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Not So Sweet: Everything In Moderation Will Bury Us All

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Pet peeve: Speaking with folks about nutritional choices and hearing the insistence that “everything in moderation” is the sensible way to go.

First objection: most people who say this (you know who you are!) have already made choices that reveal disbelief in their very own statement! They already don’t eat processed food, or limit the amount of sugar they eat, or—rarely confessed to me anymore—limit the amount of saturated fat that they eat. I’ll have to let that one go, however, we are all guilty of some degree of nearsightedness when it comes to self-knowledge, right?

Second objection is actually more content-based: it just might be true that there are some foodstuffs presented to us that we might be better off completely avoiding. Everything in moderation is a fine principle for vegetables; not so much when it comes to sugar. Considering sugar, what exactly is moderation? How many times a week—how many times a day—is it reasonable to eat something sweet or sweeten something we eat?

Since George McGovern’s Dietary Goals for Americans, we have obediently reduced the fat content of our diets, but found we had to eat something else instead, and in particular we had to find a way to flavor foods that had lost their delicious fat. The result is that we have eaten a lot more sugar in the last 50 years than ever before in human history. Nutritionists took their sides and drew their swords: Harvard School of Public Health still leads the charge in vilifying fat, John Yudkin started and Gary Taubes (author of The Case Against Sugar:  a riveting read!) continues to carry the torch spotlighting sugar as the problem.

There are several good reasons to believe that, quite separate from its caloric effect, sugar has been a primary driver for our current diabetes and obesity epidemics. Sugar has an addictive nature: think how you feel about going sugar-free for a week, a month, a year. If it makes you squirm, you may be addicted to sugar just as the laboratory rats that end up preferring sugar over cocaine!  Sugar has a unique metabolic effect. Sugar is comprised of glucose and fructose, and while the glucose turns into fuel, the fructose is stored as fat in the liver, resulting in insulin resistance, type 2 diabetes, and non-alcoholic fatty liver disease.

Fatty liver disease is now seen even in children, a medical novelty. Many doctors mistakenly counsel their patients to reduce dietary fat, but their thinking is completely wrong: it’s sugar they must reduce, particularly fructose. Individual sensitivity to fructose varies and can be presumed to exist in folks with stubborn excess weight, bellies bigger than their hips, high blood pressure, and pre-diabetics. (Just to take one of those: high blood pressure has been linked to heart disease, stroke, insomnia, anxiety and premature death. Ugh.)

My radical suggestion is that you do a little self-experimenting, with as curious and playful an attitude as you can muster. How long can you challenge yourself with a sugar-free menu? Avoiding sugar is challenging as it is found in almost every pre-made food (ketchup, mayonnaise, and almost everything in a box) and many seemingly savory sauces at your favorite restaurant (not just Teriyaki, but barbecue sauce, and any fruit-based sauce).  You’ll have some fine points to decide. No sugar substitutes: a subject for another column! Personally, I would say fruit is fine, but I’d avoid dried fruit and fruit juice; what do you think? Great snacks are raw nuts and maybe salami; jerky has sugar in it unless you make your own! You might decide to get really technical and look at blood sugar effect: whole wheat bread and a candy bar have a similar effect! But while you’re claiming your breakfast toast is out-of-bounds for this experiment, I say, fair enough: but hold the jam!  

Read more of Dr. Deborah’s healthy insights at www.DrDeborahMD.com.

1 Comment

  1. Shari
    April 30, 2017 at 10:20 am — Reply

    I’m curious as to why singling out fructose as something to avoid is mentioned. It was my understanding that fructose is processed primarily by the liver and doesn’t stimulate insulin production (therefore, it doesn’t contribute to insulin insensitivity or pre-diabetes). It’s also the primary sugar in fruit, which carries a lot of other nutritional benefits that go along for the ride.

    It would seem that you should be looking more at specifying reduction of refined sugars (glucose, dextrose) unless you’re mentioning fructose primarily as it is consumed as high fructose corn syrup. I think a little more specificity would have been constructive in a piece like this.

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