The Fructose Wars

Reading the blogs of other people with Type 2 diabetes has led me in some interesting directions. One of the side trips I took came when I read that fructose has less impact on insulin than other forms of sugar.

Did that mean it was a good choice as a sweetener for people who have diabetes? The desire to answer that question led me straight into the war over HFCS, or high-fructose corn syrup, which is made up of glucose and fructose.

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On both sides of the debate the passions are high. For those who think that HFCS is the culprit behind an epidemic of Type 2 diabetes and obesity, this is an all-out, no-holds-barred battle. On the other side are the makers of HFCS who say there is nothing wrong with their product, that sugar is sugar.

In the middle are the scientists who use blind and double-blind studies that often lead to more questions than answers. It is extremely difficult to prove one or the other of the opposing arguments absolutely right.

You can imagine the problems researchers come up against when trying to measure diets to prove anything in the laboratory. We are not good lab rats. Eating habits and body types and human nature add so many variables that neither side is going to win this argument by the scientific method any time soon.

Two things come up consistently in studies I have read. One is that fructose does not cause insulin to be released as quickly as glucose does. The problem with this is that if insulin does not go up, leptin does not go up either.

Leptin is your fullness hormone. It signals that you are no longer hungry. So a person drinks a sugary soda — which is almost sure to have lots of fructose in the form of HFCS — gets a lot of calories, but still feels hungry.

Doctors who deal with obese children see this as a big part of the obesity epidemic in the young. Children get as much as 40% of their calories from solid fat and sugar, and up to 40% of the calories they receive from added sugars comes from beverages.

When fructose is broken down in the liver, much of it is stored in fat cells, far more easily than any other carb, according to biologists. But does that mean fructose is bad for you?

Fructose is fruit sugar, found in all fruits and vegetables. It is nearly impossible to get “too much” fructose by eating fruits and vegetables, because along with the fructose you are getting loads of fiber, which has the power to change how you metabolize calories.

Also, along with fructose, fruits and vegetables contain antioxidants, vitamins, and minerals that we really need.

Where is the smoking gun?
It is hard not to blame HFCS, which started being added in large amounts to processed foods for the first time in the 1980s in the United States. Many point to the obesity epidemic that surfaced in the 1980s as well. It also happens that this was when Type 2 diabetes began to rise into the tidal wave we see today.

But it was also in the late 1970s that the war on fat was conceived. Experts thought that if we reduced fat we would reduce heart disease. Heart disease continued to rise, so it did not work, but we live with the results of their idea. There are still plenty of low-fat labels in the supermarket, even on things like bags of candy.

Much of the fat was taken out of processed foods, but then they tasted awful, so processors added sugars to put taste back in. For this reason, in the United States we eat an average of 150 pounds of sugar per year, much of it in the form of processed foods and drinks. To put this in perspective, one hundred years ago Americans ate less than 10 pounds of sugar a year on average.

Another problem is that over the years we have eaten less and less food we cook ourselves, depending more and more on packaged meals and fast food. Processed-food makers take out fiber to improve shelf life. Sugars and salt are added to keep things fresh and improve the taste. Making food from scratch at home means you will have more fiber and less sugar no matter what you cook.

In the 1970s, Americans ate out maybe once a week. Today, most of us spend roughly half of our food dollars on food eaten outside the home, which includes “takeout.” There is added sugar in so much of it.

There is also a portion problem. You can see this with bottled soda. In the 1950s the new soda size was a 12-ounce bottle. In the 1970s we saw the first 20-ounce bottles. One 20-ounce bottle of regular soda contains between 66 and 77 grams of sugar. Much of that is HFCS because it is the least expensive form of sugar available in the United States.

Today they also sell soda in a convenient one-liter bottle. So for me the smoking gun is that we eat too much sugar. It is not just in soda and cakes and donuts and ice cream. It is also in bread, sauces, canned fruit, juice drinks, crackers, cereals, frozen meals, hot dogs, peanut butter, pickles, soups, and prepared vegetables.

Dr. David Katz, a practicing physician and researcher at the Yale University Prevention Research Center, says this. “If you eat food direct from nature you don’t even need to think about [it]. You don’t have to worry about trans fat or saturated fat or salt — most of our salt comes from processed food, not the salt shaker. If you focus on real food, nutrients tend to take care of themselves.”

I think this applies very well to the sugar problem. It keeps everything simple.

He and some colleagues published a paper titled, “Can We Say What Diet Is Best for Health?” After following many popular diet types, they conclude that if you eat food as close to its natural state as you can with as little processing as possible, your diet will be a healthy one that promotes healing and helps prevent disease.

The easiest way to do this is to cook meals for yourself. But make sure to eat foods you like. Discard the recipes with weird ingredients you won’t eat. Do what is most convenient for you while you follow this man’s excellent advice, so that you can stick with the choices you have made.

Cut out the sugared drinks, eat your carbohydrates with fiber, and wait 20 minutes before you go back for seconds to give your fullness hormones time to kick in. Meanwhile, do not worry about the fructose wars. Let them battle it out. You do not need the extra stress.

Do you have diabetes and wonder what, exactly, your A1C is and why it matters? Then bookmark DiabetesSelfManagement.com and tune in tomorrow to find out from nurse David Spero.

  • RAWLCM

    When you say “cut out the sugared drinks” are you including fruit juice and milk, which contain just as much sugar per ounce as soda?