By Cindy Brinn, (string of initials) cbrinn@peacehealth.org (my comments in parentheses)
People are confused because of conflicting nutritional advice (as if you didn’t know that!)
Fewer heart attacks than Americans:
Japanese - low fat/Mexicans - high fat
Chinese - little red wine/Italians - much red wine
Germans drink beer and eat sausage but have little heart disease
Conclusion: what kills you is being American! (LOL!)
Nutrition research isn’t easy to do because you can’t study one nutrient at a time, and the truth is most likely that they all work together synergistically anyway, ref. studies where vitamin A (or was it E?) supplementation actually RAISED mortality risks in smokers.
Theory: sugar contributes to heart disease (my take: can this be extended to carbs in general?)
Study: low sugar diet – now higher in foods that don’t contain sugar – what foods, and what impact on health?
Maybe it’s not the reduced sugar, but the effect of other nutrients – how do we know?
ADA, FDA, ADtA – sugar OK in “moderation”. (WHAT exactly is moderation?) based mostly on immediate BG effects.
American Heart Association (AHA): added sugar intake – 6 tsp/day for women 9 tsp/day for men (doesn’t take into account widely different heights of women, or of men, just like 35in. waist circumference for women doesn’t take into account difference of heights)
Sugar, and especially sugary soda intake reduce essential nutrient intake, and associated with excess energy intake and higher body weight.
Sugar associated with hypertension, altered lipids, inflammation and obesity.
Sucrose and High Fructose Corn Syrup (HFCS) – sugar, 50% glucose, 50% fructose (bound) HFCS 45% glucose, 55% fructose (unbound), honey 45% glucose 43% fructose, 5% other sugars. Essentially no difference. BUT agave syrup is 100% fructose.
Sugar intake has gone up DRASTICALLY since 1970, mostly because of large servings of soda. Differentiate between added sugar and natural sugar in fruits. Not easily identifiable on labels.
27 - 30% of adults eat more than 25% of calories from added sugar. Largest source is sugary sodas (and 7-up going back to sugar instead of HFCS in their new product makes NO difference)
75% of patients seen by CDEs eat more than 10 tsp of added sugar a day (but probably not US!!!)
Natural sugar sources: glucose, fructose, galactose, sucrose (glucose/fructose) and lactose (glucose/galactose). Only milk has galactose. Fruits have from 5 - 55% glucose and fructose, depending on the fruit.
Galactose quickly converted to glucose (one thing I wanted to know)
Glucose used as energy, OR stored as glycogen, OR converted to triglycerides (TG) and stored in cells.
Fructose – used by NO cells in the body. IMMEDIATELY converted to TGs or fatty acids and stored as fat.
Beware of fructose-sweetened or all-fructose sweeteners. They DON’T raise BGs but you don’t need the triglycerides and fatty acids!
Fructose associated with chronic diseases, and uniquely metabolized.
Fructose consumption has risen drastically since 1970’s.
Sucrose (even Sugar in the Raw, which is just white sugar with molasses added) HFCS and Agave syrup HIGHLY processed – nothing natural about any of them. Only truly natural sweetener is honey, and there may be other stuff in it that counteracts the fructose.
Added fructose seems to function differently from natural fructose found in fruits.
ADA: added fructose, while not raising BGs, may adversely affect blood lipids, and therefore not recommended. (NO agave syrup, please!)
Large amounts of either sucrose or HFCS may affect digestive hormones such as insulin, ghrelin, and leptin, which regulate appetitie and increase risk of obesity.
88 studies show that soft drinks elevate energy intake and weight and associated with hypertension and DM risk. (Obviously T2)
HDL levels decrease with increased added sugar. (We want them up, not down)
TG levels increase with added sugar.
Sugary sodas increase risk of albuminuria and gout. (Who wants THAT?)
Metabolic changes in animals seen with fructose are NOT seen with glucose. (but we have to limit that too) However, human studies are inconclusive (rat are natural herbivores; we are not)
Problems with fructose: Elevated TGs, uric acid, reduced insulin,leptin, increased ghrelin (makes you hungry!)
Fructose leads to elevated TGs and VLDL. Excess glucose is converted into fatty acids (a good reason not to let your BGs run high, and another clue that carbs in excess are really not good for you. But what’s excessive?)
Processing fructose exhausts liver ATP, and also in vascular endothelial cells – acting like a type of ischemia and causing transient arrest of protein synthesis and increase production of inflammatory proteins, endothelial dysfunction and oxidative stress.
Uric acid promotes gout, but ALSO hypertension, obesity, hyperinsulinemia, insulin resistance, T2DM, renal disease, and cardiovascular disease (CVD) because of reduced endothelial nitric oxide.
Body adapts to chronic exposure, in which case even small amounts of fructose can cause metabolic abnormalities, because of increased enzymes available to process it.
TG changes much higher after fructose consumption than glucose consumption, LDL up, VLDL up, oxidated LDL up, insulin production up, insulin sensitivity down.
Accumulate much more visceral fat from fructose than glucose. (Personal observation: I HAVE gained subQ fat since limiting carbs, but my total weight has gone down, so I MUST have lost visceral fat!)
Honey may be a good substitute sweetener because it protects rats from hyperTG and pro-oxidative changes, BUT not confirmed in humans.
Whole fruits contain other phytonutrients that may be protective, but juices should probably be limited. (We might be able to eat fruits, but must exercise portion control!) No correlation with elevated BP when majority of fructose came from fruits, whereas strong correlation when it came from added sugar.
Low fructose diet lowers BP and inflammation in patients with kidney disease.
Marion Franz not convinced. (Figures!)
“More important to increase consumption of healthy foods (we know there’s a controversy about that) than to reduce number of less-healthy foods consumed” (I could argue with that)
Hippocrates: Let Food be thy Medicine … and Medicine be thy Food.
Let 20% of calories come from “fun” foods ( ice cream, hamburgers, mac and cheese, pizza, etc.) and 10% of calories from added sugar. (I actually commented that I can’t do that, because I can’t get a carton of ice cream without eating LARGE portions – better off not getting the ice cream at all)
That’s it for now – more if I think of it.