Newsletter 28, January 2011

Fructose, Diabetes, Weight Loss and High Blood Pressure

Is fructose healthy? Is it good for diabetics? Does it help you lose weight? Surely it must be good for you, because it is a natural sugar contained in honey, fruit and vegetables?

Diabetics have been encouraged to favour fructose (or 'fruit sugar') over ordinary table sugar (sucrose) because it does not require insulin to process it and because it is low on the glycaemic index, so it does not cause a spike in blood sugar.

The health-conscious and those trying to lose weight have also been encouraged to see the granulated fructose on their supermarket shelves as more healthy and natural than the bags of granulated sucrose sitting next to it. Agave syrup is another high-fructose product that has been marketed in this way.

However fructose may not be as benign as we have been led to believe. Fructose moves into the liver where it is processed into glycerol, a component of the triglyceride molecule. As a consequence, eating significant amounts of fructose usually causes levels of VLD (Very Low Density Lipoprotein) and triglycerides to rise, which is absolutely not what we want.

The latest buzz from the natural health world is that a byproduct of fructose metabolism is uric acid, which drives blood pressure up. Studies have also shown that regular consumption of fructose can impair the body's handling of glucose and lead to insulin resistance (the end point of which is type 2 diabetes). In fact, feeding lab rats fructose is a standard method of causing them to become insulin resistant and develop high blood pressure.

And what usually goes hand-in-hand with the development of insulin resistance and type 2 diabetes? Obesity. Many fructose researchers believe that high levels of fructose in our diet may be a significant factor in the development of today's obesity epidemic.

What's more, fructose is readily able to attach to proteins and damage them in the process called fructation. This can wreak havoc with critical body structures, causing permanent damage ranging from premature aging of the skin to cataracts and even failure of major organs such as the kidneys and heart.

The amount of fructose ingested and therefore the risk of suffering these effects increases massively with the consumption of processed foods and drinks. Particularly worrying in this regard are soft drinks and sodas. Almost all of those sold today contain very high levels of fructose because they are sweetened with high fructose corn syrup (HFCS). Manufacturers use HFCS instead of sucrose because it is cheaper.

So the bottom line seems to be that products containing HFCS have no place at all in anyone's diet, that granulated fructose 'fruit sugar' and agave syrup may be even worse for you than other forms of sugar, and that those who know they already have a problem with overweight, insulin resistance, diabetes or high blood pressure may even need to minimise their consumption of raw whole fruit (especially those with high levels of fructose such as grapes, mango, sharon, apples, pears and cherries).

For more information there is an excellent Youtube video on the dangers of fructose by Robert H. Lustig, MD, UCSF Professor of Pediatrics, Division of Endocrinology. On Dr Joseph Mercola's website there is also a transcript of his very interesting interview with fructose researcher Dr Richard Johnson.

New Recipes in the Low Carb / Low GI Cookbook

For those of our readers who are subscribers to the Low Carb / Low GI Cookbook, two new recipes have just been released: Sea bass with ginger (5-25) and coconut, hemp, sunflower and pumpkin seed cookies (3-27). You will find these recipes already in your Cookbook next time you log in.

Your Successes, Requests and Questions

This is your spot. Whether it's your dietary success story, a request to cover a particular topic in a future newsletter or a question you would like answered, we would love to hear from you. Please do contact us.

Here is a question we answered recently:

Q: I've been on the GI diet for three weeks now, and have lost only 2 pounds in total. I'm desperate to lose each week on a regular basis to keep me motivated - has anyone else had the same problem? I know there's not much between, low carb and GI, but from what I've read on this site, maybe I am eating too many carbs? I've been on a low carb diet before (not Atkins) and lost 7lbs my first week, and then 2-3 lbs thereafter. Perhaps I should switch, or perhaps it takes time for my body to adjust to a new way of eating?

A: It sounds to me that you may be one of those people whose level of carbohydrate tolerance is too low to lose weight on a low GI diet. I'm the same!

It is also true that losing weight gets more difficult on each successive diet. There are lots of other reasons why you might not be losing weight, but my advice would be to try out a low carb diet first to see if that helps. You might also find it helpful to read 'Why Can't I Lose Weight - the Real Reasons Diets Fail and What to Do About It'.

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With best wishes for your continued good health
Jackie Bushell
Founder Director, GoodDietGoodHealth.com

Successful Weight Loss - the Importance of the Right Diet

Once you've decided a weight loss diet is unavoidable, how do you decide what sort of diet to follow? There is so much confusing advice out there. Sadly, the official 'healthy eating' low fat/low calorie weight loss diet, which recommends basing the diet on carbohydrates, is not the best course for many people. A carbohydrate-based diet can be a real problem for up to sixty per cent of people in Western populations. For these people, foods high in carbohydrate, even 'good' carbs such as wholemeal bread and fruit, trigger an excess of insulin and cause blood sugar imbalances. This results in an increased tendency to store instead of to burn surplus energy and to crave yet more carbs in a way that is very similar to addiction to nicotine, alcohol and other 'feel good' drugs.

The big problem with the official 'healthy eating' low fat/low calorie weight loss diet is that it ignores these hormonal aspects of weight regulation and fails to deal with the fundamental issue of carbohydrate sensitivity. Carbohydrate sensitivity (sometimes referred to as carbohydrate intolerance) should not be thought of as a disease or medical condition. It is in fact our bodies' normal response to a diet high in refined carbohydrate - food that we were never designed to eat.

So what does this mean to the average person who is about to embark on a weight loss diet? Well, sadly, it means an awful lot of dashed hopes as dieters fail to lose weight or else lose a little weight at first but are then unable to keep it up long term. They don't understand that, because their weight loss diet is unsuited to their biochemical and hormonal make-up, they are being set up to fail. And worse, when they do fail, they are made to feel that they are at fault, when in fact it is the diet that is at fault.

So is going on a 'healthy eating' low fat/low calorie diet always a bad idea? Well, if this means eating far fewer foods high in refined carbohydrates than you were before, that's undoubtedly a big step towards a healthier body and significant weight loss. But if you're already ahead of that game, and your normal way of eating is already low in refined carbohydrate foods such as cakes, cookies, pastries, pasta, pizza, white bread, white rice, ice cream, desserts, candy, sugary breakfast cereals, sugary drinks and the like, then you may well find that you lose little or no weight on the official 'healthy eating' low fat/low calorie diet. If this is the case, then don't waste time and energy trying any of the countless diets that are all based on the 'reduce the calories and fat and keep carbs high' principle. Don't fall for the 'You overeat for emotional reasons' or 'You only need more willpower' trap either. Understand that your biochemical and hormonal make-up prevents you from losing weight on a carbohydrate-based diet, and try the low carb approach instead.

Unfortunately there are many myths about what you actually eat on a low carb diet and many dietary 'authorities' still maintain that the carbohydrate-based low calorie/low fat 'healthy eating' diet is the only safe and effective diet, despite more and more clinical trials saying otherwise. Other 'authorities', although still wary of low carb diets, recommend their near relations, low GI (glycemic index) diets. However, low GI diets are still not generally low enough in carbs for those who are very carbohydrate sensitive - which probably includes most of us who find it hard to lose weight. Weight loss is actually a very complex subject, until you find a straightforward explanation of how it all works. If you're interested in finding out more, then free e-book Why You Should Consider a Low Carb or Low GI Diet is a great way to start. It helps dispel these myths by explaining the science behind low carb and low GI diets, why they are healthier for many people than the standard low calorie/low fat diet and why low carb diets may be better than low GI diets for many people.

What if you've already gone low carb but are feeling you may not be able to keep it up because you're bored with your food choices and menus, and it's too hard to stick to? Then you're probably missing some important knowledge in the low carber's armoury - how to use low carb substitute ingredients to make low carb versions of favourite foods such as bread, pizza, pastry, cakes, cookies, sauces, ice cream and desserts. If you're feeling deprived on your low carb or low GI diet, then getting a good cookbook is a must for the success of your weight loss. But be aware! Many of the low carb and low GI cookbooks out there contain lots of great recipes - but they're mostly main courses of the type that don't contain carby ingredients in the first place. If the kinds of foods you most miss are baked goods, with the right knowledge you can make low carb versions of these extremely successfully. If these are the kind of recipes you need, then the Low Carb / Low GI Cookbook is definitely one to put on your list of low carb cookbooks to investigate.

Unfortunately, as seasoned dieters will know, many diets seem to work for a while and then the weight loss comes to a stop. This is often called a diet plateau or diet stall. This can happen whatever diet you are on, and there are many possible reasons for it. As a result, it can be very difficult to work out what to do to break the stall. Much of the advice out there will focus on one or two things to change to try to get your weight loss started again. But breaking your diet plateau depends upon dealing with all, not just some, of the many nutritional, biochemical and hormonal factors that may causing it. It's important therefore to find a source of information that goes systematically through all the factors that may be causing your diet plateau and helps you to draw up a personal action plan, such as Why Can't I Lose Weight.

Life is too short and precious to spend years of it unsuccessfully pursuing a weight loss goal because you have the wrong tools!

Are Our Healthy Eating Guidelines Wrong?

Obesity, diabetes and heart disease are among the major scourges of the western world. Medical science, although to some degree able to treat these conditions, has so far failed miserably in terms of prevention. Incidence rates are openly acknowledged as having reached 'epidemic' proportions.

It is generally accepted that diet is the main cause, but opinions vary as to which particular aspect of diet is at fault. The conventional belief is that a high intake of fat is the culprit. Accordingly, healthy eating advice in much of the western world is focused first and foremost on reducing fat. Subsidiary messages include increasing fiber, vegetables and fruit and taking around fifty to sixty per cent of daily calories in the form of carbohydrate. But how valid is this advice?

Evidence is mounting that the healthy eating advice we have been following over the past few decades is metabolically wrong for the majority of the population and that carbohydrates rather than fat are the real villains.

Some fats are indeed injurious to health but new understanding shows that saturated fat has been wrongly accused of the misdeeds of the true 'bad' fats -- fats called trans fats or hydrogenated fats and oils. There is also general recognition now that certain fats are essential for health -- the essential fatty acids (EFAs). In fact, many of us are actually deficient in a type of essential fatty acid called Omega-3. This has been caused in no small part by the 'fat phobia' of the past decades.

When it comes to obesity, a high fat intake may well contribute to excessive calorie intake but calories are not the whole story. Some of us are better than others at storing any surplus energy as body fat. In our caveman days our energy storage mechanism was what kept us alive from one infrequent meal to the next. Nowadays however, our food is plentiful and our storage mechanism, namely the hormone insulin, is not quite so useful. Not only do lean times come rarely, if ever, but we burn off ever less physical energy in our daily activities. Furthermore, our food is much higher in carbohydrates -- cavemen did not have refined foods such as the sugar and flour that are our staple foods today. These foods cause our blood sugar levels to rise faster, higher and more frequently than our control system was designed to handle. This results in a constant outpouring of insulin. For many this creates a blood sugar imbalance, which traps them in a vicious circle of eating, feeling hungry and eating again regardless of whether more food is needed.

By process of evolution we might expect to become genetically adapted to a diet high in refined carbohydrates, but this would take millions of years rather than the few decades that we have been eating this way. In the meantime, those who lay down fat in response to today's food are only being more efficient than the rest at doing what they are genetically programmed to do. For this group, a carbohydrate-rich diet is almost bound to cause obesity. Even a diet emphasizing 'healthy' carbohydrates such as whole grains and fruits may be too high in carbohydrates for some. Since it is estimated that this carbohydrate-sensitive group comprises up to sixty per cent of the population, and it is precisely this group that is likely to be obese, reducing fat intake and basing the diet on carbohydrates is more likely to exacerbate the obesity problem than to solve it.

Weight gain is not however the only consequence of this imbalance in our blood sugar control systems. Years of insulin overproduction are likely to be followed sooner or later by insulin resistance and ultimately, type 2 diabetes. Furthermore, there is evidence that it is these constantly high levels of insulin, and not dietary fat, that cause heart disease.

For instance, in December 2002, researchers at Harvard School of Public Health published a study of the diets of more than 100,000 people in the American Journal of Clinical Nutrition. The study had come to the totally unexpected (for some) conclusion that those who did not follow the US healthy eating guidelines lowered their risk of chronic disease by around thirty-five per cent. Dr Walter Willett, chair of the department of nutrition at Harvard, stated 'The public has been told for many years that fats are bad and carbohydrates are good. In fact, we've known for thirty or forty years that that's not really true.'

One of the most respected researchers in the field, Dr Willett also declared in articles in Obesity Review and the American Journal of Medicine: 'Dietary fat is not a major determinant of body fat and plays virtually no role in obesity.'

So if science is showing us that the root causes of the current obesity, diabetes and heart disease epidemics are not what we formerly thought, why aren't the medical world and government health departments rushing to change the healthy eating advice they promote?

Many think the answer to this question lies in conservatism, bureaucracy and vested interests. The first issue to recognize is that the new scientific concepts take more than a little time to explain and understand. Medical professionals are busy people and have little time to devote to new topics. The spread of new ideas is also inhibited by factors such as the average overworked physician's understandable reliance on drug company representatives for information on new research. The general conservatism of the medical world may also play its part in the slow recognition of the new ideas. The position is not helped by the fact that, until now, basic medical training has virtually ignored the topic of nutrition, and postgraduate courses recognized by the mainstream medical establishment are only now being established to teach this unjustly neglected area of medicine.

Slow pace of change in health policy at governmental level is inevitable. New diagnostic and treatment methods are required to go through many years of population studies and clinical trials before they are approved for general use. Moreover, state funding for such studies is limited and the research done by the commercial drug companies focuses, not unsurprisingly, on areas of research that will make them money. In other words, in the current environment nearly all research that is done is targeted at identifying block-busting drugs that can make decent returns for the pharmaceutical companies. Researching unpatentable diet and lifestyle solutions which address the root cause of illnesses is not economically viable for the pharmaceutical industry.

Added to that, the pharmaceutical, agricultural and food manufacturing industries have vested interests in the existing carbohydrate-focused, fat-phobic healthy eating advice. Since they have an extremely powerful voice with government, this no doubt also serves to put a brake on major governmental policy change in the area of healthy eating guidance.

With all these factors acting to slow the pace of change as far as healthy eating advice is concerned, it seems clear that it is up to individuals to take responsibility for their own health. Putting blind faith in official healthy eating advice seems a risky strategy.

More information on these concepts can be found in the e-book Why Can't I Lose Weight -- The Real Reason Diets Fail And What To Do About It.