Johns Hopkins Health Alert – The Compelling Case Against Sugar

Re-posted from the Johns Hopkins Health Alert email The Compelling Case Against Sugar

For years, nutrition experts have warned that consuming too much sugar contributes to excess weight gain. Now, a mounting body of scientific evidence suggests that sugar is even more detrimental to the body than was previously believed. As a result, a growing chorus of scientists and public health advocates is urging the U.S. Food and Drug Administration to set safe limits for sugar consumption.

Recently, researchers at the University of California, San Francisco, took matters even further, suggesting that sugar should be regulated by the government to protect public health — just like alcohol and tobacco. Sugar, they argue, is a toxic substance with a tremendous potential for abuse because it affects the brain in a way that encourages people to consume larger amounts, even when they should be satisfied with what they’ve already had.

What’s more, they contend, sugar changes a person’s metabolism, altering the signaling of hormones (including leptin, ghrelin, and dopamine, which regulate satiety, hunger, and pleasure, respectively) in a detrimental way. In other words, the researchers say, sugar is addictive.

That point of view is quite controversial, however, so it’s not likely that sugar is going to be banned or regulated by the government — at least not anytime soon. Nevertheless, the latest research makes a compelling case for determining just how much sugar is safe for human consumption — and for cutting back on the amount of sugar you consume.

The dangers of added sugar. First, it’s important to distinguish natural sugars from added sugars. Natural sugars are an essential part of our diet because the human body converts them to glucose to meet its energy needs. Natural sugars are found in varying amounts in fruits and vegetables, which contain fructose, and in dairy products, which contain lactose.

Added sugars, on the other hand, are not essential. Added sugars are sugars and syrups that are added to foods or beverages when they are processed or prepared, as well as the sugar you add to your coffee, tea, cereal or other foods. Whether it’s added in the form of white sugar, raw sugar, brown sugar, high fructose corn syrup, honey or molasses, it’s all sugar.

Added sugar has been implicated in a variety of ills, from raising blood pressure and increasing the risk of gout to causing liver damage and accelerating the aging process. Some of the strongest evidence to date shows associations between excess sugar consumption and diabetes, heart disease and obesity.

How much added sugar is too much? Surprisingly, the answer to this question varies. Currently, the USDA recommends that people consume no more than 10 teaspoons of added sugar in a 2,000-calorie per day diet. At 16 calories per teaspoon, that’s 160 calories each day. These days people typically consume twice that amount.

Dietary Determinants of Hepatic Steatosis and Visceral Adiposity in Overweight and Obese Youth at Risk of type 2 Diabetes

Conclusion: Hepatic steatosis is associated with a greater intake of fat and fried foods, whereas visceral obesity is associated with increased consumption of sugar and reduced consumption of fiber in overweight and obese adolescents at risk of type 2 diabetes. This study was registered at clinicaltrials.gov as NCT00755547.

via Dietary determinants of hepatic steatosis and visceral adiposity in overweight and obese youth at risk of type 2 diabetes.

Flavonoid-rich Fruit and Vegetables Improve Microvascular Reactivity and Inflammatory Status

Results: In men, the HF F&V diet increased endothelium-dependent microvascular reactivity P = 0.017 with +2 portions/d at 6 wk and reduced C-reactive protein P = 0.001, E-selectin P = 0.0005, and vascular cell adhesion molecule P = 0.0468 with +4 portions/d at 12 wk. HF F&Vs increased plasma NO P = 0.0243 with +4 portions/d at 12 wk in the group as a whole. An increase in F&Vs, regardless of flavonoid content in the groups as a whole, mitigated increases in vascular stiffness measured by PWA P = 0.0065 and reductions in NO P = 0.0299 in the control group.

via Flavonoid-rich fruit and vegetables improve microvascular reactivity and inflammatory status in men at risk of cardiovascular disease—FLAVURS: a randomized controlled trial.

Mom was right.

Yogurt and Diabetes

Eating yogurt can reduce the risk of getting Type 2 diabetes by 28 percent, compared with consuming none, according to a study published today by Diabetologia. Higher consumption of low-fat fermented dairy products, such as yogurt and some cheeses, also lowered the relative risk of diabetes by 24 percent overall, the study showed.

via Yogurt May Be an Ally in Fight Against Diabetes: Study – Bloomberg.

Update 03.28.14

I’ve started eating yogurt every day.

Mediterranean Diet Cuts Risk of Diabetes

Compared with a control diet and a Mediterranean diet supplemented with mixed nuts, the olive oil-supplemented Mediterranean diet was associated with a 40% lower likelihood for new-onset diabetes (HR 0.60, 95% CI 0.43-0.85) , according to Jordi Salas-Salvado, MD, PhD, of the Universitat Rovira i Virgili in Reus, Spain, and colleagues.

Dieters who consumed a nut-supplemented Mediterranean diet did not see such protective benefits (HR 0.82, 95% CI 0.61-1.10), they wrote online in the Annals of Internal Medicine.

via Mediterranean Diet Cuts Risk of Diabetes.

Read the article and then the readers’ comments.  The following are some excerpts:

The findings of this study identify inherent weaknesses in methodology. The low fat control group did not adhere to a low fat diet and the improbable risks of CVD were notably higher.

 

I wonder if the researchers would consider the benefits of asking their subjects to spread their food intake more evenly throughout the day rather than the the usual Spanish pattern of negligible breakfast, snack about 11, then large lunch mid-afternoon and a big, late evening meal. Also in my experience travelling in various parts of Spain, the diet includes plenty of pork.’Every bit of the pig but the eyes.’.

 

The olive oil group was probably using that in place of other vegetable oils for cooking and salad. Vegetable oils like soy and corn oil are high in pro-inflammatory omega-6, and are often partially hydrogenated (ie trans fats.) Avoidance of these in the olive group could have made a difference.

 

Be cautious in coming to conclusions based upon this study.  The sample size was small.  Perhaps too little attention was paid to what the participants did not consume.  We all know less red meat is better for health.  The Mediterranean style diet is clearly a healthy diet but I’m not quite ready to attribute all the wonderful benefits to the diet alone.

Think lifestyle.  Despite the increase in US style fast food restaurants in Spain, the overall dietary preference continues to be a Mediterranean diet.  So how much of the study’s effect come from fast food avoidance?

BTW, yesterday was a totally Mediterranean day for me.  Veggie pizza for lunch and a Greek salad with grilled chicken for dinner.

 

 

Dairy Consumption, Type 2 Diabetes, and Changes in Cardiometabolic Traits: A Prospective Cohort Study of Middle-Aged and Older Chinese in Beijing and Shanghai

CONCLUSIONS: Dairy consumption was associated with a significantly lower risk of type 2 diabetes and favorable changes of cardiometabolic traits in Chinese.

via Dairy Consumption, Type 2 Diabetes, and Changes in Cardiometabolic Traits: A Prospective Cohort Study of Middle-Aged and Older Chinese in Beijing and Shanghai.

What about non-Chinese?  Good news for me though.

Ice cream.

Vitamin D Dosing: Too Low to Matter?

Autier and colleagues found that vitamin D deficiency, in the observational studies, was associated with cardiovascular diseases, inflammation, glucose metabolism disorders, infectious diseases, mood disorders, declines in cognitive function, and even all-cause mortality.

With the exception of colorectal cancer, being vitamin D sufficient did not appear to reduce the risk of developing various types of cancer.

Vitamin D sufficiency was associated with a lower risk of cardiovascular events (up to 58%), diabetes (up to 38%), colorectal cancer (up to 33%), and all-cause mortality (29%).

via Vitamin D Dosing: Too Low to Matter?.

Mediterranean Diet May Protect Kidneys

In a prospective cohort study, patients whose eating habits were closer to the tenets of a Mediterranean diet had about a 50% reduced odds of developing chronic kidney disease (CKD) over 7 years compared with those whose diets didn\’t resemble the fruit-and-vegetable-rich, low-saturated-fat diet, according to Minesh Khatri, MD, of Columbia University Medical Center, and colleagues.

via Mediterranean Diet May Protect Kidneys.

Obesity Week!

The New DIETs (New Dietary Interventions to Enhance the Treatments for Weight Loss) Study is the first randomized trial that will compare how these four diets — none of which restrict calories — can influence body weight.

 

Obesity experts are anticipating answers on whether a vegan or vegetarian diet will offer better weight loss than a pescatarian or omnivorous one, experts told MedPage Today in the run-up to Obesity Week here.

via Obesity Week Parses Dietary Lifestyle and Weight Loss.