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Sugar-the unsweet side!

A pharmacist colleague recommended I watch “Sugar:The Bitter Truth” a lecture by Dr. Robert H. Lustig, a Professor emeritus of Pediatrics, Division of Endocrinology at the University of California, San Francisco. This video is 90 minutes long and 11 years old. He discussed the dangers of fructose.

Fructose is a type of sugar molecule. It sounds exotic, but it is not. Table sugar contains 50% fructose. High Fructose Corn Syrup contains 42-55% fructose. The difficulty with sugar is that it goes by many different names. Sugar is a processed food. All of the fiber has been stripped away from the cane or the beet. Pop and fruit juices suffer the same fate. I guess this is where Dr. Klaper created the phrase, “Fruit juice is like soda (pop), but without the fizz.” Fruit also contains fructose. However, the fiber in the fruit slows down the absorption of fructose for safe consumption.

Dr. Lustig stated that fructose does not stimulate leptin. Leptin is a hormone that tells the body that it has eaten food. Without this message, a person can overeat. He showed through biochemical pathways how the fructose is metabolized in the liver. He surmised that this can lead to non-alcoholic fatty liver disease. He also described how fructose can contribute to elevated uric acid levels which can cause gout. He demonstrated how fructose can be converted to fats. It is hard to believe that a carbohydrate like sugar can be converted to fat. However, that it is what the body does with fructose. One of the fats that is formed is called VLDL. Most people have heard that LDL is bad for the heart. Well, VLDL is even worse for atherosclerosis, hardening of the artery.

The age of this presentation becomes problematic. He updated his presentation in 2013 and called it Fat Chance:Fructose 2.0. Science is progressing at an amazing rate. Half of what I know as a pharmacist becomes out-of-date in five years. So, it is easy to find fault in Dr. Lustig’s presentation because of the time that has passed. I continued to watch his presentations in order to see how much of his presentation was still relevant.

I listened to another presentation that he did with the New York Times on July 15, 2020. He remarked that fructose causes the Maillard Reaction. This reaction can cause Advance Glycation Endpoints(AGES). For a review of AGES, please click here for more information. This reaction has been linked to wrinkles. He mentioned that artificial sweeteners increase insulin secretion. He does have dessert once a week, but does not want to have it three times a day plus snacks He also declared that it was alright to have eggs and bacon for breakfast! I found that point difficult to accept with my research about the whole-food, plant-based diet!

I searched for videos on this topic from the University of California San Francisco. They detail how fructose is unhealthy and want everyone to understand the dangers. When I see so many presentations, I need to find a review of the science. I read “Fructose metabolism and metabolic disease” in J Clin Invest. 2018 Feb 1; 128(2): 545–555.

The leptin resistance with high fructose diets was included in this paper. It explained that fructose causing non-alcoholic fatty liver disease was controversial. Hypertriglycemia, or high triglycerides in the blood, from soda drinks could increase the risk of heart disease. This review also reinforced the connection of fructose with gout and the formation of VLDL.

I located an abstract of a scientific paper that connected the Maillard Reaction with fructose. I looked at another paper that specified the stiffening of skin with this reaction. So fructose may also cause wrinkles.

I found one study that discussed increased insulin secretion with artificial sweeteners. However, their conclusion was that more studies were needed.

Dr. Lustig’s presentation was good for most of the major points: gout, VLDL, and AGES despite its age. The take home message from this blog is to please limit the consumption of sugar for your health. Thanks for reading. #lifestylemedicine

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