Christopher Still, DO, FACN, FACP, Co-Clinical Editor, Bariatric Times; Medical Director for the Center for Nutrition and Weight Management, and Director for Geisinger Obesity Research Institute, Geisinger Medical Center, Danville, Pennsylvania. Dr. Still is also a board member of the Obesity Action Coalition, Tampa, Florida.
The Journal of the American Medical Association (JAMA) published a study conducted by Yale University scientists, which showed for the first time, that fructose—or fruit sugar—frequently found in the American diet can trigger brain changes that may lead to overeating.
Using imaging test, the Yale researchers found that after drinking a fructose beverage, the brain does not register the same feeling of being full as it does when simple glucose is consumed. Glucose is a type of sugar the body uses for energy. What’s more, the scans showed that drinking glucose actually suppresses brain activity associated with the sensation of hunger.
While the study’s sample was relatively small, just 20 young, normal-weight people, it has had a big impact on perception. It’s fueled the speculation that fructose and high-fructose corn syrup may be at the root of the nation’s obesity epidemic. Like the sugars themselves, however, I think the answer is more complex.
I would suggest that we try to cut down on all sugar because that will have the double benefit of both helping to suppress our appetites and reducing caloric intake. And if you’re trying to lose weight and/or establish healthier eating habits while maintaining your current weight, reducing sugars of all types will make it that much easier.
This reminds me of the recent debate over which fat was the most harmful in our diet. Ultimately, “trans” fat was targeted and, as a result, labeling requirements were modified to identify the trans-fat content of products. We could possibly apply what we learned from that discussion to the news regarding fructose. Since fructose is found in so many foods (and we usually don’t even know it’s there), it would be helpful if labelers were required to clearly state “high fructose food” or “fructose added,” similar to what is now required with trans-fats. If we are consciously aware that we are taking in foods that contain high fructose additives, maybe we would be less likely to consume them.
This all begs the question: Is sugar toxic or not? While I don’t believe it is necessarily toxic, I do believe foods with high sugar content trigger us to eat more. So, if we can decrease the sugar that we know we’re taking in (both fructose and glucose), that may improve our health.
Of course the elimination of sugar may push us toward the use of artificial sweeteners, which have been linked to some health concerns of their own. But I contend that when comparing regular soda (160 calories) to a diet soda (0 calories), the diet soda is the better choice. In fact, I personally consume diet soda and low-calorie beverages such as Crystal Light.
Having said that, the absolute best choice for quenching our thirst is simply water! Anecdotally, when comparing patients in our clinic who drink primarily water as compared to those patients choosing to drink artificially sweetened/low-calorie beverages, the people who drink water lose more weight. My strong recommendation is that we get in those eight, 8-ounce glasses of water before we consume any type of diet or low-calorie drinks.
So, when it comes to sugar (of any type) and artificial sweeteners in your diet, just keep it simple and say “no” to as many as you can—regardless of the type of sugar.
I hope you enjoy this month’s issue of Bariatric Times. Dr. Alan Wittgrove presents a wonderful article titled “Nursing Assessment of Intraluminal and Intraperitoneal Hemorrhage Following Bariatric Surgery.” Published in the Integrated Health Continuing Education Department, the article and its accompanying activities are accredited for 1 contact hour for nursing continuing education. We hope that all members of integrated health will benefit from this offering. We thank Department Editor Tracy Martinez, RN, BSN, CBN, who has been busy lining up great topics for upcoming installments for IH Continuing Education.
Christopher Still, DO, FACN, FACP
1. Page KA, Chan O, Arora J, Belfort-Deaguiar R, Dzuira J, Roehmholdt B, Cline GW, Naik S, Sinha R, Constable RT, Sherwin RS. Effects of fructose vs glucose on regional cerebral blood flow in brain regions involved with appetite and reward pathways. JAMA. 2013;309(1):63–70.