The 3 Harbingers of Metabolic Discord -Part 1: Sugar

The 3 Harbingers of Metabolic Discord -Part 1: Sugar

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Introduction

Throughout this website you have seen a common theme; I believe that eating wholesome natural foods is the key towards health and preventing metabolic disease.

European bread often relies on traditional recipes passed down through generations, using simple ingredients like flour, water, salt, and yeast or sourdough starter. In contrast, American bread production has been heavily influenced by industrialization, leading to the widespread use of additives, preservatives, and high-fructose corn syrup in some commercial breads.

Over the last 100 years we have set in motion a path towards metabolic dynfunction in our society that eventually leads to obesity, type 2 diabetes and cardiovascular disease. We have done this by the introduction of what I call the three “harbingers of metabolic discord:”

  • Sugar (excessive consumption of refined sugar and high fructose corn syrup)
  • Ultra-processed foods (highly palatable, deconstructed foods with additives, chemicals, unhealthy fats, excess sugar/salt)
  • Refined gluten (industrially produced bread that is high in additives, preservatives and bred for high gluten content)

The Metabolic Effects of Excess Sugar

Because I am an endocrinologist, we will begin with the first harbinger; sugar.

When we consume excessive amounts of sugar (which is the hallmark of the Western Diet), we are setting up our body for weight gain, insulin resistance, fatty liver disease, caries, nervous system dysregulation and cardiometabolic disease. How does this happen?

  1. Weight Gain: Sugary foods and beverages are often high in calories but low in nutritional value. An excess of calories, leads to weight gain, which increases the risk of developing obesity.
  2. Insulin Resistance: High sugar intake leads to insulin resistance. The cells in our bodies need insulin in order to be able to use sugar for energy. Think of insulin as the “key” that allows sugar to enter the cells of the body to do its job. When we have insulin resistance, the body has to make more and more insulin. This makes it harder for the body to respond to the effects of insulin. Eventually this leads to type 2 diabetes.
  3. Increased Risk of Heart Disease: Diets high in added sugars raise the blood pressure, increase inflammation, and elevates triglycerides. This negatively impacts cardiovascular health.
  4. Dental Issues: Sugars provide a source of energy for bacteria in the mouth, leading to the production of acid. This acid can contribute to tooth decay and cavities.
  5. Blood Sugar Spikes and Crashes: Eating sugary foods and beverages can lead to rapid spikes in blood sugar levels, followed by crashes. This can result in feelings of fatigue, irritability, and cravings for more sugar.
  6. Increased Risk of Metabolic Syndrome: Excessive sugar intake increases our risk of developing metabolic syndrome. Having 3 out of the following 5 conditions confers a diagnosis of the metabolic syndrome:
    • High blood pressure
    • High fasting blood sugar
    • Abnormal cholesterol levels (low good cholesterol/HDL)
    • High triglycerides (a type of fat in the blood)
    • Having excess abdominal fat (waist above 35 inches for women above 40 inches for men)
  7. Inflammation: High sugar intake contributes to chronic inflammation in the body, which is linked to various health problems, including autoimmune diseases, cancer, and neurodegenerative disorders (read my post on meta-inflammation).
  8. Addictive Properties: Sugar has been shown to activate reward centers in the brain, leading to cravings and a potential for addiction-like behavior. This can make it challenging for some individuals to control their sugar intake (guilty as charged here).

It’s important to note that I am referring to refined and excess sugars such as those found in candy, pastries, sweets, cakes, juices, prepared cereals, sweetened canned fruits, processed foods, sugary drinks etc. When you consume naturally occurring sugars in whole foods such as fruits and vegetables, they are not as concentrated in sugars and they come with nutrients and fiber which your body needs.

Children Are Eating Too Much Sugar

Preference for sweetness starts very early and because of this children are at the highest risk of sugar overconsumption. Children are often exposed to sugary foods and beverages through various sources, including sugary snacks, sweetened beverages, and processed foods. Unfortunately, the excess intake of empty calories in children can lead to obesity and undernourishment, which not only hinders their growth and development, but also sets them up for the development of metabolic disease as adults.

According to the World Health Organization (WHO), the global prevalence of childhood obesity has been increasing. In the United States, data from the Centers for Disease Control and Prevention (CDC) indicated that around 20% of children and adolescents aged 2 to 19 had obesity during 2017-2018. This is largely due to the over-consumption of sugar in childhood. Type 2 diabetes used to be a disease of adults. However, with the increasing number of children with obesity this has led to more cases of type 2 diabetes being diagnosed in children and adolescents.

The Dangers of High Fructose Corn Syrup

One of the worse types of refined sugars has been slowly added to most of our foods over the last century; This is high fructose corn syrup (HFCS). HFCS is an addictive sweetener made from corn starch (it is made by adding lots of fructose to corn syrup). It is commonly used in various processed foods, condiments and beverages because of its economic advantages (cheaper to produce than buying sugar overseas). Because HFCS contains high levels of fructose, it is very sweet and causes cravings. Furthermore, your body does not process it like natural sugars. When the liver metabolizes HFCS it becomes overwhelmed because there is way too much fructose in it. So it starts converting it to fat and triglycerides. Hence, HFCS causes increased fat storage, insulin resistance and elevates triglycerides. All of these things contribute to the development of the metabolic syndrome, fatty liver disease and type 2 diabetes.

Actionable Steps to Reduce Sugar Consumption

Here are some practical tips and alternatives to help reduce sugar consumption, particularly in children:

  1. Educate and Involve Children:
    • Teach children about the impact of sugar on health, explaining why it’s important to limit sugary foods. Involve them in meal planning and grocery shopping to make them more aware of food choices.
  2. Read Nutrition Labels Together:
    • Make it a habit to read nutrition labels on packaged foods together. Look for hidden sugars under various names (e.g., sucrose, high fructose corn syrup) and choose alternatives with lower sugar content.
  3. Choose Whole Fruits:
    • Opt for whole fruits instead of fruit juices or fruit-flavored snacks. Whole fruits provide fiber, essential nutrients, and natural sugars in a balanced form.
  4. Limit Sugary Beverages:
    • Encourage water as the primary beverage. Limit sugary drinks like sodas, fruit juices, and flavored milk. You can add a splash of fruit to water for a refreshing and naturally flavored alternative.
  5. Healthy Snack Options:
    • Offer nutritious snacks like cut-up vegetables, fresh fruits, yogurt, or nuts instead of sugary snacks and candies. Keep healthy options easily accessible for them to try.
  6. Homemade Treats:
    • Prepare homemade treats and desserts using natural sweeteners like honey or maple syrup in moderation. This way, you can control the amount of added sugar in your child’s diet. If you like to bake treats use more natural flours like cassava flour or oat flour instead of refined white flour.
  7. Be a Role Model:
    • Children often mimic adult behavior. Be a positive role model by making healthy food choices and demonstrating a balanced approach to nutrition.
  8. Limit Processed Foods:
    • Ultra processed foods often contain hidden sugars. Limit the consumption of packaged snacks, breakfast cereals, and other processed items. Instead, focus on whole, unprocessed foods.
  9. Encourage Regular Meals:
    • Ensure that children have regular, balanced meals throughout the day. This helps stabilize blood sugar levels and reduces the likelihood of reaching for sugary snacks.
  10. Limit Desserts and Treats:
    • Reserve desserts and treats for special occasions. Reinforce the idea that these foods are occasional indulgences rather than daily staples.
  11. Involve Children in Cooking:
    • Engage children in the kitchen, allowing them to participate in cooking and meal preparation. This fosters a positive relationship with food and promotes an understanding of ingredients.
  12. Promote Physical Activity:
    • Encourage regular physical activity, as it not only contributes to overall health but also helps regulate blood sugar levels and reduces the risk of developing obesity.

Remember, the key is to create a balanced and sustainable approach to nutrition. Small, gradual changes tend to be more effective and easier to maintain over the long term than drastic approaches. Eating healthier is not about going on a diet, it is a moving towards a healthier lifestyle.

Sugar Definitions:

  • Sugar/cane sugar/table sugar: sucrose (glucose + fructose)
  • Sugar from natural sources: fructose
  • High fructose corn syrup: +++ fructose (much sweeter) + corn starch (a lot cheaper than natural sugar)
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