“In this episode, my guest is Dr Robert Lustig, M.D., a neuroendocrinologist and professor of paediatrics at the University of California, San Francisco (UCSF). He is also a bestselling author on nutrition and metabolic health. We discuss the “calories in calories out” (CICO) model of metabolism and weight regulation and how specific macronutrients (protein, fat, carbohydrates), fibre, and sugar can modify the CICO equation. We cover the impact of different types of sugars, particularly fructose, sugars found in liquid form, taste intensity, and other factors on insulin levels, liver, kidney, and metabolic health. We also explore how fructose in non-fruit sources can be addictive, similar to drugs of abuse, and how sugar alters brain circuits related to food cravings and satisfaction. Additionally, we discuss the role of sugar in childhood and adult obesity, gut health and disease, and mental health. Furthermore, we delve into how the food industry uses refined sugars to create pseudo foods and their effects on the brain and body. This episode provides actionable information about sugar and metabolism, weight control, brain health, and body composition. It should be of interest to anyone seeking to understand how specific food choices impact the immediate and long-term health of the brain and body.”
A recently compiled list of foods and drinks commonly consumed in the United States suggests why many adults inadvertently consume excessive saturated fat and added sugar in their daily diet.
The study reveals that limiting fat and sugar to the recommended 10% of daily calories is challenging due to various popular sources, such as cheese for saturated fat and soft drinks for added sugar. Unexpected sources like chicken and ketchup contribute to overconsumption, posing risks for cairdiovascular disease, diabetes, and cancer.
The analysis of data from over 35,000 U.S. adults is part of a project to develop a research tool to streamline the assessment of these dietary downsides. The work also aims to raise awareness among consumers about the unexpected sources of fat and sugar that accumulate over the overesearchers hope this will encourage shoppers to read labels and identify these hidden sources.
“Chicken breast is often promoted as a low saturated fat food, but it still contains a small amount of saturated fat. It’s important to be aware that even foods with smaller amounts of saturated fat can contribute to the overall intake, gradually adding saturated fat into the diet,” explained Christopher Taylor, the first author of the study and a professor and director of medical dietetics at The Ohio State University’s School of Health and Rehabilitation Sciences.
“Meeting less than 10% helps identify major contributors, and allows us to recognize where saturated fat and added sugar might still be present in other food options. This doesn’t mean these are bad choices – it’s about being mindful of how the morning latte might be contributing.”
Lead author Susan Schembre, an associate professor of oncology at Georgetown University’s Lombardi Comprehensive Cancer Center, raised a public health policy concern about the abundant added sugar.
“It’s present in so many unexpected foods and often in surprising amounts,” she remarked.
The researchers examined information from 36,378 adults in the United States, aged 19 and older, who took part in the National Health and Nutrition Examination Survey from 2005 to 2018. This survey gathered 24-hour dietary recalls from each participant, providing detailed information on what and when all food and beverages were consumed over the preceding two days.
Here is the rewritten text:The main sources of saturated fat were cheese, pizza, ice cream, and eggs. The leading sources of added sugar were soft drinks, tea, fruit drinks, cakes, and pies. According to the USDA’s “What We Eat in America” food list, other categories contributing to saturated fat intake include cold cuts, cream substitutes, fried potatoes, and whole milk. Categories with added sugar include tomato-based condiments, cereal bars, energy drinks, and yeast breads.
The research team also analyzed variations in the primary sources of saturated fat and added sugar across different race/ethnicity groups and age brackets, which is crucial when evaluating diets for the purpose of developing tailored health interventions, Schembre explained.
“Before you understand what you can intervene on, you have to know what people are consuming,” she said.
The team is developing an app for focused assessment of “nutrients of concern.” They have shown that this analytical method generates a comprehensive list of foods that contribute to most of the saturated fat and added sugar intake. While NHANES data is important for understanding nutrition in the United States, identifying the specific food and beverage sources of fat, added sugar, and soon, sodium, is more efficient and effective for disease interventions.
The analysis revealed that saturated fat made up at least 12% of daily calories, while added sugar intake ranged from 14% to 16% of total calories. Although dietary recommendations often highlight common culprits like pizza and ice cream, this comprehensive list provides valuable and, for some, surprising insights, according to Taylor.
“There are foods that are high in saturated fat and added sugar which are frequently consumed and often targeted. However, there is also a smaller cumulative effect of things that are generally perceived as healthy, but still contribute a little bit,” he said. “When you top it off with some of those higher sources, it ends up taking you over the threshold for 10% of the day’s calories.”
“We’re aiming to find the right balance between addressing the major issues upfront while also recognizing the subtle contributors.”
Science has made it clear that eating sugar leads to poor health. But sugar tastes good, is in seemingly everything, and is pretty cheap. On top of that, poor health is a future thing, making it hard to come up with a reason to put down the cookie or avoid grabbing the candy bar. Here are six less-scientific, but highly motivating reasons you don’t want to ruin your day by eating sugar.
For people with multiple sclerosis (MS), drinking around 290 calories per day of soda or other sugar-sweetened beverages, or the equivalent of about two cans of non-diet soda, may be tied to more severe symptoms and a higher level of disability compared to people with MS who seldom consume sugar-sweetened beverages, according to a preliminary study released today that will be presented at the American Academy of Neurology’s 71st Annual Meeting in Philadelphia, May 4 to 10, 2019. People who seldom drank sugar-sweetened beverages consumed an average of seven calories in sugar-sweetened beverages per day, or the equivalent of one-and-a-half cans of non-diet soda per month. Soda and other sweet beverages were the only type of food that was related to MS symptoms in the study.
“MS patients often want to know how diet and specific foods can affect the progression of their disease,” said study author Elisa Meier-Gerdingh, MD, of St. Josef Hospital in Bochum, Germany, and a member of the American Academy of Neurology. “While we did not find a link with overall diet, interestingly, we did find a link with those who drank sodas, flavored juices and sweetened teas and coffees.”
The study involved 135 people with MS. Participants completed a questionnaire about their diet. Researchers then looked at how close each participants’ diet was to the Dietary Approaches to Stop Hypertension (DASH) diet. The DASH diet recommends whole grains, fruits and vegetables, low-fat dairy products, lean meats, poultry and fish, and nuts and legumes and limits foods that are high in saturated fat and sugar.
“We chose to study the DASH diet because adherence to the DASH diet is associated with lower risk of other chronic diseases like high blood pressure, diabetes and cardiovascular diseases,” said Meier-Gerdingh.
Researchers also measured the participants’ level of disability using the Expanded Disability Status Scale, a common method to quantify disability ranging from 0, no symptoms, to 10 points, death due to MS. A total of 30 participants had severe disability.
Overall, researchers did not find a link between what participants ate and their level of disability.
For soda and sugar-sweetened beverages, the participants were divided into five groups based on how much they drank. The people in the top group drank an average of 290 calories of sugar-sweetened beverages per day, while the lowest group seldom drank sugar-sweetened beverages.
The study found that participants who consumed the largest amounts of sugar-sweetened beverages were five times more likely to have severe disability than people who seldom drank sugar-sweetened beverages. Of the 34 people in the top group, 12 had severe disability, compared to 4 of the 34 people in the bottom group. The top group had on average a disability score of 4.1 points, while the bottom group had an average of 3.4 points.
“While these results need to be confirmed by larger studies that follow people over a long period of time, and the results do not show that soda and sugar-sweetened beverages cause more severe disability, we do know that sodas have no nutritional value and people with MS may want to consider reducing or eliminating them from their diet,” Meier-Gerdingh said.
Limitations of the study include the relatively small number of participants. The study also assessed participants’ diets and sugar-sweetened beverages at the same time as disability, so it is not possible to distinguish whether it is actually an aspect of diet, like sugar-sweetened beverages, that contributes to higher disability or whether more severe disease impacts a person’s ability to have a healthy diet.
Additional studies are needed to evaluate whether sugar-sweetened beverages affect the course of the disease.
Learn more about multiple sclerosis at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.
The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with 36,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.
For more information about the American Academy of Neurology, visit AAN.com or find us on Facebook, Twitter, LinkedIn, Instagram and YouTube.
Doctors should consider treating chronic pain patients with sugar pills
Placebo pills relieve pain as effectively as drugs for half of chronic pain patients
Pain reduced by 30 percent
No need to fool patients, brain is primed to respond
Finding can result in vast cost savings for patients, health care system
CHICAGO — Someday doctors may prescribe sugar pills for certain chronic pain patients based on their brain anatomy and psychology. And the pills will reduce their pain as effectively as any powerful drug on the market, according to new research.
Northwestern Medicine scientists have shown they can reliably predict which chronic pain patients will respond to a sugar placebo pill based on the patients’ brain anatomy and psychological characteristics.
“Their brain is already tuned to respond,” said senior study author A. Vania Apkarian, professor of physiology at Northwestern University Feinberg School of Medicine. “They have the appropriate psychology and biology that puts them in a cognitive state that as soon as you say, ‘this may make your pain better,’ their pain gets better.”
There’s no need to fool the patient, Apkarian said.
“You can tell them, ‘I’m giving you a drug that has no physiological effect but your brain will respond to it,'” he said. “You don’t need to hide it. There is a biology behind the placebo response.”
The study was published Sept. 12 in Nature Communications.
The findings have three potential benefits:
Prescribing non-active drugs rather than active drugs. “It’s much better to give someone a non-active drug rather than an active drug and get the same result,” Apkarian said. “Most pharmacological treatments have long-term adverse effects or addictive properties. Placebo becomes as good an option for treatment as any drug we have on the market.”
Eliminating the placebo effect from drug trials. “Drug trials would need to recruit fewer people, and identifying the physiological effects would be much easier,” Apkarian said. “You’ve taken away a big component of noise in the study.”
Reduced health care costs. A sugar pill prescription for chronic pain patients would result in vast cost savings for patients and the health care system, Apkarian said.
How the study worked
About 60 chronic back pain patients were randomized into two arms of the study. In one arm, subjects didn’t know if they got the drug or the placebo. Researchers didn’t study the people who got the real drug. The other study arm included people who came to the clinic but didn’t get a placebo or drug. They were the control group.
The individuals whose pain decreased as a result of the sugar pill had a similar brain anatomy and psychological traits. The right side of their emotional brain was larger than the left, and they had a larger cortical sensory area than people who were not responsive to the placebo. The chronic pain placebo responders also were emotionally self-aware, sensitive to painful situations and mindful of their environment.
“Clinicians who are treating chronic pain patients should seriously consider that some will get as good a response to a sugar pill as any other drug,” Apkarian said. “They should use it and see the outcome. This opens up a whole new field.”
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