Tag Archive for: sucrose

Myths Busted: Eat Your Fruit

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If you’ve watched the video, you know Dr. Berry gave three myths of the sugars in fruit. We addressed Myth One and Myth Two in Tuesday’s Memo. Today let’s examine Myth Three, and then consider whether fruit will cause non-alcoholic fatty liver disease.

Myth Three: Fiber, Vitamins, Minerals, and Phytonutrients Aren’t Important

This myth is sort of grasping at straws to try to prove a point. He claims that the fiber, vitamins, minerals, and phytonutrients in fruit are meaningless because of all the sugar in the fruit. He makes the comparison of adding those nutrients to a 20-ounce cola and then asking if we would feed that to our child.

Let’s get the facts straight. A 3.3 ounce orange contains a total of 8.5 grams of sugars with all the associated nutrients that he’s saying aren’t important, and he’s comparing that to a 20-ounce cola with 65 grams of high-fructose corn syrup with some of those nutrients added. While the molecules may be identical (Myth Two), there are differences in metabolism between sucrose and high-fructose corn syrup he doesn’t seem to understand. A better way would have been to use equivalent serving sizes. Even better, don’t force an issue that’s marginal, at best, and uses observational science as the foundation.

Okay, I’ve used the term “observational science” several times—what does that mean? Dr. Berry appears to be a very good physician who has helped many people overcome type 2 diabetes and other metabolic disorders using a ketogenic diet. He deserves credit for that, but when you use what you observe as the basis for recommendations for everyone, that’s stretching it.

According to an observational rooster, his crowing makes the sun rise every morning. Observation alone isn’t enough basis for these kinds of recommendations. Unless you have documentation that someone eating 3.3 ounces of lemon containing a total of 2.3 grams of all sugars will spike her insulin and glucose levels, the argument is baseless. In fact, every example he gave should have actual examples to support it, not from the published science but from actual experience. (That would be easy enough to do just by feeding subjects the food in question and then checking their blood sugar at certain intervals.) And it should be published as a case study in a medical journal, because that metabolic response would be unusual to say the least. Until then, it’s observational science and is not meaningful applied to anyone else. Leave the observational science behind unless you have the data to support it.

The Bottom Line

In doing the background research, I found that eating fruit does not appear to be a cause of non-alcoholic fatty liver disease or even a fatty liver. Obesity always seems to precede metabolic disorders that lead to a fatty liver in the vast majority of people. The DASH Diet and the Mediterranean diet, which both recommend fruit, are often recommended to treat a fatty liver, and research shows they work—and that’s the complete opposite of what he recommends.

If you’re concerned about a fatty liver, don’t give that banana or bowl of berries a second thought; focus instead on weight reduction. As always, the key is the calories. Eat less. Eat better. Move more.

What are you prepared to do today?

        Dr. Chet

References:
1. Br J Nutr. 2020 Jul 14; 124(1): 1–13.
2. Iran J Public Health. 2017 Aug; 46(8): 1007–1017.

Fruit and Fatty Liver Disease

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Non-alcoholic fatty liver disease (NAFLD) is on the rise in the U.S. and around the world. Estimates are by 2030, NAFLD will be the primary cause of liver transplants in the world. NAFLD is caused by obesity; associated conditions such as type 2 diabetes and metabolic syndrome are contributing factors. But does fruit intake contribute to NAFLD? According to one physician it does; that inspired him to record a video titled “Secret Sugar in Fruit” or as he calls it, the Three Myths of Fruit. He’s an advocate of the ketogenic diet, as many people are today, but is he correct about fruit? I thought I’d check it out.

Myth One: Fruit Contains Only Fructose

His opening statement about fruit is that nutritionists and Internet gurus are suggesting that fructose is the only sugar in fruit. He gives examples of the breakdown of sugars in five fruits, based on the USDA Food Database. No problem with that. But to say that most nutritionists don’t know that fruit contains a variety of sugars means he’s never had a basic nutrition class on macronutrients, because it’s certainly taught in those classes. Anyone who’s ever looked up any type of fruit on the database would clearly see there’s more than one type of sugar.

He also claims that the sugar in some small servings of fruit with as little as two grams of glucose or sucrose will spike blood sugars and insulin levels and that five grams of fructose will cause a fatty liver. He offers no evidence to support those claims.

Myth One contains some accurate facts but is more observational science than fact. Myth One: busted.

Myth Two: The Chemical Structure of Sugars

According to Dr. Berry, nutritionists claim that the chemical structure of glucose, fructose, and sucrose are different in fruit than soda. Not exactly true; they’re chemically identical, but there’s more to it than that. Myth Two: mostly busted.

I’ll cover the third myth on Saturday and set the record straight on fruit and NAFLD. You can watch the short video at the link below. He’s a personable guy, committed to keto, but reliant on observational science. We’ll talk about why that’s a problem next time.

What are you prepared to do today?

        Dr. Chet

References:
1. Gastroenterology. 2020 May;158(7):1851-1864.
2. https://www.youtube.com/watch?v=URMLzoK95V4

The Actual Effects of Sucralose

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Continuing the examination of the study on diet drinks and appetite, let’s get into the details of the study. The MRI portion of the study is difficult to interpret for the layperson. The researchers seemed to think that based on the brain response, obese women would be more susceptible to overeating after consuming a drink with sucralose than sucrose. Did they eat more? More important, did their blood values vary abnormally?

Blood Response to Sucralose

To me, the most significant finding was that there were no abnormal physical responses to sucralose. A prior study suggested that sucralose raises blood insulin in anticipation of sugar following a drink sweetened with artificial sweeteners, but that didn’t happen in this study. There were no differences in blood sugar, insulin, glucagon-like peptide-1, or other measures in response to sucralose that differed from drinking water (the placebo). That in and of itself is a significant finding.

Eating Response to Sucralose

The average buffet intake two hours after consuming the drinks was about 900 calories regardless of whether the subjects had the drinks with sucrose, sucralose, or plain water.

It should be noted that the food intake varied by +/- 450 calories. When analyzed by weight class and gender, obese women ate about 100 calories more after the sucralose drink, but that’s still fewer calories than if they’d consumed a 300-calorie sugar drink. The subjects served as their own controls, meaning they were tested under each drink condition.

In this case, seeing the raw data for every subject might have helped. The subjects were tested in random order but by the third exposure to the same buffet items, they might have decided to eat more or less of their favorite snack foods.

More

The NPR science writer chose the title “Diet soda may prompt food cravings, especially in women and people with obesity.” In a television courtroom drama, they’d call that “assuming facts not in evidence.” Here’s why that title was particularly misleading: there was no diet soda used in this study. The drinks weren’t soda and they weren’t carbonated—they were more like Kool-Aid. It’s tempting to extend the idea to diet soda, but that wouldn’t take into account the effect of carbonation.

There was also no measure of food cravings. People were offered food and they ate it or they didn’t, so the headline was doubly misleading.

The Bottom Line

The study did contribute to the knowledge about artificial sweeteners, especially as they impact blood sugar and insulin. If you use sucralose, there’s no reason to stop. If you don’t, you have to decide for yourself whether you want to use it or not. Artificial sweeteners can be part of a weight loss effort, but the only way they help is if you don’t eat more to make up for the calories you’re not getting when using them. “I’m getting a diet soda, so I’ll get the large fries”—if that’s how you’re thinking, you’re missing the whole point of diet drinks. If you can maintain or decrease your caloric intake of all other foods and drinks but substitute sucralose for sugar, then you’ll be ahead of the game.

What are you prepared to do today?

        Dr. Chet

References:
1. Allison Aubrey YOUR HEALTH NPR. Diet soda may prompt food cravings, especially in women and people with obesity. October 7, 2021.
2. JAMA Network Open. 2021;4(9): doi:10.1001/jamanetworkopen.2021.26313

Does Diet Soda Increase Appetite?

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“Diet soda may prompt food cravings.” If you regularly drink diet soda with non-nutritive sweeteners such as sucralose, that headline would give you pause. Could drinking drinks with artificial sweeteners cause you to compensate later for being cheated out of calories? That’s what researchers attempted to find out in a very complex study conducted at the University of Southern California.

When I say complex, here’s what I mean. The researchers used an MRI to perform brain scans in response to photographs of different types of foods and non-foods. The 74 subjects were all tested under three conditions: after drinking 300 mL (1.25 cup) of water, 75 grams of sucrose (sugar) mixed in 300 mL water, or 300 mL of a sucralose drink matched for sweetness to the sucrose drink. Blood was tested before and after drinking the fluid at regular intervals up to two hours afterward. Then the subjects were allowed to eat as much as they wanted at a snack buffet with high-fat, high-sugar choices as well as healthy choices.

The researchers found differences in the way men and women responded to the drinks as well as the way normal, overweight, and obese subjects responded, both in the brain scans and in how much they ate at the buffet: obese women responded by eating more at the snack buffet than men or other weight classifications.

Is it time to stop drinking diet soda? A little more information from the study would be helpful before you clean out the fridge and go buy a case of Coke.

What are you prepared to do today?

        Dr. Chet

References:
1. Allison Aubrey YOUR HEALTH NPR. Diet soda may prompt food cravings, especially in women and people with obesity. October 7, 2021.
2. JAMA Network Open. 2021;4(9): doi:10.1001/jamanetworkopen.2021.26313