Learn the Facts about Sugar - How Sugar Impacts your Health

this program is presented by university of california television like what you learn visit our website or follow us on Facebook and Twitter to keep up with the latest UC TV programs okay hi everybody thank you for joining us today I'm Leanne I'm the wellness manager here at UCSF and put on this event with my team we're called living well UCSF I'm sure many of you might have heard about us but what we're really here for today is a wonderful panel discussion with our sugar science experts from UCSF so we're lucky enough to have a wonderful panel here to my right and they're going to help us bring the truth of science on sugar out of the research journals and into our laps so really make it kind of accessible to the everyday person and not necessarily just the researcher they're going to be discussing sugar science the recent initiative it was launched in November I'm sure many of you know what that is but in case you are not aware sugar science is a nationwide initiative that takes unbiased evidence-based research it makes it accessible to the public so here to introduce our panelists today and moderate our discussion is Barbara French Barbara French is our Vice Chancellor of strategic communications and University Relations at UCSF in her role she's charged with developing and implementing communications programs in Champions the university's mission so without further ado I'd like to introduce Barbara French well thank you for all making time to join us today and be here it's pretty amazing when you have a panel of distinguished faculty who are going to help call through thousands of medical journals and help you understand what you need to know particularly at a time when whether or not you're reading Michael Pollan or whether or not you're following the tax on sugar you're kind of saying what do I need to do a lot out there what do I need to know and you know if you grew up at a time where I did where my you know you serve dinner and my mom went and opened a can of string beans right and that was yet it we've come a long way towards kind of trusting what's in the can or package thinking well it must be good for us right it says vegetable on it or it says fruit and really understand what do we need to know how complicated and complex if things have become and what do we as consumers need to know and how can we take an active role in making sure we're healthy our kids are healthy on our communities are healthy so I'm really glad that we've made time for this today so let me introduce our panelists to my immediate right is Dean Schillinger Dean is a professor of medicine and residents here at UCSF and he's also chief of the division of general internal medicine at our affiliate Hospital San Francisco General Hospital he's also an internationally recognized expert in health communication science and his area focus includes health literacy health communication and chronic disease prevention and management so thankfully in the middle as Laura Schmidt Laura's a also a professor here at UCSF in our School of Medicine she has dedicated her career to how lifestyle risk factors such as alcohol poor diet influence chronic disease and health inequities and then to her right is Kristen Kearns Kristen is a postdoc fellow in the School of Medicine and she became interested in the effects of sugar when serving as a dental director for clinic serving low-income populations in Denver Colorado so each of them kind of come together from slightly different perspectives so it should be a dynamic dynamic conversation and we certainly hope you're sitting around thinking about good questions about how do I take this what do I need to know so first up Laura given a torque exactly about what sugar science is and tell us a bit about what it what it is and why it is I am happy to do that liquid sugar is everywhere it's the largest single source of added sugar in our diet and we're drinking way too much of it growing scientific evidence shows taking in too much added sugar from things like soda and sports drinks overloads critical organs which can lead to diseases like heart disease and diabetes there are things you really need to know about sugar go to sugar science org that's our commercial yeah so sugar science and a lead investigator on it it's funded through a private philanthropic donor the Loren John Arnold Foundation and the real goal of sugar science is to get what we know out of the medical journals and into the public awareness and there's a lot as you may have noticed a lot of misinformation and confusing information out there about nutrition and there's also a lot of new interest in the scientific community around sugar wee there's been really a paradigm shift around sugar in the last 5-10 years we used to just worry about you know thinking well sugar it's excess calories sugar makes you fat but now we're realizing that it actually makes you sick and there's a lot of research to support the health harms associated with consuming too much sugar particularly around liver disease diabetes and heart disease and those are the things that we focus on trying to get that message in the word from science out to the community so UCSF is a really cool place to be doing this and the reason why is because we are one of the last remaining a cadet publicly funded public sector academic medical centers in the country there's only one other and we have because of who we are we have a mission to serve the public and sugar science is really about that mission our public service mission trying to reach out and give back to the taxpayers who pay for our salaries and and support our work whether it's through the state of California or through the NIH we're the largest recipient of NIH grants in the country and taxpayers pay for us and we ought to pay back and that's really the heart of what we do as people probably where there's a lot of confusion and misinformation out there we know from scientific reviews that there that there is tremendous bias in the research and due to funding conflicts of interest studies where investigators are funded by industry studies of the relationship between sugar and obesity are five times more likely to report that there's no problem with sugar and obesity if the investigators are funded by industry so while we at sugar science in the in our large 8,000 article we work with our medical library to sift through all the literature and come up with the best information possible we look at that it's not like we exclude studies just because an investigator is industry funding but we think carefully about who's writing it what their agenda might be and we try to be as transparent as possible so our really our watchword is scientific integrity we want people to be able to come hear our message and trust us and if we don't know the right answer we say so so there's hopefully a little bit of humility and what we have to do we're doing this thing right now it's an Instagram campaign and I didn't even know what Instagram was when we started out but I've learned a little bit about social media and it's called hashtag sugar shift 2015 and the idea here is that we all know that people around this time you want to make New Year's resolutions and I'll share with you mine because it's usually like everybody you know they're way way ambitious my 12 year old daughter has a list of 12 resolutions I have one and it's really ambitious it to keep my car clean for the year but sugar shift is about making a small change that allows you to reduce your sugar consumption so we know from we did a careful review of all the expert panels and the guidelines around what would be a healthy amount and we feel that rough probably women should be consuming adult women around 360 spoons of added sugar a day added sugar not the sugar that comes in fruit and and naturally occurring but added sugar and men about nine teaspoons a day that's probably a pretty good recommendation if you can do that and so the sugar shift idea is can we work together as a public and a community to help each other make small changes in our sugar consumption that add up to big changes over time not grandiose I'm going to keep my car clean for a year but small changes that actually will you know make a difference over the course of time and so if you log on to sugar Science org or go to sugar shift 2015 using Twitter you can share with other people your commitment which is kind of a cool thing because when you think about it sharing what you're going to do with a large a bunch of other people are trying to do the same thing that's social support writ large right and we have people writing in from the public talking about all the different things that they're trying I'm just going to this year I'm going to put half of a teaspoon of sugar in my coffee in the morning you know or I'm going to just swap out a glass of water for that one soda a day and small things that will add up to big changes in your metabolic health over the course of the year so we really encourage you to join us in sugar shift we're all on Instagram telling you know you do a little a little thing make yourself a celebrity and really encourage you to do that and and really together I think UCSF as well as the large public following that we've already established in the short time that we've been out there in the media together we really can I think over time change the conversation in America about sugar and health so next up so the big question is kind of how much sugar is too much sugar Laura gave some indication of a range for women and for men and so we're going to ask Christine Kristen to come up and get into this a little bit more how much is too much there we go so I'm going to talk in a little bit more detail about how much sugar we're actually eating and on average we consume 66 pounds of sugar per year just to give you a sense for what that looks like this is a four pound bag of sugar add another pound and a half and that's what we're eating per month on average if you really want to get a sense for it put it in your backpack like I did and walk up Parnassus sugar looks like now the American Heart Association in 2009 came out with some guidelines to help us understand how much sugar really is too much in our diet so they came up with some figures we've got it here on teaspoons so for women the recommendation is no more than six teaspoons of added sugar per day for men it's nine teaspoons and then for children at ranges between three and six depending on their age and weight so to give you a sense for what six teaspoons of sugar which is the max that I should be eating in a day so that's really not very much I mean you can think about easy way to cut things out if you're adding teaspoons of sugar to your tea or coffee in the morning or if you're adding sugar to recipes at home you could certainly cut down on the sweetness but really gosh that's not much at all or some people instead of drinking coffee in the morning might drink a coke can anyone guess how many teaspoons of sugar are in this sixty five grams of sugar in this coke and actually to really understand when you're looking at products you have to be able to convert teaspoons to grams so we would multiply roughly by 425 grams of sugars the most that I should be eating in a day so right off the bat this is almost three times as much sugar that I should be consuming in a day that's pretty incredible when you think about it and then there are other products in the grocery store which by the way about 74 percent of packaged foods in the grocery store contain added sugars then we have products that like to promote themselves as being healthy this nutrigrain bar tells us this has no high fructose corn syrup made with real fruit and whole grains but then if you look at the label which you kind of actually need a magnifying glass to see it 12 grams of sugars that's half of what I should eat in a day and then I don't actually know whether that's added sugar or whether that sugar that comes from the raspberries that are supposedly in this product to really understand I actually have to look at the ingredients label and at sugar science we've actually got a list of all the different names of sugars that can be in a product so it's not just sucrose like the table sugar I had in that bag but it's corn syrup so looking at this the fruit filling made with real fruit the first ingredient is invert sugar and we've got corn syrup oh and then there's the raspberry puree concentrate but you really have to be a sleuth to understand how much added sugar are in these products especially in healthy products so with that three teaspoons of sugar love half your daily that's half my daily exactly that's right so with that I'm gonna turn it back to great so Dean come tell us if we are ingesting too much sugar what's happening how does it make us sick sure before I do that I want to actually wanted to thank Barbara for her support of the scientists on sugar science in this endeavor it's been really an incredible example of how UCSF leadership can support scientists to do their work also Kristin Bull who's been like the genius behind all the communications and then of course Laura Schmidt for for leading us in this effort we've been talking about it for a long time she actually did something about it so that's great so a couple of messages I wanted to convey first and foremost is that people tend to think about the sugar problem as the obesity problem and while sugar absolutely contributes to obesity it is not necessarily the pathway through which bad health happens you can get sick from sugar in the absence of becoming obese you can also get sick from sugar in the presence of obesity but the two are not always entirely linked the three major chronic diseases that are a consequence well I'll say four because we have a dentist on the panel the four major chronic diseases and because it's true the first one is chronic periodontal disease or gum disease and gum disease is bad because you lose your teeth and then you need dentures and then it's harder to eat fresh fruits and vegetables so there's a cycle so periodontal disease the second a major public health issue is cardiovascular disease which means heart disease and stroke the third is type 2 diabetes and the fourth is liver disease and liver failure and I'm going to go into each one of these in some detail first let me just tell a little story it's not on the slide but when I started as a resident at San Francisco General Hospital in my clinic it was pretty rare for me to take care of a patient with diabetes and when I saw a patient with diabetes I just referred them to the diabetes clinic which is the specialist clinic because they were relatively few of them and we were relatively untrained to take care of them in the outpatient setting flash-forward 25 years later I've lost hair I've gained a little weight I know I'm chief of the division and half of my patient visits in clinic are with people who have type 2 diabetes half and you can't say it's because human beings changed that dramatically in one generation something in the environment changed and what really changed was the sugar consumption so that's um fact number one fact number two I just want to make clear because I know many of you are going to have this confusion in your mind which is what is sugar so Kristen was showing you the Domino sugar package that has sucrose in it that's the chemical name sucrose and sucrose is made up of two types of sugar glucose and fructose and what I'm going to talk about next really relate to the fructose component of sugar which appears to be particularly problematic and some people believe even toxic to the body so glucose we kind of digest absorb and our body kind of uses in a fairly seamless way fructose on the other hand is digested absorbed and then is what's called metabolized or processed solely by the liver so all the sugar we eat half of it goes to the liver and the liver is a wonderful organ but it can only do so much so quickly and if the liver gets overwhelmed with fructose like in high fructose corn syrup which is almost exclusively the fructose component of sugar it begins to transform that fructose into fat so the liver becomes fatty so the first problem we see with high exposure and intake of sugar and high fructose corn syrup is fatty liver and fatty liver is one of the components of what is called metabolic syndrome these metabolic diseases that you've heard about in some communities liver failure from this process is more common than liver failure from hepatitis hepatitis A B and C people are needing liver transplants now in this country because of their intake of fructose the second problem we see related to particularly fructose intake is diabetes and then the third is heart disease there have been a number of studies now showing that intake of sugar is directly proportional to the hazard of having heart disease the more sugar added sugar you eat the greater your risk if you're in the highest quintile the highest fifth of the u.s. population in terms of how much added sugar you eat you've got over a two-fold risk of heart attack and stroke even after controlling for adjusting for obesity it's not the obesity it's just the sugar intake so we don't know exactly why this happens it may be that the fat that the liver produces from the fructose then goes into the bloodstream and that fat clogs your arteries we don't really know but we do know that there is this very strong relationship between sugar added sugar intake and heart disease and stroke and then when you have that high level of blood sugar in your mouth and in your bloodstream the bacteria in your mouth and in your bloodstream love to set up shop in the gums it's like a great they're like so happy like Oh sugar yeah let's you know and not only does this periodontal disease cause tooth loss but there's growing evidence that active inflammation in the mouth can promote diabetes can promote kidney failure the need for dialysis these other kinds of chronic diseases that all go together and as you know diabetes itself is a horrible disease related to blindness amputations kidney failure impotence you name it you can get it from type 2 diabetes so in sum the excessive intake of added sugar and we're not talking about people who are drinking 19 cokes a day we're talking about what Kristin was presenting leads to a disruption in the normal function of the liver which can't process this fructose instead it begins to create fat in the liver and make you insulin resistant which in turn leads to diabetes heart disease periodontal disease maybe kidney disease and some tantalizing evidence although small about even causing progression of cancer and poor recovery from from cancer that's early science but clearly related to these metabolic spectrum of diseases and we need to intervene at the individual level we need to intervene at the institutional level under the societal level if we're going to reduce the burden of a preventable set of diseases in our population I'll just say one last thing and then I'll pass it off which is that I work at Santa Croce no hospital which obviously takes care of folks in the southeast corner of the city where there's the highest double triple quadruple the rate of consumption of agar added sugars in in the diet as compared to let's say this neighborhood and yet that population is the least aware of the science that we're presenting so there have to be efforts to kind of spread the word in a way that can be both understood and accepted because we're asking people to make some fundamental changes in their choices changes that sometimes have deep economic impacts because to buy healthy food you got to pay more money so I'll stop there Thanks definitely want to make sure we have ample time for questions but all this kind of leads us I know if you're like me you're sitting there and thinking okay well I don't drink soda so I'm safe right and is there you know something else I need to be aware of how can I make little changes during my day or encourage my family to make little changes during the day even if I don't keep soda in the house what are the other things I need to be bought mindful of so Laura do you want to give us just a couple of examples yeah yeah because one of the things you know that we've really trust is it tried to do with sugar science is you know the news especially the news we just heard from Dean it's kind of hard to hear it's tough stuff and most of us just like smoking back in the 50s you know you grow up thinking oh well everybody does this it's benign and so now the scientific communities in the hard position of having to say hey something you love and think is benign and fine is actually harmful to your health and so that's a hard message to share and so one of the you know working we've had this wonderful communications team courtesy of Barb and and Kristin Bolin and our own local communication specialists and and we've really tried to soften the message make it understandable clear interpretable and to just so that we're not just constantly barking bad news at people and so one of the things that we try to do is share with people small changes that they can make that can add up to big improvements and because added sugars and 74% of the packaged foods in the supermarket it's hiding everywhere and that makes and labels are not adequate for actually helping people navigate how much added sugar is in any given product so the first thing we suggest people do is to really really cut down or cut out those sugary beverages sports drinks sodas fruit drinks where it's fr OoT and the reason it the there couple reasons one is because these products provide you with very limited if any nutritional value and a very as Kristen pointed out a really heavy dose of sugar in fact one coke is more than the recommended dose for or one soda for a woman on a daily basis so that's a first step in it people if the American public were able to completely cut out sugary drinks we would lower our collective sugar consumption by 37% so that's a big whopping chunk of it and there's I don't want to get into all of the details but sugar science org shares a lot of this information about why it is that liquid sugar has particularly harmful consequences for the kinds of metabolic mechanisms and disease processes that Dean was reviewing with you and by the liquid sugar you mean sports drinks sodas and fruit drinks without fruit the second thing we really encourage people to do is read those labels and if you go to sugar Science org we sent our team out and we looked at every label we could in grocery stores and round' online and stuff and we came up with 61 different names for sugar on the ingredients label right and so you know the typical you know label will say you know it's got you know it's got invert sugar and then it's got some some you know multi Textron and dextrose and then some maltose and you know what all of that stew sugar and so that helps you you know that if it says that stuff it's been added to the product and so that's the way for now until we have a sugar a nutritional label that actually pulls out and says here's how much added sugars in the product which the FDA is considering doing right now you can you can at least know that you're consuming added sugar and you should and and so when it says total sugar you know there's a lot of added sugar if it's got any of those chemical names on the product and so those would be the first two simple steps lower if not completely withdraw sugary beverages from your diet and look at those labels and try to try to avoid the hidden sugars you know it's a lot if you're taking that sugar at the table and you're holding it a teaspoon and you're putting it in something you know how much you're consuming right you're looking at it but if it's hidden in a product that's marketed as healthy if it's hidden in a product that says you know high in vitamin C and if it's hidden in a product because you need to be a chemist to read the ingredients label then that's a concern so avoiding the packaged products in general but particularly those could have it as sugary can I just comment on that because that is obviously my kids give me incessant grief about this because I buy breakfast cereals that are relatively low and you know there's one cereal that won't be named you look on the on the back and that's it says there's 12 grams of added sugar so 12 divided by 4 that's 3 grams so that's half of what of a woman or that's the total dose of my eight-year-old that's it for the day right that one bowl of cereal right 3 teaspoons because that's 12 divided by 4 is 3 teaspoons but you have to also remember that that's for one portion of cereal which is like a really tiny bowl of cereal and so it's not that you can eat as much as you want you're going to get 3 teaspoons you can eat one little tiny bowl of it and that's half of your daily sugar so the whole portion size thing is also pretty dice that's very important ok let's let's get into q and A's I think to start out the sugar addictive well I happen to be an addiction researcher and right now the jury's out we know the thing we know there are a lot of different things that go into addiction loss of control preoccupation with the substance withdrawal tolerance there are a lot of things that go into what qualifies in terms of a psychiatric definition of addiction what we do know for you know we have very solid evidence on and we need more research in this area and this is going to be a big thrust I think in the coming years in in medical research to really nail down how do sugary foods as well as hyper palatable foods foods loaded with salt and fat as well as sugar how are they addictive and in what ways we have a lot of wonderful research going on here on campus around stress Elizabeth Elizabeth work she's on our team looks at stress and stress eating as well and we know there's a connection we just haven't quite done all the research to to be able to say it's addictive but we do know one thing people crave it and the way we know we know that there's craving we study rats that from rats studies but we also know from human fMRI functional residents magnetic resonance imaging research when you put a person who's a addicted to cocaine or addicted to some other other drug of abuse into an MRI and you show them say the works you show them you know if they're heroin addict you show them an image that makes them think of the of the substance they're addicted to you'll see part certain regions of the brain light up and you will also see changes in dopamine levels it's a neurotransmitter chemical in the brain actual changes over time a phenomenon we call dopamine down regulation so the brain itself actually adjusts to the constant reintroduction of addictive substances in the brain and so we can image in in fMRI studies we know that for people who claim that they crave and sugar and have difficulty not consuming sugar we can image craving and from our rat and our human studies we also have nailed down the phenomenon of dopamine down regulation which is actual changes in this in the levels of chemicals in the brain and the neurotransmitters that bind to those chemicals and so we know we have pretty good evidence that that when people say I'm a junk food junkie and I can't stop thinking about I'm craving it that that that's a actual phenomenon and that is great the craving the craving images that you said with the sugar person are they essentially the same images you have with the heroin guy we're the same we will see the same thing of carrion light up in the brain and so this tells us that one of the hallmarks of addiction not every so there are a lot of different things that go into the disorder that we call addiction one of the hallmarks craving we have pretty strong evidence that sugar does the same thing that other drugs that we we view is addictive right I'm going to move us along because we have a lot of good questions so we have a whole Bank questions around alternatives like stevia agave what about sweeteners like Truvia are artificial sweeteners bad what sugar substitutes are okay to consume Britain so kind of all-around sugar substitutes and how do we look at them I'm gonna get that question you gotta Kristin that's a tough question actually artificial sweeteners they are regulated by the Food and Drug Administration I do look at the safety of sugars and so our products that are on the market are considered to be safe by the FDA however there are some studies that have come out more recently that are looking at artificial sweeteners in slightly different ways looking at changes in the bacteria in our gut for example was that done here right that no that was the one in nature yeah yeah there was a no not here you know more about that one do you wanna yeah describe there's actually a series of studies now the nature is one of the premier science journals in the world and so the one in nature which included studies of animals as well as humans looked at a variety of popular artificial sweeteners on the market a spar tame sucralose and saccharine and in both the animal studies and the human studies what they showed was that they raised so-so backing up a minute we've known for a long time that artificial sweetener consumption ironically is connected to increased gait weight gain and metabolic disease and so people have been saying why would that be you know they have no calories what's going on there and these guys actually figured out the answer that question the artificial sweeteners were producing a condition very related you know that dean talked about called glucose intolerance and what essentially that what they found was that there's this in our gut there's this wonderful microflora right you know those probiotics and yogurt that people are encouraged to consume that stuff is really really important for our health they talked about it now is the microbiome like a it's a it's a whole natural system living in our in our in our guts and that microbiome the the beneficial bacteria that aid in our digestion and absorption of nutrients are killed by artificial sweeteners and as a result of that through pretty complex cascade of changes going on in the body it you wind up producing glucose intolerance one of the hallmarks of metabolic disease insulin resistance insulin resistance so how about everything that Dean is seen in his diabetic patients so how about honey which is another alternative people well I guess if I'm going to choose between honey and table sugar I would probably go with honey because we do know that honey actually contains some additional good things like antioxidants potentially some vitamins so honey honey is glucose right so it doesn't have it has a desert mostly glucose but doesn't have fructose in some it does yeah and well and honey gets complicated because there's all different types of honey some is more refined than others some you get your local farmers market you know with the local bees so honey it's complicated but it does have some additional things in it that make it slightly different than the typical sugars I think it was I I have to look you know go to sugar science Touareg we have a blog on this and it actually I think we give the ratio I think it's it's not a lot it's slightly higher in glucose and lower in fructose but interestingly it has slightly more calories than table sugar but on the other hand you know maybe people and with this we have no research on maybe people put a little less of it in because it's so so viscous but but it was interesting because we have this wonderful we have a great library here at UCSF it is world class and they have been collaborators with us and we have a wonderful medical librarian on our team Evans Whitaker and we asked all of our specialists you know we got 12 people nutritionists and they all said huh honey I don't know I'm I'm thinking it's probably just the same as other kinds of sugar so wit goes and does an exhaustive pubmed you know search the literature and lo and behold he turns up all these studies that have been done in the Mideast that demonstrate actually with honey consumption not in excess but in in in in small amounts some potential heart health protection so as Kristen said if it's going to be a choice between table sugar and honey and and and you think that honey is probably coming from real bees and hasn't been processed through a factory it might be not a bad idea to pick the honey we still recommend people try to stay within those six teaspoons for women nine teaspoons for men limits it's there on the kind of these kind of areas what's the difference between regular sugar what a consumer would call regular sugar and if I go into my health food store and I see something called raw sugar right what's the difference well so far we Kimber Stanhope on our team who is a nutrition expert and and does experimental studies and wit our librarian have both looked into this issue and at this point molasses may have some antioxidants that that may be like kind of like honey there isn't a lot of research on it the but most forms of raw sugar and so forth they're probably going to impact your your metabolic health in a manner quite similar to table sugar okay how about diet sodas yeah well we already talked about about artificial sweeteners a lot of people ask about stevia because it's being marketed right now as a natural product but where do Arnett where do most of our artificial sweeteners come from well they're synthetically made so stevia is kind of a complicated case but the actual sweetener it's rebbe a foreshortened so that actually that has been looked at by the FDA and again stamped that it is safe but i think there's a lot that we don't know about stevia it's a new product not all of the stevia based brands are quite the same so i think there's the jury is still out there's a lot there was a recent study of stevia was a fairly well done study that showed that it increased insulin resistance and increased blood sugar and the irony there is that stevia has been heavily promoted as the sugar substitute for people with diabetes yeah so that's really the only study of stevia because it's so new on the market that's the only one we sugar science we like to really be careful so we like to produce what we call robust resilient shares scientific robust evidence so where we have numerous studies from rats and humans and all different kinds of studies done over and over again that boy basically point to the same conclusion when we did the Lit search there's just this one one study on stevia but the so it sounds like it's probably in the territory of the other artificial sweeteners not so good for your metabolic health what you know we got a lot into the disease ramifications so a couple of questions around are the diseases you discuss like type 2 and fatty liver if you stop eating sugar you cut back are they reversible so yeah I can respond to that there's no question particularly early in the course of the disease in type 2 diabetes and in fatty liver that if you severely curb your sugar intake that you can in the majority of cases return your blood indicators to to normal once you know once you've had diabetes for two three four years again it then it gets harder to do but there are also a number of studies in the pediatric literature where they see a lot of fatty liver of interventions that reduce sugar consumption and the fatty liver resolves to normal on imaging studies what about the what do we need to know about alcohol and sugar well if you're mixing drinks with sugary beverages those count those get back three counts the daiquiri counts alcohol itself typically we looked into this because we have a lot of people asking this question and there doesn't tend to be a lot of added sugar in say glass or wine or beer yeah it's not typical to have it added but is it safe to say that we don't know if there are interactive effects between sugar and alcohol with respective for example liver damage well we actually there's somebody at University of Colorado who's doing research on this very issue it's unpublished and so it isn't yet peer-reviewed it's in in the hopper that suggests that indeed there are adverse interactions for the liver not for the liver consuming from fructose along with alcohol and also salt so those salty snacks when those mixed bar drinks may in fact be problematic but this is only early studies on animals and so it's the kind of results that we say what we like to do is call it emerging science we watch we're going to watch it we're going to the minute we feel like there's a lot of robust evidence we'll report it out great question great question yeah so once once the alcohol hits your liver just like the fructose the process what your liver does with it it's a process called de novo epigenesis and what you're what what the your liver does with the alcohol is identical to what it does with the fructose make fat it makes fat it lays down fat in the liver and it sends fat out into the bloodstream leading to a condition called lipid e a dis lipedema which is why it's important to go in and get your blood tested and the and what's great you'll see on sugar science org is one of the there's only one way that you yourself can self diagnosis is if you suspect you might have metabolic syndrome and that's because just like a person who drinks too much alcohol gets a beer belly you'll get a sugar belly people with with metabolic syndrome tend to have a lot of fat around the waist and so even if you're thin but you have a lot of fat around the waist that could be an indication that you might have metabolic syndrome and it's really worth most of the features of metabolic syndrome you needed to go to your doctor your primary care doc and get blood tests drawn but the one way that a person looking at themselves or their son or daughter or grandparent can wonder if they might have it is to see that sugar belly and so that alcohol is operating in the liver in the very same process that the fructose is as well as trans fats by the way about trans fats also how about if you have a question why don't you write it how about rice I've heard recently people say well don't eat white rice because that's like eating sugar and then somebody the other week said to me while brown rice is just white rice in a brown suit so what I can try yeah I mean I can I get this comes up a lot for people with diabetes I have a large Asian population they eat a lot of rice and we have long discussions about rice so the classic teaching is that rice is a complex carbohydrate meaning it's it's a lot of sugars lined up together bonded together the benefit of that is that it takes a lot longer to digest and and change those into the individual glucose molecules and therefore you don't get that spike in blood sugar that you get with liquid sugar the classic teaching also is that brown rice because it is not refined because the I think is the hull is still on the the rice that that takes even longer to digest and so is less harmful than white rice which is less harmful than liquid sugar there was a recent study that many of you probably heard about in the news about glycemic load that kind of has us all up in arms and wondering you know what to make of this classic teaching about brown rice being better than white rice I'm wearing they didn't actually find that to be the case in this one single study and like Laura had said I mean it is one study and it flies in the face of many many studies that have suggested that the less refined the food is the more healthy it is so I haven't changed my practice in terms of my nutritional counseling for my patients with diabetes I don't know what you guys think about that latest study and and its implications and and in and so your white foods your white carbohydrates are good at brazos pretty darn fast into their lot like Dean said their long chains of glucose molecules and they're gonna break down pretty fast and where does the digestion start in the mouth in the mouth and what does it do to teeth well sure yeah fermentable carbohydrates we call them anything that's going to be broken down by bacteria it can be harmful to the mouth so those bacteria will right away as Dean mentioned before start turning those sugars into acids even if it's white rice or brown rice that will occur so certainly from a dental standpoint that's not the core to think about as well that you know if you're on Weight Watchers one of the things they say you know you have your little for those of us who have done it right you have your little handheld and if you eat fruit or vegetables no points right so all of a sudden I'm hearing fruits sugar right so I'm eating I'm upping my course of fruit because it doesn't count towards points because it has fiber do I need to be worried about the sugar and absolutely not this has been a topic of a lot of debate in the literature on cardiovascular disease and what we know is that fruit consumption is protective of cardiovascular disease an added sugar refined sugar consumption is detrimental it increases your risk of cardiovascular disease and cardiovascular mortality dying from heart disease as well the discussions around mechanisms there's a lot of research in this area that why fruit would help will help you prevent heart disease and added sugar and refined sugar wouldn't would harm you the current understanding is that when you eat that that fructose and the glucose in the fruit it comes with fiber it takes your body a long time to process through that fiber to get that fructose and that glucose out that gives your liver your pancreas the whole system a lot of time to work to process that stuff so you're not just hitting those organs with a blast of sugar and asking them to process things very quickly and at the same time Kimber Stanhope on our team is very interested in the fact that the antioxidants and various phytonutrients that come in fruit might actually operate in the gut to help whatever harmful effects of fructose there might be on the liver those antioxidants and goods good thing nutrients that come with the fruit might actually support improve your health and mitigate any harms that would be caused by for the fructose in the liver thank you so on in the audience says they they exercise a lot and they tend to rely on sports drinks so their question is what should I drink during and after long workouts for sustained energy if it's not sports drinks I can tackle that I mean III think that there is a market-driven assumption that most types of exercise recreational or otherwise leads to these profound imbalances and electrolytes and glucose and protein and and they've essentially created a niche that needs to be filled by their product with very rare exception that is entirely false I mean if you run a marathon or do a triathlon or whatever certainly you have to replenish you know your fluids and your electrolytes and your nutrients I think for the overwhelming majority of cases nothing is needed what other than yeah water and then eating your meal after your exercise I mean there there is really some compelling evidence particularly among children that all the benefits of exercise like kids playing soccer are being mitigated or reversed because their parents then attack them at halftime with the forgiveness and the energy drinks and whatever and like the kid has like kicked the ball once I mean I think there is validity to the question if the level of exercise is at the level that would truly you know extinguish your electrolyte and then in a systematic review that was recently published that looked at for athletes do these drinks enhance performance 50% of the formulations did nothing for for athletes the other there's a there's also been recently in the British Medical Journal a wonderful review of the research on sports drinks and it turns out that the vast majority of these studies have been industry funded and while not well just because an investigator accepts industry funding doesn't mean that everything they say is inaccurate as I pointed out before we have evidence that studies funded by industry have a palpable a higher probability of coming out with quote industry friendly findings so we're really careful when we it sugar science and looking looking at those things we so we have one other question that I'm line full of time is that this role that was more dangerous for us or is it a pace at which could actually mean it's the visceral therapy question the oh it what what kind of fad is it what's the concern with sugar belly what kind of fad is on the is is hanging around your your midsection and the concern there is that it's visceral fat which would be and and there's evidence that the it's a it's a unique kind of fat that produces hormonal signaling and may very well have its own adverse impact on the balance of hormones in your body and so it's not it's not benign fat it's it's it's fat that selectively deposited on your belly and has this property of hormonal signaling that endocrinologists are really concerned about it's probably sending out bad messages to the brain and other parts of the body one of the inches for me just for men is forty inches it's on it's all on science dot org every bit of it we so the two takeaways are go to sugar science org okay and go to and use hashtag sugar shift 2015 and tell us what it one thing one small thing you're going to do so what I have what I'm going to do is drink water more water instead of reaching for that fruit drink we literally have millions of people who are that we're reaching are reaching out to us on Twitter and social media but it would be very powerful for folks at UCSF one of the nation's leading academic medical centers at Health Sciences campuses to write in with their ideas about how to shift our sugar intake it can be really far right big hand thank you very much you

Channel: University of California Television (UCTV)

Views: 374,162

Rating: 4.7257142 out of 5

Keywords: sugar, health, diet, obesity, liver

Id: XM0vyUUvO9E

Length: 54min 54sec (3294 seconds)

Published: Wed May 06 2015