Friday, December 2, 2011

Sugar - Not So Sweet After All

I love sugar and practically any food that is sweet. Unfortunately, like most of us, I don’t do well if I eat sugary foods or too many carbohydrates. It took me many years of trial and error and a lot of research before I came to understand that my sweet tooth was making me unwell. I now understand that sugar is a particularly insidious culprit in many chronic illnesses of modern society. Diabetes, heart disease and almost any disorder that is caused or aggravated by inflammation will develop or be aggravated by eating too much sugar.

If you have ever been confused by the news reports about sugar, sugar substitutes and their safety, you are not alone. We are going to try to demystify this challenging topic with several posts covering the different issues involved. In this first post, we will look at the way sugar affects our bodies.

The Big Three Sugars - What are they and what is the difference?

There are a lot of different sugars that can be found in the body. Essentially, they are all carbohydrates (they contain only carbon, hydrogen, and oxygen) that the body uses for various purposes, mostly to do with energy. Different sugars react differently when you eat them, and research is now unravelling the confusion that has permeated this topic.

For the purposes of this article we will focus on the three you are most likely to call “sugar”.

Glucose (or Dextrose) is the fuel that keeps your body running. Everything from your brain to your muscles use glucose as an energy source. Glucose is also known as Dextrose because the actual full name of the sugar as it is found in nature is Dextroglucose. Glucose comes from a Greek word meaning sweet, and Dextrose comes from Latin referring to the way the molecule is organized.

They might look different, but all
four are sucrose.
Fructose, mostly found in fruits or other plants, is particularly bad for your body. While this seems counter-intuitive (shouldn’t a sugar from fruit and plants be good for you?), in fact, the refined version is removed from a plant and has no fiber left to balance it’s metabolism. Fiber slows the absorption of fructose, making it a bit easier for your body to process.

When you eat fructose, your body just doesn’t handle it very well, especially if you eat a lot of it in a short time. Essentially, your body sends the fructose directly to your liver, where it is processed and turned straight into fat. This is unhealthy for a number of reasons, which we will discuss further below.

Sucrose, or common table sugar, is a 50/50 mix of glucose and fructose bound together. This is one of the most common forms of sugar that people use. You might use sucrose to bake a cake, sweeten your morning coffee or tea, or at lunch for your lemonade or iced tea. When you eat it, your body splits the glucose and fructose and sends each on its way to get processed. Unfortunately, the fructose portion of sucrose is what really gives it the “sweet” flavor we all associate with “sugar”.

So why is sugar bad for you?

Sugar isn’t necessarily bad for you. It allows you to absorb electrolytes and gives you and your brain energy so that you can move around and think. In the proper amounts, the right type of sugar is helpful and necessary for your body and your brain. But, the amount and type of sugar in a typical modern diet is simply unhealthy and far higher than what we require for basic functions.

Our bodies are remarkable and are able to extract the necessary sugar for our optimal functioning from the foods we eat. As long as we are provided with adequate protein and fat, we never actually require any sugar either refined or unrefined. Contrary to popular misconceptions, carbs are not, and never were, your friend.   

Physiologically, when we eat sugar in excess of our immediate requirements, our body must  produce insulin in order to convert and store that energy for later. Typically, the way excess sugar is stored is as fat. However, as we store more fat, insulin becomes less effective.

Fructose and Fat

Fructose only makes things worse. If you eat (or drink) a lot of sugar, a sudden rush of fructose floods into your liver, where it is promptly turned into fat. In some cases, so much fat is produced that it starts to build up inside the liver, leading to what is called “fatty liver”.

Fatty liver is the start of a long cycle of illness. For starters, fatty liver greatly increases insulin resistance. Insulin resistance means that the insulin you make no longer works as efficiently to convert sugar in your bloodstream into fat. In fact, any buildup of fat in your body increases insulin resistance, but especially so in the liver. Even moderately elevated liver fat content is closely associated with worse blood sugar profiles.

As you become more and more insulin resistant, your body produces more insulin to try to overcome this, producing more fat in the process. In addition, your pancreas (which makes insulin) is stressed by having to make more and more insulin, and can eventually start to wear out; you probably know this as diabetes, where you have to manually add insulin because your pancreas simply can’t produce any more.

Because fructose is directly converted into fat, the more sugar you eat, the more fat is produced from the fructose portion of that sugar. Obviously, this leads to obesity, which has a host of other issues associated with it. Unfortunately, the kind of fats that are produced this way are directly related to low density lipoproteins (LDL), the “bad” type of cholesterol. This type of fat is often mistaken by your immune system as a similar fat produced by bacteria in an infection. When this case of mistaken identity causes the immune system to react, the first response is inflammation.

We discussed inflammation in some detail in another post, but the consequences come into play here. LDL causes (oxidative) damage to arteries, especially around the heart. The inflammatory response here tries to “wall off” this damage, which manifests as a plaque buildup in the arteries causing blockages.

The increased use of sugars in recent years are tied to
the increased rates of obesity and diabetes.
Herein lies the problem and a vicious cycle that starts with fructose. Fructose causes LDL fats to be made in the liver, which can lead to fatty liver. Fatty liver increases insulin resistance and the LDL produced causes an inflammatory response. Both of these factors lead to weight gain, making insulin resistance and inflammation worse. If you keep eating sugar regularly, the problem quickly spirals out of control. This is very likely the main reason behind the obesity and diabetes epidemics that have developed in recent years.

Carbohydrates, the hidden sugar

Most people probably wouldn’t consider a potato to be particularly “sugary”. But potatoes and other starchy foods are essentially just huge chains of glucose molecules bonded together with a very minor amount of nutrients wrapped up inside. If you consider that tubers (like potatoes) and grains are intended to have the energy stored up inside them to start growing an entire plant from underground, this kind of makes sense.

However, we humans are not especially well developed at handling large amounts of carbohydrates in our diet. The effects on our body is particularly negative if you eat large amounts of carbohydrates. You can feel sluggish and tired as your body rushes to pump out enough insulin to handle the onslaught of glucose. Then, your blood sugar levels drop again as the insulin turns that glucose into fat. The result is that you crave more carbohydrates to quickly raise your blood sugar levels back to normal. As you can see, the cycle keeps going.

High Fructose Corn Syrup

High Fructose Corn Syrup,
worse for you than sugar.
High Fructose Corn Syrup (HFCS) was created in a lab and subsequently marketed as a cheaper alternative to sugar in food products. HFCS comes in a few varieties, but the most commonly used version (HFCS-55) contains about 55% fructose and 45% glucose (about the same as honey). Other, less used versions contain 60% or even 65% fructose. This increased amount of fructose makes HFCS slightly sweeter than ordinary table sugar. The increased sweetness and far lower cost compared to sugar is probably why HCFS is so widely used in sodas and candy.

But, as we discussed above, the increase in fructose makes this even worse for you than table sugar. Sadly, HFCS is in so many products, it’s really hard to avoid unless you are really careful. Some of the products you find it in are unexpected, as in breads, yogurt, crackers, and even so-called “natural” foods. Sodas, candy bars, and other sweet, “sugary” snacks contain very high levels of HFCS.

On top of all that, high fructose corn syrup also interferes with a chemical called leptin, which you body uses to tell your brain that you’re full after eating. HCFS makes it harder for this chemical to tell you that you’re full and shouldn’t eat anymore. Obviously this is bad, since overeating products with HFCS is even worse for you.

Only the Beginning

Like many people, I realize now that I do best if avoid not only sugar, but most carbohydrates almost entirely. This may seem like a very odd choice - after all eating a sandwich for lunch is almost a ritual for most of us but bread, pizza, and potatoes are just not worth it for me. Not only does eating sugar or carbs cause me more sugar cravings, it also invariably causes me to gain weight. If I ignore my own best advice and eat too much sugar or carbs, I will eventually suffer intestinal pain and dysbiosis. Avoiding carbs, while not easy, makes me feel so much better that it has just become routine and well worth it.

The topic of sugar is very important for us all to understand. The number of diabetic and overweight people, especially here in the United States, is reaching scary levels. If sugar or high fructose corn syrup is high on the list of ingredients in the food you want to purchase, maybe you should consider buying something else to eat. And, if you think that sugar wouldn’t be in sodas if it weren’t safe, then consider that not too long ago, sodas also used to contain another “harmless” white powdery ingredient in them, cocaine. There is a lot more to discuss about sugar and we will address the topic of alternatives to sugar and ways to decrease your sugar cravings in upcoming posts.

Researched and written by Dr. Rebecca Malamed, M.D. with assistance from Mr. Malcolm Potter.

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