Dr. Robbi’s Blog

How Sugar Affects Your Health

The insulin response: The health issues that develop as a result of a high-sugar diet are strongly linked to the response of the hormone insulin to carbohydrate ingestion, a phenomenon known as the glycemic response. Simple carbohydrates such as sugar are considered high glycemic and are metabolized quickly by the body, resulting in a rapid release of insulin and a quick rise and fall in blood sugar. This is often felt as a burst of energy followed by feelings of fatigue (i.e., a crash).

Insulin resistance is a progressive condition that occurs when normal insulin activity is inadequate to produce a response on insulin receptors on muscle and adipose (fat) cells. Initial signs of insulin insensitivity include high circulating levels of both glucose and insulin. In addition, consumption of excess dietary carbohydrate can stimulate lipolysis (fat generation), resulting in higher levels of circulating triglycerides, very-low-density lipoprotein and low-density lipoprotein (VLDL and LDL, respectively) cholesterol.

Fat storage leading to disease: As the body’s ability to store excess energy becomes further impaired, fat deposition begins to occur around the internal organs. This specific form of weight gain, known as visceral fat, is characteristic of insulin resistance and is strongly linked to an increased risk for cardiovascular disease and metabolic syndrome. Insulin resistance and other metabolic disorders also appear to correlate with higher levels of C-reactive protein (CRP) and other inflammatory markers which have been strongly linked to cardiovascular risk.

Dental health and immunity: Other negative effects of high sugar consumption include its impact on dental health and immunity. Simple carbohydrates are the preferable food source for pathogenic oral and intestinal microbes such as Strep mutans and Candida albicans. A diet high in refined sugars stimulates the proliferation of these microbes and can lead to intestinal bacteria overgrowthand dental issues including cavities and gingivitis. Research has also shown that sugar may suppress immune function resulting in impairments in the body’s resistance to infections.

In addition to these adverse effects on physical health, a diet high in sugar may also influence mental and emotional well-being. High sugar intake has been linked to attention disorders, and populations that consume a diet high in refined carbohydrates are more likely to experience mental disorders such as depression and anxiety.

Other negative health effects: In addition to the aforementioned effects, a diet high in dietary sugar may also induce inflammatory destruction to other body organ systems. Advanced glycation end products (AGEs) are toxic compounds that are formed when circulating sugars combine with the free amino acid groups of proteins, nucleic acids, and lipids. AGEs exert their toxic effects by promoting pathogenic cellular alterations which result in widespread inflammation and tissue damage. AGEs are now seen as a key influential factor in the development of arthritis, heart disease, asthma, and accelerated aging due to their mediation of pro-inflammatory activity. AGEs are also found in the brains of dementia patients, and may contribute to the neurofibrillary tangles that are characteristic of Alzheimer’s disease.

How to Limit Your Sugar Intake

Increased understanding of the damaging effects of AGEs has led to the realization that reducing sugar intake could have positive effects all across the health spectrum. The first step to limiting dietary sugar intake is to identify what the sources are in your diet. While many of us associate sugar with sweet foods, like pastries and candy, these types of foods only contribute to about 10 percent of overall sugar intake. High contributors of dietary sugar include sweetened beverages like sodas and juices as well as processed foods such as sauces and dressings. It is important to recognize that sugar is not only added to food to increase sweetness; it also has “hygroscopic” properties that contribute to a food’s moisture content and mouth-feel. These attributes are why sugar is often added to unexpected foods, like spaghetti sauce and bread, and why it enjoys such widespread distribution within our food supply.

Recognizing the sources of sugar in your diet can require some savvy label reading skills. Sugar can be listed on food packages in a variety of ways, including glucose, fructose, dextrose, corn syrup, sucrose, and cane sugar, to name a few.

As a consumer, it is important to recognize that all of these are types of sugar, and as a result all can cause negative health effects. A particular form of sugar used in processed foods, high-fructose corn syrup (HFCS), may be especially damaging. HFCS is one of the most commonly used sweeteners in the U.S., and is produced from corn starch via a series of enzymatic processes. Clinical research now shows that HFCS may present more health risks than regular cane sugar. Opponents of the use of HFCS claim that it promotes elevated triglycerides, weight gain, and the formation of AGEs. Studies have shown that soda beverages sweetened with HFCS are more likely to contain methylglyoxal derivatives, a form of AGE that has been linked to diabetic complications.

Watch Out for Sugar Substitutes

When looking to reduce dietary sugar intake, many of us turn to artificial sweeteners or sugar substitutes as an alternative option. The most common non-nutritive artificial sweeteners used in our food supply today are aspartame, saccharin, acesulfame K and sucralose. Since being introduced into the American diet, there have been handfuls of published studies linking the use of artificial sweeteners to conditions such as cancer and attention deficit disorder.

According to the FDA, none of these claims has been backed extensively by clinical research, and the use of artificial sweeteners continues to be prevalent within our food supply. Recent research, however, has shown that regular use of artificial sweeteners may actually promote weight gain and interfere with appetite control mechanisms. Ingestion of artificial sweeteners still initiates an insulin response from the pancreas as a means of inducing carbohydrate metabolism. Since artificial sweeteners provide no carbohydrate value, insulin levels remain high, leading to hypoglycemia and increased hunger. This interference with appetite control mechanisms can lead to overconsumption of food at the next meal. The correlation between artificial sweeteners and increased food intake may indicate that their use is not supportive in weight management protocols.

Sugar has become as much of a part of American culture as apple pie. Unfortunately, the adverse health conditions associated with sugar intake have also become a prevalent component of our society. Reducing dietary sugar intake can be challenging, but the numerous associated health benefits make it well-worth the effort.

If your current diet is high in refined sugars, try taking small steps to regulate your intake. Cut down on soda drinking or dilute juices with water. You can also reduce your intake of processed foods and start making your own meals at home to limit your exposure to sugars that are incorporated as part of food processing. If you must use sugar, try sticking with more natural varieties, such as honey, agave, molasses, fruit, and cane sugar. Making these minor adjustments can have significant benefits on all aspects of your health and well-being.

Lots of Added Sugar … and Little Else?

Considering that for a 2,000 calorie diet, the author’s recommended sugar intake is approximately 30-50 grams per day (6-10 percent of food calories [kcals]), you might be surprised at how much sugar these classic brand-name foods contain. You might also be surprised at their relatively poor nutritional content (in some cases, the food is essentially sugar and little else) - but we’ll leave that for another article.

Nutrition

Depression is often associated with or made worse by poor eating habits; people who worry about their food choices or who gain weight as a result are less likely to feel good about themselves, which plants the seeds for poor self-esteem, anxiety and depression. Skipping meals, overeating and other unhealthy eating tactics only increase the chances you’ll feel depressed.

Relaxation

Some experts believe depression is a reaction to stress and resultant anxiety; when people get overwhelmed and see “danger” in the form of a stressful situation lurking around every corner, they may become depressed as a coping mechanism. Depression also seems to be preceded or accompanied by anxiety, which underscores the value of finding ways to limit stress.

Exercise

Evidence suggests physical activity increases the body’s ability to tolerate stress and affects the nervous system and neurohormones involved in emotion and mood. Consistent exercise also increases positive self-perception and general sense of well-being, reducing the likelihood that feelings of anxiety, negativity and depression will rear their ugly heads.

To Your Health
December, 2009

If you live in an area of the country that sees snow during the winter months, or even if you’ve only visited a part of the country that does, you know fresh snow is one of the most beautiful and peaceful things to witness.

However, you probably also know that with snow comes the need to remove it from driveways, walkways, and other traffic areas. That’s often where you - the snow-shoveler - come in.

Anyone who has shoveled snow before knows how good a workout it can be. When you consider that the average shovelful of snow weighs 5-10 pounds, the average driveway or walkway may hold hundreds of pounds of snow. But despite the benefits, shoveling snow can also be physically stressful; bending, lifting, and twisting, combined with the exposure to freezing weather conditions, can take a serious toll on the body.

Typically, the arms, shoulders and back get sore and may occasionally feel pain. The cold air invigorates most people into action; however, the same cold air can numb the sensations of pain and fatigue. Unfortunately, pain is a sign that an injury has already occurred or that mechanically you are doing something incorrect in shoveling the snow. In short, there is a right way and a wrong way to shovel snow, and paying attention to your technique can make a big difference in how you feel the next day. As with any project, the prep work is the most important. The following are some quick tips on how to shovel snow smarter:

• Be prepared. Spray your shovel with Teflon so the snow won’t stick to it. The more snow that stays on the shovel, the heavier it gets and the more chance for injury - and frustration.

• Do a warm-up first. A tight, stiff body is asking for injury. A few minutes of stretching can save you a lot of pain later. When you are shoveling, don’t forget to breathe. Holding your breath makes you tight and stiff.
  

• Layer your clothing. Layered clothing will keep your muscles warm and flexible. You can shed a layer if you get too hot. Make sure you wear gloves that cover your wrists; if your wrists get cold, your fingers, hands and arms will be cold, too.
  

• Wear the right shoes. Choose shoes with plenty of cushioning in the soles to absorb the impact of walking on hard, frozen ground.
  

• Use the right size shovel. Your shovel should be about chest high on you, allowing you to keep your back straight when lifting. A shovel with a short staff forces you to bend more to lift the load; a too-tall shovel makes the weight heavier at the end. (Note: Save your money - don’t buy a fancy ergonomic shovel; studies have shown that in some models, the hook end is too deep. Twisting to unload a shovelful of snow with this tool may hurt your wrists.) Also keep one hand close to the base of the shovel to balance weight and lessen the strain on your back.
  

• Timing is everything. Listen to weather forecasts so you can shovel in ideal conditions. If possible, wait until the afternoon to shovel. Many spinal disc injuries occur in the morning when there is increased fluid pressure in the disc because your body has been at rest all night.
  

• Drink lots of water. Drinking water frequently throughout the day helps to keep muscles and body hydrated. Be careful with hot drinks like coffee or hot chocolate. Coffee contains caffeine, which has a dehydrating effect and adds even more stress to the body.
  

• Use proper posture. When you do shovel, bend your knees and keep your back straight while lifting with your legs. Push the snow straight ahead; don’t try to throw it. Walk it to the snow bank. Try to shovel forward to avoid sudden twists of the torso and reduce strain on the back. The American Chiropractic Association recommends using the “scissors stance,” in which you work with your right foot forward for a few minutes and then shift to the front foot.
  

• Take your time. Working too hard, too fast is an easy way to strain muscles. Take frequent breaks. Shovel for about five minutes at a time and then rest for two minutes.
  

• See your chiropractor. Gentle spinal manipulation will help keep your back flexible and minimize the chance for injury. If you do overdo it, your chiropractor can help you feel better and prevent more injury.

So enjoy the snow this year, but remember that when it comes to shoveling snow, stay safe. Taking heed of these simple tips could make the difference between spending your day enjoying the new snowfall or lying in bed with a sore back, sprained ankle or other injury that could have been easily avoided. Talk to your doctor for additional information.

To Your Health
December, 2009 (Vol. 03, Issue 12)