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Updated: December 10, 2022 @ 5:46 am
“Sugar, Pure, White and Deadly” is the title from a visionary book of its time, published by John Yudkin, professor of nutrition at the University of London in 1970. It was perceived at the time as being anti-science due to the prevailing mantra of the day that dietary saturated fats and cholesterol were the drivers of heart disease with deadly consequences.
What is it about sugar that, on the face of it, has a lower caloric value than fat — 4 calories per gram as opposed to 9 calories per gram for fat? The proponents of the low-fat, low-cholesterol dogma could hear or see no evil in sugar. Well, 50 years after adopting the low-fat, low-cholesterol diet, the results are less than overwhelming. There is rampant obesity, Type 2 diabetes, hypertension, heart disease, strokes and cancer.
In order to understand what sugar does, you need to understand the various terms and definitions. Regular table sugar, or sucrose, consists of two sugar molecules — glucose and fructose — called monosaccharides. Two sugars connected together are called a disaccharide. Another example of a disaccharide is lactose or milk sugar, which consists of glucose and galactose. Mono and disaccharides are also referred to as simple sugars, whereas starches or complex sugars consist of many, often hundreds of sugar molecules, such as glucose tied together in large bundles as in bread, rice and potatoes.
When we talk about diabetes, we refer to glucose as “sugar.” Glucose by itself is not very sweet. It is essential for our well-being and survival, providing the energy for our cell metabolism. It is regulated by the hormone insulin, secreted by the pancreas in response to a meal. Insulin is the key that opens the locks on our cells so they can receive the glucose. Any glucose that cannot be used by our cells right away, such as those in the brain or the muscles, is stored in the liver or muscles as glycogen. Glycogen serves as a reservoir for bursts of energy needed to finish the last 2 miles of a marathon or so we can sleep through the night, since all our cells need glucose on a continuous basis.
The other molecule in table sugar or sucrose is fructose. It is much sweeter than glucose, and this sweet taste makes it desirable. From the first moment we get a taste of it, we are “hooked,” so to speak. You can circumcise a male infant without anesthesia by administering sugar, having him suck on a lollipop. Fructose is present in fruit and probably helped our ancestors stay alive since the presence of fructose signaled that the fruit was edible and not poisonous.
But in those days, you had to look long and hard to find sweet-tasting fruit or honey, for that matter. Up until 200 years ago, sugar or sucrose was a rare commodity and mostly available to the aristocrats. British cartoons from the time depict a portly duke sitting in a lounge chair with one leg propped up due to a gout attack in his big toe, pointing to sugar as a culprit. The Industrial Age in the mid-1800s made sucrose cheap and widely available, even to the poor. British factory workers were living on tea sweetened with sugar, resulting in tooth decay and early loss of one’s teeth.
Fructose, in contrast to glucose, does not stimulate the release of insulin from the pancreas. No organ except the liver can process fructose. After ingestion and enzymatic split from its “cousin” glucose, fructose is shunted into the liver, where it is metabolized into fat. This appears to be an ancient survival mechanism. When we roamed the earth as hunter/gatherers, we had no “food security” and were always threatened with starvation. Recall the seven fat and seven lean years of ancient Egypt.
Another example is the bears who eat voraciously, consuming berries, fruit and honey during the summer months so they can live off their fat stores in the liver and abdomen during the long winter months. Thanks to the fructose content of the fruits and honey, their livers make fat out of fructose, which they use for energy during hibernation.
So, what is wrong with eating fructose? After all, the American Diabetes Association recommends pure fructose as an alternative to sucrose/table sugar in years past since it does not raise insulin. Unfortunately, however, this was bad advice, with diabetics gaining more weight. But so did the general, non-diabetic population.
At this time, close to 70 percent of the population in the US is overweight and almost 40 percent are grossly obese. When table sugar or sucrose was an expensive commodity available only to the affluent, the average person consumed only about 10 grams (2.5 teaspoons) of fructose a day. The current intake of fructose is anywhere from 90 to 100 grams (13-14 teaspoons) a day. But nobody is loading up for a rainy day or hibernation. Likewise, we don’t expend enough energy in a day to use up the fat deposits in the liver. We also do not face any food insecurity, with a fast-food joint, coffee shop or juice bar practically at every corner. As with so many things, it is the dose that makes the poison.
Too much fat in the liver leads to fatty liver and insulin resistance. The latter is detrimental to the human metabolism. It is the gateway to Type 2 diabetes, heart disease, gout and cancer.
The breakdown of fructose in the cells hijacks the cell’s normal energy production leading to the production of excess uric acid, causing gout, high blood pressure and ultimately kidney problems. High insulin levels due to insulin resistance contribute to weight gain and lead to the dreaded metabolic syndrome with high triglycerides, the result of fructose being converted into fat in the liver, elevated small, dense LDL, the so-called “bad” cholesterol and low HDL or “good” cholesterol. This is the major driver of hardening of the arteries with heart attacks, strokes and dementia of the Alzheimer’s type.
People may counter that there is no way they eat 13 to 14 teaspoons of fructose in a day. Take a close look at what you eat or drink. Soft drinks in particular are stealth bombs of excess fructose delivery, since most of them contain HCFS or high-fructose corn syrup, which can contain up to 70-90 percent fructose. HCFS was developed in the 1970s as a substitute for cane sugar, which is 50 percent glucose and 50 percent fructose. Coca-Cola, Pepsi, Sprite and 7UP started using the HCFS extensively since it is a liquid, dissolves easily in water and, above all, is cheap! Once you start looking for fructose, you will be surprised at the variety of foods containing it, such as tomato sauce and soup, ketchup, salad dressings, pastries, hamburger buns and processed meats such as salami and bacon. The list is endless, especially if your diet consists mostly of prepared or fast foods.
To summarize, sugar does not kill you instantly, but the consequences of a diet full of sucrose/fructose is killing you slowly. To get away from the excess sugar, consumption you need to go back to “real food” and dump “fast food.” Remember, “an apple a day keeps the doctor away!” Adding fresh vegetables, at least three servings a day, as in a salad consisting of lettuce, tomatoes, cucumbers or carrots with a home-made dressing, equal parts of olive oil and balsamic vinegar, a little salt and pepper, easy and fast to fix! Store-bought salad dressings are chock full of fructose and various additives. An easy dinner is rice and beans or lentil soup.You can cook it ahead on the weekend so you have leftovers. When you are hungry and starved, you are unable to resist the temptation to get the bad fix at a Wendy’s or McDonald’s.
Above all, stop drinking soft drinks and fruit juices — the latter are even worse than the colas, since they are fructose bombs! A glass of orange juice is the product of at least five to six oranges, which nobody would eat in one sitting. Additionally, it is stripped of its fiber. Fiber in real fruit delays the rapid absorption of the sucrose or sugar. Cutting down on sugar that way will not only make you feel better you will also lose your cravings for the toxic fast food with its deadly consequences of either dying before your time or spending the last few years of your life going from doctor to doctor and spending your life savings on expensive medications such as the newer injectable GLP 1 medications to treat obesity and diabetes.
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Dr. Eva Abbo is a doctor of internal medicine in
La Jolla, Calif., and former Laurel resident who still frequently visits.
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