Sugar-free but high-fat?

Static
Marvin A. Tort

I have been grappling with blood-sugar issues in the last 14 years, although I have never been diagnosed as a diabetic. “Borderline,” as my doctors have put it, and thus the imperative to lose weight. I have been unsuccessful with that, to date. But, it is in this line that I try to keep myself updated on any new medical research, and natural methods, to regulate blood sugar.

It was thus with much interest that I noted the published comments of Dr. Augusto D. Litonjua, founder and president of the Philippine Center for Diabetes Education Foundation, Inc. (PCDEF), after his public lecture last week entitled, “Fats and Sugars: Friends and Foes?” Litonjua is a recognized expert on diabetes and has done much research in this field.

In a news report, Dr. Litonjua was quoted as saying that people should minimize their consumption of “fructose.” To differentiate from table sugar, which is mainly “sucrose,” fructose is a type of sugar found in fruits and honey, as well as in drinks and food items sweetened with it. Even fruit sugar, he said, could lead to diabetes, obesity, stroke, and other conditions.

“The USDA made a study wherein people thought table sugar was bad, so they removed table sugar and encouraged people to eat fruits. After which, the prevalence of diabetes and obesity went up along with the increased consumption of fruit sugar. Diabetes and obesity rate became higher than when Americans were consuming table sugar,” Litonjua claimed.

He was also quoted to have explained that “fructose is not metabolized by insulin, unlike glucose. Fructose goes to the liver where it is being deposited, and the liver turns it into triglyceride, a form of fat storage making the liver fatty with intake of too much fructose.” And here I was, thinking, that food fat — rather than fructose — was to blame for my fatty liver.

Litonjua, an endocrinologist, was also quoted to have advised people to be careful of what they eat and drink, being generally unaware that many food and drinks sold to the public also contain a chemically produced form of fructose known as high-fructose corn syrup (HFCS). Processed from cornstarch, HFCS is used in food and beverage manufacturing as alternative to raw sugar.

I find Litonjua’s assertions quite revealing. I have always been under the impression that all types of sugar required insulin to be processed by the body. Apparently not, particularly in the case of fructose. I am uncertain, however, if the same finding applies to HFCS, meaning that the fructose in the syrup also cannot be broken down by insulin, and is instead deposited in the liver.

And, that the condition known as “fatty liver” is not just the result of a high-fat diet, but can also be connected as well to the consumption of sugar like fructose.

In the same line, I have always associated the high levels of triglyceride in my blood with my high-fat diet. And, that my “fatty liver” is also the direct result of my high-fat diet. Little did I realize that that “fat” in my liver can actually be the result of consuming much fructose, or from a sweetener like HFCS. I have never regarded a sugar-free sweetener like HFCS as bad for the health, until now.

Perhaps people should be more concerned with food labels, and actually bother to read the list of ingredients before any purchase. After all, with Litonjua’s claims, it seems, a food or drink can actually be “free” of sugar as it uses an alternative like HFCS, but at the same time still add to what Litonjua referred to as “fat storage” in your liver, and give one a fatty liver.

Borrowing his logic, is it possible that consuming too much fruit, even in their natural state, can still give one a dangerously fatty liver? Medical literature tells us that having “fat” in your liver is normal. But, too much fat in it, as in the case with “fatty liver,” can actually interfere with its function of “filtering” everything we eat or drink, or take, like medicine.

In an article in Healthline News in 2015 written by Cameron Scott noted that a study published in the American Journal of Clinical Nutrition in 2004 proposed that “the growing use of HFCS as a sweetener in processed foods could be linked to ballooning rates of obesity.”

It also noted that a published paper in the Mayo Clinic Proceedings that “calorie for calorie, added sugars — especially fructose — are more damaging to the body’s metabolic systems than other carbohydrates and are more likely to lead to type 2 diabetes and obesity.”

“The new study — drawing on clinical trials, basic science, and animal studies — concludes that fructose is more damaging to health than glucose,” Scott wrote. He noted that study authors Lucan and DiNicolantonio laid out a series of findings that show the digestive tract didn’t absorb fructose as well as other sugars.

“More fructose then goes into the liver. Too much fructose in the liver eventually creates a cascade of metabolic problems that includes fatty liver disease, systemic inflammation, type 2 diabetes, and obesity,” Scott added, quoting the study.

This situation now prompts me to ask: are fruits not as healthy as we had thought? Is soda or soft drinks better sweetened with sugar or a sweetener like high fructose corn syrup? Is fruit juice, 100% all natural and unsweetened, better than soda or soft drinks? Should we favor sugar over other sweeteners? Checking on these questions, this was what I found.

By way of analogy, the Healthline News article explained: A soda has about as much sugar as three or four oranges. If the soda is, like most, sweetened with high-fructose corn syrup, about 10% more of that sugar is fructose, which is harder on the body. But, unlike the soda, oranges include fiber, which slows down the rate at which the sugars are digested, and it has phytochemicals that counteract inflammation. It would also take quite a bit longer to eat four oranges, and the speed of ingestion can help overwhelm the body’s ability to process sugars.

As for fruit juice, it’s not much better than soda, claimed Michael Goran, Ph.D., a professor of preventive medicine and physiology at the University of Southern California. Goran, who was also interviewed by Healthline News, had published papers on fructose, and also saw fructose as “especially harmful.”

“Fruit juice would be an example of something that the population wouldn’t think of as a sugary drink and might even have some positive valence in terms of health messaging, but it’s actually just as high in sugar,” he said. But, choosing between processed and natural, he added, “My advice for patients is to go for something that doesn’t have any [added] sugar… Really the message is to avoid processed foods.”

My take away from all this? Obviously, not all sugar types are the same. Some, apparently, can be more harmful than others. Fructose, for instance, is apparently processed by the body differently than table sugar. With this in mind, I believe people should more conscious of reading food labels, and be more cautious of what they eat or drink.

Marvin A. Tort is a former managing editor of ����ý, and a former chairman of the Philippines Press Council.

[email protected]