Four decades ago, a healthy alternative to sugar was introduced into our food supply: fructose. I remember being told that, because it was the natural sweetening in fruit, it was far superior to refined sugar. Now we all know about the evils of high fructose corn syrup. Some soft drink manufacturers have gone back to sugar. And, for the really health conscious, guava nectar has found its way into food. I was told by a young woman selling sweets at our local farmers market that guava nectar is totally natural and healthy and nothing like sugar or high fructose corn syrup. This despite the fact that guava nectar is refined using the same process that produces high fructose corn syrup and consists primarily of fructose.
For perhaps a decade now it’s been generally known that both sucrose (that is, refined sugar) and fructose are bad for your health. Recent research has made the story even worse. That tale is told in a recent article in the New York Times by Gary Taubes, the man who some years ago brought to the mainstream press the idea that the bad reputation of saturated fat was probably wrong.
The first thing to know is that both sucrose and high fructose corn syrup are a combination of glucose and fructose, both of which are carbohydrates. A sucrose molecule consists of a glucose molecule attached to a fructose molecule. In high fructose corn syrup, the molecules aren’t attached and there’s more fructose than glucose. You will no doubt recall that glucose, once in you blood stream, is called blood sugar. Starches are the principal (although not the only) delivery system for glucose—starch molecules are essentially strings of glucose molecules.
You will also no doubt recall that glucose as blood sugar stimulates the release of insulin, which in turn regulates glucose and other aspects of energy metabolism. Fructose, on the other hand, does not stimulate insulin release. Instead, it is converted by the liver into saturated fatty acids that are stored in the liver until the body needs fuel for energy metabolism. And, no, the problem is not that fructose turns into saturated fat.
The problem is that the body’s energy metabolism is disrupted. Researchers are now talking opening about not only obesity and diabetes resulting from this disruption, but all manner of heart disease and cancer too. Now, to be fair, I’m putting words in their mouth when I say that a disruption to the body’s energy metabolism results in all of these disease states because what the researchers talk about is fatty livers and elevated triglycerides and insulin as a growth factor and insulin resistance and metabolic syndrome and on and on. That is, they remain focused on single biochemical pathways to illness—focused on the one, not the many.
Bold scientists such as Dr. Robert Lustig of UC San Francisco refer to sugar and fructose as toxic. The critical point they want to make is that sugar and fructose don’t simply add empty calories to your diet. These molecules cause injury and illness. The scientists point to the rise in the rate of obesity and diabetes with the rise in the use of high fructose corn syrup over the past 40 years. They also point to the rise in heart disease and cancer at the beginning of the 20th Century with the rise in consumption of candy, soda, and other sweetened confections.
But the scientists do not dwell upon the fact that both were the result of strategies by the food industry. In other words, while courageous in calling sugar a toxin, the thinking seems to be that these greater consumption levels fell from the sky or were caused by bad eating habits or lack of information or addictive behavior. Rarely discussed is the essential need of industry to create foods to which people will be addicted through the use of chemicals such as the devil sugar. But I digress. For the moment.
Let’s pick up the thread of sugar and fructose as toxins. One of the things we’ve learned about toxins is that toxins are often less problematic when acting alone than when acting together. Those who point to the consumption of sugar and fructose as the cause of disease are carrying on in a long tradition of reductionist science that is now outdated.
So what other toxic exposures might there be that work in concert with the consumption of the devil sugar?
Recent research has, in an environment-wide association study of 266 chemicals, identified a handful that are, in combination, associated with type 2 diabetes. This is an improvement because it looks at the many as the cause. But still, its focus is on chemicals.
A recent example of the social determinants of health showed a positive effect of social cohesion in reducing the risk of stroke. And then, of course, there is the broader political economy of agricultural production and food manufacturing, where people work tirelessly to find ways to satisfy that essential industrial need to sell products.
It’s a good idea to avoid sugar and fructose—even if they’re natural—whatever that means exactly. But it’s foolish to think that resisting temptation is a good way to reduce complex environmental exposures that cause illness and injury. It is not the one, but the many that need to change.
