Sugar: The Bitter Truth

My friend, who is a fellow SJSU Dance grad and Stott Pilates instructor, just posted this video on Facebook and I had to watch it.

The YouTube description says, “Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology, explores the damage caused by sugary foods. He argues that fructose (too much) and fiber (not enough) appear to be cornerstones of the obesity epidemic through their effects on insulin.”

Now, I don’t claim to be a scientist or even an academic, by any stretch of the imagination, but I took down some notes and quotes as I watched.  I just had to share!  Watch the video for the full story (and more sciencey explanations and diagrams) or just take a look at my notes (with fewer sciencey explanations).  I’m not asking you to accept what you see here as the gospel.  Rather, I invite you to be more conscious of what you are consuming and what may be the possible health effects from what you consume. (I could definitely be more careful with what I consume, although I have come a long way from an upbringing of fast food, Chef Boyardee, TV dinners, Top Ramen, and an unlimited supply of Pepsi!).  You are what you eat, right?

Here’s some food for thought (!) that I gleaned from this video.  Please forgive the writing style, or lack thereof.  These are just sloppy notes cleaned up somewhat.

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If you drank just one 20 oz Coke per day, that could add an extra 16 pounds of weight to your body per year.  Just imagine what years of consumption could do!  I used to drink at least 2 or 3 cans of Pepsi a day!!  The tricky thing with sodas like this is that you want to drink more and all of that extra sugar adds up.  Caffeine is a diuretic, which makes you pee; there is also 55 mg of sodium per can, which makes you more thirsty.  Then there is so much sugar to hide the salt.

“Soda goes way beyond empty calories.”  It’s not about the calories, though.  The current US annual consumption of High Fructose Corn Syrup (HFCS) = 63 pounds per person!  HFCS is sweeter than regular sugar, so you think there would be less needed, but there is not necessarily less added to foods and beverages.  Unfortunately, fructose is a poison and Dr. Lustig demonstrates this through lots of sciencey talk and diagrams.

From a 2008 Press Release, CSPI (Center for Science in the Public Interest) executive director Michael F. Jacobsen and Corn Refiners Association president Audrae Erickson wrote, “The real issue is that excessive consumption of any sugars may lead to health problems.”  Dr. Lustig adds, “not MAY; DOES” lead to health problems, although the Scientist for National Soft Drink Association said in 2003 “There is no association between sugar consumption and obesity.”  Hmmm, check your source, I guess.

HFCS was  invented in 1966 and brought into the American market in 1975.  1972 Richard Nixon – Food prices were going up and down and thought it would affect his election.  He was out to find ways to decrease the price of food to make it a non-issue in the election.  At about half the price of regular sugar,  “it’s not metabolically evil, it’s economically evil”.  It’s in everything like hamburger buns, pretzels, etc.  Dr. Lustig received an email from someone who said that out of 32 types of bread on the grocery store shelves, only one did NOT have HFCS.  A study done on juice (sucrose) consumption with inner-city toddlers showed that juice servings per day predicts BMI changes per month.  These toddlers get their juice from WIC (Women Infants Children) – set up by Nixon!

CHOLESTEROL

There are two different types of LDL:

Pattern-A LDL is large and buoyant and doesn’t have a chance to form plaque = neutral LDL.
Pattern-B LDL is small and dense and starts the plaque formation = bad LDL.
Both LDLs are measured together because it’s too difficult to distinguish the two.  How do you know which LDLs are which?  Triglicerydes tell you the difference.  TG should be low and HDL should be high.  TG to HDL ratio predicts heart disease much better than LDL.

Dietary fat raises large buoyant; carbohydrate raises small dense.  The problem in 1982 is that we went on a high carb diet which was supposed to be low fat.  Low-fat processed food means substiitution with carbohydrate (either HFCS [55% fructose] or Sucrose [50% fructose]).  Cooking low-fat at home can be controlled.  How could companies make low-fat foods tasty?  Add sugar!  But that is the worst thing to do!

The “browning agent” part of the fructose also goes on in our arteries, contributing to atherosclerosis. :(

Removal of fiber:  50,000 years ago, we consumed 100-300g of fiber; today, we only consume 12g.  It takes too long to cook, too long to eat, and shelf life is affected.  Fast food = fiberless food.  Producers can freeze the food, ship it around the world, cook it quickly, and eat it can be eaten quickly.

This is what has happened over the last 30 years.

BIOCHEMISTRY

Fructose is not glucose and what it does to the liver is unique.  Fructose does not suppress the hunger hormone (ghrelin).

“Acute fructose does not stimulate insulin (or leptin)”.  There is no receptor for fructose on the beta cell that makes insulin; insulin doesn’t go up; leptin doesn’t go up; brain doesn’t see that you ate something; then you eat more!

“Chronic fructose exposure (alone) promotes metabolic syndrome”. Metabolic Syndrome = obesity, type 2 diabetes, lipid problems, CVD, hypertension.

Because of the way fructose is metabolized (only about half of calories from sucrose, in the form of fructose, can be metabolized by the liver), bad stuff happens.  Fructose does not stimulate insulin and it gets broken down to uric acid (a waste product), which causes gout and hypertension.  Uric acid blocks the enzyme in blood vessels that keeps blood pressure low.   When the liver becomes insulin resistant,it  makes pancreas works harder, which raises insulin levels, which raises blood pressure, which causes further fat making, which causes more energy to go into your fat cell (obesity), the higher insulin goes, the less well your brain can see leptin, you don’t think that you’re full, you continue consuming. Whew!  High insulin generates obesity.

If you understand sciencey stuff, here’s a slide:

It’s a vicious cycle of consumption and disease.

Fructose consumption increases risk for gout in adults.

A study of adolescents showed that sugar sweetened beverages causes uric acid and systolic blood pressure to go up.
Sports drink companies put HFCS in drinks because you can replete glycogen faster with HFCS than with glucose alone. For elite athletes, it makes sense!  But who really drinks these?  Kids!!!  When Gatorade was invented in 1967, it didn’t contain HFCS (it apparently tasted awful).  But when Pepsi bought Gatorade in 1992 and thought of how to market it, they added HFCS to make it taste good!

This graph shows glucose versus fructose consumption.  This indicates that in taking in a fructose load of the same amount of calories, ~30% ends up as fat, versus almost no fat with glucose load (the essentially flat line at the bottom).  Fructose increases de novo lipogenesis in normal adults, or when you consume fructose, essentially, you’re not consuming a carbohydrate, you’re consuming fat.  “High sugar diet is a high fat diet.”

Take a look at Chronic ethanol exposure versus Chronic fructose exposure:

The UCSF WATCH Clinic advice for the kids and parents:

Get rid of all sugared liquids–only water and milk

Eat your carbs with fiber

Wait 20 minutes for your second portion (to get satiety signal)

Buy your screen time minute-for-minute with physcial activity.  (You get 30 minutes of TV time for 30 minutes of playing.)

Why is exercise important in obesity:

Sure it burns calories, but a 20 minute jog = only a chocolate cookie.

More importantly, it “improves skeletal muscle insulin sensitivity”

“It reduces stress, and resultant cortisol release” (and appetite goes down) and “it makes the TCA cycle run faster, and detoxifies fructose, improving hepatic insulin sensitivy” (burn the calories before it becomes fat = higher metabolism)

Why is fiber important in obesity?

Eat your carbs with fiber, that’s why fruit is okay. It gives you essential nutrients, limits your fructose intake.

“Reduces rate of intestinal carbohydrate absorption, reducing insulin response”

“Increases speed of transit of intestinal contents to ileum, to….induce satiety”

“Inhibits absorption of some free fatty acids to the colon, which are metabolized by colonic bacteria to short-chain fatty acids (SFCA), which suppress insulin” (“as opposed to long-chain fatty acids which stimulate insulin”)

What can we do about it?  Can the FDA do something?  The FDA will only regulate acute toxins, not chronic toxins.  The liver will not get sick after 1 fructose meal, but after 1,000 fructose meals….  The FDA and USDA won’t touch this as it would be an admission that our food is a problem, which affects what we can export ($$$).

For more information, Dr. Lustig claims that Pure, White and Deadly written by John Yutkin written in 1972 is prophecy come true.  And for the UCSF Osher Mini Medical School for the Public:  http://lifelonglearning.ucsf.edu/

To balance it out, here is an interesting rebuttal (and rebuttals to the rebuttal in the form of blog comments).

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So, in closing, I don’t have all of the answers!  Do scientists even have all of the answers?  Research is always demonstrating a different good food or bad food and it is ever-changing.  Just think before you buy and consider what exactly you are putting  into your body.  Do it for your health!

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