Sugar: Too much of a sweet thing.
Sugar is Bad!! Did you know that a Big Gulp (44oz) soda has 532 calories, or 35 teaspoons of sugar? And the average American consumes up to 75 pounds of additional or added sugar per year! Not that we are surprised, but a recent article published in British Medical Journal by Steele, et al, outlines the alarming contribution to our diet from processed foods in the United States. They found that ultra-processed food comprised 60% of our energy intake and contributed almost 90% of the energy intake from added sugars. The majority of this is high-fructose corn syrup, which is added to as much as 75% of packaged foods and beverages. This follows a study in children by Lustig et al, published in 2015, which illustrated that even when consuming the same amount of calories, carbohydrates, fats, and protein, multiple metabolic markers improved within 10 days. This included reductions in diastolic blood pressure, triglycerides, LDL cholesterol, and weight, as well as reductions in insulin secretion. Even with the same calories, this was accomplished with decreasing dietary sugar and replacing with other carbohydrates.
Other reports have illustrated that added sugar is related to increased weight gain, obesity, Type 2 diabetes mellitus, higher triglycerides, elevated blood pressure, cardiovascular disease, and dental caries. The Mayo Clinic Proceedings in 2015 (DiNicolantonio et al) noted that fructose is a “principle driver” of the epidemic of Type 2 diabetes mellitus. A study in Human Reproduction in 2014 (Carwile et al) associated soft drinks with early menarche and increased risks of cancer later in life. I could go on and on. From a different viewpoint, the Credit Suisse Research Institute’s 2013 study looked at this issue from an economic point of view, pointing out the escalation of diabetes mellitus and obesity associated with excessive sugar costs our global healthcare system billions of dollars.
As medical providers, we are obligated to address this issue in the majority of our patients. There are several keys in this area. First we can provide guidance to patients and families about the importance of healthy foods and a healthy food system. Here are a few ideas we can share with others to encourage improved nutrition:
* Choose mostly whole or minimally processed foods
* Avoid highly processed and fast foods
* Avoid high-fructose corn syrup
* Increase your fruits and vegetables
* Hydrate with water instead of sweetened beverages
Secondly, we should work with our local and regional communities to improve nutrition thorough education and promotion of healthy food systems.
Lastly, let’s be excellent role models for our family and friends. Healthy Eating for Life.
Mike Reeder, Cycling CME March 10, 2016