Sugar Crush

Dr. Richard Jacoby, Raquel Baldelomar

• Publisher: Harper
• Year: 2015
• ISBN:
  9780062348234
• Topic: Medicina
• Subtopic: Nutrizione, dietetica e bariatria

A shocking look at the link between sugar, inflammation, and a host of preventable chronic diseases—perfect for fans of bestselling author Gary Taubes' The Case Against Sugar —from leading nerve surgeon Dr. Richard Jacoby.

What Grain Brain did for wheat, this book by a leading peripheral nerve surgeon now does for sugar, revealing how it causes crippling nerve damage throughout the body—in our feet, organs, and brain—why sugar and carbohydrates are harmful to the body's nerves, and how eliminating them can mitigate and even reverse the damage.

If you suffer from ailments your doctors can't seem to diagnose or help—mysterious rashes, unpredictable digestive problems, debilitating headaches, mood and energy swings, constant tiredness—nerve compression is the likely cause. Sugar Crush exposes the shocking truth about how a diet high in sugar, processed carbohydrates, and wheat compresses and damages the peripheral nerves of the body, leading to pain, numbness, and tingling in the hands and feet, along with a host of related conditions, including migraines, gall bladder disease, and diabetes.

Over the years, Dr. Richard Jacoby has treated thousands of patients with peripheral neuropathy. Now, he shares his insights as well as the story of how he connected the dots to determine how sugar is the common denominator of many chronic diseases. In Sugar Crush, he offers a unique holistic approach to understanding the exacting toll sugar and carbs take on the body. Based on his clinical work, he breaks down his highly effective methods, showing how dietary changes reducing sugar and wheat, coinciding with an increase of good fats, can dramatically help regenerate nerves and rehabilitate their normal function.

Sugar Crush includes a quiz to assess your nerve damage, practical dietary advice, and the latest thinking on ways to prevent and reverse neuropathy. If you have diabetes, this essential guide will help you understand the dangers and give you the tools you need to make a difference beyond your doctor's prescriptions. If you have the metabolic syndrome or prediabetes, or are just concerned about your health, it will help you reverse and prevent nerve damage.

PART I

This Fine Sweet Mess

1

The 500-Pound Canary

A SUGAR TSUNAMI

Regardless of metaphor, we should address the painfully obvious. Each year, the average American eats 160 pounds of processed sugar.

And by sugar, I mean all of the -ose and -itol words: glucose, fructose, dextrose, sorbitol, polyglycitol, galactose, and others. It’s difficult to find out just how many “chemically sugar” compounds are approved by the U.S. Food and Drug Administration (FDA) for use in food, toothpaste, vitamins, or nighttime cold medicines—but it’s more than simply being labeled “sugar.” And that’s not counting consumption of alcohol. Pervasive seems too weak a word. We love sugar; a spoonful of it makes anything go down.

Meanwhile, 40–50 percent of American adults will develop diabetes (those at greatest risk are Hispanic men and women as well as non-Hispanic black women). Obesity is the main factor in the increase in diabetes among all demographics. The treatment and care of diagnosed patients cost approximately $174 billion per year. If you have diabetes, you’re also two to four times more likely to experience a stroke. That means your brain stops acknowledging a major part of your body. Your arm, your legs. The side of your face. Oh, yeah, and your bodily functions falter. We haven’t even gotten to cardiovascular challenges. Or breathing. But you get the picture.

Diabetes

Presently, most forms of diabetes are categorized in three groups:^*

• type 1, in which the body’s immune system destroys the cells making insulin

• type 2, in which an individual has too little insulin or cannot process insulin

• gestational, which can occur in pregnancy if a woman’s hormones interfere with insulin production.

This book is concerned with type 2 diabetes and the primary culprits surrounding its causes, progression, and control.

As early as the 1990s, I saw a crisis developing around peripheral diabetic neuropathy, foot ulcers, and amputation—direct results of the increase in diabetes. The number of people being diagnosed with type 2 diabetes was skyrocketing—even kids were getting it. Remember, it’s well understood that this chronic disease is directly linked to lifestyle. Combine a diet high in sugar (including fruits, honey, and starch—all of which turn into varying amounts of sugar when digested) with a lack of exercise and the eventual result will be type 2 diabetes and all the miserable complications that come with it.

The link between sugar and diabetes mellitus type 2 is the defining trait of the disease. Diabetes comes from the Greek, meaning “siphon,” as in siphoning water out of the body. Mellitus comes from the Greek word for “sweet.” Put them together and what you have is a very descriptive term for a symptom of diabetes: sweet urine. And for thousands of years, physicians tasted a patient’s urine—if sweet, the diagnosis was diabetes mellitus. Another way of diagnosing diabetes in the ancient era was to observe if a person’s urine attracted bees. Today we’re a little more sophisticated about it—we conduct blood tests to check your plasma glucose (blood sugar) level.

The Dinner Guest Who Just Moved In

Sucrose is the chemical name for refined or table sugar (be it white or brown, organic or packed with pesticides) and it consists of two carbohydrate molecules—glucose and fructose. But you don’t get off that easily. Sucrose is also the primary component in fruit juice, milk, yogurt, honey, molasses, and maple syrup.^* Until the early 1800s, refined sugar was still a relatively expensive product and most of us didn’t eat that much of it. Jack Challem, a nutrition researcher and the author of The Inflammation Syndrome, calls refined sugar a genetically unfamiliar ingredient. He observes that “a lot of health problems today are the result of ancient genes bumping up against modern foods.”

In the late 1700s, the discovery that crystallized sugar could be extracted from the sugar beet, along with increased sugarcane production in the tropical areas of the world, meant that the price of sugar dropped. Soon sugar was an everyday food, no longer a luxury product to be locked away in silver boxes.

At the beginning of the twentieth century, while sugar was a bigger part of the standard diet than it had ever been in human history—most people still ate only about 25 pounds of it in a year. Today, consumption has roughly quintupled. As I mentioned earlier, the average American now eats about 160 pounds of sugar every year, or slightly more than 7 ounces a day. To visualize this daily amount, imagine taking the teaspoon next to your morning coffee and filling it 27 times with sugar. In reality, much of that sugar enters our diet in the form of highly processed snack foods. In fact, the top eight sources for half of the average American’s diet are: soft drinks, sweet baked goods (cake, doughnuts, etc.), pizza, salty snack foods (potato chips, corn chips, popcorn), bread products (bread, rolls, bagels, English muffins), beer, and French fries or other frozen potato products.

The link between sucrose and obesity, with its compounding symptoms of high blood pressure, high blood glucose, high cholesterol, as well as ancillary conditions such as migraine headaches, carpal tunnel syndrome, gallbladder disease, irritable bowel syndrome, reflux disease, and other chronic health issues, is irrefutable. Robert Lustig, pediatric endocrinologist and professor of clinical pediatrics at the University of California, San Francisco, simply calls sugar poison.

Even without an official diagnosis of diabetes, you could already be experiencing the earliest signs of neuropathy: those little zings in your wrist; the occasional burning sensation in your feet; the mild numbness in your fingers that comes and goes; and the headaches that come out of the blue. These are all harbingers of things to come.

And yet, despite this rap sheet, sucrose has an even more destructive twin.

High-Fructose Corn Syrup

While regular sugar is about half glucose and half fructose, high-fructose corn syrup (HFCS), as the name suggests, is up to 55 percent fructose and only about 45 percent glucose. This matters because the more fructose, the sweeter the taste. However, the most insidious distinction comes because the fructose in both sugar and HFCS is more quickly converted to fat (metabolized and stored) in the liver, a precious organ that has plenty to do besides dealing with yet another toxin. Meanwhile, the glucose in both refined sugar and starchy carbohydrates can be metabolized by any cell in your body. Reading a book, running a marathon, breathing—any cell called to action uses the energy of glucose to keep you going.

We’ll talk more about the metabolism of sucrose and HFCS (and how they most often turn into fat) later, but it can get confusing so, for now, a quick crib sheet:

• Carbohydrates contain the simple sugars sucrose, glucose, and fructose.^*

• Sucrose (table sugar) is 50/50 fructose and glucose.

• HFCS has more fructose and tastes sweeter.

• Fructose quickly metabolizes in the liver (which has enough to do already), often leading to what’s known as a “fatty” liver.

• Glucose, on the other hand, can be metabolized by every cell in the body, meaning you have a better chance of burning it off.

• Ergo, fructose is a double whammy.

And yet, when this “sweeter than sweet” product first became available in the 1970s, it seemed a miracle, solving a huge problem in the American food supply. Because at that time, the cost of plain ol’ sugar had risen sharply, primarily due to international trade tariffs and sugar quotas in the United States. Fun sweets and crunchy/salties were costing more. Maybe people could learn to do without them.

This new, inexpensive sweetener, made from corn grown in the United States (and subsidized by the government), was just what the food industry needed to keep order. In fact, high-fructose corn syrup turned out to be not only cheaper than sugar, but, from the perspective of industrial food producers, it was better.

The “sprinkles on the cupcake” was that it’s also a liquid, and thus easier to combine with other ingredients, such as flour for hamburger buns and flavoring for soft drinks. That’s why fast-food restaurants were suddenly able to offer their soft drinks in larger sizes for the same money—and why you sometimes get a free soda with your pizza delivery.

High-fructose corn syrup is one of the primary reasons that portion sizes—and waistlines—have ballooned in recent decades. Americans today consume the equivalent of 12 teaspoons a day of HFCS alone; that works out to be about 10 percent of our daily calories.

There’s one additional consequence of the way high-fructose corn syrup has largely replaced sugar in our manufactured foods. Mercury contamination has been documented in a frighteningly high number of snack foods made with high-fructose corn syrup. Mercury-grade caustic soda (street name, lye) is a key ingredient in the complex milling process that separates the cornstarch from the corn kernel, the first step in creating HFCS.^*

Secret Sugar

The food industry hides the added sugar in their products under a lot of different aliases, evil twins, you might say. But sugar is sugar. When you check the ingredients label, skip the product if any of these more common weasel words for sugar is among the first five ingredients:

Agave nectar

Barley malt

Beet sugar

Blackstrap molasses

Brown rice syrup

Brown sugar

Cane sugar

Caramel

Carob syrup

Coconut palm sugar

Corn sweetener

Corn syrup

Corn syrup solids

Crystalline fructose

Date sugar

Dehydrated cane juice

Dextrin

Dextrose

Dried oat syrup

Evaporated cane juice

Evaporated cane juice crystals

Fruit juice concentrate

Glucose

Golden syrup

Gum syrup

High-fructose corn syrup

Honey

Inverted sugar

Malt syrup

Maltodextrin

Maltose

Maple syrup

Molasses

Muscavado

Palm sugar

Rapadura

Refiner’s syrup

Simple syrup

Sorghum syrup

Sucanat

Sucrose

Treacle

Turbinado

And Let Us Not Forget Booze

Eat the bread with joy and drink the wine with a merry heart.

—ECCLESIASTES 9:7

Okay, sounds good. And yet, metabolically speaking, if sugar has an evil twin, then “drinking alcohol” can become the demon spawn. This is because sugar converted to booze converts to ethanol plus carbon dioxide, and if you imbibe—do not pass Go. Do not collect two hundred dollars. Go straight to the liver. It’s all about intake volume.

How Your Body Copes with All That Sweetness

In order to recognize sugar’s destructive powers, it helps to understand how your body reacts to it. As the British physiologist and nutritionist John Yudkin details in Pure, White, and Deadly, refined sugar is a substance for which your body has “no physiological requirement.”

As mentioned earlier, when sugar enters your body, simple carbohydrates are quickly dismantled into glucose (which passes directly from your intestines into the bloodstream to be used for quick energy) and fructose (which moves through your liver to generally be stored as fat). So far, so good. Your body needs glucose to function efficiently (as in breathing or jaywalking), as well as some fat to store energy (for the lean times) and to cushion your organs.

But the human body has evolved to get limited sugar from naturally sweet sources such as vegetables and fruits in season (meaning not everything all year-round) and the occasional taste of honey—all of which release glucose and fructose into the bloodstream slowly. Nothing in your biologic history has prepared your body for the onslaught of concentrated sugar that you now pour into it every day.

As a result, glucose spikes. If energy needs are high at the time, sugar is efficiently put to good use and metabolized, which is to say that it is broken down to build up the compo...