While listening to the Ted Radio Hour podcast during a long run I came across an episode titled, “The Food We Eat.” The episode was all about how we connect, think about, and experience food. I remember being so intrigued by this episode especially when guest speaker Dr. Robert Lustig, a pediatrician and researcher at the University of California, came on the air. Dr. Lustig began to discuss how almost 74% of all food in a chain grocery store has some sort of added sugar in it. I was absolutely blown away by that comment!
Dr. Lustig went on to say there are 56 different names for sugar that companies use to hide the fact that there is added sugar in their products. (I’ve listed them all out for you at the bottom!) Dr. Lustig then described the effects that added sugar has on our bodies. Studies have shown that excess sugar causes diseases like Type II Diabetes, Heart Disease, and Fatty Liver Disease (1). I want to dive deeper into the effects of excess sugar and it’s link to these 3 diseases and end this post with some tips on how you can monitor your own sugar intake. Hope you enjoy!
Type II Diabetes
I was a little skeptical on this one because I know a LOT of factors cause type 2 diabetes and I wasn’t sure how great of an effect sugar had on the development of the disease. However, after looking at study after study on how sugar (especially in soft drinks) can cause the development of type 2 diabetes I was convinced. One of the most eye opening studies I read was one that consolidated 11 different studies dealing with the development of metabolic syndrome and type 2 diabetes from the consumption of sugar-sweetened beverages (SSB) like soft drinks, fruit drinks, iced tea, and vitamin water drinks. The meta-analysis done in 2010 found that individuals who drank 1-2 servings of SSB per day had a 26% greater risk of developing type 2 diabetes than individuals who drank <1 serving per month (2). From my experience with patients who have type 2 diabetes, it is expensive, it is unforgiving, and it is disease that can worsen very quickly if not properly taken care of.
Heart Disease
The American Heart Association in 2011 released a statement about how avoiding excess fructose is one mechanism for decreasing the risk of hypertriglyceridemia, (fancy way of saying high blood levels of fatty molecules) a condition that increases the risk of coronary artery disease (3). One study followed female nurses over the course of 24 years and found that regular consumption of SSBs, 2-6 severing per week, is associated with a higher risk of coronary heart disease, stroke, and diabetes even after the unhealthy lifestyle choices and dietary factors were accounted for (4). The thing about our hearts it that we only have one. That heart is vital to many different functions of our body and if it is not working properly, damaging and even fatal problems can occur. The average wait for a heart transplant is almost 6 months! (5) By that time, a lot of patients suffering from CHD pass without even getting close to the top of the transplant list.
Non-alcoholic Fatty Liver Disease (NAFLD)
First of all what is fatty liver disease? It is the excess build up of fat on the liver causing inflammation and eventually fibrosis (scaring). Fatty liver disease causes obesity, insulin resistance, high levels of sugar and fat in the blood, liver cancer, and eventually liver failure which is fatal (6). The sneaky thing about this disease is that there is almost no symptoms until it reaches advanced stages where the damage done is often irreversible. There isn’t a lot of studies that I found correlating sugar and NAFLD, but the ones I did find were astonishing. A study published in the Journal of Hepatology found that patients with non-alcoholic fatty liver disease consumed 2-3 times more fructose than individuals without the disease in the same body mass index and age (7). Not only has sugar been linked to NAFLD, but another study found that it can actually increase the speed of disease course by promoting the activation of a enzyme that promotes the death of liver cells and eventually causing scarring of the tissue (8).
Now I don't want you to leave this article thinking that you have to cut sugar out of your diet. Sugar in it’s natural form along with fiber (ingredients found in fresh fruits) is a healthy way to obtain it. And I’m all in for indulging in desserts now and then, trust me. The key is moderation. As Dr. Lustig says in the Ted Radio Hour, “If you're going to have breakfast cereal with orange juice and a Capri Sun a granola bar and that's all before 3 o’clock, then you've got a problem.” So enjoy your chocolate cake! Just be aware of the ingredients your food contains in order to maintain a dose of sugar that is tolerable for your body to digest and process. I highly recommend listening to Dr. Lustig’s section on the Ted Radio Hour. It’s only about 10 minutes long and after hearing it over 2 months ago, I’m still in awe of what he has to say. (The link is below is #1 in the resources.) And don’t worry I didn’t forget! The list of the 56 names for sugars is just bellow! Use this list when looking at the ingredients list on food products. If any of these names are among the first 3 ingredients listed and the product is not made from real fruit, I would take the time to look for another option.
56 NAMES FOR SUGAR
Barley malt, Dehydrated cane juice, Golden sugar, Molasses, Barbados sugar, Demerara sugar, Golden syrup, Muscovado, Beet sugar, Dextran, Grape sugar, Panocha, Brown sugar, Dextrose, High fructose corn syrup, Powdered sugar, Buttered syrup, Diastatic malt, Honey, Raw sugar, Cane juice, Diatase, Icing sugar, Refiner’s syrup, Cane sugar, Ethyl maltol, Invert sugar, Rice syrup, Caramel, Free flowing brown sugars, Lactose, Sorbitol, Corn syrup, Fructose, Malt, Sorghum syrup, Corn syrup solids, Fruit juice, Maltodextrin, Sucrose, Confectioner’s sugar, Fruit juice concentrate, Maltose, Sugar (granulated), Carob syrup, Galactose, Malt syrup, Treacle, Castor sugar, Glucose, Mannitol, Turbinado sugar, Date sugar, Glucose solids, Maple syrup, Yellow sugar
Resources: #1. http://www.npr.org/templates/transcript/transcript.php?storyId=502171330 #2. https://www.ncbi.nlm.nih.gov/pubmed/20693348 #3. https://www.ncbi.nlm.nih.gov/pubmed/21502576/ #4. https://www.ncbi.nlm.nih.gov/pubmed/19211821 #5. https://www.ucsfhealth.org/education/heart_transplant/ #6.http://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/dxc-20211639 #7. http://www.journal-of-hepatology.eu/article/S0168-8278(08)00164-5/fulltext #8. http://onlinelibrary.wiley.com/doi/10.1002/hep.23535/full