic tests and their efficacy at diagnosing diabetes, and the condition known as reactive hypoglycemia. However, here again we find a big push for high protein diets without any other health considerations, and for various supplements. A “supplement stack” as the author puts it, is in my opinion not a successful way of dealing with something just like a pill stack isn’t.

Chapter 14 – Dissolved was a moving chapter to read, and one where we can put aside the studies and facts in exchange for an emotional connection. Here the author recounts his last times with his estranged father who died of diabetes. In what I am sure must not have been an easy chapter to write, the author paints a very realistic scene of the seriousness of diabetes. It is not something to take lightly, as its ramifications are oftentimes worse than a quick death from some other disease.

Overall the book was a good read, even though it may have been challenging at times in terms of the nutritional advice dispensed. I think that if the dietary side of the book was polished up and better explained, it could be an outstanding resource for diabetics, pre-diabetics and most in our population alike to learn from.

In the end, I felt deep compassion for the author as I feel there is a lot of pain within him that needs to be healed based on his various life challenges. I know that in writing this book he is doing what he feels is right and is genuinely trying to help people. His intentions are in the right place, and his hard work, dedication to helping others and bringing awareness to life saving topics have not been taken for granted.

Here is a quick list of the general pros of the book:


  • Presents an excellent array of facts on how diabetes is a preventable, lifestyle disease
  • Brings awareness to the seriousness of diabetes
  • Brings awareness and education about how flawed our medical system is
  • Brings awareness and education about the self-serving nature of the health agencies and pharmaceutical companies
  • Brings awareness to how inadequate the nutritional information taught on a national level is
  • Brings awareness to the immense diabetes impact on various cultures
  • Dispels some great, popular myths, like “skinny = healthy and fat = sick”
  • Presents the diabetes solution as a change in diet and exercise
  • Presents an excellent analysis for how and why pharmaceuticals should not be the treatment of choice for diabetes
  • Is empowering and encourages people to take their health into their own hands

And while I am happy that a low carb, high protein, high fat diet has proven to be current solution for Jeff’s pre-diabetic state, it is prudent to consider that this may not be the approach for everyone, or even a sound long term approach. Again, we cannot solve or help one thing, while putting another area of our health in danger. I understand that a big part of this book is his personal journey, but great care has to be taken when dispensing nutritional advice. Too many people continue to suffer due to so much nutritional confusion out there made of half-truths, personal stakes and incomplete stories. Also, a whole body, as well as mind and spirit approach needs to be taken to be truly effective and successful at dealing with prevention and treatment of any condition.

Therefore, here are some areas of the book that I found to be problematic, misleading and/or not covered enough to provide a complete picture of the whole story when it comes to nutritional advice for diabetics (or anyone).


  • Classifying all carbohydrate food sources as ones to be avoided or greatly minimized without proper differentiation between vegetables, fruits, whole unrefined grains, whole refined grains and white refined grain products, etc.
  • Recommends a dietary lifestyle based on counting nutrient numbers
  • No consideration given to the effects of cooked versus raw foods
  • No proper explanation given to the quality of fats and proteins to be consumed
  • No consideration given to the importance of an acid/alkaline balance in the body
  • Minimal discussion on health risks of high protein and/or high fat diets
  • No consideration given to quality or source of animal foods
  • No consideration given to GMO foods
  • Support and/or promotion of artificial sweeteners
  • No consideration of global ramifications if everyone ate an animal product-based diet (meat, eggs and cheese are main foods promoted)
  • Aside from one indirect mention, no help given for any vegetarians who may be pre- or fully diabetic


Ultimately, I cannot help but think how much simpler Jeff’s own path and advice could be if there was simply a distinction made between processed and natural foods. In chapter 10 he himself states, “I needed foods as they appear in nature, not canned or shrink-wrapped.” Yet this very idea has virtually no re-enforcement throughout the book. Instead, the focus is often on refined and/or packaged foods and “counting the right numbers”. Nutritionally speaking, the problem in our society for the diabetes, as well as cancer, heart disease and other conditions is first and foremost processed food. This means processed carbs, processed fats and processed proteins. Each of these categories has healthy and unhealthy counterparts. Put another way any packaged, refined, prepared foods with ingredient lists longer than one word. So powdered protein shakes are not the answer in my opinion for healthy people, let alone for those whose health is already compromised in some way. This is what needs to be highlighted and differentiated between to make a complete story.

For example, leading-edge medical doctors and diabetes reversal experts like Dr. Gabriel Cousens or Dr. Joel Fuhrman reverse people’s diabetes with a whole-food, plant-based food approach without counting anything, with outstanding success. It would have been powerful I think to have sources like that considered in the book to give people more choices as to their prevention and treatment.

In the end, I still recommend this book for diabetics, pre-diabetics and really anyone in the general population who feels some interest in it, as one of the resources on their personal health journey. This book is definitely an excellent wake-up call to how the medical, health and pharmaceutical agencies and systems work in our society. Equally so, Jeff did a great job at presenting the real side of diabetes, which is often “ugly”, “harsh” and very serious. It is definitely not a “take a pill and/or injection” disease, but a complete body breakdown that is painful on a physical, mental and emotional level….and one that is completely preventable.