Sugar added foods increase diabetes risk
Sugar-Added Foods Increase Diabetes Risk
 by Dr. Gabe Mirkin

Sugar added to foods, but not in whole fruits,
increases risk for diabetes, heart attack and
premature death, according to a new summary of
animal and human studies, clinical trials in
humans and epidemiological human population
studies (Mayo Clinic Proceedings, published online
January 29, 2015). The report shows that adding
sugar to foods and processing foods appear to be
the main reasons for the epidemic of diabetes that
is expected to affect 40 percent of North
Americans. However, sugar eaten in fruit is not
associated with increased risk for disease and
death. This excellent comprehensive literature
review shows that even when people do not increase
their caloric intake, sugar-added foods increase
risk for diabetes and damage to nerves, kidneys,
eyes, and heart. The authors conclude that "by
limiting sugar to five to ten percent of total
caloric intake, the harmful effects of sugar,
particularly fructose, on insulin resistance could
be minimized."

Too Much Sugar is Added to Processed Foods
 The authors of the Mayo Clinic report say that,
"Seventy-five percent of packaged foods and
beverages in the United States have added sugar,
and Americans eat up to 22 to 47 teaspoons of
sugar a day, including hidden sugar in processed
foods." They write that current guidelines for
sugar recommend amounts that can damage your
health. The American Heart Association recommends
that we should restrict added sugars to no more
than six teaspoons (24 g), or 100 calories, per
day for women, and nine teaspoons (36 g), or 150
calories per day, for men and that sugar-sweetened
beverages should be reduced to less than 36
ounces, or 450 calories, per week. The World
Health Organization has proposed that added sugar
should be restricted to less than five percent of
a person’s daily calories. Both of these
recommendations are far too high.

Table Sugar vs High Fructose Corn Syrup
 Compared to glucose, fructose causes
 * higher blood sugar and insulin levels,
 * more fat to be stored in your body,
 * more inflammation, and
 * more high blood pressure,
 However, most nutritionists believe that table
sugar is no better for you than high fructose corn
syrup (HFCS). They both contain the same two
sugars, glucose and fructose, but table sugar has
the two sugars bound together in a single
molecule, while HFCS has them already separated.
Once table sugar reaches your stomach, the glucose
and fructose are separated so that both table
sugar and HFCS are digested in the same way. In
spite of its name, HFCS does not contain much more
fructose than table sugar. It has 55 percent
fructose while table sugar is 50 percent fructose,
which is not a significant difference.

 The problem with HFCS is that it is cheaper than
table sugar, so manufacturers use more of it. The
authors recommend that the government should stop
subsidizing corn, which drops the price of corn
products (HFCS) to less than table sugar made from
sugar cane or sugar beets. People should restrict
all forms of sugar and not argue about which form
of sugar is more harmful.

Diabetes Linked to Sugar and Refined
Carbohydrates, Not Just Excess Calories
 The authors state, "We need to understand that it
isn't the over-consuming of calories that leads to
obesity and leads to diabetes. It's refined carbs
and added sugars that lead to insulin resistance
and diabetes, which lead to high insulin levels,
which drives obesity."

 Sugar added to foods and drinks causes high rises
in blood sugar levels. When blood sugar levels
rise too high:
 * sugar is used for energy and a limited amount
can be stored in muscles and the liver
 * the rest of the sugar is rapidly converted to a
type of fat called triglycerides (high
triglycerides)
 * high levels of triglycerides are deposited in
fat cells to make you fat (obesity)
 * your good HDL cholesterol clears triglycerides
from the bloodstream by carrying it to the liver
(low HDL cholesterol)
 * the liver fills up with triglycerides (fatty
liver)
 * when blood sugar levels rise too high, insulin
lowers blood sugar levels by driving sugar from
the bloodstream into the liver
 * fat in the liver prevents the liver from
clearing sugar from the bloodstream and this
drives blood sugar levels even higher (insulin
resistance and diabetes)
 * high blood sugar levels cause sugar to stick to
surface membranes of cells throughout your body
 * once sugar is stuck on the outside surface of a
cell membrane, it can never get off; it is
eventually converted chemically to sorbitol to
destroy the cell
 * this sequence explains why high blood sugar
levels lead to dementia, impotence, heart attacks,
strokes, kidney failure, osteoporosis, cancers,
nerve damage and more.

Dangers of Added Sugars
 All calories are not equal. The authors quote
many studies that show that added sugars are much
more harmful than starches in whole grains, fruits
or vegetables. Added sugars caused higher insulin
and blood sugar levels that precede metabolic
syndrome, diabetes, and extensive cell damage;
harmful fat storage, particularly in the belly,
that causes diabetes; and inflammation and high
blood pressure that cause heart attacks.
 * The risk for diabetes is 11 times higher for
each 150-kcal/person per day increase in sugar vs
a similar increase in total calories (PLoS One,
2013;8:e57873).
 * A diet with five percent sugar (rather than 18
percent or 33 percent) drops blood sugar levels to
normal (Am J Clin Nutr, 1981;34:2477-2483; Am J
Clin Nutr, 2009;89:438-440; JAMA, 2004;292:927-
934; Nutrients, 2014;6:2088-2103; Am J Public
Health, 2013;103:2071-2077).
 * People who were fed just fructose had 25
percent less insulin sensitivity (harmful)
compared to those who received just glucose (Am J
Clin Nutr, 1980;33:273-278).
 * Sugar added to food is associated with
increased risk for high blood pressure (Open
Heart, Jan, 2014;1(1)).

Sugared Drinks vs Sugar in Foods
 Sugars are far more damaging to your health in
drinks than in solid foods. You get higher blood
levels of sugar after drinking sugar than eating
it. A teaspoon of sugar in coffee is more damaging
than the same amount in a cookie, and sugar in a
soft drink is more damaging than the same amount
of sugar in a piece of cake.

My Recommendations
 * Try to replace most of the processed foods in
your diet with the same foods in their natural
state: fruits, vegetables, whole grains, beans,
nuts and other seeds
 * Avoid sugar in liquid forms, including fruit
juices
 * Restrict foods that have had sugars added to
them.