Category Archives: Sugar

Sugar Industry Made Dietary Fat the Villain

See Larry Husten’s article for MedPageToday”

“Newly uncovered documents reveal that 50 years ago the sugar industry gave secret support to prominent Harvard researchers to write an influential series of articles in the New England Journal of Medicine that downplayed the negative effects of sugar.Instead, the articles shifted the blame from sugar to fat as the “dietary culprit” behind heart disease.

In recent years there has been growing awareness that decades of dietary policy demonized fat and ignored or played down the dangers of increased consumption of carbohydrates and sugars. Many believe this policy had a significant adverse effect on public health, contributing to the obesity and diabetes epidemics.”

Source: How Sweet: Sugar Industry Made Fat the Villain | Medpage Today

Remember that sugar doesn’t always refer to just table sugar. Starches -as in bread, potatoes, and peas – are easily and quickly broken down by the body into simple sugars.

1 Comment

Filed under coronary heart disease, Heart Disease, Sugar

No Dentist Ever Told Me, “No Carbs, No Cavities”

But it’s true to a great extent. And the worst carbohydrates for your teeth seem to be sugars.

173 Years of U.S. Sugar Consumption

(Thanks to Dr. Stephan Guyenet and Jeremy Landen for this sugar consumption graph.)

MNT on September 16, 2014, published an article about the very prominent role of sugars as a cause of cavities, aka dental caries. This idea deserves much wider circulation.

I’ve written before about the carbohydrate connection to dental health and chronic systemic disease. Furthermore, sugar-sweetened beverages are linked to 200,000 yearly worldwide deaths

Investigators at University College London and the London School of Hygiene & Tropical Medicine think the World Health Organization’s recommendation of a maximum of 10% total daily calories from “free sugar” should be reduced to 3%, with 5% (25 grams) as a fall-back position.

Six teaspoons of granulated table sugar (sucrose) is 25 grams. That should be enough daily sugar for anyone, right? But it’s incredibly easy to exceed that limit due to subtly hidden sugars in multiple foods, especially commercially prepared foods that you wouldn’t expect contain sugar. Chances are, for instance, that you have in your house store-bought sausage, salad dressings, and various condiments with added sugars such as high fructose corn syrup. Sugar’s a flavor enhancer.

tooth structure, paleo diet, caries, enamel

Cross-section of a tooth

The aforementioned “free sugar” as defined as any monosaccharides and disaccharides that a consumer, cook, or food manufacturer adds to foods. In the U.S., we just call these “added sugars” instead of free sugars. From the MNT article, “Sugars that are naturally present in honey, syrup, and fruit juices are also classed as free sugars.” Sugar in the whole fruit you eat is not counted as free or added sugar.

The London researchers found that—in children at least—moving from consuming almost no sugar to 5% of total daily calories doubled the rate of tooth decay. This rose with every incremental increase in sugar intake.

From the MNT article:

“Tooth decay is a serious problem worldwide and reducing sugar intake makes a huge difference,” says study author Aubrey Sheiham, of the Department of Epidemiology & Public Health at University College London. “Data from Japan were particularly revealing, as the population had no access to sugar during or shortly after the Second World War. We found that decay was hugely reduced during this time, but then increased as they began to import sugar again.”

I’m convinced. How about you?

Steve Parker, M.D.

11 Comments

Filed under Sugar

Is Excessive Fructose Consumption the Cause of Type 2 Diabetes?

Lumps of Diabetes

Cubes of Diabetes?

A Pharm.D (Dr of Pharmacology) and a pair of MD’s surveyed much of the available scientific literature—both animal and human studies—and concluded that fructose is a major culprit in the rise of type 2 diabetes and prediabetes. Fructose does its damage by increasing insulin resistance. ScienceDaily has the details.

Be aware that their conclusion is certainly not universally accepted. I just read “Pathogenesis of type 2 diabetes mellitus” at UpToDate.com and saw no mention of fructose. Under dietary factors, they mainly talked about obesity and how that increases insulin resistance, leading to elevated blood sugars, while the reverse happens with weight loss. I haven’t looked at all the research so I have no definite opinion yet on the fructose-diabetes theory; I’m skeptical.

Fructose is a type of simple sugar. Common dietary sources of fructose are fruits, table sugar (aka sucrose, a 50:50 combination of glucose and fructose molecules), and high-fructose corn syrup (which is usually 42 or 55% fructose).

Damaging effects, if any, of fructose in these fruits may be mitigated by the fiber

Damaging effects, if any, of fructose in these fruits may be mitigated by the fiber

A few quotes from ScienceDaily:

“At current levels, added-sugar consumption, and added-fructose consumption in particular, are fueling a worsening epidemic of type 2 diabetes,” said lead author James J. DiNicolantonio, PharmD, a cardiovascular research scientist at Saint Luke’s Mid America Heart Institute, Kansas City, MO. “Approximately 40% of U.S. adults already have some degree of insulin resistance with projections that nearly the same percentage will eventually develop frank diabetes.”

*   *   *

While fructose is found naturally in some whole foods like fruits and vegetables, consuming these foods poses no problem for human health. Indeed, consuming fruits and vegetables is likely protective against diabetes and broader cardiometabolic dysfunction, explained DiNicolantonio and colleagues. The authors propose that dietary guidelines should be modified to encourage individuals to replace processed foods, laden with added sugars and fructose, with whole foods like fruits and vegetables. “Most existing guidelines fall short of this mark at the potential cost of worsening rates of diabetes and related cardiovascular and other consequences,” they wrote.

If you’re eating a typical Western or American diet, you’ll reduce your fructose consumption by moving to the Mediterranean diet, the Advanced Mediterranean Diet, Low-Carb Mediterranean Diet, or the Paleobetic Diet.

RTWT.

Steve Parker, M.D.

5 Comments

Filed under Causes of Diabetes, Sugar

John Yudkin Wrote a Book About Sugar Called “Pure, White, and Deadly”

Sugar is poisonous according to John Yudkin and Robert Lustig, among others. Australia’s “The Age” had the details but my prior link is no good. A quote:

[Robert] Lustig is one of a growing number of scientists who don’t just believe sugar makes you fat and rots teeth. They’re convinced it’s the cause of several chronic and very common illnesses, including heart disease, cancer, Alzheimer’s and diabetes. It’s also addictive, since it interferes with our appetites and creates an irresistible urge to eat.

This year [2014], Lustig’s message has gone mainstream; many of the New Year diet books focused not on fat or carbohydrates, but on cutting out sugar and the everyday foods (soups, fruit juices, bread) that contain high levels of sucrose. The anti-sugar camp is not celebrating yet, however. They know what happened to Yudkin and what a ruthless and unscrupulous adversary the sugar industry proved to be.

In 1822, we in the U.S. ate 6.2 pounds of sugar per person per year. By 1999, we were up to 108 pounds.

An occasional teaspoon of sugar probably won't hurt you

An occasional teaspoon of sugar won’t hurt you

The U.S. Department of Agriculture estimates that added sugars provide 17% of the total calories in the average American diet.  A typical carbonated soda contain the equivalent of 10 tsp (50 ml) of sugar.  The average U.S. adult eats 30 tsp  (150 ml) daily of added sweeteners and sugars.

On the other hand, Fanatic Cook Bix found a study linking higher sugar consumption with lower body weight, which you might think would protect against type 2 diabetes, heart disease, and some cancers.

Steve Parker, M.D.

h/t Jamie Scott

2 Comments

Filed under Carbohydrate, Sugar

Sugary Drinks Linked to Overweight in Preschoolers

…according to an article at MedPageToday. A sample:

DeBoer and colleagues evaluated the effect of sugary drinks on body mass index in 9,600 children evaluated at ages 9 months, 2 years, 4 years, and 5 years, who were enrolled in the Early Childhood Longitudinal Survey — Birth Cohort, a representative survey of the U.S. population of children born in 2001.

Parents answered survey questions about beverage intake at ages 2, 4, and 5. Sugar-sweetened beverages were defined as soda, sports drinks, and fruit drinks that were not 100% fruit juice. They also looked at when the drinks were consumed — such as at meals or with snacks — and if the child was a regular or infrequent/nondrinker.

diabetic diet, low-carb mediterranean diet

Why not teach your kids to cook?

Toddlers drinking at least one sugary drink daily were much more likely to have mothers who were overweight or obese. The sugared-up kids also watched more TV and drank less milk.

Comments Off on Sugary Drinks Linked to Overweight in Preschoolers

Filed under Carbohydrate, Overweight and Obesity, Sugar

Sources of Calories in U.S. Diet Over Last Four Decades

Italian seaside totally unrelated to this post

Do you ever wonder how many of your total calories come from added sugars? Grains? Dairy products? Added fats?

Deriving your personal numbers would require detailed nutrient analysis, but if you’d like U.S. averages, see this cool infographic at Civil Eats.

It also shows how many calories are or were available for consumption per capita over time (without accounting for wastage in restaurants). It’s based on U.S. Department of Agriculture data.

A superficial glance suggests that U.S. per capita daily calorie consumption has increased by about 600 from the 1970s until now. But remember, these numbers don’t discount for restaurant wastage. Nor do I see an adjustment for children versus adults. I’ve seen other calculations of and extra daily 150 calories (women) to 300 calories (men). Even the lower numbers could explain our explosion of overweight and obesity.

Steve Parker, M.D.

Comments Off on Sources of Calories in U.S. Diet Over Last Four Decades

Filed under Dairy Products, Fat in Diet, Grains, Overweight and Obesity, Sugar

Does Cutting Out Sugary Drinks Help With Weight Loss?

Are you obese, love sugary drinks, and want to easily lose four pounds (1.8 kg) over the next six months? Simply cut a couple of sugary drinks out of your daily diet, replace them with water or diet soa, and you may lose the pounds.  Or so say University of North Carolina researchers.
Down 4 pounds in 6 months. I’ll take it!

In the U.S., our consumption of calories from sugar-sweetened beverages (SSBs) almost doubled between 1965 and 2002, now comprising 21% of our total calories.  (I’ve seen lower estimates, too, such as all added sugars accounting for 17% of total calories.)  Remember that our overweight and obesity rates started rising around 1970.  Any connection there?

Some have speculated that cutting back on SSB consumption would lead to loss of some excess weight.  But it’s never really been tested until now.

By the way, your typical sugary carbonated beverage has 145 calories of pure carbohydrate, most often high fructose corn syrup.  That’s equivalent to 10 tsp (50 ml) of table sugar.  Soft drinks are liquid candy.

Methodology

UNC investigators recruited  about 300 overweight and obese folks (average BMI 36, average weight 100 kg (220 lb), 84% female, 54% black) who drank at least 280 calories daily of caloric beverages (sugar-sweetened beverages, juice, juice drinks, sweetened coffee and tea, sweetened milk, sports drinks, and alcohol).  In other words, they all drank at least two soft drinks or the equivalent daily.  Participants agreed to make a dietary substitution for six months.

The participants were randomly assigned to one of three study groups with a hundred participants per group. For the next six months…

  • Group WA substituted at least two of their SSBs daily with water (WA), any type as long as it was calorie-free.  Bottled water was provided.  This reduced sugary drink calories by 230/day.
  • Group DB substituted at least two of their SSBs daily with calorie-free diet beverages (DB).  Beverages were provided.  This reduced sugary drink calories by 230/day.
  • Group AC (attention controls) made no changes in baseline beverage consumption.  Investigators made a point not to talk to them about beverages.

All three groups had monthly group meetings.  WA and DB group meetings were focused on adherence to the beverage substitution guidelines.
The AC group meetings will involved a weigh-in and general weight loss information (e.g., read food labels, increase vegetable consumption, portion control, and increase physical exercise).

“All … groups had access to a group-specific …website, where they recorded the beverages (water and DB only) they consumed, reported their weekly weight, received feedback on progress, viewed tips, and linked to group-specific resources.”

Results

All three groups lost statistically significant amounts of weight, but there was no difference in amount of weight lost among the groups.  In other words, the folks who substituted water or diet beverages for  sweet drinks didn’t do any better than the AC (attentive control) group.

Average amounts of weight lost were in the range of 1.8 to 2.5% of total body weight.  For example, if you weigh 200 lb (91 kg) and lose 2% of your weight, that’s a 4-lb loss (1.8 kg).

Compared to the AC group, the WA group showed a statistically significant decrease in fasting blood sugar (down 3 mg/dl).  BTW, none of the participants were diabetic.

Sugar cane

Take-Home Points

Would the substituters have lost weight if they had simply cut out two sugary drinks a day, skipping the monthy meetings and website?  Don’t know.  But I bet that’s how the mainstream press will spin this.

If I were obese and had a sugary drink habit, I’d start substituting water.  Yesterday.

Substituting water for a couple sugary drinks a day could reduce risk of developing diabetes.

I was hoping to see a significantly greater weight loss in the water and diet drink substituters compared to the AC (Attention Control) group.  Presumably all of these AC folks would have stayed at their baseline weights if they hadn’t done any of this.  The substitution groups apparently didn’t receive the general weight-loss information given to the AC group.

One caveat: All groups had monthly meetings for six months.  What were the substitution groups  talking about other than adherence to the protocol?  Your guess is as good as mine since the researchers don’t say.  Perhaps something about those meetings led to the weight loss, not the act of substituting water or diet drinks for sugar.

So they lost an average of 4–5 lb (2 kg).  Big deal, right?  But remember this was just a six-month study.  Could that 4 lb turn into 12 lb (5.5 kg) over 18 months?  Maybe, but we don’t know.

Here’s the thing about averages.  Some of these people I’m sure lost closer to 5% of body weight, and some didn’t lose any, or gained.  Which group would you be in?  Only one way to find out.

Remember that many medical conditions linked to overweight and obesity improve with loss of just 5% of body weight.

The substituters cut out 230 calories a day of sugary drinks.  All other things being equal, they should have lost 12 lb (5.5 kg).  Problem is, all other things aren’t equal.  Numerous other factors are at play, such as activity levels, replacement of sugary drink calories with other calories, measurement errors, reporting errors, etc.

This was a female-heavy study.  Would this strategy work for men?  Even better in men?  We don’t know.  Why not try it yourself?

Steve Parker, M.D.

PS: I did a sugar-free and wheat-free experiment on myself earlier this year.  Lost some weight, too.

Reference: Tate, Deborah, et al.  Replacing caloric beverages with water or diet beverages for weight loss in adults: main results of the Choose Healthy Options Conscioulsly Everday (CHOICE) randomized clinical trialAmerican Journal of Clinical Nutrition, February 1, 2012, Epub ahead of print.  doi: 10.3945/ajcn.111.026278

Comments Off on Does Cutting Out Sugary Drinks Help With Weight Loss?

Filed under Carbohydrate, Overweight and Obesity, Sugar, Weight Loss