Between 1985 and 2010, average daily caloric intake rose by
eight percent, while diabetes rates rose by 727 percent. Clearly,
total calorie consumption cannot explain the meteoric rise in
Researchers discovered that itís the increase in total fats
and carbohydrates specifically thatís causing the massive weight
gain in people around the world. Itís the combination of fat and
carb that causes metabolic disruption.
The only food on Earth that is both a fat and a carbohydrate,
is sugar, which includes both sucrose (regular table sugar) and
high fructose corn syrup both of which contain both glucose
Your body metabolizes glucose and fructose in two distinctly
different ways. Fructose is metabolized much like alcohol, and
damages your liver and causes mitochondrial and metabolic dysfunction
in the same way as ethanol and other toxins.
In the video
above, part two of the excellent series "The Skinny on Obesity,"
Dr. Robert Lustig, Professor of Pediatrics in the Division of Endocrinology,
and Elissa Epel with the Center for Obesity Assessment, Study and
Treatment at the University of California, continue the discussion
about the impact of sugar on disease rates around the world.
calorie consumption has contributed to increases in diabetes rates
around the world, they don't explain the whole story. In 1985,
the year I finished my residency and started in private practice,
the average number of calories consumed per day for the global population
At the time,
0.62 percent of the global population had diabetes.
By 2010, the
average daily caloric intake had risen to 2,866 an eight
percent increase but surprisingly, the diabetes rate rose
by a whopping 727 percent, to 5.13 percent of the total
dug deeper to determine what it is that people are eating that's
contributing most to the global crisis in obesity and obesity-related
diseases, they discovered that a calorie isn't just a calorie.
of the calories you consume makes all the difference in the world. They
discovered that it's the increase in total fats and carbohydrates
specifically that's causing the massive weight gain in people around
the world. What's more, there's just ONE food on Earth that,
because of its unique composition, metabolizes in your body as both
fat and carbohydrate and that product is sugar.
Sugar is Both
a Fat and a Carb, and this Combo Drives World-Wide Obesity-Related
Sugar is the
only calorie source that correlates with the increase in diabetes.
In 1985, when the world-wide sugar consumption was 98 million tons,
diabetes affected 30 million people. By 2010, sugar consumption
had risen to 160 million tons, and global diabetes prevalence reached
346 million people. Overall, sugar is 50 times more
potent than calories, in terms of causing diabetes. But
why does it have this extraordinarily potent effect?
lies in its unique structure. As just mentioned, it metabolizes
as both fat and carbohydrate, and the reason for this is
because it contains both glucose and fructose. These two sugars
are not interchangeable, and your body processes each of them differently.
sugar) is 50 percent glucose and 50 percent fructose. High fructose
corn syrup (HFCS) is anywhere from 42 to 55 percent fructose depending
on which type is used. Glucose is the form of energy your body is
designed to run on. Every cell in your body uses glucose for energy,
and it's metabolized in every organ of your body; about 20 percent
of glucose is metabolized in your liver. Fructose, on the other
hand, can only be metabolized by your liver, because your
liver is the only organ that has the transporter for it.
fructose gets shuttled to your liver, and, if you eat a typical
Western-style diet, you consume high amounts of it, fructose ends
up taxing and damaging your liver in the same way alcohol and other
toxins do. In fact, fructose is virtually identical to alcohol with
regards to the metabolic havoc it wreaks. According to Dr. Lustig,
fructose is a "chronic, dose-dependent liver toxin." And just like
alcohol, fructose is metabolized directly into fat
not cellular energy, like glucose. So eating fructose is really
like eating fat it just gets stored in your fat cells, which
leads to mitochondrial malfunction.
Not even fatty
fruits like avocado or coconut have this effect, because your body
treats them as either a fat or a carb not both.
Sugar is the only food that functions as both a fat and a carb simultaneously,
and it is this combination of fat and carb that causes metabolic
derangements and, subsequently, disease. So, please, don't be fooled:
when it comes to sugar, the claim you hear on TV, that "sugar is
sugar" no matter what form it's in, is a misstatement that can,
quite literally, kill you albeit slowly.
explain the differences between glucose and fructose, and the similarities
between fructose and ethanol (alcohol), let's review how each is
metabolized in your body.
Metabolism: Glucose is a product of photosynthesis and
is found in rice, corn and other grains. Once you take in glucose
from a meal, 80 percent of it is used by all of the organs of your
body; 20 percent goes to your liver to be metabolized and stored.
The following is what happens to that 20 percent, once it reaches
your liver (this is normal, and how your body was designed to operate):
glucose your body doesn't need immediately gets converted into
glycogen for storage in your liver. Glycogen
can be easily converted to energy when you need it. Your liver
has no limit to how much glycogen it can store without detrimental
amount of pyruvate is produced, which ends up being converted
to ATP (the chemical storage form of energy) and carbon dioxide.
is released by your pancreas in response to the rise in blood
glucose (i.e., blood sugar), which helps the glucose get into
your cells. Without insulin, your cells would not be able to process
the glucose and therefore would have no energy for movement, growth,
repair, or other functions. Insulin is key to unlocking the door
of the cell to allow the glucose to be transferred from the bloodstream
into the cell.
you consume 120 calories of glucose, less than ONE calorie
contributes to adverse metabolic outcomes.
Metabolism: 100 percent of the fructose you consume goes
directly to your liver. Fructose metabolism creates a number of
adverse effects, including:
is immediately converted to fructose-1-phosphate (F1P), depleting
your liver cells of phosphates. This process produces waste products
in the form of uric acid. Uric acid blocks an enzyme that makes
nitric oxide, which is your body's natural blood pressure regulator.
Hence your blood pressure rises, leading to hypertension.
Elevated uric acid levels can also cause gout.
of the F1P is turned into pyruvate, ending up as citrate, which
results in de novo lipogenesis, the end products of which
are free fatty acids (FFAs), very low-density lipoproteins (VLDLs
are smaller, denser LDLs that get stuck beneath your epithelial
cells and stimulate plaque formation), and triglycerides. The
end result is hyperlipidemia.
stimulates g-3-p (activated glycerol), which is the crucial molecule
for creating triglycerides within fat cells. The more g-3-p that
is available, the more fat is deposited.
exported from your liver and taken up in skeletal muscle, causing
skeletal muscle insulin resistance. Some of the FFAs
also stay in your liver, leading to fat accumulation, hepatic
insulin resistance and nonalcoholic fatty liver disease
resistance stresses your pancreas, which pumps out more insulin
in response to rising blood sugar as your cells are unable to
get the sugar out of your bloodstream, and this can progress to
type 2 diabetes.
you consume 120 calories of fructose, about 40 calories contribute
to adverse metabolic outcomes.
Metabolism: After consuming an alcoholic beverage, 10 percent
of the ethanol gets broken down by your stomach and intestine as
a "first pass" effect, and another 10 percent is metabolized by
your brain and other organs. The fact that ethanol is partially
metabolized in your brain is the reason you experience that familiar
"buzz." The remaining 80 percent is broken down by your liver, causing
the following metabolic cascade:
converts ethanol to aldehydes, which produce free radicals that
damage proteins in your liver. Excess citrate is formed in the
process, stimulating the production of FFAs, VLDL and triglycerides.
lipids, together with the ethanol, create a cascade of inflammation,
causing hepatic insulin resistance, liver inflammation and cirrhosis.
Fat accumulation in your liver can also lead to fatty liver
your skeletal muscles to become insulin resistant. This is a worse
form of insulin resistance than hepatic insulin resistance and
can lead to type 2 diabetes.
you consume 120 calories of ethanol, about 40 calories contribute
to adverse metabolic outcomes the same amount as fructose.
Cause Identical Diseases
As you can
see, in nearly every way, fructose is metabolized the same way
as ethanol, creating the same toxic effects in your body. However,
while Dr. Lustig uses the term "liver toxin" to describe fructose,
he's also careful to note that it's not fructose per se
that is toxic. There are instances when your body can use
it. The problem is that people consume so MUCH of it that it turns
toxic by virtue of the fact your body cannot use it. It simply gets
shuttled into your cells and stored as fat. So it's the MASSIVE
DOSES you're exposed to that make it dangerous.
When you compare
the health outcomes of fructose versus alcohol consumption, you
end up seeing a very familiar pattern the diseases they cause
are virtually identical! According to the chart included in the
video above, these include:
if not addiction
How Much Fructose
is Safe to Eat?
If you want
to shed excess pounds and maintain a healthy weight long-term, and
RADICALLY reduce (and in many cases virtually eliminate) your risk
of diabetes, heart disease and cancer, then start getting serious
about restricting your consumption of fructose to no more than 25
grams per day. If you're already overweight, or have any of these
diseases or are at high risk of any of them, then you're probably
better off cutting that down to 10-15 grams per day.
included a chart below of fructose levels in fruit to give you an
idea of what 25 grams a day looks like. Just remember fruit is only
one source, as fructose is a staple ingredient in the vast
majority of sweetened beverages and processed foods of all kinds,
from pre-packaged meals to baked goods and condiments.
In the past
many have objected to my position on limiting fruit intake and I
am fine with that, BUT if you are convinced, for whatever reason,
that you can have unlimited fruits than I would strongly encourage
you to have a blood uric acid level drawn. High uric acid is a potent
marker for fructose toxicity, so if your levels are above:
... then you
would be wise to avoid all forms of fructose until your levels have
normalized just as you would with high insulin levels. Here's
a quick reference list of some of the most common fruits that you
can use to help you count your fructose grams:
pink or red
seedless (green or red)
What Can You
Use to Sweeten Your Food if You Don't Eat Sugar? (Hint: NOT Artificial
to realize that when we talk about "sugar," ALL sugars are included.
So when you're evaluating your sugar consumption, you can't stop
counting once you've accounted for the number of spoons of table
sugar you've added to foods and beverages. You must also include
all other types of sweeteners, such as HFCS, honey and agave.
is another artificial sweetener that is touting their "improved"
versions as a smart and healthy way to sweeten your food, but please
do not be misled. Splenda is likely to push your health in the wrong
direction, and there's nothing smart about that Ö
artificial sweeteners can cause distortions in your biochemistry,
and if you drink diet soda in an attempt to lose weight, it won't
help you. Instead, most studies looking at this show very clearly
that diet soft drinks actually increase
your obesity risk by stimulating your appetite, increasing carbohydrate
cravings, and stimulating fat storage!
do your homework on this, and do not be swayed by sweet-talking
dietitians, doctors, or any other health professional that tells
you artificial sweeteners have gotten the 'green light' and are
safe to use. There's simply too much evidence pointing in the other
direction. So, what can you use if you want an occasional sweetener?
I recommend using:
stevia (my favorites are the liquid forms that come in flavors
like French Vanilla and English Toffee)
(pure glucose) (glucose can be used directly by every cell in
your body and as such is far safer than the metabolic poison fructose)
switching to cane sugar, honey, date sugar, coconut sugar, brown
rice syrup, fruit juice, molasses, maple syrup, sucanat, sorghum,
turbinado or agave syrup will NOT ameliorate any of the risks of
sugar consumption, as they all contain HIGH amounts of fructose.
Craze Adds to Metabolic Disease
in the habit of reading labels, you've no doubt realized it's difficult
to find any kind of processed, packaged food that does not contain
some form of added sugar or high fructose corn syrup. And low-fat
or "diet" foods tend to be the worst of the bunch. The
reason for this is that when fat is removed, most of the flavor
goes with it. To compensate, sugars are added.
most processed, packaged foods are toxic for your metabolism and
lead to mitochondrial damage and disease. Considering the fact that
many eat virtually nothing BUT processed foods, it's no wonder obesity-related
diseases are peaking.
of course, is to return to a more natural diet, meaning a diet of
whole, preferably organic, foods, cooked from scratch, without added
sugars and other chemicals. Ideally, you would eat as much of your
food raw as possible, as cooking destroys many valuable nutrients.
people, I have very little "free time" in my life, but still I am
committed to preparing over 95 percent of my meals in order to preserve
my health. A major leap in the right direction would be to strive
for a diet of 90 percent non-processed food and only 10 percent
from other sources. To help you get started, I've created a complete
program that is freely available online. It's divided into beginner,
intermediate, and advanced, to help you progress at your own pace.