Friday, April 22, 2011

Is sugar toxic?

http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?_r=3&adxnnl=1&ref=homepage&src=me&pagewanted=all&adxnnlx=1303339871-np8HMDjThEJmLpLPzTQSew
http://www.kqed.org/a/forum/R201104211000

Maybe you have heard about this issue, which is part of the health care debate. We know that cardiovascular diseases account for over $400B of medical costs in the US per year, and countless other social harm and externalities (lost productivity, caretaking, etc.). We assume that fatty foods are the problem, and that's part of it, but a UCSF pediatrics researcher (and plenty of others) has concluded that the biggest culprit is actually sugar: natural sugar fructose, or processed sugar sucrose which is fructose+glucose. Many foods can cause us to gain weight, but sugars push us to metabolic syndromes like insulin dysregulation (leading to diabetes, which increases risk or exacerbates all the other inflammatory cardio diseases, which is the leading cause of death in the West).

We know that sugar "rots our teeth" and sweets are a guilty pleasure, but there is very little human data out there comparing high vs. low sugar diets in controlled studies. This is partly because it takes so long and it's hard to keep subjects on a regulated diet. In lab animals, it's pretty darn convincing:

http://www.sciencedaily.com/releases/2008/12/081210090819.htm
http://www.portlandtribune.com/news/story.php?story_id=129728500537306200
http://beavercountyblue.org/2010/09/15/high-fructose-corn-syrup-major-cause-of-obesity/

But fructose exists in nature. It's a part of fresh fruit, which the diet experts say are good, right? But in nature, most high-fructose foods also contain a large amount of fiber, which negates the negative effects of fructose. High-fructose corn syrup is all sugar with no fiber, and it's practically everywhere. Actually fiber is mostly absent in processed and fast foods, because fiber falls apart when frozen unless you add stabilizing preservatives. Why is sugar not even on the food pyramid? Americans have no idea how much is dangerous, and frankly most doctors don't know either. The USDA and FDA are really behind the curve on this issue, possibly due to political pressure from the agri-business and food lobbies. The last FDA study on sugar was in 1986, and basically gave it a pass. You probably wouldn't be surprised to know that the FDA administrator in charge of that study later went on to work for the Corn Refiners Association. The study proposed that a sugar consumption (beyond fruit/veggie intake) of less than 40 lbs/person/year is "safe", even though the average American consumption at the time was 75. Now we're up to 90+. But the study didn't say what happens to people at those levels.

Yes, sugar products are pleasurable to consume, and they make most foods taste better (think baker's chocolate vs. milk chocolate, or medical electrolyte solution vs. Gatorade). But it's scary that one 12 oz. Coke contains 39 g of sugars. A typical mouse weighs 25 g. Now convert that to # of tablespoons in your head, and it's a scary picture.

It's one thing to know that sugars are bad, but it's another to stop people from harming themselves with it. Children, with very low impulse control, are abusing sugars and are the group with the highest surge of cardio diseases vs. their historical peers. That's partly why Michelle Obama and others are trying to get parents and schools to reduce their kids' exposure to junk foods. Maybe at some point we will need to implement a "fat and sugar tax", which would raise the prices on these dangerous foods in order to partly cover the social costs of consumers' future health problems. Heck we could even use some of those revenues to subsidize healthier, better foods for the poor, who are the model customers for bad foods because they are less educated in nutrition, and more likely to rely on cheap, fast food for survival.

But then you get the pro-business backlash and the conservative criticisms that gov't is trying to "run your life". People should be free to eat what they want! Even if it puts all of us at risk? The recent threat of a gov't shutdown, and our current debate about raising the federal debt limit, should remind us about the consequences of wasting money on preventable problems. Plus, the gov't already regulates other ingestibles like drugs, tobacco, and alcohol. The costs of abusing those products is arguable smaller than fat/sugar abuse. But it's so easy for these discussions to degenerate into culture war fodder (like climate change), instead of keeping it science and public policy based.

Other peoples, who traditionally consume very different diets than ours, are recently getting exposed to Western high-fat/sugar foods due to globalized food commerce. Fast food consumption in the West is leveling out, so firms are trying to tap new markets, often with great success. Inuits in northern Canada, who have survived on fish and marine mammals for millennia, are now getting Burger Kings in their villages. They're thrilled to eat such good-tasting, affordable food that doesn't need to be caught and hunted, but now their incidence of diabetes is going from near zero to through the roof. The same happened with some Pacific Islanders in the 20th Century.

http://www.npr.org/2011/03/24/132745785/how-western-diets-are-making-the-world-sick

Close to some of us, UCSF + the city of Martinez are experimenting with being sugar-free for a year (I couldn't find any web links about it though). This is ironic because a C&H Sugar plant is down the road from them in Crockett. I can imagine the findings will be quite noteworthy.

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I heard about this while back. But since everything is better in
moderation, better yet anything is bad for you if you over do it, then
everything (not just sugar) can be considered poisonous no? Surely we
can't label everything poisonous just because people can exercise
"moderation". Stick to the dictionary definition. Poison is something
that is harmful in all dose, not something we normally need as a food
group but now can be harmful because some gluttonous people over eat
themselves to self harm and destruction

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Well, this doctor is saying high fructose corn syrup (HFCS) in particular is bad for you no matter the dose. The body doesn't gain anything from it, and it only leads to increased triglyceride formation and insulin resistance. Maybe just having one Coke per month, you won't see a change in your health, but every little bit is making a small difference for the worst. So by that definition, HFCS is a poison. Natural fructose is a little different, because it exists in fresh foods with counter-balancing good nutritional properties. So maybe eating an apple is a net gain, even if it contains a small amount of "poisonous" fructose.

Some foods contain formaldehyde, iodine, etc. which are things that can be toxic at high doses, or can be good at low doses. If food labels would educate people on how much sugar becomes dangerous (depending on body weight, age, metabolism, etc.), then maybe consumers could make better decisions. But the problem is more economics than medicine. Our food industry has made sugar cheap and ubiquitous. And biologically, it is pleasurable and addictive like nicotine. So that is a dangerous combination. If we just let diabetic and hypertension people die, no problem. But we're pouring billions into their care, which is often preventable with different life choices. We force people to wear seatbelts and not talk on cell in the car to reduce the risk of harm, and if they violate we fine them. So we can tax booze, smokes, and maybe sugar. People can still eat it if they want, but they have to pay more to help cover the costs of the social harm. I guess it's the same idea as raising the costs of water on those who waste it.

I doubt any of this would happen, but we would have a healthier, more stable society if we did.

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article did not mention the word 'inflammation' even once.
metabolism discussion only.
nothing of the true disease cause... not all caused by sugar metabolism in host tissues
boo.

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Yeah, I mean he is on the extreme sugar fringe on the obesity-diabetes debate in order to shock people and draw more attention to sugar (that has a more positive perception in society than fat). He has plenty of detractors, but since the article/interview was meant for the general public, maybe he didn't want to get into too much inflammation and metabolic pathway science.

But his basic argument is (my interpretation at least, since I am not well versed in these matters):

-Natural fructose is more tolerable because it is found in high-fiber fruits that counter-balance the harms.
-Calories are not equal, and 100 cal of glucose intake is less harmful than 100 cal of fructose.
-Animal studies show sugar is addictive, and increases triglyceride production and insulin resistance.
-High-fructose corn syrup is more harmful than other forms of sugar.

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