Sugar Nation: Diabetes, Glycation, HFCS And Liver Disease

by Claudius J West

“Everyone knows that sugar isn’t good for you, but I didn’t know how dangerous it could truly be.”—-Crystal Matthews

“Everyone knows that sugar isn't good for you, but I didn't know how dangerous it could truly be.”----Crystal Matthews  In Sugar Nation, Jeff O’Connell blends his personal quest to discover the reasons and cure for his own pre-diabetes with a portrait of his father as he is gruesomely whittled down by diabetes. In this case, “whittled down” is more than a figure of speech.  If you thought the worse thing about having diabetes was finger pricks and injections, with a good chance of amputation or blindness thrown in, then you may be surprised that diabetes can get a lot worse than that.  Mr. O’Connell has written a page-turner that I found hard to put down, part autobiography, part expose. It read like a suspense novel. Perhaps that was because I was waiting for the benighted forces of medicine, the American Diabetics Association, and misled doctors to eventually get their comeuppance when commonsense and truth finally prevailed.  The sense in which truth prevails is the degree to which readers of the book respond to and use for their personal benefit (and for the health of those they love) the information O’Connell has synthesized from personal experience, peer-reviewed research and loads of interviews with top experts.  I’m not diabetic myself, though I suspect, during my soda years, I was likely pre-diabetic. Being as healthy as we can be, I believe, must take into account an appreciation of the role insulin has in our health. When our cell membranes get knocked on too often by insulin, they stop responding (known as insulin insensitivity, a bad condition for your cells to be in), which means the membranes stop letting in the glucose your cells need to survive. Without glucose, cells starve and die.  Insulin insensitivity is deleterious in other ways, too. The more insensitive your cells are, the more insulin your pancreas pumps out in order to inveigle your cells into letting the glucose through the cell membranes.   Meanwhile, all of that insulin floating around your blood turns the glucose that isn’t being absorbed by your cells into triglycerides (fatty acids). Eventually, the triglycerides get cleared out of your blood and stuffed into fat cells (called adipocytes, known to us as expanding waistlines, bulges and flab). Until that happens, excess triglycerides in the blood can cause problems that have been linked to arteriosclerosis.   Loathsome In Its Own Deliciousness  Fructose is the kind of sugar found in fruit, honey, table sugar (half fructose, half glucose) and high-fructose corn syrup (HFCS), which is to say, fructose is the kind of sugar found in just about everything you buy in a grocery store, especially soda.   Here’s the bizarre part: fructose does not have an effect on your glycemic load. (The glycemic index tells us how fast a carbohydrate gets into our blood; glycemic load takes into consideration how fast and how much. A lot of something slow can be as problematic as a little bit of something fast. Knowing the glycemic load is more useful than knowing the glycemic index.)  Hey, fructose sounds like what we want, doesn’t it? Fructose doesn’t mess with our blood sugar levels, doesn’t prompt a gush of insulin, doesn’t lead to insulin insensitivity and diabetes. This is good, right? This is something we should want more of.  Here’s the catch: because fructose doesn’t effect our blood sugar levels, we don’t get the signal that we’ve consumed enough calories and it’s time to stop consuming, so we tend to overeat and over-drink.  Where does the fructose go once it’s out of the guts? It goes straight to the liver and gets processed into triglycerides, which eventually get stuffed into fat cells.  Double-Whammy  With all of those triglycerides flying in and out of the liver, some lipids (fats) stick around and accumulate. Those accumulated lipids can lead to non-alcoholic fatty liver disease (NAFLD).   Having non-alcoholic fatty liver disease isn’t a good thing, but it gets worse: if the liver becomes inflamed, that can lead to cirrhosis. The complications and syndromes that accompany cirrhosis are legion. They’re bad, really bad. You don’t want to know. Suffice it to say that acute renal failure is on the list: no more kidneys.   Nothing about cirrhosis is reversible, but it can be stopped. How? Proper diet.  Fructose from fruits and honey, by themselves, aren’t likely to harm us because we don’t consume them in mass quantities the way we do high-fructose corn syrup. Also, the fiber in fruit acts to slow down the absorption of fructose and changes the picture entirely. It’s the difference between eating an apple, grapefruit or orange contrasted with drinking their juices.  For example, the glycemic index for an orange and orange juice is, respectively, 40 and 54, which doesn’t sound like much of a difference. For grapefruit and grapefruit juice the difference is a bit more: 25 and 48.   But consider the difference in glycemic load: for the oranges: 3 versus 12, a 400% increase for the juice; for the grapefruits: 3 versus 9, a 300% increase for the juice.   Fiber makes a whopping difference. Avoid juice. If you’re going to have fruit, eat it whole.  We’re not through beating up on high-fructose corn syrup, though; you need to know a few more crucial facts. First, most of the HFCS you encounter in your sodas, breads, cereals, breakfast bars, breakfast pastries, lunch meats (you gotta be kidding me), yogurts, soups, crackers, cookies, condiments and just about everything else, is called HFCS 55.   The 55 means that it is 55% fructose and 45% glucose. It’s another double-whammy: the 45% glucose raises your blood sugar levels while the 55% fructose raises your triglycerides and plays silly buggers with your liver, making you fatter and more susceptible to diseases coming and going.  If we consumed HFCS on a moderate basis, we would have our hands full, but with HFCS in nearly everything that comes out of a package or bottle, avoiding HFCS is hard to do, and consuming it in moderation nearly impossible.  Triple-Whammy  Here comes the sockdolager, the thing that fructose does worse than glucose does, a big reason why it’s really bad to have it in your system: “It produces what are called advanced glycation end products (“AGE”) at a rate ten times greater than that triggered by glucose. Normally, only a small fraction of your bloodstream’s sugar content becomes glycated; the rest is used for metabolism. But in diabetics with chronic hyperglycemia, AGE formation accelerates to a dangerous rate. The body can handle these rogue agents, but only slowly, since AGEs stick around twice as long as average cells. Especially prone are long-lived cells such as nerve cells, collagen proteins, and DNA; and metabolically active cells, which happen to include cells in the pancreas (beta), kidneys, and retina. Weakening of the collagen in blood-vessel walls leads to hypertension and heightens stroke risk. And fructose increases the oxidation of LDL particles, raising the specter of heart disease.” p. 171-172  Enough AGEs in your retinas equal cataracts. Glycation of the proteins in collagen and elastin (the fibers that support the skin) leads to wrinkles and saggy skin, hardly the stuff of immortality. After all, we want to be old but we don’t want to look old.  These and many more reasons to leave the sugar nation are laid out by Jeff O’Connell in his excellent book. Easier said than done, of course, even by me, a true believer in the eminently noxious and ultimately poisonous properties of sugar and refined carbs. Reading Mr. O’Connell’s words helped me every time I read them to renew my determination to eschew the bad stuff that is all around me tempting me almost beyond the capacity of my merely human willpower to resist. But the truth shall set ye free, and I found plenty to bolster my resolve in Sugar Nation.   This is a book for more than those afflicted with diabetes or pre-diabetes. If we are citizens of Sugar Nation, as we surely are, and without the benefit of extraordinary genetic gifts, and that includes most of us, then we are all headed down the road to the sinkhole of diabetes---if we live long enough. Jeff O’Connell provides the roadmap out of town and across the border. Pack your bags.                             In Sugar Nation, Jeff O’Connell blends his personal quest to discover the reasons and cure for his own pre-diabetes with a portrait of his father as he is gruesomely whittled down by diabetes. In this case, “whittled down” is more than a figure of speech.

If you thought the worse thing about having diabetes was finger pricks and injections, with a good chance of amputation or blindness thrown in, then you may be surprised that diabetes can be so much worse.

Mr. O’Connell has written a page-turner I found hard to put down, part autobiography, part expose. It read like a suspense novel. Perhaps that was because I was waiting for the benighted forces of medicine, the American Diabetics Association, and ill-informed doctors to eventually get their comeuppance when commonsense and truth finally prevailed.

The sense in which truth prevails is the degree to which readers of the book respond to and utilize for their own benefit (and for the health of those they love) the information O’Connell has synthesized from personal experience, peer-reviewed research and loads of interviews with top experts.

I’m not diabetic myself, though I suspect, during my soda years, I was likely pre-diabetic. Being as healthy as we can be, I believe, must take into account an appreciation of the role insulin has in our health. When our cell membranes get knocked on too often by insulin, they stop responding (known as insulin insensitivity, a bad condition for your cells to be in), which means the membranes stop letting in the glucose your cells need to survive. Without glucose, cells starve and die.

Insulin insensitivity is deleterious in other ways, too. The more insensitive your cells are, the more insulin your pancreas pumps out in order to inveigle your cells into letting the glucose through the cell membranes.

Meanwhile, all of that elevated insulin floating around your blood turns the glucose that isn’t being absorbed by your cells into triglycerides (fatty acids). Eventually, the triglycerides get cleared out of your blood and stuffed into fat cells (called adipocytes, known to us as expanding waistlines, bulges and flab). Until that happens, excess triglycerides in the blood can cause problems that have been linked to arteriosclerosis.

Loathsome In Its Own Deliciousness

corn-syrup

High-Fructose Corn Syrup

Fructose is the kind of sugar found in fruit, honey, table sugar (half fructose, half glucose) and high-fructose corn syrup (HFCS), which is to say, fructose is the kind of sugar found in just about everything you buy in a grocery store, especially soda.

Here’s the bizarre part: fructose does not have an effect on your glycemic load. (The glycemic index tells us how fast a carbohydrate gets into our blood; glycemic load takes into consideration how fast and how much. A lot of something slow can be as problematic as a little bit of something fast. Knowing the glycemic load is more useful than knowing the glycemic index.)

Fructose sounds like what we want, doesn’t it? Fructose doesn’t mess with our blood sugar levels, doesn’t prompt a gush of insulin, doesn’t lead to insulin insensitivity and diabetes. This is good, right? This is something we should want more of.

fishing-hookHere’s the catch: because fructose doesn’t affect our blood sugar levels, we don’t get the signal that we’ve consumed enough calories and it’s time to stop consuming, so we tend to overeat and over-drink.

Where does the fructose go once it’s out of the gastrointestinal tract? It goes straight to the liver and gets processed into triglycerides, which eventually get stuffed into our fat cells.

Double-Whammy

With all of those triglycerides flying in and out of the liver, some lipids (fats) stick around and accumulate. Those accumulated lipids can lead to non-alcoholic fatty liver disease (NAFLD).

Having non-alcoholic fatty liver disease isn’t a good thing, but it can get worse: if the liver becomes inflamed, that can lead to cirrhosis. The complications and syndromes that accompany cirrhosis are legion. They’re bad, really bad. You don’t want to know. Suffice it to say that acute renal failure is on the list: kiss your kidneys good-bye.

Nothing about cirrhosis is reversible, but it can be stopped. How? Proper diet.

Fructose from fruits and honey, by themselves, aren’t likely to harm us because we don’t consume them in mass quantities the way we do high-fructose corn syrup. Also, the fiber in fruit acts to slow down the absorption of fructose and that changes the picture entirely. It’s the difference between eating an apple, grapefruit or orange contrasted with drinking their juices.

For example, the glycemic index for an orange and orange juice is, respectively, 40 and 54, which doesn’t sound like much of a difference. For grapefruit and grapefruit juice the difference is a bit more: 25 and 48.

But consider the difference in glycemic load: for the oranges: 3 versus 12, a 400% increase for the juice; for the grapefruits: 3 versus 9, a 300% increase for the juice.

Fiber makes a whopping difference. Avoid juice. If you’re going to have fruit, eat it whole.

We’re not through beating up on high-fructose corn syrup, though; you need to know a few more crucial facts. First, most of the HFCS you encounter in your sodas, breads, cereals, breakfast bars, breakfast pastries, lunch meats (you gotta be kidding me), yogurts, soups, crackers, cookies, condiments and just about everything else, is called HFCS 55.

The 55 means that it is 55% fructose and 45% glucose. It’s another double-whammy: the 45% glucose raises your blood sugar levels while the 55% fructose raises your triglycerides and plays silly buggers with your liver, making you fatter and more susceptible to diseases coming and going.

If we consumed HFCS on a moderate basis, we would have our hands full, but with HFCS in nearly everything that comes out of a package or bottle, avoiding HFCS is hard to do, consuming it in moderation nearly impossible.

Triple-Whammy

children-of-the-corn-cover-art

In Sugar Nation, we are all children of the corn.

Here comes the sockdolager, the thing that fructose does worse than glucose, and a big reason  it’s really bad to have it in your system: “It produces what are called advanced glycation end products (“AGE”) at a rate ten times greater than that triggered by glucose. Normally, only a small fraction of your bloodstream’s sugar content becomes glycated; the rest is used for metabolism. But in diabetics with chronic hyperglycemia, AGE formation accelerates to a dangerous rate. The body can handle these rogue agents, but only slowly, since AGEs stick around twice as long as average cells. Especially prone are long-lived cells such as nerve cells, collagen proteins, and DNA; and metabolically active cells, which happen to include cells in the pancreas (beta), kidneys, and retina. Weakening of the collagen in blood-vessel walls leads to hypertension and heightens stroke risk. And fructose increases the oxidation of LDL particles, raising the specter of heart disease.” p. 171-172

Enough AGEs in your retinas equal cataracts. Glycation of the proteins in collagen and elastin (the fibers that support the skin) leads to wrinkles and saggy skin, hardly the stuff of immortality. After all, we want to be old but we don’t want to look old.

These and many more reasons to flee the sugar nation are laid out by Jeff O’Connell in his excellent book. Easier said than done, of course, quitting sugar and refined carbs, even by me, a true believer in the noxious and eminently dangerous properties of sugar and refined carbs. Mr. O’Connell’s words helped me every time I read them to renew my determination to eschew the bad stuff all around me and tempting me almost beyond the capacity of my merely human willpower to resist. But the truth shall set ye free, and I found plenty to bolster my resolve in Sugar Nation.

children of the corn

Malachai likes corn, too. You know he does.

This is a book for more than those afflicted with diabetes or pre-diabetes. If we are citizens of Sugar Nation, as we surely are, and if we are without the benefit of extraordinary genetic gifts, and that includes most of us, then we are all headed down the same road leading to the sinkhole of diabetes—if we live long enough. Jeff O’Connell provides the roadmap out of town and across the border.

Pack your bags. It’s time to leave.

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