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Sugar

Added sugar increases risk of many diseases

By David Dunaief, M.D.

Dr. David Dunaief

We should all reduce the amount of added sugar we consume because of its negative effects on our health. It is recommended that we get no more than 10 percent of our diet from added sugars (1). However, approximately 14 percent of our diet is from added sugars alone (2).

Is all sugar bad for us? The answer is not straightforward. It really depends on the source, and when I mention source, my meaning may surprise you.

We know that white, processed sugar is bad. But I am constantly asked: Which sugar source is better — honey, agave, raw sugar, brown sugar or maple syrup? None are really good for us; they all raise the level of glucose (a type of sugar) in our blood. Forty-seven percent of our added sugar intake comes from processed food, while 39 percent comes from sweetened beverages, according to the most recent report from the Centers for Disease Control and Prevention (2). Sweetened beverages are defined as soft drinks, sports and energy drinks and fruit drinks. Even 100 percent fruit juice can raise our glucose levels. Don’t be deceived because it says it’s natural and doesn’t include “added” sugar.

These sugars increase the risk of, and may exacerbate, chronic diseases such as diabetes, heart disease, high blood pressure, cancer and obesity. This is such a significant problem that municipal legislatures have considered adding warning labels to sweetened drinks (3).

However, I did say that sugar’s source impacts its effect. Most fruits have beneficial effects in preventing disease, including diabetes, and do not raise sugar levels, even in patients with diabetes. It is a myth that whole fruit raises your sugar levels. However, dried fruits, fruit juice and fruit concentrate do raise your sugar levels. Note that sugar extracted from fruit has an effect similar to that of sugar added to foods and sweetened beverages.

Let’s look at the evidence.

Heart disease

When we think of sugar’s effects, heart disease is not usually the first disease that comes to mind. However, results from a 20-year study of 31,000 U.S. adults showed that, when comparing those who consumed the least amount of added sugar (less than 10 percent of calories daily) with those who consumed 10 to 25 percent and those who consumed more than 25 percent of daily calories from sugar, there were significant increases in risk of death from heart disease (4). The added sugar was from foods and sweetened beverages, not from fruit and fruit juices.

This was not just an increased risk of heart disease but an increased risk of cardiovascular death. This is a wake-up call to rein in our sugar consumption.

Obesity and weight gain

Does soda increase obesity risk? An assessment published in PLoS One, a highly respected, peer-reviewed journal, showed that it depends whether studies were funded by the beverage industry or had no ties to any lobbying groups (5). Study results were mirror images of each other: Studies not affiliated with the industry show that soda may increase obesity risk, while studies funded by the beverage industry show there may not be any association.

In studies without beverage industry funding, greater than 80 percent (10 of 12) showed associations between sugary drinks and increased weight or obesity, whereas with the beverage industry-funded studies, greater than 80 percent of them did not show this result (5 of 6). The moral of the story is that patients must be diligent in understanding studies’ funding and, if the results sound odd, they probably are. If this is the case, make sure to ask your doctor about the studies’ findings. Not all studies are equally well designed.

Diabetes and the benefits of fruit

Diabetes requires the patient to limit or avoid fruit altogether. Correct? This may not be true. Several studies may help change the long-standing, commonly held paradigm that fruit should be restricted in patients with diabetes and to prevent development of diabetes.

One study found that whole fruit may reduce the risk of diabetes by reducing inflammation and reducing insulin resistance (6). Specifically, results demonstrated a reduction in the inflammatory biomarker hsCRP. Ultimately, this may result in better glucose control. A potential reason for these impressive results may be the high levels of flavonoids, specifically anthocyanins and flavones. Flavonoids, as a class, are phytochemicals (plant nutrients) that provide pigment to fruits and vegetables and may have substantial antioxidant activities. Substances that are high in these two flavonoids include red grapes, berries, tea and wine.

Another study, a meta-analysis that looked at three large studies, including the Nurses’ Health Study, NHS II, and the Health Professionals Follow-up Study, showed that those who consumed the highest amount of anthocyanins were likely to experience a 15 percent reduction in the development of type 2 diabetes (7). Researchers compared those in the highest quintile of anthocyanin consumption with those in the lowest quintile.

Specifically, at least two servings of blueberries per week were shown to reduce the risk of diabetes by 23 percent, and at least five servings of apples and pears per week were also shown to reduce the risk by 23 percent. These were compared to those who consumed less than one serving per month. This is a small amount of fruit for a significant reduction.

From the same three studies, it was also shown that grapes, bananas and grapefruit reduce the risk of diabetes, while fruit juice and cantaloupe may increase risk (8).

In still another diabetes study, involving those who were newly diagnosed with type 2 diabetes, the risk of increasing glucose levels was no greater in those who consumed more than two servings of fruit per day compared to those who consumed fewer than two servings per day (9). The properties of flavonoids, for example, those found in whole fruit, may also result in anticancer and anticardiovascular disease properties, the opposite of added sugars (10).

Chronic disease incidence and complications from these diseases have skyrocketed in the last several decades. Therefore, any modifiable risk factor should be utilized to decrease our risk. By keeping added sugar to a minimum in our diets, we could make great strides in the fight to maintain our quality of life as we age.

We don’t have to avoid sugar completely; we still can satiate a sweet tooth by eating ripe fruits. Our access to fruit, even off-season, has expanded considerably. The most amazing thing is that fruit may actually reduce the risk of diabetes, something for years we thought might exacerbate it.

References: (1) 2015-2020 Dietary Guidelines for Americans. (2) cdc.gov. (3) reuters.com. (4) JAMA Intern Med. online Feb 03, 2014. (5) PLoS Med. 2013 Dec;10(12):e1001578. (6) J Nutr. 2014 Feb;144(2):202-208. (7) Am J Clin Nutr. 2012 Apr;95(4):925-933. (8) BMJ. online Aug 29, 2013. (9) Nutr J. published online March 5, 2013. (10) Plant Foods Hum Nutr. 2004 Summer;59(3):113-122.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

Stock photo.

By Chris Zenyuh

Throughout our evolution, fruit stood as the primary source of sugars in our diet. That we evolved to desire sweetness, I contend, was not for energy but for the vitamins, minerals, fiber and antioxidants that come with the fruit. The fiber helps slow sugar absorption and reduce its negative metabolic potential, and the vitamins compensate.

The limitations of seasonal fruit accessibility made getting too much of these sugars infrequent, at most. Access to purified cane sugar was limited as well, due its tropical origins. The cost of growing and shipping cane sugar slowed its consumption, certainly for those of lesser means. Still, the demand for sugar steadily increased, a fact that the English monarchy used to fund its war chest.

William Duffy (in his book “Sugar Blues”) has suggested that the sugar machine was largely behind English colonization and enslavement through the 1800s. Duffy suggests that denying sugar’s responsibility for metabolic dysfunction dates back to Dr. Thomas Willis, private physician to King Charles II. Willis both discovered and named diabetes mellitus. Smart enough to recognize the illness and its sugar-related cause, Willis was also smart enough to name it after “honey” instead of sugar, perhaps to keep his job and his head!

Enjoying rations of sugar and rum, tens of thousands of the British sailors who guarded the sugar routes fell ill and died from scurvy. School children are taught that scurvy is a vitamin C deficiency, as it was discovered that the symptoms could be reversed with the addition of citrus to the rations. Sadly, this well-known story promotes the denial of the cause: too much sugar (and rum). Our food, medical and supplement industries continue to promote the use of fortification and vitamin supplements to “protect” against illnesses like scurvy, rather than incur financial loses that would result from curtailed consumption of sugars.

The spiraling decline of our general health gained momentum in 1973, when then Secretary of Agriculture Earl Butz instituted a 180 degree change in the farm subsidy program. Prior to 1973, farmers were directed by the government to curtail production to keep the supply and demand for corn in check. Sometimes, the farmers were instructed not to grow corn but were compensated for lost income. The restricted supplies kept corn prices high, making it too expensive to use high fructose corn syrup as a sweetener. Sugar cane, expensive due to its tropical origins, found itself in a limited range of food products.

The new program launched in 1973 rewarded corn farmers for producing as much corn as possible. Soon, the science to produce more corn, then the science to engineer additional uses for the extra corn became big businesses. High fructose corn syrup and cattle feed businesses were early beneficiaries of the new system. The ranchers and corn refiners lobbied to pay below cost for corn. Corn farmers would lose money, but, the new farm bills enabled the farmers to make up their losses (and more) by receiving the subsidies, funded by tax dollars. That made it cheaper to feed cattle corn than to feed them grass and cheaper to sweeten food with high fructose corn syrup (HFCS) than with sugar.

Americans were now able to purchase foods sweetened with HFCS and corn-fed meat at much cheaper prices than ever before. The cost, of course, does not include the medical expenses that may be incurred from chronic exposure to glucose and fructose, though.

The Sugar Association, still burdened with the expense of sugar cane’s tropical origins, has expanded its use of sugar beets to become price competitive in the caloric sweetener market. Farmed and processed in the continental United States, sugar beets are used to sweeten processed foods almost as cheaply as HFCS. If the ingredient label doesn’t specify cane sugar, it may very well be beet sugar. Of course, it is still sucrose.

Now you know why caloric sweeteners are omnipresent in our food system and how “food” can be available so cheap. You might want to reconsider the amount that you consume of what nature so frugally offers. Regardless of its source or history, it is metabolically the same!

Chris Zenyuh is a science teacher at Harborfields High School and has been teaching for
30 years.

Flavorings in drinks can make the refreshment less healthy than it appears. Stock photo

By Chris Zenyuh

“Natural” is one of the most abused terms in food marketing.

Most “natural flavors,” for example, are simply chemical compounds synthesized in the same laboratories as artificial flavors using slightly different techniques and sources.  Similarly, “fruit sugar” or fructose has an enticing natural sounding name, but very little of our fructose consumption actually comes from fruit.  Instead, we typically accumulate fructose via table sugar — half of every teaspoon turns to fructose in our digestive system — and/or high fructose corn syrup found in almost all processed foods and beverages, even fruit juice. Though coffee and tea are, by themselves, free of fructose, the commonly consumed versions with syrups and flavoring from familiar national chains are more akin to soda, nutritionally.

When it comes to fructose, you should keep a few things in mind to keep a more healthful perspective. As a sweetener, fructose hits 170 on a scale that ranks table sugar at 100 and glucose at 70.  It also tastes sweet faster, browns faster, and holds more moisture than other sugars.  These characteristics have made fructose an industry favorite, especially once the chemistry behind high fructose corn syrup became cost efficient.

The only organ in your body that can process fructose is your liver.  Metabolically, your body makes very little distinction between alcohol and fructose.  Both are seen as poisons and both are detoxified by your liver accordingly.  The primary distinction is that your brain can metabolize about 10 percent of the alcohol consumed, thus inebriation. Chronic exposure to fructose generates much of the same metabolic dysfunction as alcohol, including liver disease. Unfortunately, there is no “drinking age” for fructose, so even the youngest of children are regularly exposed to fructose.

Glucose and fructose molecules can stick to proteins in your body.  This is known as glycation.  The more your cells are exposed to these sugars, the more frequently this occurs.  Your body does have the ability to disconnect these molecules, but too much glycation can overwhelm that system. Eventually, the attachments become permanent, known as ‘advanced glycation end-products’ or A.G.E.s (a telling acronym, for sure).

These compromised proteins cross-link with each other in a manner that disrupts their function. Collagen fibers that should slide past each other become rigid and tear under stress. Skin wrinkles, ligaments tear, and the lens of your eye can start to block light (glaucoma). Consistently high levels of exposure are recorded by your blood cells as the hemoglobin becomes glycated. Blood tests can thereby show your general glucose and fructose levels over the three months preceding the test and indicate a pre-diabetic condition.

Notably, fructose attaches to proteins seven to ten times faster than glucose, and it is harder for your body to undo these attachments.  Following simple logic, that makes you age up to ten times faster, or faster than your dog.

Eating a reasonable amount of fruit is not a problem.  Beware of how easy it is to consume too much dried fruit, though. And remember that the true nutritional value of fruit resides in its vitamins, antioxidants and fiber.  When consumed whole, the potential negative metabolic impact of the sugars within is greatly lessened by the presence of the other nutrients, especially the fiber. Consuming ‘fruit sugar’ isolated from these beneficial components of fruit, including fruit juice, is a far more dangerous game to play with your metabolism.

Knowing how your body responds to fructose enables you to make more healthful choices regarding food and beverages. Choose well, live well.

Chris Zenyuh is a science teacher at Harborfields High School and has been teaching for
30 years.

Stock photo.

It’s time to connect sugars to metabolic dysfunction. As a quick reminder, sugar is a paired unit made up of glucose and fructose.  These are the same two sugars (a term that can be used generically for the various related calorie-bearing sweeteners) that comprise high fructose corn syrup. Also notable is that starch is composed of long chains of glucose. Consuming too much of any or all of these substances puts stress on your body in numerous ways. Our individual metabolic vulnerabilities fall prey to this stress, as some individuals may develop diabetes and others cardiovascular disease, etc. This lesson will focus on the stress that too much glucose can place on your metabolism.

Since your body can use glucose for energy, we are quick to accept this “blood sugar” as a good thing. We are equally inclined to believe the marketing that encourages us to buy more (sport drinks, pasta, etc.) especially if we also believe the claims that dietary fat is unhealthy. It turns out, however, high blood levels of glucose (more than two teaspoons) can be lethal. Consuming a typical sugary beverage (or a bagel) threatens to introduce five to 10 times that amount.   

Chris Zenyuh.

Luckily, your body is equipped to protect itself from such assaults and in the case of a glucose “rush,” it calls upon cells buried within your pancreas to produce insulin.  Insulin works like a verbal command to your fat cells, directing them to remove glucose from your blood before it can reach dangerous levels.  The more glucose consumed, the more insulin produced and the more your fat cells are called into action. (Notably and ironically, high insulin levels actually reduce the ability of your muscle cells to absorb this energy, leaving them, and you, still hungry.)

These verbal directions, when repeated frequently throughout the day, become tiresome to your fat cells, which develop a sort of hearing loss described by the medical community as “insulin insensitivity.” Progressively more insulin than before will be required to get the job done, crossing the line to a pre-diabetic state. Eventually, the cells become unable to “hear” the insulin commands (insulin resistance), a condition known as diabetes.

If that is not concerning enough, insulin also functions as an inflammatory signal to your body. Inflammation, a topic of its own, is a critical component of our health maintenance. It should work in concert with our natural repair mechanisms. But when out of balance, it inhibits our recovery from even normal wear and tear. One may develop arthritis, cardiovascular disease, and/or require extended recovery times for illness and injury.

Recent research places the blame for heart attacks on the inflammation that can develop along the walls of your arteries. Ironically, the cholesterol that was once thought to be the culprit is now seen as evidence of your body’s attempts to repair this inflammation.

Similarly, obesity, once viewed as a pre-cursor to diabetes, is now known to be just one symptom of glucose management malfunction that may occur as diabetes progresses. The acronym TOFI (Thin on the Outside, Fat on the Inside) has been coined to describe individuals who appear healthy, but have metabolic dysfunction that is dangerously real.

Our society has yet to learn the difference between looks and health. Many thin individuals are unknowingly pre-diabetic or at risk for heart disease. Even the acronym TOFI continues to promote the stereotype that fat is unhealthy. And yet, there are plenty of active, overweight individuals who are metabolically healthier than many of the thin people who judge them.

Whether absorbed from starchy foods or literally half of table sugar, glucose represents both an energy source and a cause of disease, depending on the amount and frequency of its consumption. Knowing how your body metabolizes glucose is an important step in being able to make better food and beverage choices for a healthier life.  Choose well, live well. “Chow for now!”

Chris Zenyuh is a science teacher at Harborfields High School and has been teaching for
30 years.

Chris Zenyuh.
Chris Zenyuh.

I have had the privilege of teaching high school science (biology, chemistry and physics) for the last thirty years. For the last ten years, I’ve had the additional privilege and responsibility of developing and teaching an elective we simply call “Food Science.” It’s not your usual health class dietary guidelines, nor does it rehash the familiar mantras of counting calories and exercising to balance intake. Instead, we study the cultural, historical, scientific, political and economic contexts of our food system and how that system impacts our environments, both external and internal. This in turn enables students to make much more informed decisions about what they want to put in their bodies.

When it comes to sugars, confusion is the name of the game. There are dozens of ingredients that mark the presence of sugars in our food: maltodextrin, dextrose, invert sugar, cane sugar, high fructose corn syrup and starch, to name a few. Regardless of what the food industry calls them, your body sees basically three end products of their digestion: glucose, fructose and galactose. Which ones you eat, and how much, will dictate both their value and their danger to you.

You may have heard of three additional sugars — lactose, sucrose and maltose. Lactose is a combination of one glucose and one galactose. Also known as “milk sugar,” lactose is the nemesis of lactose-intolerant individuals who lack sufficient quantities of the enzyme that can digest it. Instead, bacteria that reside in their intestines get to process it, making painful amounts of gas as a by-product. Galactose can be converted to glucose in your body, but most individuals do not consume enough dairy to make this a source of concern.

Maltose is another type of sugar. It is a pairing of two glucose units and is the namesake for maltodextrin, etc. Consuming foods with maltose adds glucose to your diet — worth keeping track of as part of your total glucose consumption.

However, the most likely source of sugars in your diet is either sucrose or high fructose corn syrup. Sucrose, known also as table sugar, can be derived from sugar cane (cane sugar) or sugar beets (sugar.) Like lactose and maltose, sucrose is a paired structure, made of one glucose subunit and one fructose subunit. That is what your body absorbs regardless of the source (even organic.)

Sparing you the science behind its production, high fructose corn syrup is approximately half glucose, and half fructose too. Regardless of the marketing efforts by the Sugar Association and the Corn Refiners Association to make you believe one is better for you than the other, they end up, metabolically, in a virtual tie. Debating which to consume is a distraction from the consequences of consuming too much of either, or both.

Stock photo.

The consumption of sugar (the term is legally owned by the Sugar Association as the sole name for sucrose) used to be limited by the relative expense and difficulty in obtaining it from its tropical source. Now the record levels of corn production in America have made it relatively cheap to produce and distribute sugar’s nearly identical-tasting competitor, high fructose corn syrup. You can find it in soda for sure, but also in pickles, peanut butter, ketchup and pretty much anywhere sugar might be used for additional appeal to consumers.

This has paved the way for the combined consumption of these sweeteners to reach more than 150 pounds per year per person in America. This far surpasses the 60 pounds per year considered by some experts to be the maximum amount that can be metabolized without ill consequences including diabetes, cardiovascular disease, fatty liver, cataracts, personality and cognitive dysfunction, some cancers and (by the way) obesity.

Tying glucose and fructose consumption to the metabolic consequences noted above requires further discussion. And now, you are properly prepared for those lessons. As we say in Food Science class, “Chow!”

Chris Zenyuh is a science teacher  at Harborfields High School and has been teaching for 30 years.

Hoyt Farm Nature Preserve in Commack hosted a maple sugaring event this past Sunday, Feb. 28, where employees of the park demonstrated both Native American and colonial techniques on maple sugaring.

All participants were able to taste real maple syrup after they learned how to tap a tree for it in their own backyards and also learned about tree anatomy and photosynthesis.

The community roamed around Benner’s Farm in Setauket in search of sweets on Saturday, Feb. 20, during its annual Maple Sugaring Day. Families learned the history of maple sugaring, how to tap trees, turn sap into syrup and how to make sugar candies. Participants also enjoyed freshly made pancakes with farm-made syrup. Maple syrup, sugar candies and jams were also sold during the event.

In between eating pancakes, learning about maple sugaring and sampling sap from a tree, families roamed the farm to visit the animals and treat some to a leftover pancake. Children played on the Big Swing up in the woods and visited with the resident barn cats, Lightning, Thunder and Storm. A sweet time was had by all!

Kelan Benner boils down the sap over a wood fire in a previous year. File photo

February is always sweet at Benner’s Farm in Setauket.

The farm, located at 56 Gnarled Hollow Road, will hold its annual Maple Sugaring Day on Saturday, Feb. 20, from noon to 4 p.m. Although the Benners tapped their Norway maple trees last month, the community can come down to learn about the sugaring process from how to tap the trees to boiling down the sap.

Those who wish to attend the event will see the Benners collect and boil the sap down to syrup, see how to make maple sugar candies and enjoy fresh flapjacks drizzled with the syrup collected earlier that day. Owner Bob Benner will also teach residents about the history of maple sugaring and its ties to Native Americans.

While sticky sweet syrup is the main focus of the farm’s Maple Sugaring Day, families can sip hot chocolate and visit Benner’s farm animals during the event. Maple syrup, sugar candies and other maple-based products will also be available for sale.

The Benners started maple sugaring shortly after establishing the farm 39 years ago. The family started its annual maple sugaring event when they opened the event to the public around 1978.

“The event came after we started maple sugaring … we had been tapping our trees [and] as we have lived on the farm. More and more things we share with the public because they’re interested,” said Benner.

According to Benner around 100 people attended the event in the first few years alone. While the sugaring process has changed over the years, the Benners stick to boiling down their sap over a wood fire. Benner said the smoke from the wood enhances the syrup’s flavor.

While sugar maple trees are traditionally used for sugaring events, Benner said people can collect sap from a variety of trees. The farm produces around two to three gallons of syrup annually, but this year may be a little different. The warmer weather earlier this winter gave the trees more time to produce and store more sap, which helps the tree blossom during the spring.

“This is really the beginning of spring because the trees are making sugar [to have enough energy to blossom], Benner said. “Most plants do something like that but maple makes a lot.”

Scouts and small groups can register separately for the farm’s Maple Sugaring tours on Feb. 19 to the 21. Admission for these tours is $10 per person.

Admission for the public event on Saturday, Feb. 20, from noon to 4 p.m. is $8 for adults and $6 for senior citizens and children under 12 years old. Proceeds benefit Homestead Arts, a non-for-profit organization that was established to increase interest in homesteading, folklore and agricultural arts. For more information, call 631-689-8172 or visit the farm’s website at www.bennersfarm.com.

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We should all reduce the amount of added sugar we consume, because of its negative effects on our health. It is recommended that we get no more than 5 to 15 percent of our diet from added sugars and solid fats, combined. (1) However, approximately 13 percent of our diet is from added sugars alone. (2)

Is all sugar bad for us? The answer is not straightforward. It really depends on the source, and when I mention source, my meaning may surprise you.

We know that white, processed sugar is bad. But, I am constantly asked which sugar source is better: honey, agave, raw sugar, brown sugar or maple syrup? None are really good for us; they all raise the level of glucose (a type of sugar) in our blood. Two-thirds of our sugar intake comes from processed food, while one-third comes from sweetened beverages, according to the most recent report from the CDC. (2) Sweetened beverages are defined as sodas, sports drinks, energy drinks and fruit juices. That’s right: even 100 percent fruit juice can raise our glucose levels. Don’t be deceived because it says it’s natural and doesn’t include “added” sugar.

These sugars increase the risk of, and may exacerbate, chronic diseases, such as diabetes, heart disease, high blood pressure, cancer and obesity. This is such a significant problem that California’s legislature is considering adding warning labels to sweetened drinks. (3) The label would indicate that added sugars can increase the risk of diabetes and obesity, as well as tooth decay.

However, I did say that sugar’s source impacts its effect. Most fruits have beneficial effects in preventing disease, including diabetes, and do not raise sugar levels, even in patients with diabetes. It is a myth that whole fruit raises your sugar levels. However, dried fruits, fruit juice, and fruit concentrate do raise your sugar levels. Note that sugar extracted from fruit has an effect similar to that of sugar added to foods and sweetened beverages. Let’s look at the evidence.

Heart disease
When we think of sugar’s effects, heart disease is not usually the first disease that comes to mind. However, results from a 20-year study of 31,000 U.S. adults showed that, when comparing those who consumed the least amount of added sugar (less than 10 percent of calories daily), with those who consumed 10 to 25 percent and those who consumed more than 25 percent of daily calories from sugar, there were significant increases in risk of death from heart disease. (4) The added sugar was from foods and sweetened beverages, not from fruit and fruit juices.

This was not just an increased risk of heart disease, but an increased risk of cardiovascular death. This is a wake-up call to rein in our sugar consumption.

Obesity and weight gain
Does soda increase obesity risk? A recent assessment published in PLoS One, a highly respected, peer-reviewed journal, showed that it depends whether studies were funded by the beverage industry or had no ties to any lobbying groups.(5) Study results were mirror images of each other: studies not affiliated with the industry show that soda may increase obesity risk, while studies funded by the beverage industry show there may not be any association.

In studies without beverage industry funding, greater than 80 percent (10 of 12) showed associations between sugary drinks and increased weight or obesity, whereas with the beverage industry-funded studies, greater than 80 percent of them did not show this result (5 of 6). The moral of the story is that patients must be diligent in understanding studies’ funding, and if the results sound odd, they probably are. If this is the case, make sure to ask your doctor about the studies’ findings. Not all studies are equally well-designed.

Diabetes and the benefits of fruit
Diabetes requires the patient to limit or avoid fruit altogether, correct? This may not be true. Several recent studies may help change the long-standing, commonly held paradigm that fruit should be restricted in patients with diabetes and to prevent development of diabetes.

One study found that whole fruit may reduce the risk of diabetes by reducing inflammation and reducing insulin resistance. (6) Specifically, results demonstrated a reduction in the inflammatory biomarker hsCRP. Ultimately, this may result in better glucose control. A potential reason for these impressive results may be the high levels of flavonoids, specifically anthocyanins and flavones. Flavonoids, as a class, are phytochemicals (plant nutrients) that provide pigment to fruits and vegetables and may have substantial antioxidant activities. Substances that are high in these two flavonoids include red grapes, berries, tea and wine.

Another study, a meta-analysis that looked at three large studies, including the Nurses’ Health Study, NHS II, and the Health Professionals Follow-up Study, showed that those who consumed the highest amount of anthocyanins were likely to experience a 15 percent reduction in the development of type 2 diabetes. (7) Researchers compared those in the highest quintile of anthocyanin consumption with those in the lowest quintile.

Specifically, at least two servings of blueberries per week were shown to reduce the risk of diabetes by 23 percent, and at least five servings of apples and pears per week were also shown to reduce the risk by 23 percent. These were compared to those who consumed less than one serving per month. This is a small amount of fruit for a significant reduction.

From the same three studies, it was also shown that grapes, bananas and grapefruit reduce the risk of diabetes, while fruit juice and cantaloupe may increase risk. (8)

In still another diabetes study, involving those who were newly diagnosed with type 2 diabetes, the risk of increasing glucose levels was no greater in those who consumed more than two servings of fruit per day compared to those who consumed fewer than two servings per day. (9) For more details on this study, please review my March 14, 2013, article, “Diabetes: looking beyond obesity to other factors.”

The properties of flavonoids, for example found in whole fruit, may also result in anticancer and anticardiovascular disease properties, the opposite of added sugars. (10)

Chronic disease incidence and complications from these diseases have skyrocketed in the last several decades. Therefore, any modifiable risk factor should be utilized to decrease our risk. By keeping added sugar to a minimum in our diets, we could make great strides in the fight to maintain our quality of life as we age.
We don’t have to avoid sugar completely; we still can satiate a sweet tooth by eating ripe fruits. Our access to fruit, even off-season, has expanded considerably. The most amazing thing is that fruit may actually reduce the risk of diabetes, something for years we thought might exacerbate it.

References: (1) 2010 Dietary Guidelines for Americans. (2) cdc.gov. (3) reuters.com. (4) JAMA Intern Med. online February 03, 2014. (5) PLoS Med. 2013 Dec;10(12):e1001578. (6) J Nutr. 2014 Feb;144(2):202-8. (7) Am J Clin Nutr. 2012 Apr;95(4):925-33. (8) BMJ. online August 29, 2013. (9) Nutr J. published online March 5, 2013. (10) Plant Foods Hum Nutr. 2004 Summer;59(3):113-22.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website medicalcompassmd.com or consult your personal physician.