Oh...Sugar! We have a problem
She stood there in the middle of the shop, barely 2 years old, hands held out, eyes fixed on her mothers fingers that were busily poking a straw into the juice container. She was hanging out… could hardly wait for her fix. The reward centre in her brain was screaming for that sugar and she needed it badly. She took that first sip…eyes distant, she became deaf to her mothers calls and didn’t realise that she was being spoken to or that her mother was leaving the shop. She stood motionless in the middle of the shop sucking hard on that juicebox. I witnessed this scene just the other day and it was a powerful show of the effect of sugar on our kids minds…but the effect on their bodies and ours is just as scary.
Sugar is turning out to be the one of the most toxic compounds that we regularly ingest. Recent research shows that sugar, in particular the fructose half of it, is directly damaging our livers and causing a condition called Non Alcoholic Fatty Liver Disease (NAFLD). This NAFLD is indistinguishable from the liver disease caused by alcohol when viewed under the microscope and exactly like alcohol, can lead to chirrosis, hepatitis and will soon become one of the leading reasons for liver transplants. It is also the underlying cause of the majority of metabolic syndrome in combination with our excessive carbohydrate consumption. Unfortunately, as opposed to alcohol, this type of fatty liver disease is affecting our children and we now see younger and younger children developing metabolic syndrome and increasing their risk of developing diabetes, obesity and heart disease at an earlier age. In this post I want to show you how the body deals with sugar and why it is so toxic to us in the doses we are taking.
The problem with sugar
Sugar in all its many forms is one of the biggest culprits in the development of poor metabolic health. It really doesn’t matter whether it's white, brown, icing, agave nectar, maple syrup, honey, organic or palm… whatever form you want to consume it in, it is essentially one glucose molecule and one fructose molecule joined together. Usually the mix is about 50% glucose to 50% fructose but the ratios can change a little depending on the type of sugar. Fructose is also found naturally in fruits along with glucose and here the ratios between fruits can vary a lot. In general, moderate and seasonal fruit consumption is OK if you are metabolically healthy as you ingest a lot of fibre along with the fructose which changes the way it gets absorbed...I’ll get back to fruits in another post.
If we go back a few hundred years, our access to fructose was a lot more limited than it is today. We could consume it the form of fruits when they were in season (only at certain times of the year, unlike now) and in the form of honey if we could find it. Otherwise, there was very little of it around to bother us. Studies show that in the U.S. there has been a 25 fold increase in sugar consumption in the past 200 years…yes 25 fold… which means the average American is now consuming almost 1kg of sugar of a week…I doubt it's much better here in Australia given we are seeing similar health problems.
So what exactly is the issue with this amount of sugar?
When we eat or drink sugar we are taking in both glucose and fructose in roughly equal amounts. The bond between the glucose and fructose is quickly broken down and these are then dealt with by the body in two completely different ways.
Let's deal with the ‘less' toxic glucose first.
The glucose is taken up by the lining of the intestines which releases a chemical messenger that signals to the pancreas to release insulin. The glucose is then transferred from our intestinal lining into the bloodstream and then transported around the body and a small amount of that glucose is taken up by almost every cell in the body. This process of taking up the glucose in the cells is helped by the hormone insulin and as mentioned earlier it is either used for energy and burned or stored for later.
Why is insulin realeased so quickly? At any time, our body only wants to have approximately the equivalent of one teaspoon of glucose in our bloodstream… this equates to a blood glucose level of about 5.0mmol/L. This is a normal level. The body wants to maintain this level as much as possible because too much glucose in the blood is actually toxic to cells: it causes ageing of the cells, interferes with normal cell functioning, interferes with the immune system, damages the lining of the blood vessels and has many more toxic effects at high levels. So when our blood glucose rises after meals/drinks, the bodies response is to burn what we can for energy and then stuff the excess glucose into our cells either as a safe storage form of glucose called glycogen (which occurs in our muscles and liver) or when our glycogen stores are full, the glucose is then shoved into fat cells and converted to fat for later use…. hopefully….
So every time you consume sugar this process is repeated - a cycle of increasing glucose - increasing insulin - storage in the form of glycogen if space allows - then storage as fat. However, if we over consume glucose these storage areas become full so the pancreas releases even more insulin to try to cram increasing amounts of circulating glucose into our cells and this is when our insulin levels -unbeknownst to us and our GP’s - start to become chronically elevated. This state is called hyperinsulinaemia (too much insulin) and it prevents us from accessing our fat stores and burning them as fuel. This makes total sense because if there is so much glucose around and high glucose is toxic to the body, it will try to use this for energy burning first, rather than the less toxic and safer stores of fat.
But what about the fructose, I hear you ask?
If too much glucose is ingested and it’s already causing problems then what on earth could the fructose be doing? Fructose is also taken up by the lining of the small intestine but unlike glucose which can be used or stored by most of the cells in the body, fructose can only be processed in the liver so 100% of it ends up there. There are no other cells in the body that can regularly deal with fructose. This means that every molecule of fructose we consume hits the liver and starts a nasty chain of events which further exacerbates the problems that excessive glucose is already causing as mentioned above.
Fructose enters the liver and rapidly gets broken down and a small amount is used for energy production. This process is quickly overwhelmed due to the volume of fructose that we usually consume in soft drinks, processed junk foods, cakes etc so that the excess fructose that can't be used for energy production gets converted into fat. This fat is then either sent out of the liver in the form of triglycerides to be deposited into your fat cells to make you fatter or it’s sent into your arteries to cause blockages or it’s stored in the liver as fat droplets leading to the condition called Non Alcoholic Fatty Liver Disease (NAFLD). A condition that is so similar to the damage caused by alcohol that the two look exactly the same under the microscope and have the same effects.
In the process of breaking down fructose and making these fat droplets a number of toxic chemicals are also made such as uric acid which leads to an increase in blood pressure and to a condition called gout. Another compound called Methylgloxyl is also produced and this causes damage inside the liver by producing free radicals - chemicals that directly damage the proteins and tiny organs inside our cells (1). This chemical damage leads to inflammation of the liver and a state where the liver cannot properly see and respond to insulin in the blood stream. When the liver can't respond to insulin properly, it stops taking in the excess glucose from the bloodstream as it should and instead actually makes extra glucose in its cells and releases it into an already flooded bloodstream full of glucose causing further release of insulin from the pancreas and exacerbating the whole toxic cycle glucose created.
Methylglyoxyl also speeds up the process of ageing of our cells in a similar fashion to glucose. And while glucose does this a little bit at a time, the effect of methylglyoxyl is 250 times more pronounced causing widespread damage and inflammation contributing to heart disease, Alzheimers, bad lipid profiles, atherosclerosis and exacerbates fatty liver disease. Of course the dose of the toxin is related to how poisonous it is. Small amounts of sugar occasionally can be dealt with safely by our organs but in the amounts that we now consume it as a society we are all placing ourselves at extreme risk. We know this because the rates of fatty liver disease are rising along with insulin levels, diabetes and heart disease. (2)
So the little child in the market normally only has a quarter of teaspoon of glucose in her tiny bloodstream. When she chugs back that 250ml fruit juice which contains 28 grams of sugar or 7 teaspoons, she has to somehow shove an extra 3.5 teaspoons of glucose into her muscle, liver and fats cells which may already be full from the cocoa pops, corn flakes or toast she ate for breakfast. Now her body has to deal with the extra toxic load of 3.5 teaspoons of fructose hitting that baby liver of hers…
It is no wonder that adults as well as children are now being diagnosed with NAFLD, pre diabetes, diabetes, hypertension, bad lipids profiles, obesity and TOFI. Fructose is clearly associated with the development of all of these metabolic conditions and this is just the physical and physiological side of things. I haven’t even touched on the addiction aspect of this substance. Remember it isn’t just table sugar that causes these issues, it’s those sneaky added sugars in our ultraprocessed junk foods and our beloved treats. Worryingly, it is also being discovered that the chronic ingestion of high amounts of glucose containing foods alone (even without fructose) in people who already have high blood glucose levels, high uric acid levels and high salt diets from processed foods can actually cause the body to convert some of the glucose into the more toxic fructose!! Double whammy!
References:
(1).Isocaloric Fructose Restriction Reduces Serum d-Lactate Concentration in Children With Obesity and Metabolic Syndrome. Erkin-Cakmak, Bains et all
