Tempest in a Teapot

May 6, 2011 in Health, Nutrition, Weight Management by Mary Ireland

In her most recent blog, Reduce Your Diabetes Risk – Just Do It, Dr. Grandma discusses the importance of taking steps to make your body more insulin receptive. One of the things she recommends doing is reducing added sugars. There is a lot of evidence for the need to substantially reduce sugar consumption, especially sugar sweetened beverages (SSBs). SSB consumption has increased dramatically over the past 20 years. Survey data shows that from From 1988–1994 to 1999–2004, the percentage of adult SSB drinkers increased from 58% to 63%; consumption of SSB increased by 46 calories per day; and daily SSB consumption among drinkers increased by 6 oz. In both survey periods, SSB calorie consumption was highest among young adults (202 for females and 367 for males) compared to the American Heart Association Guidelines of 100 for adult women and 150 for adult men.

With reports of sugar consumption so high, I’ve watched with interest the last month as Gary Taubes’ article “Is Sugar Toxic?” appeared and the various reactions to it. Forbes writer, Matthew Herper says that his wife was so shaken by Taubes’ article that he was afraid that she wouldn’t give the kids Easter candy. Herper’s kidding aside, he expressed concern that in demonizing sugar, attention will shift away from saturated fat. It could be a reversing of the Snackwell Syndrome – an issue I will return to later.

Taubes' article frequently quotes Dr. Robert Lustig, the leading expert in childhood obesity at the University of California, San Francisco, School of Medicine. In a presentation, Sugar: The Bitter Truth, Lustig presents a persuasive argument about the dangers of processed granular sugar and other added sugars such as agave, honey, molasses, and High Fructose Corn Syrup (HFCS). The presentation confirms the HFCS industry statement that fructose and sugar are processed exactly the same by the body. Both are comprised of a glucose molecule and a fructose molecule. He then gives a detailed analysis of how he thinks that sugar and fructose are processed differently from glucose (e.g., potato or bread). Lustig goes into a very detailed explanation of how the body processes sugar and fructose and explains his controversial view of how that processing accounts for increased fat production. The presentation has been interesting enough to attract over a million viewers, and may well be worth the 90 minutes of your time it takes to watch it.

NOTE: As a point of clarification, Lustig is not saying the fructose in fruits is toxic. He is talking only about those processed sugars, referred to as “added sugars.”

Lustig seems more willing to make assertions and to go beyond the hard evidence than other writers. I agree that both sucrose and HFCS are consumed in excess, and are linked to the obesity epidemic and many related ailments. However, at Dr. Grandma’s we advise against the evils of nutritionism, and to us demonizing fructose is another example of a nutritionism error. Lustig goes in the opposite direction, away from making a single positive nutrient the be-all and end-all, but this opposite extreme isn’t the correct course either. Lustig admits that, but reverts to another nutritionism foible, by asserting that it is the fiber in fruit that makes the fructose acceptable. Given all the other ingredients in whole fruit and their interactions, this is a careless assertion that will surely lead processors to put cheap sources of fiber in with their processed fructose to neutralize the inherent wickedness that Lustig has assigned to it.

Some of the Lustig’s conclusions seem to be supported by recent research documented in previous posts on our website: A Rat’s Eye View of the Recent Junk Food Study (a 2010 animal study reported in Nature Neuroscience Journal) and Can We Not Get Plump Enough with Sugar? (Another 2010 animal study out of Princeton.) Adding to the evidence, Duke University has released results of a study linking consumption of 100% processed fructose to scarring of the liver. (Do not become alarmed that eating fruit will do this. The animals were fed the isolated, processed fructose.)

Please note that there is a veritable firestorm of reaction to Lustig's presentation. Alan Aragon’s Blog is a good place to start to hear other points of view. Whether fructose is a toxin or whether it is the amount we eat that is the problem, we consumers continue to be the rats regarding fructose. The most important take away from the debate is to not get caught in a nutritionism trap. Good health is based on a well-balanced diet. As we learned from the Snackwell Syndrome, to signal out one component of diet such as fat, sugar or fructose and call it categorically bad, while labeling a components such as fiber as categorically good will not result a diet that supports optimal health. To focus only on fructose and disregard saturated fat would be ludicrous.

As a species, we like sweet. People are eager (dare I say desperate) to find a sweetener they feel is safe and tastes good. In recent years agave nectar has been touted, especially by raw foodists and the alternative health industry as an alternative to sugar and HFCS. Proponents claims that it does not raise blood sugar levels was especially attractive. Unfortunately, like honey, molasses and other natural sweeteners, agave nectar is an added sugar. Fructose levels in agave nectar can range from 56% to 92%, depending on how it is processed. In June of the last year, the Glycemic Research Institute de-listed agave products and issued a warning to the public and manufacturers about the dangers of agave on their use in foods, beverages and chocolate due to results of five years of Human In Vivo Clinical Trials. The trials found a risk of severe and dangerous side effects in those with diabetes.

Because of Dr. Grandpa’s sweet tooth, Dr. Grandma conducted an extensive search for a sweetener. Her search led her to adopt Erythritol as a sweetener safe enough for her Love. Although referred to as a sugar alcohol, Erythritol is not a sugar or an alcohol. It is a product created from the fermentation of vegetables and fruits. Erythritol is absorbed by the small intestines and excreted through the kidneys virtually unchanged by the body. We encourage your to do your own research, check all of the facts and the latest research and then decide what is best for you.