By: Dr. Steven Chaney
It’s no secret that Americans
eat too much sugar. The American Heart Association recommends no more than 100
calories/day of added sugar for women and 150 for men. And one recent study
concluded that 78% of women and 67% of men consume too much sugar every day (J.
Nutr, 140: 1832, 2010).
But the real question is which matters more – the type
of sugar or the type of food? The answer is both – but let me explain. Let’s
start with the type of foods.
You’ve probably
heard that sugar sweetened beverages are not good for you. Is that correct? The
answer is clearly yes. Several studies have shown that people drinking sugar
sweetened beverages on a daily basis gain more weight than those who drink them
only occasionally (For example, JAMA, 292: 927, 2004; Am J Clin Nutr, 89: 438,
2009).
Now let’s look at
the type of sugar, but first let me give you a little background. Back in the
60s and 70s, sugar sweetened beverages foods primarily contained sucrose (table
sugar) or glucose (also known as dextrose).
And a number of studies showed that
beverages containing a lot of those sugars caused obesity and resulted in high
blood triglycerides.
As a result sucrose
and glucose were vilified and the food industry largely replaced them with high
fructose corn syrup. Well today fructose and high fructose corn syrup are the
sugars that are vilified.
Some “experts” will tell you to avoid them at all
cost. Is that recommendation accurate? Here the answer is more complex. It is
clearly true for sugar sweetened beverages, may be true for “junk foods”, but
is probably not true for healthy foods.
More importantly,
most other natural sugars are no better. The “knock” on fructose and high
fructose corn syrup is that they increase visceral fat (also known as belly
fat), which increases the risk of insulin resistance, elevated triglycerides
and type 2 diabetes – among other things. The data supporting this concern are
quite strong.
Numerous studies
have shown that when people are given beverages sweetened with fructose or high
fructose corn syrup they gain more belly fat than people given beverages
sweetened with glucose (J Clin Invest, 119: 1322, 2009; Am J Clin Nutr, 95:
283, 2012; cdc.gov/nchs/data/databriefs/db71.htm).
Other studies have
shown that high consumption of sugar sweetened beverages (mostly sweetened with
high fructose corn syrup in today’s world) was associated with increased risk
of diabetes (Diabetes Care, 33: 2477, 2010) and heart attack (Am J Clin Nutr,
89: 1037, 2009).
So you might say: “Case closed. Fructose and high fructose
corn syrup should be avoided at all cost”.
But the first
question is: “What would you use in their place?”
It turns out that honey,
molasses, maple syrup, orange, apple or grape juice concentrate (used as
natural sweeteners in a lot of “health” foods), table sugar (sucrose), raw
sugar, evaporated cane juice and brown sugar all have an almost identical sugar
composition as high fructose corn syrup.
And agave sugar is
88% fructose. That just leaves glucose/dextrose, and we learned that it was bad
for us way back in the 70s.
And clinical studies show that those similarities
in sugar composition result in similar detrimental health consequences. For
example, in one study people consuming beverages with sucrose gained just as
much belly fat as people consuming beverages with fructose (Am J Clin Nutr, 94:
479, 2011).
In other studies
people consuming large amounts of fruit juice had just as much risk of obesity
and diabetes as those consuming large amounts of sodas (Am J Clin Nutr, 89:
438, 2009; Int J Obesity, 24: 794, 2000).
And don’t think that artificial
sweeteners are the way out. Although recent studies have shown that in a very
controlled environment in which consumption of diet sodas actually resulted in
decreased calorie intake people lost weight by switching from sugar sweetened
sodas to diet sodas, in the real world we don’t have a dietitian peering over
our shoulder.
We appear to
compensate for the decreased calories in the diet sodas by consuming extra
calories somewhere else. In real world studies people gain just as much weight
drinking diet sodas as sugar sweetened sodas (Dhingra et al, Circulation, 116:
480-488, 2007; Fowler et al, Obesity, 16:1894-1900, 2008). But the big caveat
is that all of these studies have been done with beverages.
We suspect that the
same effects will be seen in sugar sweetened junk foods – foods low in fiber
and protein – but those studies have not actually been done. But when you start
talking about healthy foods, it’s a whole different story.
We’ve known for
years that the same amount of sugar can cause a large spike in blood sugar and
triglyceride levels if consumed in a soda, fruit juice or junk food, but causes
a much smaller increase in blood sugar and triglycerides if consumed in a
healthier food containing lots of fiber and protein.
That is the science
behind the “glycemic index” concept that you’ve been hearing so much about.
Similarly, fructose appears to cause obesity and an increase in belly fat when
consumed in sodas and fruit juices, but the same amount of fructose has little
or no effect on either obesity or belly fat when consumed in fruits.
So what is
the bottom line for you?
1) There are no good sugars, only good foods.
If you are talking
about sugar sweetened beverages (sodas, juices or teas) honey, molasses, fruit
juice concentrates and sucrose are no healthier than high fructose corn syrup.
And agave sugar is no healthier than pure fructose. Experts recommend drinking
water, tea and coffee, and for the tea and coffee keeping sweeteners to the
minimum.
2) Artificially sweetened sodas don’t appear to be any better than
the sugar sweetened variety.
In free living
populations they are just as likely to be associated with weight gain. And, of
course, they are just as likely to dissolve your bones as the regular sodas.
3) Although some experts will tell that artificial sweeteners are
safe, I don’t recommend any of them.
They all have unresolved health
issues. And since they don’t appear to prevent obesity, my question is: “Why
would you want to use them”. The only non-nutritive sweetener that I recommend
is stevia. But if you use stevia sweetened foods or beverages you need to be a
careful label reader.
Because stevia has
a bit of an aftertaste many foods advertising that they are sweetened with
stevia actually contain a combination of stevia and artificial sweeteners.
4) Although much more research in this area is needed, it appears
that the kind of sugar you are getting is much less important than the food you
are getting it in.
Sugars are a natural component
of many healthy foods such as fruits and dairy products, and sugars in these
foods are not associated with obesity and other health problems.
Although we don’t know the
exact mechanism, it is thought that the protein and fiber in healthy foods slow
the absorption of sugars and alter their metabolism.
To Your Health!
Dr. Stephen G Chaney
P.S. I know that many of you will want to ask me about Shaklee’s Cinch products.
Dr. Stephen G Chaney
P.S. I know that many of you will want to ask me about Shaklee’s Cinch products.
The first question people often ask is: “Doesn’t the product have too
much sugar?”
The answer to that is a clear no. I know that there are a lot of
other products out there with less sugar, but they ignore a fundamental
metabolic fact that protein will be used to maintain normal blood sugar levels
before it will be utilized to build muscle tissue.
By providing more
carbohydrate, which can be utilized directly to maintain normal blood glucose
levels, Shaklee assures that the protein in their Cinch products is optimally
utilized for increasing muscle mass, which is a cornerstone of the Cinch Inch
Loss Program.
The second question people
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If you were paying
attention to what I said in today’s tip, there are no good sugars, only good foods.
And because of their high protein and fiber content, Cinch products are good
foods. The proof, of course, is in the pudding. The clinical studies with Cinch
products show that they help people lose weight, reduce “belly fat” and lower
blood pressure.
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