During the 1960’s and 1970’s, the incidence of obesity stayed relatively stable, but from 1980 to 2008, the rate of adult obesity rose from 13.45 to 34.3%. Today, more than 70% of Americans are overweight or obese, (those with a BMI, body mass index, of over 30). Compared to healthy weight adults, those with a BMI > 30 have an increased risk of premature death from all causes. Significant, for sure. But why is this happening? We can see that in the last few decades there have been multiple environmental and lifestyle factors coming together to negatively change our physiology. While the entire scope of the problem is beyond this post, without question, the increased intake of processed foods and simple sugars tops the list of culprits!
Just coming out of the holiday season, most can relate to indulging in extra sweet treats, and consequently, post-season, struggling with what seems to be an addictive draw to still reach for those sweets. The addictive nature of sugar and the effects on our physiology create a perfect storm for creating an obesity epidemic. What’s becoming clear, though, is that "lack of willpower" may not just be your fault! Much of sugar addiction and its negative health consequences, including the obesity epidemic and an increased risk for many associated chronic diseases, may be secretly supported by the food industry. Overindulging might not only be an issue of self-control, but rather a symptom of a carefully crafted food, (or “food-like “substance as Michael Pollen would say), specifically formulated to excite the senses enough to keep us coming back for more, but not enough to allow our bodies to feel satisfied.
Making Food Addictive
The food industry spends millions of dollars to research just what combination of sugar, salt and fat make up the perfect mix to create an addictive “food-like substance”. Ever grab a snack food and feel like you just can’t stop eating it? There’s a scientific reason behind this and it is deliberate. The combinations of flavors - sugars, salts, fats - are just complex enough to be desirable and “addictive”, but not satiating enough to signal the brain and tell us “hey, I’ve had enough”. Known as “sensory-specific satiety”, the “I’ve had enough” feeling is caused by intense flavors overwhelming the brain which decreases your desire to have more. For example, think of many of the foods we consider “rich” like cheesecake or a homemade (and only homemade – without the added stuff) bowl of chicken broth. Foods that feel “addictive” have just enough flavor to keep us coming back for more, but not enough for us to feel fulfilled.
Food companies spend millions of dollars finding this “bliss point”. A mixture of sugars, salts, and fats that create “the greatest amount of crave”. How do they get to this formulation? They do taste tests of 30, 60, 100 different formulations with thousands of participants. The end result for many formulations, even those commonly thought of as healthy – add sugar!
Sugar and our Physiology
Sugar affects the pleasure centers of the brain (the nucleus accumbens) - it is addicting! A study in Neuroscience found that daily bingeing on sugar repeatedly releases dopamine into the brain in rats. This study found that the dopamine rush associated with sugar intake was similar to the increase in dopamine found in drug addiction!
Our bodies crave sugar, so why is it so bad? The innate desire for sweet foods pushed early man to gather berries and fruit for the concentrated antioxidant and phytochemical content; however, sugar and other refined carbohydrates like, white flour, which our bodies convert to glucose, are handled much differently in our bodies physiology than sugars naturally found in fruits and berries.
To give you a feel for a way to gauge how different forms of sugar affect blood glucose levels, we can look at GI, or Glycemic Index. GI is a scale which indicates how quickly a food is broken down and then how quickly and how high the blood sugar rises from ingesting it. High GI index is over 70, while low is below 55. Glucose is given a value of 100 and other foods are compared relative to that. White flour has a glycemic index of 71 because it breaks down into glucose (which has a GI of 100), while table sugar (sucrose) is actually LOWER at 63. What that means is that white flour is broken down quickly, to glucose, and raises blood sugar more quickly, and higher, than even table sugar. Glucose, then, is the simple monosaccharide that enters our bloodstream and that we use for energy. In excess, glucose is stored as fat, and can affect our physiology and contribute to a number of health issues overtime.
Excess sugar consumption creates a cascade of negative health effects, creating inflammation in several ways. Sugar itself is inflammatory and damages proteins in the body affecting their function. Increased blood sugar levels also trigger higher insulin levels (also inflammatory), and ultimately overtime blood sugar regulation is tempered, resulting in insulin resistance and glucose intolerance, and ultimately leading to diabetes. High refined carbohydrate and sugar intake also affects gut health, creating dysbiosis and leaky gut, which triggers immune responses and more inflammation. As the cascade continues, and energy dysregulation occurs, the body is setup to store fat instead of burning energy well, and obesity can result. Adipose tissue is now considered another body organ and not just a storage site, and it puts out more inflammatory particles called cytokines. Inflammation is the precursor to all chronic disease, and poor gut health and inflammation is associated with cardiovascular risk, cancer risk, cell damage, mental health and mood issues (see my post on Leaky Gut and Mental Health) , Alzheimer’s and more. Below is a list of just some of the negative health effects of excess sugar intake:
- Unstable blood sugar control/Insulin Resistance - Sugar can damage the insulin receptor sites on cells causing them to not work as well as they should. This makes it harder to get the glucose into the cells to use as energy. The body, sensing it needs more glucose in the cells, puts out more insulin to try to compensate.
- Increased Risk for Type II Diabetes – Eventually, the compensation can’t keep up, and a person’s blood glucose levels rise. There is a continuum of dysfunction, until a diagnosis of Type II diabetes can result. High insulin levels are inflammatory in and of themselves and can also create a host of other issues.
- Increased Body Fat/Obesity – An increase in belly fat increases risk of chronic disease like heart disease, obesity, type 2 diabetes and cancer.
- Increased Free Fatty Acid Accumulation - An which can have negative effects on blood lipids (triglycerides and cholesterol).
- Leaky Gut - Excess sugar feeds the bad bacteria (like Candida) in the gut, and can lead to an imbalance in the gut bacteria. Dysbiosis, or and overgrowth of bad bacteria is inflammatory and contributes to leaky gut, and a cascade of mental, digestive, and systemic health issues over time.
- Increased Risk for Certain Cancers – Sugar feeds cancer and excess sugar intake, poor blood sugar control and increased insulin production increases your risk for certain cancers.
- Increased Inflammation which is the precursor for all chronic disease.
- Adrenal Stress - The effect on destabilizing blood sugar levels creates “fight or flight” response which creates a stress on adrenal function.
- Cell Damage - Damage to the cells in your body which lowers your cells ability to communicate properly with each other. Sugar reacts with proteins in the body and damages them and their ability to function properly.
- Increase in dental caries
- Cardiovascular Health issues
- Negatively affects BRAIN HEALTH. Did you know that we now call Alzheimers Type III Diabetes?
How Much Sugar is Too Much?
The US Dietary Guideline recommend limiting calories from sugar to 10% of your total intake. For a standard 2,000 calorie diet, this would allow for 50 g of sugar, or 12.5 tsp a day! Not everyone will be consuming 2000 calories a day, and even at that calorie level, 50 g of added sugar intake a day is way too much! The American Heart Association (AHA), on the other hand recommends 6 tsp sugar (24g) for women and 9 tsp sugar (36g) for men a day. For children the max recommendation is only 3 tsp. or 12 grams of added sugar a day. So what is your daily intake of added sugar?
In the functional medicine field, we recognize that each person will metabolize sugars differently, depending on their physiology, insulin function and glucose tolerance. At Optimal Health Solutions, we can do direct measures of your cardiometabolic profile, look at your blood sugar control, your lipids, and inflammation markers to get a better feel for your specific physiology, and then develop a program to get you balanced with lifestyle recommendations and targeted nutritional therapies that can directly affect your blood sugar control and risk for disease.
STOP THE CASCADE!! My 4 -week Clean Eating, Detox program can include additional testing and Results Review to see where you are and to create a targeted blueprint for optimizing your health. You will get a personalized program, results review and program adjustment, supplement recommendations and 4 weeks of nutritional coaching to get you on a path to wellness !
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US Dept of Health and Human Services. Office of the Surgeon General. Overweight and Obesity: Health Consequences. http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.html
NHANES. National Health and Nutrition Examination Survey