Kamal Patel: Fructose

hello and welcome to another episode of the Iraqi nutrition podcast I'm your host Juma Iraqi and joining me today is Kamal Patel and the topic we're going to talk about is fructose hi Kamal how are you doing I'm doing good how about you I'm doing perfect thank you so much for agreeing to do this podcast and before we go into the questions for people that might not know you could you give us a introduction about yourself sure so I live in San Francisco California before this podcasts Jumma and I were talking about how it's cold there in Norway it's cold here where I live - I live by the beach which is the chilliest part of the west coast and the US so it's always windy and chilly but all the or that meaning that I don't get much vitamin D from going outside it's it's a good place to do nutrition research there's always a lot of good stuff happening here University of Berkeley and Stanford and that kind of thing personally I'm the director of examined comm I've been involved in nutrition research and was a wannabe power lifter about a decade and a half ago and currently I just read studies all day and kind of put the data together and I'm here to talk about fructose because a research group I was in published a meta-analysis of fructose a couple years ago excellent and I'm really looking forward because this is a topic that there seems to be a lot of misconception in regards to fructose so I'm really really looking forward and I really appreciate that you are taking the time to do this podcast so can you briefly just explain what what fructose is for the people that might not know what we're talking about sure so everybody knows sugar sugar sucrose disaccharide the three main monosaccharides make up other sugars are glucose fructose and galactose so fructose looks just like glucose it's a it has six carbons so it's a hexose sugar DNA is a pentose sugar and refer me you watch this game of thrones but I think pentose is on there as a as a city in the east but pentose sugars don't come up much at nutrition because we can eat DNA and it might actually have some health effects but we don't need it in Greater enough quantities in contrast we eat a lot of glucose and fructose which is why it's it's such a hot research issue so fructose difference in glucose and that just in one spot it's got a keto group attached to the carbon instead of aldehyde group and because of the slightly different structure even though it has a same molecular formula it has different functions in the body completely different so glucose is essential that's kind of skirting the issue that some some people even researchers like Tim Noakes do a lot of athletic activity under ketogenic diets and don't really use glucose much either for fueling their muscle or brain but for 99.99% of people glucose is essential and if you get less than around let's say 50 grams of glucose a day you're gonna start running low and either burning some muscle I'm using some fat byproducts or you know what have you if you get below 100 or 150 grams of glucose a day then you might have more kind of sub clinical issues over time so glucose is essential we've established that fructose is not essential for anything fructose does provide fuel for your sperm to swim so sperm motility depends on fructose but I don't think you have to eat fructose for that to happen and actually there's not a lot known about fructose health effects you might think because there's been so many studies out that everything is known it's not true in fact when we're doing our research some kind of physician focus groups we talked to either didn't know much about fructose or sometimes they would you know hear the fructose and they won't even recognize it like oh is it fructose is it fructose has it fructose you know people know a lot about fats and glucose and starch but not a ton about fructose so um I guess we'll talk more about how fructose is dealt with in the body a bit later on but the key point is that we have to have a constant low level of glucose in our blood and not only do we not have to have a constant low level of fructose but but I doesn't want us to have fructose in her blood so it's completely different the only other place you'll really see fructose is fruit Dan's are chains of fructose that are sometimes not well digested by people but also can beneficially fuel certain bacteria in the gut so for some people certain types of fruit dance like fos are good for you and for others that cause a stomach upset yeah yeah and that's a recent podcast that I actually did with Cassandra for sat where we actually talked about irritable bowel syndrome and FODMAPs where we go into this she's a nurse on our advisory boards yeah yeah okay so could you also give us some like what are the major sorcerer's sources that we have for fructose because a lot of people when they hear fructose they automatically thinks that fructose is only in fruits because of the name mm-hmm so fructose actually is a fairly interesting history and that a lot of the things that we eat nowadays are things that either didn't exist before and the diets of sort of Western people or they're in much different quantities than before so there was this link going around on Facebook a month or two ago about the changing American diet and I think it applies to all European and American or in North American countries so for example wheat is not categorically a bad food you know gluten depends on dosage like everything but we does not categorically be bad but wheat is different our modern we it is different plus and remember the exact number but the the modern Western intake of wheat is somewhere around 130 pounds a year which is a ton because it was like 1/10 of that you know a couple centuries ago so similarly fructose comes from fruit originally and honey those are really the only two sources now honey was always a priced food throughout humanity you know bees try to guard their honey but they can't outsmart us so we'll always get honey when we can will cultivate bees when we can except they're dying off now and then there is some controversy about fruit originally people said you know we ate a lot of starches and not a lot of fruit because we diverged from monkeys who are fruit eaters and we became these meat and starch eaters and then the fruit that was available back when was not very sweet you know and the fruit that we eat now is cultivated to be sweet so it has a lot more sucrose and fructose so then the views kind of changed and that people said well you know think about what fruit is fruit wants to be you know so it can spread a bit seed and there are naturally sweet fruits and places that are not cultivated like in Africa for example so I think the truth is kind of between those two extremes so some types of fruit like mango they have been cultivated a bit but there they've always been extremely sweet on the flip side there's things like strawberries so like the modern strawberry was originally cultivated in France northwestern France and Brittany and it was a combination of a strawberry from I think South America or something and some other strawberry and it created a much sweeter strawberry fruit much bigger and plumper and juicier as well so if you take an older strawberry and eat it you'd be like you know this this is the worst job ever eaten whereas if you take a modern strawberry most people love modern strawberries so I think we do get even more fructose from fruit than we used to get from fruit but that isn't to say that people didn't eat much fruit before because we have a fairly low threshold for detecting sweetness on our tongue so like you know everything that we eat and find that tastes good has a reason you know obviously the reason that what why sweet tastes good is because it's a fuel source but the reason my savory tastes good the reason why msg tastes good is because it's an indicator of amino acid and protein availability so you know MSG glutamate usually is not a bad thing unless you're hyper sensitive for a reason and everything is like that so even like steak tastes different than chicken because steak has amino acid steak has more minerals than chicken does so calcium mineral water has a different taste in tap water anyway that's getting tangential off of fructose but the point is is that we've always gotten some fructose in our diet but we get a lot more now but the source has not fruit or honey it's table sugar or high fructose corn syrup excellent and how let's go a bit deeper into how the body actually handles fructose compared to glucose because there's a major difference there so could you please explain how fructose is metabolized in the body compared to glucose sure so we got glucose from everything you know whether it's called glucose or not at the most basic level I don't know if any of your well your podcast listeners are fairly advanced compared to most podcast listeners so you probably know dextrose is the form of glucose that you can extract from like grapes and corn and stuff we don't get the other form of glucose al glucose in the diet but it actually trivia fact was considered as a supplement for diabetic patients because I'll get to this later but fructose was originally thought of as a way to get sweetness fried the diabetic patient without increasing insulin but then it ran into troubles glucose you know is just what we eat anyway but instead of dextrose the L glucose form is sweet on the tongue but we can't digest it pretty much at all so you just you know poop it out so it would seem to be perfect as a way for diabetic patients to get sweetness without Keller and it's obviously not toxic like maybe some other artificial things are but it's super expensive to produce so in the next few years Lisa won't be use fructose and glucose are both metabolized and absorbed and digested differently so glucose it's either it cleaved off from starch or it's an disaccharide of glucose and fructose or a disaccharide of glucose and galactose and glucose goes through the intestine or through the enter site and the intestine and then it goes through the portal vein into the liver and then some portion of it let's say 20% or maybe you know give or take five percent once it goes to the liver goes into the liver cell the hepatocyte and then the rest of the glucose just you know gets rushed away in the blood so the stuff that goes into the liver cells that's called first pass metabolism and glucose is not really subject to much first pass metabolism because only that 20% or so goes into the liver cells the rest gets you know rushed away in normal blood so then the glucose undergoes a few steps to become energy three steps specifically and all of those steps have feedback mechanisms so that when you eat stuff that has glucose then any of those three steps can be inhibited if the body senses that it's getting too much glucose so really glucose matches your energy requirements glucose and the liver that is fructose is not attuned to your energy needs so that's the main difference between glucose and fructose glucose escapes that first mask first pass metabolism in the liver fructose does not at all the liver wants to get rid of fructose ASAP so I think there's actually maybe been studies that show that fructose increases body heat a bit you know like temporary metabolic rate and I'm hypothesizing the reason is because the liver really wants to get rid of it because it's a bit of a metabolic not a poison because things like die nitro fin all DNP those are metabolic poisons and that when you eat stuff it gets converted to heat instead of fuel fructose is just not a really super intrinsically healthy thing so when it goes to the liver it gets all metabolized by the liver so when it gets into the liver cell then there's two steps for it to become energy and neither of those enzymes and those steps are regulated by how much you're eating or your current energy intake or anything like that so that means that the fructose I you eat it's not regulated at your liver and it's actually doesn't do so well that your gut either in your intestine so fructose in one particular study even in healthy people more than half of them had issues absorbing more than let's say I don't remember if there's thirty grams of fructose or something like that so the con of that is that if you're eating a ton of fructose then it's probably gonna sit in your gut a bit more and then your bacteria will feed on it which isn't necessarily a great thing but not as bad thing is that usually people don't eat free fructose they eat it in the form of sucrose along with glucose or even fruit like a piece of fruit might have 50% sucrose 25 percent free fructose 25 percent free glucose so basically the end result is it's 50 percent glucose 50% fructose and then if you get multiple sources of carbohydrate then you're occupying different transporters and then it's less of an issue for the huge bolus of free fructose but that being said a lot of fructose in the gut is generally a bad thing and that's where stuff like small intestinal bacterial overgrowth comes into play so if you have got issues eating a lot of fructose is pretty much never a good idea so once the fructose is in that liver cell then the liver cell wants to get rid of it and it will create energy so either create ATP it'll shut the fructose and glycogen storage or it'll make lactate which will then go into muscles to be used as fuel the fructose ended of itself cannot be used by the muscles as fuel so when athletes eat fructose it's not really to increase stores of glycogen and muscle or anything like that and then a very small percentage of the fructose in the the result becomes fat through a process called DeNoble lipogenesis excellent and a little bit back to the topic because you said that fructose was marketed towards diabetic patients because of the lower insulin response compared to glucose and I remember that when there was a real push for this in in the industry that you had a lot of these fructose packages that was marketed towards diabetic but what started the the fear of fructose consumption because like you said we like theoretically it wasn't a good idea to substitute the glucose for that population but then people started to run into proper code so could you please explain what actually one of the concerns that actually popped up so there were research concerns when fructose started to be seen as a potential aid for diabetic patients and then studies then really pan out but I think the main things that started fructose phobia were you know number one I'd say is Robert Lustig is a great researcher he's a smart guy but his YouTube video got you know I don't know how many millions of views and it was not totally evidence supported and it was a continuation of in the 80s there is this book by John Yadkin pure white and Dudley about how sugar is bad and then fast forward 15 or 20 years and then now we have the internet and everybody who's interested in nutrition sees this video by Robert Lustig um that's talking about all the bad things associated with fructose and how it's basically a poison so my personal viewpoint is somewhere in between so this isn't a dichotomous variable it's not that fructose is bad or it's good so industrially made trans fats are bad some things are good in certain doses everything else is in between fructose has squarely in between good and bad so the video the Robert Lustig shows all these possible bad things from fructose and then people at the time were really getting onto low-carb diets which is the second factor so when you combine the Robert Lustig type thing with people getting on low-carb diets because the 80s was all fatphobia so then once you get away from fat phobia because people are like oh maybe omega-3s are good or oh maybe even saturated fats not so bad then you need to grab onto something to be afraid of so does up so there's like there's low-carb diets and then I think the the third thing those two things are for people who are into nutrition and who listens podcasts the third thing was high fructose corn syrup so high fructose corn syrup has started to be used more and more in the 70s and then 80s was huge and then 90s it's just kind of normal to use fructose high fructose corn syrup because it's cheaper so only countries like you know Mexico use sugar and their coke and then a lot of other countries use high fructose corn syrup so it's a the corn industry realized their mistake weight too late and started calling it corn sugar but they already kind of screwed up and called it high fructose corn syrup which is a misnomer because it's not high fructose it's generally about 55% fructose whereas sucrose is 50% fructose so not much different and then it's just a long name you know when when you want to get people scared of something you make the name long like you know fats or fatty acids don't sound so bad but mono and diglycerides sound bad corn sugar doesn't sound bad but high fructose corn syrup sounds bad so high fructose corn syrup is not bad it's not really any different than sucrose you know the it is free fructose and glucose but those don't act differently and then testin and really the thing that matters is what happens when they get your liver which we already talked about so Lustig low carb diets and high fructose corn syrup was a perfect storm and that's really what caused for your fructose before then like I said before it was basically all fruit and I don't think the internet you know and then kind of writings were around back in the 16th and 17th century but I think there maybe was a it more kind of grandparents fear like don't eat too much sugar because around that time beverages started having sugar so before the 16th and 17th century in Europe you would get sugar from fruit and that's it because there weren't a ton of honeybees around but then when tea coffee and then eventually chocolate and cocoa started being imported from the West then you need to sweeten those things up or else they taste like crap so when you sweeten those up with sugar and then the trade routes start making it so that you can get sugar cane from India then sugar consumption went way up so that was the first spike in sugar consumption beverage sugar and then it took another two to three centuries to get the the huge increase in sugar from the building to combine sugar with processed food and I think that's about as high as the sugar intake is gonna get because you can't get much more sugar without just feeling really crappy and your intestine and then you know it's bad so this is we're at the peak I think right now a fructose flow bi and fructose consumption excellent and is there a is there a is there a limit that people recommended that people shouldn't go above in regards to fructose consumption yeah so it's a bit interesting depending on who you talk to because like when we were doing our study and I was looking at previous studies then it's hard when you're not doing a study to be in the it to be in the issues of the researchers so a researcher well present at a conference about fructose and then you look at his or her disclosure statement and they'll be funded by like coca-cola and Monsanto so say oh well the studies crap well it's not not certain crap because who's Ana fun all these well controlled fructose studies that have enough patients in order to get statistical significance you know nobody so on the one hand there's that you know just because they're funded by somebody here have been paid speaker fees doesn't mean that that's bad on the other hand if you look at some of the more like review papers or edit Orioles or stuff um I think they're to like oh there's no problem with fructose if anything fructose is good now those researchers I think they may mean it you know it might it might be their personal viewpoint but you can't write negative those guidelines if you receive most of your money from coke or whoever so if they say that you know an intake of 50 grams a day of fructose is totally harmless I'd say don't believe them because the answer the truth is that we don't know how much fructose is healthy or unhealthy and the reason is because there's been a lot of research and to metabolic effects of fructose but the main issue with fructose is not the metabolic effects the main unknown issue is when you eat fructose with or without certain levels of glucose then what is the effect on future food consumption because the main drivers and studies of ill-health metabolic syndrome and whatever from fructose are not from the fructose in and of itself it's from the downstream effects of fructose does it increase eating later on does it have some insulin sensitivities sensitivity issues and the liver over the course of months it's never over the course of weeks so even a pretty big dose of fructose like 80 or 100 grams isn't that bad over the course of a month it's really over the course of many months and those trials just cost too much so I'd say so the the current average intake of fructose in America is I think around 55 grams a day so that's a moderate amount but it's not as high as you might think the issue is that that masks variability on the top end like the the top quintile or whatever those people are eating like 80 grams you know 90 even a hundred grams of fructose a day that's enough to match the fructose overdosing studies so those people are screwed because they're gonna get fatty liver they're gonna have intestinal problems their their bodies eventually gonna shut down as they get older so I'd say a kind of safe range my 20 to 50 grams and you shouldn't have fear if you eat around 30 grams that seems normal to me okay excellent a follow-up question to that is like we talked about the amount but there is there a difference if you for example consume it from fruit compared to pure fruit juice for yeah there is so um as far as I've seen there's never been a study linking bad health there have been like in vitro study or something but no real clinical trial over weeks or months and that's because of a few things so you know they always say you know fruits good and juice is bad don't feed your kids juice or else they're gonna get dental caries and they're gonna get diabetes and whatever like most pieces of nutrition advice that's false because juice is not intrinsically bad it's it's because it's from fruit that it's not nearly as bad as even a higher dose of sugar from coke and the reason is that when you look at studies of like orange juice now granted most of these are funded by the orange juice industry but I don't think they're that evil so the orange shoes that you drink it's been shown to in moderate amounts decrease the amount of endotoxin produced by bacteria in your gut which is extremely important because that endotoxin aka LPS aka lipopolysaccharide it's bits and pieces of the bacteria in your gut that generally you don't want around and causes inflammation and then bad stuff later on so orange juice if taken with you know like a steak or something not that I'm saying you should eat steak with orange juice although that could taste good maybe for breakfast that actually the fat from the steak could increase the permeability of your intestine and then it could increase the amount of those bacterial bits that get through so that's bad but the orange juice will suppress that so they don't know all the mechanisms yet but because it's fruit it's related to phytochemicals and the fruit and you don't get that from other sugary beverages so I'm not saying you should drink juice all every day but fruit is generally healthy overdoses of fruit are not really ever seen and the people who should watch out for fruit are the people with intestinal issues not the people with metabolic issues the people with intestinal issues need to watch out for the fruit because of the fiber because you can never be sure what types of fiber your gut bacteria your personal gut bacteria like and they don't like so you should titrate up your dose of fruit if you have intestine issues otherwise you know eat fruit til the cows come home excellent yeah because I think this is a very good thing to talk about because people when they hear fructose it the fear made people eat like eliminating fruits from from their diets but they didn't really eliminate the other sources to fructose that we have in our diet but if like hypothetically if we were to say like the upper limit is 30 to 50 grams of fructose a day if you were to consume that from fruit how much fruit are we talking about you know the studies that look at different doses of fructose and health that's kind of where I base this 30 to 50 from which I'm not sticking to I'm just throwing that out there fruit I there's people who you know probably some of your readers have logged all their food intake you know on my fitness pal or chronometer or whatever to see what the fructose adds up to I think you can eat you know tons of fruit and still be healthy because it doesn't affect any known parameters so it doesn't negatively affect blood sugar doesn't negatively affect lipids doesn't negatively affect body weight it's possible that if you eat only fruit that you'll get too much triglyceride because triglyceride is the one thing that you can reliably increase by eating fructose I think the lowest doses that have been seen or maybe 40 grams or so and it increases triglycerides a lot more and heavier people than it doesn't lighter people but still that is that's the one thing that could possibly happen but with with other people so males and females who exercise along with all premenopausal females dose is fairly beneficial because those people tend to have good results from clinical trials much more so than older people or men who don't exercise so when you metabolize fructose and you're something you exercises like I said before that lactic acid can be used by your working muscle so then the liver is not so worried about your fructose that you eat and that can improve physical performance so that's good for you as well and another thing is that fructose is much better at contributing to glycogen within the liver than glucose so if you're using up your glycogen and you want to refuel your liver then it's great you know you eat a bunch of fruit if you can handle it and even other than those two groups of people um this is kind of a touchy issue because people with blood sugar issues especially people who have advanced type 2 diabetes you need to really control their blood sugar or else they'll have bad stuff happen but if you eat a certain dose of fructose I don't remember what it is thirty grams or something a day and you have poor blood sugar regulation then you can get about a point five percent reduction and your hba1c now that's not point five percent this is 0.5 out of like your hba1c is six point two you know minus 0.5 that's a huge absolute decrease in hba1c and that's just from eating enough fruit to provide a catalytic effect of you know then you're not just eating glucose you also have other transporters working and you don't as of high of insulin increase after meals so you get that benefit for hba1c without having the adverse effect on triglycerides without having increased body weight without any of other bad stuff so fruit is almost universally a good thing interesting so to sum it up a bit you you mentioned that you did a meta-analysis on fructose and I think it also was high fructose corn syrup consumption in their guards to liver health you could you please explain what what your findings were in that study and you were what you were looking for sure so we wanted to look at high fructose corn syrup free fructose and sugar sweetened beverages so those are the main things that contain fructose and then see what their effect was on liberal health and the way we estimated that is liver enzymes ast and alt and then also liver fat which isn't so easy to capture and it's like 21 randomized trials that fit the criteria and to of observational studies so the observational studies you know it's important to kind of get a grasp of things but those studies weren't very good in the first place out of the randomized trials we found some decent amount of evidence that linked over feeding of fructose to worsen liver health and increase fat but only in the context of overfeeding fructose above and beyond your normal calorie intake so what that means is that for an average person worrying about the fructose intake they're not gonna go on a diet that has their current calorie intake and then add in 30 grams of fructose a day in free fructose form they're gonna eat fructose with meals um now some of the studies did look at sugar and sugar sweetened beverages and stuff but you really have to eat a lot more fruit dose in order to get bad physical effects now that isn't to say that fructose is not bad it's just the evidence was not very high-quality and the populations are all different so my analysis is good and that there's all these disparate studies and you need to group them together to get an overall picture and that overall picture that we found is that overfeeding fructose can be bad but only if it leads to extra calories so this is again this is where the rubber hits the road I hate that term but this is the crux of the issue um people are always gonna say oh I read these studies and it only shows that fructose is unhealthy in kept in studies that are not isocaloric you know in studies that add fructose above your calories so that's what I thought for years I was like Oh fructose isn't that bad but we don't know what the effect of fructose is on food intake as far as I know I haven't looked at the data recently if it turns out that eating an extra 20 to 30 grams of fructose makes you eat an extra 200 or 300 calories a day that's substantial it's never gonna be 2 or 300 calories but and that's substantial because the combined bad effect from extra calories because fructose is sweeter than glucose and also is not regulated by your current energy intake can deliver those two things combined mean that our appetites probably are not as well regulated when we eat more fruit dose so that combined with the bad effects of fructose independently like advanced glycation end-products increased probability of inflammation that kind of stuff makes it so that people who have metabolic disorders people who are older people who are overweight people who have health conditions should watch out for too much glucose people who are athletes people who are healthy people who are says a lot don't have to worry as much and then athlete specifically should think about eating a bit more fructose because it could replenish liver glycogen and in regards to gut health as well I've seen like when we talk about the food map for for IBS usually it's recommended that you consume if you consume fruits is it's the fruits that contains more glucose than fructose because they seems to cause seem to cause GI issues for for people with IBS but over time I would moderately back that but but not fully cuz at a clinic that I worked at a few years ago the physician did a quantified self tracking program with the patients and then I would work with the patients to see what medications they were taking along with the food they were eating and this is what I found in my n equals you know 20 I people will go on low fodmap diet and they'd be like I'm gonna stick to this low fodmap diet um you know over over two months and see if it helps me but I had this patient who who loved grapes and grapes are pretty much 50% fructose percent glucose so perfect right grapes were the worst offender for their irritable bowel and it can't be the glucose fructose ratio it can't be the fiber because grapes have very little fiber so then you know what is it I don't think researchers really know so I'd say if you're gonna go on a low fodmap diet then go on low fodmap plus very high personalization you know if after like two times the equal glucose fructose fruit isn't helping ditch it and go to something else and if a high fructose fruit is helping keep eating it it's really just a very general guideline to go by yeah and I totally agree I used to work with used to work at a medical clinic so I had a lot of IBS patients and I totally agree with your your view on that and that sometimes when you're working with the fodmap diet and you you see foods that usually trigger symptoms and people actually don't get the reactions from it but then you switch them or like for example lactose is something that people that have I bet should limit or reduce but I've had I've had a couple of patients that even reacted just to two dairy even though they didn't have an allergy so that was also ditched from from the diet yeah I think when people go to some physicians or dieticians then some some guidelines are too strict because the physician or dietician or researcher thinks that they know more than they do we don't know about the microbiome um you know it's gonna be like twenty years until we do so you know people know a lot about sets and reps at the gym they know a lot about what refills liver glycogen they don't know anything about what happens at the intestine so that kind of stuff you know personal experience is much better usually than research yeah excellent excellent point so last question because this is my like this is my area in regards to sports nutrition because it's been over the last couple of years it's been more popular to use fructose especially during like during competitions if you are supposed to consume high amount of carbohydrate during a race for example people have started to use ratio between glucose and fructose instead of just using only glucose could you explain a bit about that the reasoning behind it yeah so fructose and glucose use different transporters and then fructose is catalytic for point glycogen in the liver so typically when you do a trial and you include some fructose then the endurance athlete usually it's an endurance athletics performs better I don't think this is really the case with an aerobic activity but I could be wrong because I haven't read the literature in a while but one of the barriers to something like you know a 5k race or a marathon or especially ultra endurance is liver glycogen depletion liver glycogen depletion sucks because then you get hypoglycemia and then you hit a wall and you can deplete liver glycogen very easily I think a typical person has 150 grams of sugar in their liver and then that if you don't pay attention especially to your diet the day before you can have that amount of sugar so then you're down to like 75 and then you're using that liver glycogen during your event and then suddenly you're down so if you're gonna use like a gel you know carbohydrate gel or something then uhm there's been studies looking at different amounts of glucose and fructose the ratio so you could get something like you know almost a hundred percent fructose almost 1 percent glucose you're never gonna actually find a gel with almost one percent fructose I'm just saying that for hypothetical reasons and then somewhere in between like 5050 so I don't know if there's been a meta-analysis on this but if you kind of put together the data yourself then it's most likely that a predominantly glucose fueled gel and a bit less fructose will lead to the highest rate of glycogen synthesis so 70/30 glucose fructose or something like that so that will maintain blood sugar maintain liver glycogen and then probably lead to a bit lower chance of stomach upset than if you ate all fructose are all glucose which you would never do have either of but and this is a case where I again I've seen this mostly during in turn South Lennox but people's pre-race diets are interesting because the evidence is is not that strong for any particular food so then some people just go for powdered stuff so dextrose has actually absorbed very well so that's a very safe thing to do maltodextrin is pretty much as well some people will eat like a banana or something you know which which has both fructose glucose and starch and if that's safe for them that's great but if you're new to racing other than getting a bananas great but then we saw sometimes we look at these studies for our research digest at examined calm and we saw this one there's this research lab that always like tests a new food for pre-race and they tested pistachios and it turned out that pistachios was like the worst thing to eat before a race and that was because of I think ironically enough things like fruit dance I know if they're specifically fruit dance or some other type of fruit jam like substance but that messes with your gut and the more gut to stress you have the worse you do during the race so it's probably equally important to refuel your liver and make sure that you don't have stomach distress during your athletic activity yeah I totally agree and this is a area that I focus a lot with my endurance athlete that we try to find a strategy for foods that dough doesn't cause stomach upset and we usually do this in in training we don't do it for the first time in competition because yeah sometimes you eat stuff during your your season out of competition and you don't react to it but because of stress and the nerves and stuff like that thing starts to mess up in your system and so we try to do all the testing before competitions that's really smart I actually haven't seen that much but you know people go off of clinic trials law at the time but like those conditions don't match the conditions of a given person so you really need to test something out in a competition like state so yeah pretty clever yeah we always always do that and one of the strategies that we are actually do is lower fiber intake a couple of days in advance we usually lower like dairy lactose containing dairy products we try to eliminate that and we also pay attention to to like fructose and stuff like that because that also seems to cause problems and another thing is like the source of caffeine because I have some athletes that can handle high amounts of caffeine in in supplement form but as soon as they start to consume caffeine from beverages like coffee for example they start to get some symptoms from that yeah you know I we were writing something about caffeine a couple years ago and I saw there was a paper talking about potential mechanisms for why you have to some people have to poop after drinking coffee and I think the guy said that they had always thought that it was purely the caffeine but it turns out it's probably the caffeine plus other stuff in the coffee and you can't replicate that stuff in a supplement so you know people will think oh you know if I take my nodoz or whatever other caffeine supplement I'm fine then they drink coffee before a race and then within 20 minutes they have to poop and they're screwed so yeah supplements versus food that's a pretty interesting topic yeah and the one thing that I wanted to mention follow up in regards to fructose consumption during exercise is that this is a topic that has been like misunderstood in regards to sports nutrition because if you're if you're going to consume up to sixty grams of carbohydrate per hour it doesn't really you don't necessarily need to add in extra fructose but it's when you go from 60 and like from let's say you're gonna consume 90 grams of carbohydrates during an endurance race then where you actually can see a benefit from using a two-to-one ratio between glucose and fructose because you can metabolize six up to 60 grams an hour of glucose but it's above that where it's the the transporters get saturated so then you can add in fructose and you can take more advantage of that I think ya can droop did a study and the highest amounts that you'd oxidized was 78 grams an hour so even though you can consume 90 grams you like the limit seems to be 78 but if you look at other studies that consume 90 grams of glucose it's it's like 60 grams it's where it stopped all the time so like one gram gram one gram a minute yeah and I trust two studies above all else yeah yeah totally agree okay come on thank you so much for agreeing to do this podcast could you please just tell us where people can find more information about you yeah so you can go to examine calm and just send me an email through the contact link there and I respond to all emails we're also on Facebook at facebook.com slash examine calm I'm personally on facebook at slash Miranda July it's a long story but that's not my actual name but that's my facebook address and and we love talking to people who like nutrition sports nutrition or dealing with their health issues or whatever it's kind of all the same as far as research goes so been in touch with us excellent for people that might not know examined outcome is an excellent resource to use in regards to looking at research for different types of supplements and I'm so impressed with the job you guys are doing and recommend it to all my students so thank you so much for doing such such a great job with with examine calm yep it's it's our pleasure we enjoyed it so for this podcast will be available as video on youtube but you can now also listen to it in all you format on on iTunes and I would appreciate if you shared and commented on the video and spread spread it a bit around so people can listen to the great knowledge that Kemal has given us today so Kemal once again thank you so much for taking the time to do this podcast and I wish you a pleasant day yeah I just want to repeat basically what you said this is probably the most underrated podcasts out there so it would be a great service to everybody to send a link cuz more people should probably be listening thank you so much come on have a nice day you too

Channel: Coach Juma Iraki

Views: 7,202

Rating: 4.8293839 out of 5

Keywords: Kamalpatel, fatloss, fructose, irakinutrition

Id: a4pTZLOsUR8

Length: 47min 23sec (2843 seconds)

Published: Fri Aug 12 2016