Consuming lots of sugar leads to diseases
Pittsburgh Post-Gazette (PA)
But the pediatric endocrinologist's proclamations are supported by research his team has done at the
1. Sugar is poison.
2. Sugar is sugar and unhealthy in any form.
3. A calorie is not just a calorie. There are good ones and bad ones, including sugar.
4. Obesity is not a prerequisite for metabolic illness. Eighty percent of those with obesity do have metabolic disease or resulting chronic illness. But 40 percent of people of normal weight also have such diseases.
5. And don't blame those who are obese or chronically ill for their conditions. It's not so much poor lifestyle behavior as it is biochemical exposures to sugar and other unhealthful ingredients that food manufacturers routinely put into food products, with consumers often being unaware.
Dr. Lustig's latest YouTube video, "Fat Chance: Fructose 2.0," has received 155,000 views and climbing. But his 2009
But he defers to
"Sugar?" Agent J says, with an inquisitive lilt.
"He got it right. We know these substances are addictive and hazardous to health," Dr. Lustig said, leading to an audience scold. "
By any other name
Sugar is listed in Nutrition Facts food labels by 56 names, including various malts and syrups. Most people might be unaware that dextran, athyl maltol, treacle, panocha, lactose and sorbitol also are names for sugar.
Fructose is drawing attention with the increased use of high fructose corn syrup in foods, especially in soft drinks. The sweetener produced chemically from corn starch provides better texture and improves shelf life.
Sucrose, or table sugar, is half fructose, which is metabolized in the liver, and glucose, which is blood sugar that produces cellular energy to muscles and organs.
In the liver, excess fructose is transformed into fat, which can be a factor in elevated cholesterol and arterial plaque. High fructose corn syrup used in soft drinks has a 55-45 ratio of fructose to glucose.
Dr. Lustig says sugar is addictive, although not everyone agrees. Some researchers link high consumption rates to its overabundant availability in American culture and diet.
A recent study by Dr. Lustig's team concludes that 25 percent of type 2 diabetes is caused specifically by sugar consumption.
Studies also conclude that sugar consumption leads to fatty liver, high triglyceride and bad LDL cholesterol levels, plaque in blood vessels and insulin resistance leading to metabolic syndrome and diabetes.
"There definitely are a number of studies that show within big populations a big relationship between sugar consumption and every metabolic disease we have -- diabetes, cardiovascular disease, metabolic syndrome, fatty liver, hypertension and particular risk factors of [high cholesterol and triglycerides]," said
"These studies, along with evidence from diet-intervention studies in which we compare risk factors in human subjects consuming high- or low-sugar diets, suggest that consumption of high amounts of sugar promotes metabolic disease," she said.
In February, a study published in the journal JAMA Internal Medicine found that "most
Those whose added sugar consumption was more than 10 percent but below 25 percent of total daily calories face a 30 percent higher risk of cardiovascular disease than those whose sugar consumption was less than 10 percent. The risk of cardiovascular disease nearly tripled for those whose diet consisted of 25 percent or more of added sugar.
The study said that findings were largely consistent across age groups, gender, race or ethnicity (except for non-Hispanic African-Americans), education level, physical activity and body mass index.
"A higher percentage of calories from added sugar is associated with significantly increased risk of cardiovascular disease mortality," the study concludes. "In addition, regular consumption of sugar-sweetened beverages is associated with elevated cardiovascular mortality.
"Our results support current recommendations to limit the intake of calories from added sugars in U.S. diets," it concludes.
New Nutrition Facts labels proposed by the
Path to disease
High fructose corn syrup is used in numerous processed foods, including many soft drinks such as Coca-Cola and Pepsi.
Fructose in fruit isn't considered a health risk because levels are so low, because the fruit fiber slows the rate of metabolism. Sucrose comprises equal amounts of glucose and fructose. Too much of it overwhelms the liver, which causes the liver to start turning some of the fructose into fat, Ms. Stanhope said.
"Fat can stay in the liver, which may interfere with the liver's ability to use insulin properly," Ms. Stanhope said. "This is called insulin resistance, and it increases risk for diabetes and cardiovascular disease. Or the liver can send the fat made from fructose into the blood stream where it can increase risk of cardiovascular disease."
The process is compounded by America's high consumption of foods full of fat and sugar.
The study, conducted by
"What we found was that women with greater weight loss at both six months and 48 months were eating fewer desserts and sugar-sweetened beverages vs. when they started the study," said Ms. Gibbs, a doctor of epidemiology. "A few other eating behaviors were related to better weight loss at either six months or 48 months, but only reducing desserts and sugar-sweetened beverages was associated with better weight loss in both the short and long term."
While research likely will never provide absolute proof of sugar's impact on human health, population studies reveal a close association between sugar consumption and metabolic disease. That among growing evidence from diet intervention studies raise red flags about its harm, much the way the health impacts of cigarette smoking were determined, Ms. Stanhope said.
In his latest video, Dr. Lustig noted that "old medicine" recognized infection as the main cause of disease with the vector being the various microbes -- viruses, bacteria and fungi. Nowadays, he says, medicine must focus on chronic disease with the vector being "multinational corporations," if we place the blame on food manufacturing and marketing.
Because of the lack of direct evidence Ms. Stanhope referred to, food companies maintain there is no proof that consuming sugar causes a person to be more likely to get sick.
A Q&A on the
"Some studies have found that consumption of unusually high amounts of pure fructose may trigger health concerns,"
But Ms. Stanhope, who consumes sugar only on special occasions (about once a month) said evidence is more than sufficient to advise people against its consumption.
"I think the data we have are strong but not definitive," she said. "People should be looking and listening and realizing that there are no risks associated with reducing sugar intake, but there may be risk in continuing to eat high amounts of sugar while waiting for more definitive scientific evidence. Parents should get their kids off sugar and they should get off sugar themselves."
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