Tuesday, April 21, 2009

Fructose vs. Glucose Showdown

As you've probably noticed, I believe sugar is one of the primary players in the diseases of civilization. It's one of the "big three" that I focus on: sugar, industrial vegetable oil and white flour. It's becoming increasingly clear that fructose, which constitutes half of table sugar and typically 55% of high-fructose corn syrup, is the problem. A reader pointed me to a brand new study (free full text!), published in the Journal of Clinical Investigation, comparing the effect of ingesting glucose vs. fructose.

The investigators divided 32 overweight men and women into two groups, and instructed each group to drink a sweetened beverage three times per day. They were told not to eat any other sugar. The drinks were designed to provide 25% of the participants' caloric intake. That might sound like a lot, but the average American actually gets about 25% of her calories from sugar! That's the average, so there are people who get a third or more of their calories from sugar. In one group, the drinks were sweetened with glucose, while in the other group they were sweetened with fructose.

After ten weeks, both groups had gained about three pounds. But they didn't gain it in the same place. The fructose group gained a disproportionate amount of visceral fat, which increased by 14%! Visceral fat is the most dangerous type; it's associated with and contributes to chronic disease, particularly metabolic syndrome, the quintessential modern metabolic disorder (see the end of the post for more information and references). You can bet their livers were fattening up too.

The good news doesn't end there. The fructose group saw a worsening of blood glucose control and insulin sensitivity. They also saw an increase in small, dense LDL particles and oxidized LDL, both factors that associate strongly with the risk of heart attack and may in fact contribute to it. Liver synthesis of fat after meals increased by 75%. If you look at table 4, it's clear that the fructose group experienced a major metabolic shift, and the glucose group didn't. Practically every parameter they measured in the fructose group changed significantly over the course of the 9 weeks. It's incredible.

25% of calories from fructose is a lot. The average American gets about 13%. But plenty of people exceed that, perhaps going up to 20% or more. Furthermore, the intervention was only 10 weeks. What would a lower intake of fructose, say 10% of calories, do to a person over a lifetime? Nothing good, in my opinion. Avoiding refined sugar is one of the best things you can do for your health.

U.S. Fructose Consumption Trends
Peripheral vs. Ectopic Fat
Visceral Fat
Visceral Fat and Dementia
How to Give a Rat Metabolic Syndrome
How to Fatten Your Liver

49 comments:

Tom Jeanne said...

Wow, possibly the most compelling evidence yet that excess fructose is highly detrimental to the body. Thanks for the analysis and commentary!

Gyan said...

That avg consumption of sugar is 25% total Cal does not imply that fructose consumption is 13%. You are forgetting Lactose.
My own typical sugar consumption is ~15%. I take no sugared drinks and only slight sugar in tea. But I drink a lot of milk and unsugared yogurt.

Robert Andrew Brown said...

Great find Stephan, and thanks to whom ever sent to you.

Staggering implications.

It make perfect sense

Unknown said...

Would you dileneate more on the the differences between fructose and glucose?
Are we talking refined sugar here or the fructose found on many commons fruits and root vegetables?
I am somewhat concerned and would like to hear your opinion.
Thanks.

youngblood.carl said...

Same question as DO. Does this imply (excess?) fruit is also bad for you?

Thanks!

Anonymous said...

So if I read it right, the beverages were either 100% Fructose sweetened or 100% Glucose sweetened. I wish they had run a third set at a 50/50 combo (like regular sugar). Could this study also change the thinking on the glycemic index? Thinking specifically with regards to fruits.

Jenny Light said...

Stephan:

What is your opinion on raw honey? That, and stevia are the only sweeteners that I allow in my diet. I use honey very, very sparingly.

A quick search in Pub shows 4,135 items, so much research has apparently been done. Several very good books have been written on the subject as well.

I feel that honey's many medicinal qualities outweigh any potential negatives. It has also helped curb any temptation I might have in the grocery store, as virtually nothing is sweetened with honey exclusively. If I want something sweet, I have to make it myself!

Ed said...

Gyan -- read the related post, http://wholehealthsource.blogspot.com/2008/05/us-fructose-consumption-trends.html. It really is the non-milk sugars.

DO, youngblood, and Jenny -- "fructose" is what it is, no matter the source. The difference is in quantity. Read http://wholehealthsource.blogspot.com/2008/11/fructose-index-is-new-glycemic-index.html, and the discussion that followed. Target a limit of 15-40 grams of fructose per day from all sources. My understanding is that lower is better, but some small amount may be better than zero.

Anna said...

Oh, I know lots of people who are avoiding refined sugar...but they use honey pretty liberally (high in fructose) and worse, they use agave syrup with abandon, because they're convinced by the marketing of agave as a low-glycemic sweetener that it is a "get out of jail card". Hmmmph!

Monica said...

Great post.

There's no question that honey is like magic for wounds. *Raw* honey has a couple of antibacterial enzymes and, depending on the nectar source, some additional antimicrobial compounds. That makes it quite unlikely that bacteria will develop resistance to it. I know immunocompromised people that keep plenty of raw honey on hand. There is even an FDA-approved product on the market -- a topical dressing made of honey and marketed under the name Medihoney. (Yeah, hopefully the regulators will still recognize peoples' right to use an age-old remedy without buying it from a corporation 50 years from now.)

As a beekeeper I can be biased toward my love of honey but as Anna says it does contain more fructose. Personally, on my scale of evil, it lies somewhere around evaporated cane sugar and maple syrup. I believe it's superior to other refined sweeteners (even despite a higher fructose content) but obviously our primitive ancestors wouldn't have had daily access to honey due to the danger and pain associated with its harvest. Honey will have more minerals, pollen, floral essences, antibacterial agents and other goodies but despite my love of it I eat it in strict moderation -- i.e. about a tablespoon once every couple of months. The rest gets given away. I'd be interested to hear other opinions on ingestion of honey, though.

And just a plug for your local beekeeper -- even if you eat *raw* honey from the store, you are missing out! Get thyself to a local honey festival.

Monica said...

Here are some more thoughts re: sugars in general as they relate to dental health.

Here are Price's data: the first number is the percent of teeth attacked by cavities in the isolated primitive group. The second number is the percent cavities in teeth in the same race of people that had gone onto the western diet (flours, canned goods, sweets):

Swiss 4.6 29.8
Gaelic 1.2 30.0
Eskimos 0.09 13.0
Northern Indians 0.16 21.5
Seminole Indians 4.00 40.0
Melanesians 0.38 29.0
Polynesians 0.32 21.9
Africans 0.2 6.8
Australian Aborigines 0.00 (!) 70.9
New Zealand Maori 0.01 55.3
Malays 0.09 20.6
Coastal Peruvians 0.04 40.0+
High Andes Indians 0.00 40.0+
Amazon Jungle Indians 0.00 40.0+

Data from Nutrition and Physical Degeneration, p. 441

But what is also interesting here is a comparison of the cavity percentage *solely among primitive groups*. Interestingly, cavities are highest in the 2 primitive cultures eating grains and in the Seminoles in comparison to the rest of the healthy groups. Sure, they are all generally low but if you do a chi square goodness of fit test of the percentages of these three groups that are highest in comparison to the percentages of all the rest, you get a highly significant p value with Yates' correction.

Here's where it gets interesting. I searched Nutrition and Physical Degeneration to try to discover what was in the diet of the Seminoles -- unfortunately Price doesn't say, but does indicate that they were the most secretive group he came into contact with. It would be interesting to know if something they were eating was correlated with slightly inferior dental health.

Another person I corresponded with sent me this about the Seminole diet:

.....................................

Monica,

A book on the Seminole from 1884 lists the following on their food:

"Read the bill of fare from which the Florida Indians may select, and compare with that the scanty supplies within reach of the North Carolina Cherokee or the Lake Superior Chippewa. Here is a list of their meats: Of flesh, at any time venison, often opossum, sometimes rabbit and squirrel, occasionally bear, and a land terrapin, called the “gopher,” and pork whenever they wish it. Of wild fowl, duck, quail, and turkey in abundance. Of home reared fowl, chickens, more than they are willing to use. Of fish, they can catch myriads of the many kinds which teem in the inland waters of Florida, especially of the large bass, called “trout” by the whites of the State, while on the seashore they can get many forms of edible marine life, especially turtles and oysters. Equally well off are these Indians in respect to grains, vegetables, roots, and fruits. They grow maize in considerable quantity, and from it make hominy and flour, and all the rice they need they gather from the swamps. Their vegetables are chiefly sweet potatoes, large and much praised melons and pumpkins, and, if I may classify it with vegetables, the tender new growth of the tree called the cabbage palmetto. Among roots, there is the great dependence of these Indians, the abounding Koonti; also the wild potato, a small tuber found in black swamp land, and peanuts in great quantities. Of fruits, the Seminole family may supply itself with bananas, oranges (sour and sweet), limes, lemons, guavas, pineapples, grapes (black and red), cocoa nuts, cocoa plums, sea grapes, and wild plums. And with even this enumeration the bill of fare is not exhausted. The Seminole, living in a perennial summer, is never at a loss when he seeks something, and something good, to eat. I have omitted from the above list honey and the sugar cane juice and syrup, nor have I referred to the purchases the Indians now and then make from the white man, of salt pork, wheat flour, coffee, and salt, and of the various canned delicacies, whose attractive labels catch their eyes."

http://www.gutenberg.org/etext/19155

Could it be the sweet fruits, maize, sugar cane syrup, honey, etc?

... or maybe something they were getting "now and then from the white man"?
.......................................

Brian said...

Does anyone have experience with brown rice syrup and barley malt syrup? Apparently they are the best options (besides the artificial no-calorie kinds). How do they actually taste?

Robert McLeod said...

Has anyone here seen a distribution of sugar consumption in the USA? I figure average intake is around 85 +/- 25 grams, but I'm interested in the actual tails of the distribution as well (since it probably isn't normal).

Another question I have that I didn't address either is why is visceral fat not as heavily saturated as that under the skin if fructose is converted to palmate?

Jenny Light said...

Monica:

Thank you for your thoughts on honey!

As a reformed sugar addict, I now restrict sweets to holidays, so my consumption of honey is VERY limited (and this used as an ingredient, and always combined with lots of fat).

I will second your note on wound healing/burns! I always apply raw honey to kitchen scalds (immediately, and for 30 min), and have also used it the one time that I was stung by a bee. Absolutely no swelling or pain from the sting, and elimination of redness and pain from the scalds! I also use it on my kids for cuts and scrapes.

I would rank honey above evap cane sugar juice and maple syrup as both of those have been processed somewhat (heat), and raw honey is unheated and unfiltered. No other sweetener has medicinal qualities that I am aware of.

Honey is the only allowable sweetener used on the highly restrictive SCD and GAPS diets, due primarily to its strong antibacterial properties and friendliness to the gut.

daiikkon said...

Hey Stephan

I work a tough job and like to run 5-7 miles four times a week. I eat about 3200 calories a day (i'm a 6'4" male in my twenties).
About 1000 of those calories come from fat in the form of raw butter or cream. Ever since I have started this I have had insomnia but I'm not tired. I'll get 3-4 hours sleep and just be jacked and ready to go when I awake.
I would really like to get back to sleeping 7-8 hours a night. Obviously the fat has something to do with it. I was just wondering if you or anyone else has experienced this and what percentage of calories do you intake of butter & cream?

Thank you

Anna said...

Raw honey is in my cupboard, but used in tiny amounts and not so frequently, but wow, I love a bit on really nice thick whole milk yogurt! But most of the time I have yogurt completely plain or with fresh fruit.

I stock organic maple syrup in my pantry, too. I buy Grade B to maximize the flavor, minimize the amount needed. I personally use it fairly rarely (when making ice cream, baking with coconut flour, etc.), but my son has a teaspoon or so drizzled on things like the soaked oatmeal/buckwheat,almond meal concoction I make for his breakfast some mornings, coconut flour pancakes (GF, very egg-y), etc, a few times a week. Of course, like most kids, if it was up to him, he'd have a lot of maple syrup on oatmeal or pancakes every morning, but even when he's pouring, I notice he's more sparing with the syrup than his friends.

I also do buy some organic evap cane juice (which is refined sugar IMO) to use in small quantities now and then, but I don't think I buy more than 1 or 2 pounds a year, so consumption is quite low (and often is made into something for a potluck or entertaining event, not consumed entirely by my family).

I'm trying to figure out what to get for my hummingbird feeder and western oriole feeder. All the info says regular white sugar boiled in water in varying concentrations for each bird (and cheap grape jelly for the orioles - ours are grape eaters and don't go for other fruits). But it kills me to feed that stuff to them. Anyone know another option?

I've purged my cupboards of all wheat, though. Mostly I just use coconut flour now.

Nick said...
This comment has been removed by the author.
Tom Jeanne said...

Brian, you are right that brown rice syrup and barley malt are among the best sweeteners, because they result from enzymatic action on starch, which is glucose polymers. Hence, they contain no fructose. I use barley malt and find it delicious. It's similar to molasses but milder and has that wonderful malt taste. However, beware that glucose is much less sweet than sucrose or fructose, gram for gram. Rough guess: one tablespoon of barley malt has the same sweetness as one teaspoon of honey.

daikkon, sounds to me like your diet change triggered some hyperthyroid symptoms. Thyroid problems are more and more common nowadays.

Nick said...
This comment has been removed by the author.
Jenny Light said...

Could it be that the fructose and glucose found in fruits (often found in near equal amounts as in raspberries at 2890/2288 mg respectively) offset each other in some way when metabolized?

Natural whole foods tend to contain components that balance each other in some way (like high vitamin cod liver oil with its Vit A & D). Any thoughts!

Aaron Blaisdell said...

Anna,

Could you post your recipe for pancakes made with coconut flour? Or email me if you don't want to post (blaisdell@psych.ucla.edu)?

Thanks!
Aaron

Stephan Guyenet said...

Gyan,

I don't know if that 25% figure includes lactose. I'd have to look into it. Even if it does, lactose can't account for more than a few percent of calories for the average American.

DO,

Fructose is roughly 50% of most naturally occurring sugars. I'm mostly targeting refined sugar, but I think it probably just comes down to quantity. A modest amount of fructose, say the amount in a banana, is not a problem at all in my opinion. If you drink two sodas a day, you're in the danger zone. This is far from proven, but my guess is that large amounts of naturally occurring sugars are probably not good either.

Justin,

That would have been nice, I agree. I do think it impacts the glycemic index theory. Originally, fructose was seen as good because it has a lower GI than sucrose and glucose. So they had some trials in diabetics, and found that it has negative metabolic effects. No one really recommends it for diabetics anymore.

Jenny,

In my opinion, raw honey is one of the best sweeteners, if not the best. It's somewhat nutritious, it's fairly easily assimilated, and it tastes damn good. As with fruit, I don't see anything wrong with using honey in moderation.

Monica,

One tablespoon every couple of months! You must be the most spartan beekeeper I've ever met! Even I eat more honey than that.

Thanks for the information about the Seminoles. I think you're right that grains are not ideal. Mellanby felt they increased the need for fat-soluble vitamins. Like commenter Scott W. has said, we can choose between mesolithic health and paleolithic health. Both are a big step up from modern health, but neither seem to lead to chronic disease. Paleo may be optimal overall though.

Stephan Guyenet said...

Brian,

I can see that, because they're all made from glucose. I've tried brown rice syrup and it's OK. It has an earthy flavor and it's less sweet than honey. I think it would work fine as a sweetener.

Robert,

I got my sugar consumption stats from NHANES data somewhere on the internet. They may have standard deviations for it, I can't remember. As for visceral fat, I don't know why it's less saturated. Actually I'm surprised by that, because in pigs and cows it's the most saturated fat in the body.

Daiikkon,

I haven't experienced anything like that. I agree that you should try to get back to the point where you can sleep at least 7 hours. Here are a few thoughts:

1- Your body may be going through some hormonal adjustments, as Tom mentioned. It could be worth waiting to see if it improves on its own.

2- You may be reacting poorly to dairy protein. You might try cutting out dairy except for ghee for a while to see if that helps. I don't know where you live, but around here I can get top-quality beef tallow and lard for dirt cheap. Coconut oil is another good option; you can get it cheaper online.

3- You may want to play around with your macronutrient ratios. If you think the fat is the problem, try cutting back.

4- If I recall, you eat a ton of rice. Maybe try switching to a different grain for a while, or potatoes? Not that there's anything wrong with rice, but it could be worth a try.

Jenny,

That's possible. I'm not aware of any research on it. Until proven otherwise, I'm going to assume sugar is sugar.

Anna said...

Aaron,

Coconut flour pancake recipe is up on my blog now with photos! I've been meaning to write that one up, so thanks for the push into action. I already had some photos from the last batch.

Please let me know how they come out for you if you try the recipe. These are kid-tested and very popular with my son's 4-6th grade friends, most of whom eat conventional pancakes at their own homes. They're always a slightly tough crowd to please universally, but these seem to do it, even with the kids who claim not to like coconut (they don't really taste like coconut).

Unknown said...

Brian said: beware that glucose is much less sweet than sucrose or fructose

How come both glucose and fructose are not as sweet as sucrose. Yet sucrose is a mixture of the two? Agave syrup is not nearly as sweet as white sugar. Neither was the pure fructose that I bought many years ago to make ice cream.

Also, I was wondering if our reaction to fructose is on purpose. Perhaps back in the past when we found a big stock of fruit we gorged on it. Our bodies reacted by turning as much of it to fat as we could to keep us through leaner times.

Finally, how does xylitol fit into this picture?

Tom Jeanne said...

I think you misquoted Brian because I wrote that.

Actually, fructose is sweeter than glucose and sucrose is in between. One paper I looked at rated the relative sweetness thus: sucrose 145, glucose 100, fructose 200. My nutrition textbook lists the relative sweetness as: sucrose 1, glucose 0.7, and fructose 1.2-1.8. So clearly fructose is the sweetest on a per gram basis.

Unknown said...

Sorry Tom. There must be padding in the sources of fructose that I have used. I presume water in agave syrup.

daiikkon said...

Hey Stephan

I thought butter and cream have no dairy protein.

Robert McLeod said...

daikkon:

Butter and cream have plenty of dairy protein in them. Butter is only about 2/3rds milk fat, the remainder is protein and water.

Anna:

I wouldn't worry much about feeding sugar to birds. They can produce vitamin C, we can't.

Stephan:

I may be guilty of some verb confusion between visceral and ectopic fat.

Robert Andrew Brown said...

Robert do you have a ref or source for this please.

"Another question I have that I didn't address either is why is visceral fat not as heavily saturated as that under the skin "

Many thanks

Aaron Blaisdell said...

Thanks Anna! I copied the recipe off of your blog and will try these pancakes out as soon as I amass the ingredients.

Monica said...

Love the discussions in these threads!

Anna said: "but wow, I love a bit on really nice thick whole milk yogurt!"

ME TOO! This is my absolute favorite use for honey. To be honest, I would eat more honey but I'm about 15 lbs. overweight and until I can knock all of that weight off, and it's been tough, I probably need to restrict sugar.

After reading Taubes, I think I was shocked out of eating sugar or grains in any amounts. After more careful consideration, I'll try adding these items (properly prepared) back in once I lose weight.

Anna, I share your concern about refined white sugar for hummingbirds. It would seem logical that flower nectar has minerals and other nutrients in it. Hopefully they have some instinct that guides them toward flowers if artificial feeders don't provide adequate nutrition.

Stephan Guyenet said...

Daikkon,

Cream doesn't have much protein and butter has very little, but it's enough if you're very sensitive to it (pretty rare for butter from what I understand). Butter is about 0.5% protein by calories.

Richard A. said...

Relative sweetness of sugars and sweeteners --

http://en.wikipedia.org/wiki/File:Relativesweetness.png

Scott Kustes said...

Stephen, awesome post! I consider sugar and trans fats to be the worst food ingredients. Like you, I don't disagree with a modest use of honey and typically add some to my sweet potatoes (< 1 tbsp), along with a bit of fruit per day.

But as you and Anna said, even honey and agave nectar are sugar and the body processes it all the same way.

Keep up the great work!
Scott Kustes
Life Spotlight

Unknown said...

daikkon: I have experienced insomnia and that "jacked" feeling when I should be sleeping. This happens typically when I reduce my carbs while not restricting fats.

One workaround that has helped me is to save my carbs for the evening meal or snack. They make me sleepy!

Good luck!

Me said...

daikkon:
Could you be getting reactive hypoglycemia which your body is trying to treat by increasing adrenalin?
I find that when this happens to me (which is usually when I've been sticking to an especially low-carb diet) a stick of string cheese puts me back to sleep. Of course, a spoonful of honey or sugar would work even better. (You could check out my theory most easily by trying the sugar or honey once or twice.)

Unknown said...

Did the sugary drinks contain caffeine? Caffeine has been shown to reduce insulin sensitivity by around 40% in healthy men consuming a high GI meal. The effect persists for at least a week and is evident up to 12 hours after administration.

Sources: http://www.cbsnews.com/stories/2008/01/29/health/webmd/main3763964.shtml
http://www.ncbi.nlm.nih.gov/pubmed/17998023?ordinalpos=17&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/pubmed/18469247?ordinalpos=10&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Stephan Guyenet said...

Admin,

The sweet drinks did not contain caffeine. Thanks for the links.

Anna said...

Aaron,

I've been experimenting with a baked pancake you might like. The batter mixes very quickly with just three ingredients (though you can add additional spices and flavorings). You can even mix up the batter the night before (store in the fridge) and bake it pretty fast in the morning (allow enough time for the oven and pan to preheat, though).

Preheat oven to 425°F.

Basic batter:

1 large egg, beaten
1/4 cup full fat coconut milk
1/4 cup almond meal (preferably from freshly ground soaked or sprouted dried almonds) - walnuts or hazelnuts would be good, too

Combine ingredients and whisk until well blended.

Use a sauté pan that can go in the oven - I use De Buyer carbon steel pans (well-seasoned), but well-seasoned cast iron or non-stick aluminum skillets with oven safe handles will work, too. Haven't tried my stainless sauté pan yet, but with enough lubrication, it might work without sticking. Remember to use oven mitts (don't ask me how many times I haven't remembered!).

Once the oven is preheated, it's important to preheat the pan (time needed varies - cast iron takes a lot longer than carbon steel (you might put that in when turning on the oven) - aluminum pans need just a minute or two and the non-stick finish shouldn't be heated too long without food). With an oven mitt, remove hot pan from oven to apply generous lubrication to the pan - 1 TBL or so of coconut oil, butter, ghee, lard, etc. Return to oven to heat the fat for a moment, but don't let it burn.

Pour batter into hot oiled pan (it should be hot enough to sizzle - watch out for splatters) and return pan immediately to hot oven to bake for about 11-13 minutes. Do not turn. Pancake will puff up a bit and brown nicely on the underside (not so much on the top). When center of pancake is cooked through, remove pan from oven (you'll see it deflate rather quickly). Pancake should slide right out of pan onto a plate.

Garnish with grass-fed butter, a sprinkle of ground cinnamon or nutmeg, fresh berries, and/or a sauce of blended berries and a bit of coconut milk.

Makes one 7-8" pancake (size is determined by your pan diameter). It's thicker and denser than a flour-based pancake, and with fruit and coconut milk sauce or mascarpone cream cheese, it can be quite filling.

I'm experimenting with adding additional flavorings to the batter - try cinnamon, nutmeg, cocoa, even savory herbs and spices. A small amount of honey , dark maple syrup, or molasses could be added for those who think it needs a touch of sweetness.

The pancake can be used like a bread or tortilla, too, or a base for a saucy meat stew, etc.

Double the batter amount and cook in a 10 inch pan for a larger pancake. If you need more pancakes, I suggest using two pans instead of trying to fit more batter in one pan. The batter volume to pan diameter ratio matters for even cooking.

If you try this, let me know what you think.

Unknown said...

Sorry for the late post.

Stephen, I'm concerned that the delivery system affected the results of this study. Refined, processed, unadulterated fructose may indeed produce negative health consequences. But that's not a particularly interesting finding- we know that processed foods in any form have negative health consequences.

But what if you eat fructose in it's natural, unprocessed form- ie, from a piece of fruit? If this test was re-run, but those who were assigned to the fructose group were made to get their fructose from fruits, how do you think this would affect the results?

I guess I don't understand your argument. Are you interested in determining whether highly processed and refined fructose has dangerous health consequences? Or are you interested in showing that unrefined fructose has health consequences?

Stephan Guyenet said...

Ian,

My argument is that refined sugar/HFCS is bad. Beyond that, you're on your own. My opinion is that fructose is probably fructose whether it comes from HFCS or fruit. But it hasn't been directly studied to my knowledge, so it remains speculation.

What I do know is that fructose from an apple elevates blood uric acid just as well as fructose from a soda, at least in the short term. Uric acid seems to have a role in the process that leads to the metabolic syndrome.

Neonomide said...

The onfamous "tier two villain" in Taubes' GCBC George Bray seems to have almost jumped off the official wagon already:

http://www.pbrc.edu/pdf/bray-final-paper-080508.pdf

Unknown said...

Hi:

Great blog-you are providing a very helpful service to those around you. Thanks so much.

I have a question-I have the genetic form of fructose malabsorption. I know coconut is not good for me to eat, but is coconut oil okay for someone with fructose malabsorption problems?

Thanks

Tim said...

Stephen said:

"In my opinion, raw honey is one of the best sweeteners, if not the best. It's somewhat nutritious, it's fairly easily assimilated, and it tastes damn good. As with fruit, I don't see anything wrong with using honey in moderation."

What is nutritious about honey? Honey has more fructose than cane sugar. Comparable to HFCS. HFCS is easily assimilable too.

Judging from the science I have read and observing my body I have come to the conclusion that glucose powder is the healthiest sweetener. Brown rice syrup is probably just as good. They don't contain fructose.

Tim

Unknown said...

There is a really simple daily formula here-

5 serves vegies + 2 serves fruit + about 60g protein = healthy

adjust the protein over the week to include a few serves of fish (esp. deepwater marine), and minimize higher fat meats. Keep up the fibre, and piss off added sugar/sugar alternatives in anything.

You won't have to worry about any bloody glucose versus fructose debate. If you have done a search on the internet you will find out that studies used Fructose based corn syrup, and the study descriptions very carefully stay clear of connecting the results to fructose in fruit. Why? because there are many more compounds than just fructose in fruit buddy, and some of them are involved in the digestion process!! By the way has anyone seen this equation before....
sucrose = Type 2 Diabetes

Mike said...

Check out the gluten issue. Undiagnosed gluten sensitivity could affect as many as 1 in 3 in the US alone. The complicated syndromes this leads to (by reducing intestinal villi and thus proper absorption of nutrients) has many side effects, the ultimate form of which lead to CD (celiac disease), which has been implicated as having a major correlation with Type 2 Diabetes and the like. But many other issues regarding adrenal exhaustion, "leaky gut", and others complicate the simple sugar equation.

Studies mostly have tended to ignore this, and only recently (in the last year or so) are there better ways available to test for this. I've paid for and had the most recent antibody test battery (12 types of gluten and 16 or so cross-reactive foods), and boy, was I sensitive! Most alternative grains (quinoa, amaranth, millet, spelt, buckwheat, sorghum) are gone, as are dairy (including cheeses and milk chocolate), and potatoes. Mostly left with rice and corn, but I should also be avoiding soy.

So what have I got left, besides the usual neutral foods (from the standard American diet)? Almond milk and flours are good, and in my experience, now that I'm off gluten, I can process sugar somewhat better. Not sure if my blood glucose level is in recovery too now (holding off the test because it can take a year or more to get rid of gluten effects from the body systems), but I do feel more energy, and some weight has dropped off. Still, I probably haven't hit my own "magic formula" yet, but I think I'm on the right track, at least.

Google some links on the book called "Gluten Effect" for more food for thought. Nutrition has not been taught well in medical schools, so doctors are often not prepared to deal with this well. Luckily for me I found a chiropractor with proper nutrition and other alternative medicines in his expertise, and the campaign goes on. And also discovered doctors nearby who are also getting savvy to the new information.

Wishing you all the best on your journeys as well. All the votes aren't in, but we learn more all the time.

Anonymous said...

Before you draw too many conclusions from this report consider that N=32 is a very very small study, especially when there are other variables besides the sugars themselves. Men, women, degree of obesity are just a couple. Genetic variablility itself could easily acount for the differences. I am not convinced. could confermation bias lead one to like the "conclusion?

Tatter Salad said...

(Jan2013)  In a series of exploratory MRI analyses, consumption of fructose compared with glucose resulted in a distinct difference in detection (by those consuming) as to 'satiation.' These data strongly suggests that fructose fails to trigger hunger satisfaction, while consuming glucose does.

Ref: http://jama.jamanetwork.com/article.aspx?articleid=1555133