Health News

REPORTING POINT 10/12

HEALTH NEWS

“Live healthy...Live well”

Dedicated to providing pertinent information on health, fitness, and nutrition to foster a culture of wellness among Southwest Airlines flight crews and their families.

by Larry Kline

email: livehealthy-livewell@cox.net

Another Cup Of Tea - Green tea contains catechins, polyphenolic compounds that are known to exert numerous protective effects, particularly on the cardiovascular system. Green tea catechins at doses ranging from 145 to 3,000 mg per day taken for 3 to 24 weeks led to statistically significant reductions in total and LDL ("bad") cholesterol. Journal of the American Dietetic Association, 11/11.

IS SUGAR MAKING AMERICA FAT? – high-fructose corn syrup (HFCS) is thought to be similar to sugar in the body because it contains either 42 percent or 55 percent fructose (which is close to table sugar’s 50-50 glucose-fructose split).  Scientists at the University of Southern California found that all the U.S. sodas they tested contained at least 58 percent fructose.  A study published in the Journal of Clinical Investigation found that adults who consumed drinks sweetened only with fructose for 10 weeks saw levels of abdominal fat and several harmful blood lipids increase, and their insulin sensitivity decrease, compared with adults who drank only glucose-sweetened drinks. The average American drinks 57 gallons of soda a year, about 600 cans of which over half is not sugar-free. That is one reason there is so much added sugar in the American diet. Americans consume 450 calories of added sugar every day, and that is not counting fruit.  Some scientists believe that all of that sugar, especially fructose, can be hard on your liver, just like excess alcohol consumption.

SUGAR-THE BITTER TRUTH

(The following is a transcript presented on NPR’s Science Friday of a controversial interview with Dr. Robert Lustig-edited and condensed for this publication. Since Dr. Lustig’s views are controversial, several counterpoint opinions are presented for rebuttal and educational purposes for the reader. LK)

 According to Robert Lustig, professor of pediatrics in the Division of Endocrinology, University of California, San Francisco (head of the Weight Assessment for Teen and Child Health Program), it's not just the addition of sugar that is a primary issue but it is also the removal of fiber in the American diet. The reason why fiber is so important is because it actually delays the absorption of sugar so that your liver has a chance to “catch up.”

Metabolized sugar is delivered to an area of the cell called the mitochondria. The mitochondria is the part of the cell that burns energy and creates chemical energy for your body to use. If you overload your mitochondria (with consumed added sugar) the mitochondria convert (excess energy) to fat. 

There is no (food) label indication separating added sugars from total sugars in a food product. Numerous studies, both in animals and humans, show that the area of the brain, the reward center, is affected by sugar the same way it is by tobacco, alcohol, nicotine, cocaine, heroin, and therefore it fosters continued consumption. 

HOW WE GOT THIS WAY

With an evolutionary view we as human beings really only had sugar available to us one month a year - at harvest time. Fruit would fall to the ground, we'd gorge on it, consume it like crazy. That would increase our adiposity, it would increase our fat stores very specifically.

What would come after that? Four months of winter; little food available. So putting on those extra pounds in advance of a four-month famine was actually adaptive and actually let us make it through winter so that we could repeat the cycle all over again. It was actually metabolically and evolutionary adaptive.

The problem is that we now have a maladaptive situation because sugar is available 24/7, 365 in amounts that has never been known to man previously. How do we know this is true? Because the orangutans in Papua New Guinea have what are known as masting fruit orgies every January when harvest time comes  The food falls to the ground, and they do exactly the same thing. We assume that this must be the reason sugar was put here for us in the first place.

The sugar that is in fruit is not a problem.  It's what you do to the manufacturing of processed food that's the problem. Adding sugar and removing fiber creates processed food and that is where the problem is. Sugar is just one manifestation of food processing. Sugar is specifically added to processed foods for palatability, especially with the directive to decrease the fat in the diet, which makes no sense at all when you understand the science. Sugar, not fat, says Lustig, is to blame for the obesity epidemic.

Lustig continues, “…we've had a reduction in percent consumption of fat from 40 to 30 percent over the past 30 years. In the process, our obesity and metabolic syndrome prevalence has gone through the absolute roof. In 1977, the McGovern commission’s dietary guidelines for Americans basically told us that we needed to reduce our consumption of fat. In the early 1970s, we learned about this thing in our blood called LDL, low-density lipoproteins. We learned that dietary fat raised our LDL, which is true. We also then learned in the late 1970s that LDL levels in populations correlated with cardiovascular disease. So the thought was if dietary fat raises your LDL and LDL raises your risk for cardiovascular disease, let's get rid of dietary fat and cardiovascular disease would go down. That was the thought process. The AHA, the AMA and the USDA all bought into this. The food industry went along with it.” (Total calories consumed is up significantly since 1977-LK)

The food industry retooled. They reengineered all their recipes. That's how we got Entenmann's fat-free cakes. That's how we got Snackwells. They're still with us. Bottom line, not only has it not worked, but it's actually made things way worse .Dietary fat does raise your LDL - that's true - but there are two LDLs, not one. There's one called large buoyant, and there's one called small dense. 

When you measure your LDL levels in your blood, you measure both at the same time. It turns out the large buoyant has nothing to do with cardiovascular disease. They float. They go along inside your blood vessels. They're too large to get under the surface of the cells that line the arterial wall. They don't cause any damage. The small dense ones are the ones that are driven up by carbohydrate consumption. They are small enough to get under the surface of endothelial cells. They are the ones that start the foam cell process which starts atherogenesis, and they're the ones that have gone through the roof, because when we took the fat out, the food tasted like cardboard. We had to substitute something. We substituted  with simple carbohydrates; in other words, sugars. So our percent fat went down, and our percent carbohydrate went up astronomically, which drove hyperinsulinemia.

WHAT TO DO

According to Robert Lustig, when considering food, remember three words: Eat Real Food. Because all food is inherently good, whether it's meat, whether it's fat, even whether it's carbohydrate because carbohydrate comes with its inherent fiber. That's what ultimately mitigates the negative effects of carbohydrate.  It's refined carbohydrate, the processed carbohydrate, which is the problem. The fat that occurs naturally, even saturated fat, does raise your LDL, but it raises the LDL that doesn't matter. It's the trans-fat that causes significant cardiovascular disease. That's synthetic (food).  In other words, if you ate what came out of the ground or you ate the animals that ate what came out of the ground, you would be fine. Men’s Health 04/11, Science Friday 2/17/12(NPR)

            COUNTERPOINTS

It appears that the rise in obesity is due in large part to an increase in caloric intake in general, rather than an increase in added sugars in particular. Lustig insufficiently addresses the ‘energy out’ side of the equation. According to the research, it’s possible that over the last couple of decades, we’ve become more sedentary. King and colleagues recently compared the physical activity data in the National Health & Nutrition Examination Survey (NHANES) from 1988-1994 with the NHANES data from 2001-2006, and found a 10 percent decrease. From a personal observation standpoint, that figure seems conservative (internet surfing for hours, etc). It’s safe to say that all 603 extra daily calories have been landing in the nation’s collective adipose depot. It’s also safe to say that all this finger-pointing at carbohydrate is just as silly as the finger-pointing toward fat in the ’80′s. Lustig takes the scapegoating of carbohydrate up a notch by singling out fructose. Perhaps the most passionate point he makes throughout the lecture is that fructose is a poison. Well, that’s just what we need in this day and age – obsessive alarmism over a single macronutrient subtype rather than an aerial view of the bigger picture.

I share (Dr. Lustig’s) concern for the nation’s penchant for sitting around and overconsuming food and beverages of all sorts. However, I disagree (as does the bulk of the research) with his myopic, militant focus on fructose avoidance. He’s missing the forest while barking up a single tree. The big picture solution is in managing total caloric balance with a predominance of minimally refined foods and sufficient physical activity. The bitter truth about fructose alarmism by Alan Aragon (MS-Nutrition).

Dr. Lustig doesn't really address the calorie-in versus calorie-out equation which is pertinent to the issue. The liver and mitochondria are all parts of the process which enables us to produce energy for activity and to store energy (fat) for later use Fructose has a slightly different metabolism than glucose, however, even though it may affect appetite; the bottom line is not the fructose itself but the fact the person over eats. Compared with consumption of high glucose beverages, drinking high fructose beverages with meals results in lower circulating insulin and leptin levels, and higher ghrelin levels after the meal Since leptin and insulin decrease appetite and ghrelin increases appetite, some researchers suspect that eating large amounts of fructose increases the likelihood of weight gain. Christine Kline RD