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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...