Sugar, Friend or Foe?


I just recently finished reading the book, Fat Chance, by Robert Lustig, M.D., in preparation for a sugar reduction program that I am planning for my business. Dr. Lustig is a pediatric endocrinologist who has specialized in obesity and is famous for a You Tube video called “Sugar, the Bitter Truth”. This video has over 6.5 million views and if you have not seen it, I encourage you to take the time to watch it.

Sugar consumption per capita worldwide has increased 50% over the past 50 years. As you may know, diabetes and metabolic syndrome has been increasing exponentially not only in the U.S., but also in most parts of the world. Lustig states that the amount of sugar availability explains over 25% of the increase in diabetes over the past decade. Interestingly, for every 150 calories per day per capita increase in food consumption other than sugar, there was little change in the rate of diabetes in a country. If that same 150 calories were from sugar, the diabetes rate rose seven times! Obviously a calorie is not a calorie.

There are many different traditional diets worldwide as documented by Dr. Weston A. Price, among others. These diets had a great variety in types of foods as well as macronutrient composition. Traditionally people ate what was available in their local region. One extreme is the diet of traditional Inuit Eskimos, whose diet is 80% fat and contains very few carbohydrates due to the lack of vegetation in the Arctic. On the other end, the diet of the South Pacific Polynesians is up to 70% carbohydrate from taro, coconut and fruit. Low-carbohydrate and low-fat diets have both been promoted for weight loss. The common element among all of these ways of eating is that they are very low in added sugar.

Sugar acts like both a fat and a carbohydrate because the sucrose molecule is made of almost equal portions of glucose, which is processed as a carbohydrate in the digestive tract, and fructose, which goes straight to the liver and is processed like a fat. Lustig points out that the vast majority of whole foods that we eat contain either carbohydrates or fat, but not both together. Vegetables, fruits and grains are primarily carbohydrate and are generally low in fat. Meats, eggs, and fish are higher in fat, but have little carbohydrate.

There are a few foods that are high in both fat and moderate in carbohydrate such as nuts, coconut and avocados but they are also full of fiber. This fiber slows down the absorption of glucose to a pace that the liver can handle. The other exception is milk. Traditionally most cultures did not consume a lot of dairy products and those that did, consumed very little added sugar.

Processed food, on the other hand, contains lots of added carbohydrate and fat together. Cookies and cakes have sugar (fructose and glucose), flour (glucose) and butter (fat). And non-sweet processed foods are no better. French fries and potato chips are carbohydrate (glucose) cooked in vegetable oil (fat). Dr. Lustig found that all healthy eating plans are low in added sugar and high in fiber. When fat and carbohydrates are consumed together there is also offsetting fiber in the meal. For most people, the more starchy carbohydrates that you eat on a regular basis, the less fat you should have. That is why the Ornish diet works, which recommends about 80% carbohydrate, but only 10% fat. At the opposite extreme, the low-carbohydrate Ketogenic diet also works, which is up to 80% fat, but only 5-10% carbohydrates.

The American Heart Association recommends that daily consumption of added sugar be no more than six teaspoons (100 calories) for women and no more than nine teaspoons (150 calories) for men. If you have diabetes or pre-diabetes, it will be important to limit starchy carbohydrates in addition to sugar and eat a lower carbohydrate, higher fat diet. Everyone should limit processed food-like-substances and eat real whole foods with limited added sugars, including honey, maple syrup or coconut sugar.

If you want to learn more about the problems with sugar or need help with reducing the sugar in your diet, stay tuned for my free on-line program later this month.

Source: Lustig, Robert, M.D., (2013) Fat Chance. New York: Hudson Street Press.

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