Some history about sugar

Refined sugars (table sugar, corn syrup, honey, molasses among others)  have only been available to humans for about 3,000 years. Widespread consumption only began in the late 1800s.  Our bodies never evolved to digest large amounts of sugars. Our remote ancestors consumed sugar when they are small amounts of fruit as part of their hunter-gatherer type diet. Fruit contains fructose, a type of sugar which does not raise our blood sugar level because it is converted to fat in the liver rather than being used directly as a fuel. They also ate roots which contained carbohydrates.

Refined sugars only came into common consumption in the 1800s. A description of the production of sugar from both the sugar cane plant and the beet is available here. Thanks to Whole Vegan for an excellent timeline of the history of refined sugar production which is available here.  In the 1700s the average person ate 4 pounds of sugar per year; currently folks in developed countries eat 160 pounds per person per year.  The human body has not had time to evolve a process to manage well the digestion of the large amounts of refined sugars. Instead the body converts the excess sugar-energy into fat

Why is sugar so damaging?

Sugars are simple carbohydrates which are rapidly absorbed into the body resulting in a rise in blood sugar levels requiring the pancreas to make excess insulin to control them. Unfortunately, elevated blood sugar is often converted into excess body fat which leads to a condition in which the body becomes resistant to its own insulin. Chronic elevation of blood sugars leads to major and often silent damage to the body’s proteins, arteries, and nerves.This starts early in life and avoiding sugars can reduce the risk of many “metabolic” diseases.”

Peter Attia, MD answers the question ” Is sugar toxic here.”

Some useful definitions follow as well as a description of the process of metabolic syndrome.

Insulin.  A small hormone which lowers blood sugar. It also causes fat to accumulate in the liver, around the middle and inside the abdomen (visceral fat) Public enemy number ONE!

Metabolic syndrome (MS): a condition in which blood sugar, triglycerides, blood pressure and waist size are increased and the good cholesterol (HDL) levels are low. People with untreated MS lose 15 to 20 years of life versus those without it.

Insulin resistance (IR) occurs when cells in the body won’t absorb sugar normally because they are resistant the usual effect of insulin. The pancreas is forced to make more and more insulin to control the blood sugars. As the insulin levels rise, the fat cells in the liver and abdomen grow and produce more and more “resistin,” a hormone which causes insulin resistance.

Adult onset diabetes. (AODM) Blood sugars remain above normal because the body has built up resistance to insulin which is so great that the blood sugar cannot be brought down to normal with the body’s usual insulin production.

Fatty liver disease. (NAFLD = nonalcoholic fatty liver disease and the much more serious NASH = Non-alcoholic steatohepatitis which can lead to cirrhosis) The accumulation of energy in the form of fat beyond minimal levels in liver cells. Now present in nearly 40% of Americans.

55% of Americans are overweight and most (but not all) have IR and MS. But 40% of normal weight Americans also have IR.  30 – 40 % of all Americans have fatty liver and the vast majority do not know they have a disorder which has the potential to cause fatal cirrhosis.

What happens inside us to cause metabolic syndrome and insulin resistance?

• Energy (mostly from excess sugar and starch intake*) accumulates in the “visceral fat” (liver and belly fat) causing insulin resistance to develop in the liver.
• The insulin resistance in the liver forces the pancreas to make more insulin to drive the chemical reactions which manage energy (fat and sugar) in the liver. Then,
• Skyrocketing Insulin levels cause more and more visceral fat deposition which further worsens insulin resistance. This vicious cycle leads to obesity and other consequences:
• Blood fat levels rise significantly (triglycerides)
• Excess insulin causes arteries to stiffen which elevates blood pressure.
• Elevated blood pressure, lipids, and insulin together cause inflammation and plaque formation along the lining of the arteries often leading to stroke or heart attack.
• The excess fat in the liver causes inflammation and may lead to cirrhosis (1/3 of ALL Americans NOW have fatty livers! And 2% will likely develop cirrhosis)
• The insulin producing cells in the pancreas often “burn out” causing diabetes.
• Insulin causes cells to divide, promoting the growth of many types of cancer.
• Insulin resistance may play a role in or cause dementia.
• Insulin causes hunger by blocking the hormone (leptin) which suppresses it.

* many forms of sugar are found in processed foods, some names to look for on labels include, sugar, syrup, sucrose, molasses, dextrose, fructose, cane juice, fruit juice, treacle, corn syrup solids, HFCS among others.

*What is causing the epidemic of obesity and all the disease related to it?

In FAT Chance, Dr. Robert Lustig notes:

• We now consume an average of 160 pounds/yr of sugar ( the equivalent of 22 teaspoons a day of table sugar) versus 40 pounds 100 years ago.
• 20 -25% of all our total calories come from sugar (up to 40% in adolescents)
• Most of this is in the form of HFCS (high fructose corn syrup)
• HFCS’s most devastating effect: The fructose is ONLY processed in the liver and it is ONLY converted into fat, unlike table sugar and milk sugar which can be burned as fuel.
• HFCS is the most potent (non alcohol) cause of fatty liver and insulin resistance
• Insulin resistance increases hunger which leads to more calorie consumption AND
• HFCS does NOT trigger the switch to turn off hunger despite a huge calorie intake.
• HFCS slowly poisons your liver and wreaks havoc on your arteries. IT IS TOXIC.

So what happens when I drink a COKE? (Hint: it’s all bad!)

HFCS contains some glucose and lots of fructose.  The glucose rapidly stimulates insulin production while the liver is converting the fructose into fat (triglycerides.) The insulin lowers the blood sugar and forces the triglycerides into the fat cells in liver and belly. It’s a vicious cycle leading to more obesity, insulin resistance and metabolic syndrome (and you are no less hungry than before you drank the Coke)

What can we do? The simple answer is cut out the sugar!!! Oh, if it were only that simple…

• Don‘t drink any liquid which contains more than 5 calories total. (NO soda, health drinks, fruit juice, gatorade)
• Avoid milk. (Take 2000 units of vit D3 daily and one Tums to replace calcium)
• Eat real food! Fruits contain fructose but lots of fiber reduces hunger and the absorption of the sugars.
• for alcohol, choose red wine over beer and mixed drinks (it may reduce inflammation) and limit to a maximum of 2 drinks per day  for men or 1 drink per day for women. Alcohol is converted to fat in the liver and nearly all regular heavy drinkers have a fatty liver.
• read labels. Foods with more than a few grams of “sugar” should be avoided. **
• Avoid grain based carbohydrates (bread,bagels,pizza,pita,breakfast cereal,). If you choose these look for low sugar, high fiber content and whole grain (e.g. shredded wheat, Irish oatmeal).”Low carb”bread has only 7 gm per slice.
• Avoid any food with “trans fats” or which says “hydrogenated” on the label. These fats are toxic to the liver and the lining of the arteries.
• When eating out decline the bread and potato, and order meat/fish with vegetable sides to reduce your total carbohydrate intake.
• Skip dessert most days of the week or substitute fruit.
• Exercise. 15 minutes of exercise a day improved life expectancy three years in a large population based study. (Brisk walk 15 – 20 minutes after a big meal reduces absorption of calories.) Exercise fights insulin resistance.
• If you have diabetes, metabolic syndrome, heart disease, hypertension you should discuss the various types of diet with your health care provider. Proven health promoting diets include Low carbohydrate, Mediterranean, and Weight Watchers.
• Most patients with insulin resistance (by definition, trouble managing blood sugars) do well on a low carbohydrate diet (60 to 80 grams a day of total carbohydrate) Folks with diabetes or high blood pressure may even reduce or eliminate need for insulin and medication after a few months on the diet. A low carbohydrate diet has been proven to dramatically reduce insulin resistance and put the metabolic syndrome in remission.

Regardless of how “healthy” you feel now, these preventive measures will maximize your chances of being healthy long into the future.

Dr. Mercola’s excellent summary of  these disorders is available here.

If you missed the information on Insulin Resistance/ Metabolic syndrome click here

To go on to public enemy number two (wheat) click here