What’s Making Us Fat and Sick?
Is sugar evil? Here I examine why sugar and other high glycemic carbohydrates have been denounced, and examine if it’s deserved. (It is.) Americans now eat 20+ times the amount of sugar than in the late 19th century, with a concomitant spike in obesity, and need to know the truth about what’s making us fat and sick.
Over time, I would have established some bedrock truths, you’d think. But it seems when it comes to health matters, the more I know, the more I realize I don’t.
Or, another way to put it: everything is equivocal in this subject area, or so it seems.
Are carbohydrates bad for you?
First it was “no”, then it was “yes” and now it’s, “maybe yes” or “maybe no”.
This post dives into the story of carbs, and how certain kinds of them make us fat and sick.
Somewhere in the late 1970s, “science” and government and, certainly, food manufacturers jumped on the proposition that fat is bad and carbs are good. So, everything became low or non-fat.
The challenge was, given that fat is a big part of what gives food flavor, if you take away the fat, something has to be added to produce flavor.
How to make up for no-fat?
Sugar-stuff is carbs in their worst incarnation.
Carbohydrates are one of three “macronutrients” essential for human life, the other two being protein and fat. The best balance of these three macronutrients has been debated about for decades.
In all these years since the late 70’s, the “experts” favored carbs over fat.
It wasn’t just any carb that was favored (at least by the rest of us), but a certain pernicious kind that came in different forms, but had one common trait – they were “high glycemic” carbohydrates.
What Are “High Glycemic” Carbs?
All carbohydrates have been “rated” on a scale that represents the effects of carbs in food on blood sugar levels.
The Glycemic Index (“GI”) estimates how much each gram of carbohydrate (minus fiber) in a particular food raises your blood glucose level after you’ve eaten it, relative to glucose (pure sugar).
Glucose has a GI of 100, by definition, and all other foods have a lower glycemic index, except various other types of sugar that may also be rated at 100 (and, strangely, on some charts potatoes and corn bread rate above 100, 104 and 110, respectively).
[You can learn more about the Glycemic Index in Wikipedia here.]
Whereas the Glycemic Index indicates how quickly food raises blood sugar levels, the Glycemic Load considers the serving size of the food consumed, and calculates the number of carbs in that particular serving of food. (More here.)
Knowing the Glycemic Index of a food is good, but the real value to you is to also know its Glycemic Load, because if the GI is high (spikes blood sugar), but the GL is low (relatively few carbs per serving), then all is well.
We need examples, so let’s look at two typical choices, breakfast.
Oatmeal vs Raisin Bran:
Raisin Brand (1 cup): GI = 61; GL = 24
Oatmeal (1 cup): GI = 58; GL = 13
To give those numbers meaning, consider that irrespective of the GI number, you want the GL number – which takes into account the number of carbs consumed – to be between 10 and 20 in order for them to have a moderate effect on your blood sugar.
Ten and under is ideal. (More on this here.)
So, in our breakfast example above,
Corn Flakes Qatmeal is the better choice – even though its GI is higher than that of Oatmeal nearly the same as Raisin Bran because the GL of Oatmeal is nearly half that of Raisin Bran.
Since oatmeal is more filling, a person might wind up eating three cups of
Corn Flakes Raisin Bran to one of Oatmeal, which, of course underscore Oatmeal as the far better choice.
One more example: drinks.
You’ve heard the admonition not to “drink your calories”. This has become a popular saying because, well, American’s drink too many calories. Consider the “Big Gulp”: 64 ounces of soda with nearly 50 teaspoons of sugar!
Our drink contestants: Cranberry Juice Cocktail vs Tomato Juice.
Cranberry Juice (1 cup): GI = 68; GL = 24
Tomato Juice (1 cup): GI = 38; GL = 3
No contest here. Both the GI and GL numbers for Tomato Juice are substantially superior to those of Cranberry Juice (despite its usefulness for urinary tract infections).
To visualize all this, check out this Figure 1:
In summary: know the Glycemic Load of the foods you eat regularly. Here’s a good table presenting various foods, their glycemic index and load.
Why Should I Care About Blood Sugar?
(Hint: The pancreas makes it, Type I diabetics have too little of it and Type II have too much of it that they can not effectively use.)
For those of you who really want to dig into the answer to this question, I refer you to the current Champion of Blood Sugar, Dr. Mark Hyman, author of the The Blood Sugar Solution. (Dr. Hyman’s web site.)
But since you’ve waded this far into this post, know that the bottom line reason why you should care about blood sugar is that, if its too high too often, a cascade of biological events are instigated which can cause you to grow fat, get sick, and even die “before your time”.
The cascade begins with insulin’s response to a spike in blood sugar.
The purpose of insulin is to lower blood sugar levels by increasing its rate of utilization by the cells in order to use them as energy now, or to store them (as fat) for future energy needs.
Without insulin, your cells would starve, and you would die.
The standard American diet is dominated by high glycemic foods, so-called “simple carbs” like breads, pastas and various fruit and sugary drinks. Such foods spike blood sugar.
The more you eat of them, the more your blood sugar rises, and the more insulin your very tired pancreas must produce to combat this very unnaturally high blood sugar load.
Eventually, the body becomes resistant to its insulin. Ever committed to its cause, the pancreas keeps cranking out insulin, but insulin’s ability to do its job (store nutrients and blood sugar) is compromised.
The result is an over-production of insulin known as hyperinsulinemia.
What’s the first indication of hyperisulinemia?
[It’s beyond the focus of this post, but know that hyperinsulinemia is what sparks the numerous biochemical responses to high, ineffective insulin levels, including hormone balance disruption, various degenerative diseases and premature aging, all aspects of Type II Diabetes. Dr. Hyman, reference above, writes about this sorta thing at his web site.]
In sum: You should care about blood sugar because too much of it has the potential to make you fat, sick and dead.
I’ll next dive into the first of this triumvirate, “fat”.
How High Glyemic Carbs Make Us Fat and Sick
Go anywhere where lots of people are milling about. What do you see? If you notice that two of three are overweight, you can become a statistician, because in America, 66 percent of us are overweight. And 33 percent are obese.
Do you know how that happened?
(Hint: it relates to that part written above about high glycemic carbs.)
“A picture is worth a 1,000 words”, it’s said, so let me convey the story with some charts.
First up is Chart 1: Carbohydrates consumed per day per person as measured in grams, and obesity rates.
The above chart shows both carb consumption (grams per day) and obesity rates (percent of total U.S. population) from 1960 thru 2000.
Examine the chart and note that obesity rates begin steadily climbing in the early ‘80s; soon after food manufacturers began producing food low in fat and high in high glycemic carbs.
In the late ‘70s and early ‘80s, a plethora of manufactured food (stuff in boxes, cans and plastic) burst on the scene, much of it sweetened with High Fructose Corn Syrup, a really nasty type of sugar. Combined with our emergence as a “Fast Food Nation”, America began to get fat.
Chart 2 (below) shows the rate of growth in obesity as measured by different “Body Measurement Indices” (“BMI”). An overweight designation in the BMI starts at “25”, and – as the chart shows – a number of “30” or higher indicates obesity.
Note how fast the top BMI number, 50+ (the orange bar) is growing. This is the segment of obese people who will first experience disease states like “Diabesity”.
[Incidentally, I have a pet peeve with the BMI measurement. I think it’s too simplistic, and certainly it’s a worthless indicator of fatness for the very young, old, tall, short and muscular, as I write in, Just Exactly How Fat Are You Anyway?.]
Chart 3 (below) doesn’t as emphatically show the rates of growth within the BMI numbers associated with obesity, but I add it to the mix because it goes out to 2005, rather ending at 2000, as does Chart 2.
Note that the curve between 2000 and 2005 is still, decidedly, up.
Turning next to our kids, let’s see what’s happened to them.
[If you really want to get blown away about what's happening to America's children, check out Dr. Hyman's article, Sugar Babies, How to Stop the Genoicide of Our Children.]
Yes, as Chart 4 (below) indicates, it appears that children are eating at the same trough as their parents.
Chart 4 shows overweight children by age group, ages two to 19. Note that the difference between 1974 and 1980 are slight compared to what happens come 1994 and beyond.
Chart 4 is a visual display representing why medical professionals today decry that our children may be the first generation not to outlive their parents.
So, I’ve now established what everybody who looks into the matter knows: Americans have gotten fatter at an ever-increasing rate since the early 1980s.
But not everyone agrees – particularly the food manufactures and farmers who get subsidized for growing cereals, such as the corn that makes High Fructose Corn Syrup – that there’s a causal relationship between ingesting high glycemic carbs and getting fat.
“Causality” is A caused B to happen, such as the proposition that flooding America (and now the rest of the world) with high glyemic foods (and drinks) made fat happen.
To some, the carbs-causes-fat relationship is not causal, but coincidence or correlation.
Well, next up is Chart 5. Does it show a “causal” or “coincident” relationship between the two things it measures, obesity and High Fructose Corn Syrup?
Chart 5 overlays the growth of obesity (unfortunately only to the year 2000) with the consumption of High Fructose Corn Syrup, a handy and arguably accurate proxy for the avalanche of high glycemic foods that have swamped us for over 30 years.
So, what do you think? Causal or coincidence?
Is There Still A Debate About The Evils of Sugar?
Yes, there is still a debate about the evils of sugar. Somewhat. It’s becoming a bit unbalanced, the pro sugar-is-evil camp outweighing (ha!) the con sugar-is-evil camp.
I’ll introduce two worthy opponents, briefly summarize their respective positions, and link to their respective treatises.
In the pro sugar-is-evil camp I nominate Gary Taubes, a Robert Wood Johnson Foundation independent investigator in health policy and the author of Why We Get Fat: And What to Do About It.
I choose Mr. Taubes to champion the pro sugar-is-evil camp because of the New York Times article he wrote in April of 2011 entitled, Is Sugar Toxic?. Therein, he examines both sides of the sugar story – with Dr. Robert Lustig as protagonist.
Taubes winds up admitting that the proof that sugar is evil (or toxic) is not absolute, but his last sentence is this:
“Officially I’m not supposed to worry because the evidence isn’t conclusive, but I do.”
He perhaps came to this view due to the following statements that I’ve culled from his well-researched and educational article:
– Fructose and glucose are pretty much identical but are metabolized differently. Every cell in the body metabolizes the sugar and starches in glucose; whereas fructose is metabolized by the liver alone, which overtaxes it and makes it (and the rest of the body) fat.
– The records show two times in recent history of a surge in sugar eating, one in the early 20th century and the other over the last decade, and in each the rate of diabetes increased substantially.
– In countries with low sugar consumption, there is markedly less obesity and obesity-related diseases, even in those countries with high fat consumption.
(Enter the con sugar-is-evil camp champion.)
Not so fast, says science and health writer, David Despain at Evolving Health.
He claims that people like Drs. Mercola and Lustig are off base with their sugar-is-evil diatribes.
Mr. Despain wrote Sievenpiper: Fructose should not “worry” in diabetes, which despite the awkward title cites credible people and studies that say the concern with sugar and high glycemic carbohydrate consumption is overblown.
Pertinent to this subject, he also wrote Sugar Showdown: Science Responds to “Fructophobia“.
I suggest you read both. I’ll comment on the first.
In citing a review of the literature made by Dr. Sievenpiper in his “Sievenpiper” post, Mr. Despain wrote:
“[Sievenpiper’s] analyses found fructose had no significant effect on body weight or blood pressure in humans (as it does in rats, for example). In fact, fructose in amounts similar to that found in fruit improved glycemic control in humans.”
Further, about Type II Diabetics, Despain represented Sievenpiper’s view thus:
“In the context of a healthy, nutritionally balanced, weight-maintaining diet, people with type 2 diabetes do not need to worry about avoiding sources of fructose.”
The strange thing is that after presenting their case that, in effect, high glycemic carbs are not a problem, it is noted their quantity consumed matters:
“…dose matters, as it does with most nutrients and bioactive compounds, and that fructose can be healthy when eating as part of a well-balanced diet.”
Yes, quantity matters… but isn’t that the essential message of the pro sugar-is-evil camp?
Today, each year an average American consumes between 110 and 156 pounds of sugar. At the end of the 19th century that number was just five pounds. (Source)
Yeah, I’d say quantity matters.
My Bottom Line
I invite you to share you’re thoughts on the matter in the Comments section below.
My bottom line underscores what my Grandma often said:
“Everything in balance is best.”
And the right balance of high glycemic carbs for me – particularly High Fructose Corn Syrup and its ilk – is that less is more, as in “more better” for your health.
It’s not only a question of quantity consumed (surely, a very important factor), but also the metabolic effects of some high glycemic carbs, which I think is given insufficient attention by the con sugar-is-evil camp. (For more on the metabolic effects, read Gary Taubes’ Is Sugar Toxic?.)
Remember that a diet dominated by high glycemic carbs dramatically increases your chance of becoming fat and sick.
For more about diet, check out these two articles lurking on this site:
Ciao for now.
P.S. You can read more about carbohydrates at Precision Nutrition, a real smart site.