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Why It’s So Hard To Give Up Sugar

Blame it on the brain. Researchers at Yale have found that our brains respond differently to sweet tastes and to calories. The brain is hardwired to seek out sugar to provide itself calories, but it considers sweetness separately, and it will go for the calories - energy - every time. "It turns out the brain actually has two segregated sets of neurons to process sweetness and energy signals," the Yale study’s senior author explained in a press release. "If the brain is given the choice between pleasant taste and no energy, or unpleasant taste and energy, the brain picks energy." The study found that both sweet taste and nutrient value register in an ancient brain region called the striatum, which is involved in processing rewards. In studies with mice and sugar, the researchers found that signals for taste and nutrients are processed in two separate areas of the striatum. One, the ventral striatum processes taste signals while the other, the dorsal striatum responds to energy signals. As far as eating behavior is concerned, the study showed that the brain chose signals that sugar (even sugar made to taste very bad) was delivering calories every time. The bottom line: Our human sweet tooth evolved to ensure that we eat enough to provide our brains with the calories it needs to operate at peak efficiency, but it is our brains desire for calories - not sweetness - that dominates our strong cravings for sugar, the researchers reported. 

Sugary Drinks and Your Liver

Drinking just one sweetened beverage a day may be all it takes to increase the risk for non-alcoholic fatty liver disease (NAFLD). As the name suggests, this disorder, marked by an accumulation of fat in liver cells, has nothing to do with alcohol consumption, and many people with NAFLD have no symptoms. However, it affects approximately 25 percent of Americans and puts them at greater risk of cardiovascular disease and type 2 diabetes.  Researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University reported the risks of developing liver disease posed by sweetened beverages after analyzing 2,634 questionnaires from middle-aged men and women enrolled in the Framingham Heart Study’s Offspring and Third Generation cohorts. The beverages at issue include both caffeinated-and caffeine-free colas, other carbonated drinks containing sugar, fruit punches, and lemonade or other non-carbonated fruit drinks.  All of these beverages are significant dietary sources of fructose, a compound that may increase the risk of NAFLD because of the way it is processed in our bodies, the researchers said. The study participants underwent CT scans to assess the amount of fat in their livers. The link to sweetened beverages remained after the researchers accounted for age, gender, body mass index, calorie intake, alcohol consumption and smoking.

My take: This isn’t the first study to find a link between NAFLD and sugar-sweetened beverages. In 2010 researchers at Duke University Medical Center linked foods and beverages sweetened with high fructose corn syrup to NAFLD and scarring of the liver. Researchers there looked at dietary questionnaires completed by 427 adults with NAFLD. Only 19 percent of these patients reported no consumption of fructose containing beverages. The more of these drinks study participants consumed, the more liver scarring was seen. There's no treatment for NAFLD - all you can do is lose weight and lower your triglycerides if they're elevated. These beverages have no place in a healthy diet.

Drinking Soda May Accelerate Aging

We know that habitually sipping sugary sodas can lead to obesity, diabetes, and heart disease, but new research suggests that consuming sugar-sweetened drinks daily may have a negative effect on telomeres, the repeating DNA sequences at the ends of chromosomes that shorten with age. Investigators from the University of California, San Francisco looked at telomeres in the white blood cells of stored DNA from 5,309 individuals who participated in the National Health and Nutrition Examination Survey from 1999-2002. They calculated that the telomere shortening observed among individuals who consumed one 20-ounce soda daily was comparable to the effect of smoking. Over time, these changes were associated with 4.6 years of additional biological aging. In addition to the link between short telomeres and decreased human lifespan, the length of telomeres within white blood cells has been associated with development of heart disease, diabetes and some types of cancer. Study leader Elissa Epel, Ph.D., noted that the association between drinking sugar-sweetened soda and telomere shortening "held regardless of age, race, income and education level."

My take? These new findings don't surprise me. Earlier research has shown that drinking a single sugar-containing soda per day is linked to weight gain. A daily soda habit also increases a woman's risk of developing diabetes by 83 percent compared to women who have less than one sweetened drink per month. Sodas of any kind don't belong in a healthy, well-balanced diet. Opt instead for filtered water, tea or sparkling water mixed with natural fruit juice.

What Does 250 Calories Mean to You?

Researchers at Johns Hopkins found that posting signs about how many miles customers would have to walk or run to burn off the 250 calories a sugary drink contains was enough to encourage some teens to opt for healthier choices. The study, performed in Baltimore corner stores, was designed to show that simply posting the calorie counts for sweet drinks doesn't change any habits, but that providing real world information on how those calories translate to miles of walking or running can make an impression great enough to influence behavior. Before the signs were put up, the researchers reported that 98 percent of drink purchases by teens in the stores were sugary beverages. Afterward, regardless of the type of sign, the percentage of sugary drink purchases dropped to 89 percent. The investigators found that the most effective sign was the one informing teens that they would have to walk five miles to burn off 250 calories. Of the 35 percent of the teens who said they saw the signs, 59 percent said they believed them, and 40 percent of them said that they bought something else - a smaller drink or water or nothing at all - as a result. The investigators observed 3,098 purchases, mostly by African Americans between the ages of 12 and 18.

My take? A few similar studies along these lines have been completed in the past and showed that providing information on how much activity is required to work off calories in foods apparently can make a difference. If you're interested in knowing more about how much exercise it takes to burn off a set amount of calories, you can find any number of online calculators that will give you calories burned per hour for many different activities for someone of your height and weight. Learning how much effort is involved in eliminating excess calories is worthwhile - it may stop you from overindulging in the first place, and can also help motivate you to get more exercise.

Surprising News About Sugar

We know that the excessive amount of sugar in western diets isn't healthy, and now a study from the U.K. has identified sugar as the onlycause of tooth decay in children and adults. That finding implicates all the sugars in our diets, especially those added to food (including beverages) by manufacturers, as well as the sugars found naturally in honey, syrups, fruit juices and fruit concentrates. The researchers backed up their findings with epidemiology linking sugar consumption with tooth decay across the globe. For instance, during World War II, tooth decay was "hugely reduced" in Japan, but increased after the war when sugar could again be imported. The researchers also reported that only two percent of the people in Nigeria (whose diets contain negligible amounts of sugar) have tooth decay, compared to 92 percent of adults living in the United States. To rein in this problem, the researchers from University College London and the London School of Hygiene & Tropical Medicine recommended reducing the amount of sugar in the diet to less than three percent of total calories (that would work out to 60 calories on a 2000 calorie daily diet). Current guidelines from the World Health Organization set a maximum of 10 percent of total calories from sugar with a target of half that amount, five percent.

My take? In addition to its unwelcome effect on teeth, sugar has a negative impact on health in generalDiets high in sugar may predispose some people, especially women, to yeast infections, may aggravate some kinds of arthritis and asthma and may raise triglyceride levels. In people genetically programmed to develop insulin resistance, high-sugar diets may drive obesity and high blood pressure and increase risks of developing type 2 diabetes. Our physiology does not require foods made with copious amounts of sugar, and does not respond well to it. Cutting sugar back to three percent of total calories is a tough goal, but it would have a considerable positive payoff for your teeth - and the rest of your body.

What Is Your Main Source of Sugar? (Poll)

A recent Q&A discussed sugar in the diet and what too much sugar can do to our health: Is Sugar a Killer? Check out the article and let us know what the main source of sugar is in your diet.

Is Sugar the New Tobacco?

That surprising notion – from the statement of a British health expert - was the lead story splashed across the front page of the British tabloid the Daily Mail, on January 8. The eye-catching headline heralded a new global campaign to stem the epidemics of obesity and type 2 diabetes. The strategy begins by heightening public awareness of the amount of sugar hidden in processed food and drinks and inducing producers to slash the amount of added sugar in their products by 20 to 30 per cent within three to five years. That reduction would eliminate 100 calories a day from the typical diet, enough to halt or even reverse rising levels of obesity, type 2 diabetes, metabolic syndrome, fatty liver and even cardiovascular disease and associated ill-health, according to Action on Sugar, the group spearheading the campaign. The amount of sugar hidden in processed foods and drinks amounts to a “public health hazard,” according to Action on Sugar’s scientific director.

My take? This is great news and long overdue. Sugar's negative impact on health is often cumulative, and virtually all Americans consume far too much - about 64 pounds per person per year, according to a U.S. Department of Agriculture survey. Awareness is key to changing behaviors, and prompting consumers to read labels may quickly convince them to seek products without added sugar. The best way to satisfy a sweet tooth is with foods in which the sugar naturally present is part of a whole food, such as in fresh or dried fruit, because the sugars are bound in a matrix of fiber that slows digestion and limits rapid increases in blood glucose. I applaud Action on Sugar and its goals.

Nathan Gray, “Action on Sugar: New Global Campaign Takes Aim at High Level of Sugar in Foods and Drinks,” Food and Drink, January 9, 2014, accessed January 10, 2014,

How Much Sugar Is Too Much?

A new analysis from England puts the recommended sugar limit at five percent or less of your total daily intake of calories. Be aware that total includes all the “free sugar” in your diet – the sugar you put in your coffee or tea, and the amounts added to foods in cooking - in addition to the sugar contained in processed foods such as honey, syrups, fruit juices and fruit concentrates. According to the report from Newcastle University, limiting intake to five percent (about five teaspoons for most people) can help protect your teeth from decay and minimize the risk of cavities for life. Previous estimates of sugar limits were based on the average risks of developing decay in three or fewer teeth in 12-year-olds, the Newcastle researchers noted, adding that by looking at patterns of tooth decay in populations over time “we now know that children with less than three cavities at age 12 go on to develop a high number of cavities in adulthood.” The new estimate is based on looking at data on dental caries and sugar intake gathered from studies across several decades. The researchers said that sugary foods that used to be an occasional treat are now staples in many people’s diet, and that while fluoride protects against tooth decay, it does not eliminate the cause – dietary sugars.

My take? Virtually all Americans consume too much sugar. In addition to being bad for the teeth, sugar may predispose some women to yeast infections, may aggravate some kinds of arthritis and asthma, and may raise triglyceride levels. In people genetically susceptible to developing insulin resistance, high-sugar diets may drive obesity and high blood pressure and increase risks of type 2 diabetes. Although conventional medical studies haven't shown that sugar causes hyperactivity in children, in many cases limiting sugar intake improves kids' behavior and attention. Recent research also indicates that sugar, rather than saturated fat, is the primary culprit in America's high rates of cardiovascular disease. It is important to bear in mind that sugar's negative impact on health can slowly, insidiously accumulate over the years. The best way to satisfy a sweet tooth is with foods that contain sugar as part of a whole food, such as fresh or dried fruit, because the sugars are bound in a matrix of fiber that slows digestion and limits rapid increases in blood glucose.

Paula J. Moynihan and Sarah A. M. Kelly. “Effect on Caries of Restricting Sugars Intake: Systematic Review to Inform WHO Guidelines”. Journal of Dental Research, 2013; 93 (1): 8 DOI: 10.1177/0022034513508954

Sugary Drinks Strike Again

The evidence is undeniable that sugar-sweetened drinks raise the risk of type 2 diabetes and have a big impact on obesity. Now a new study shows that these beverages also seem to raise the risk of endometrial cancer. An investigation from the University of Minnesota School of Public Health found that women who drank the most sugar-sweetened drinks had a risk for the most common type of endometrial cancer that was 78 percent higher than that of women who did not consume these beverages. The researchers reviewed data from more than 23,000 postmenopausal women taking part in the Iowa Women’s Health Study. The women were asked to complete a questionnaire that asked about consumption of 127 food items. Between 1986 and 2010, 506 of the women developed type 1 endometrial cancer, an estrogen-dependent disease. The study revealed only an association between the risk of endometrial cancer and sugar-sweetened drinks. While it doesn’t prove that the drinks caused the cancer, there is a plausible link: “increase(ed) consumption of sugar-sweetened drinks has paralleled the increase in obesity. Obese women tend to have higher levels of estrogens and insulin than women of normal weight. Increased levels of estrogens and insulin are established risk factors for endometrial cancer,” said study leader Maki Inoue-Choi, Ph.D., M.S., R.D.

My take? I've warned for many years to avoid consuming high fructose corn syrup, which is used to sweeten most soft drinks. These products represent a major source of the average American intake of an unhealthy amount of sugar, 355 calories per person per day. That amounts to 22 teaspoons of sugar daily. A single 12-ounce soda contains about 130 calories and the equivalent of eight teaspoons of sugar. The high glycemic load of these sugary drinks provokes insulin resistance in many people, which underlies much of the obesity in our society and raises risks of type 2 diabetes. And now we have evidence suggesting that these drinks also raise the risk of endometrial cancer, the most common cancer of the female reproductive system. These beverages have absolutely no place in a healthy diet.

Maki Inoue-Choi et al, “Sugar-Sweetened Beverage Intake and the Risk of Type I and Type II Endometrial Cancer among Postmenopausal Women”, Cancer Epidemiology Biomarkers & Prevention, 2013; DOI: 10.1158/1055-9965.EPI-13-0636