What’s the number one killer in the developed world right now, and the leading health problem for both sexes? Surveys would tell you that 7 out of 10 women might say it was breast cancer, but make no mistake, it’s heart disease. And it’s caused by a confluence of our diet and lifestyle. It’s not a disease of later life, either. Even at young ages, arteries can show extensive atherosclerotic plaques – the buildup of fat in the walls of the arteries that can block bloodflow, release inflammatory mediators, and rupture to cause strokes and heart attacks. Using intravascular ultrasound, a cool technique where a catheter containing an ultrasonic probe is used to create a 3D map of blood vessels from the inside, has allowed researchers to visualize extensive plaque build up in the coronary arteries of transplant donor hearts from 19 year olds who were otherwise healthy.
There is no denying the increasing prevalence of obesity in the US, and it’s spreading to other industrialized nations. This epidemic is characterized by spectrum of weight-related disorders, including hypertension, insulin resistance, obesity – these combine to form what’s known as metabolic syndrome. As many as 1/4 to 1/2 the US population may suffer from metabolic syndrome. Metabolic syndrome begins early in life, starting with sedentary children who get too many empty calories. Lots of saturated fats have been the traditional culprits, but new evidence also suggests a role for fructose.
In the US, a very vocal and powerful sugar lobby has ensured that sugar imports into the country are very expensive. As a result, the corn industry takes advantage of this to create high fructose corn syrup (HFCS) through of a process that breaks down the starch in corn into glucose, some of which is then converted into fructose enzymatically. This is then combined with glucose to be blended and formulated into various grades; these normally contain 42 percent, 55 percent or up to 90 percent fructose. This syrup is then used by commercial food manufacturers in just about every processed food you find in the US today; cereals, breads, sweets, soft drinks, condiments, prepackaged meals, fast food – it is almost ubiquitous. But is it bad for you?
More after the jump
As you may have learnt in biology, glucose is essential to all cells. It is metabolized by every cell in the body, then used to provide ATP via the Krebs cycle. This provides every living organism with the energy needed to live. Fructose, on the other hand, is not metabolized in the same way. In fact, it is only broken down in the liver, and stimulates production of glycogen, a complex polysaccharide, and lipids, so most of the energy contained gets stored, rather than used. In addition, fructose does not cause a satiating response, and does not stimulate insulin production in the short term, and can cause insulin resistance following chronic exposure. Finally, fructose also increases production of LDL cholesterol, which is the bad kind that is a driving force in CVD.
So fructose isn’t that great for us, but here it’s important to note that normal refined sugar, the kind the rest of the world uses and gets from sugar cane, also contains fructose, and in similar proportions to the lower blends of HFCS. So in and of itself, HFCS probably isn’t any worse for you than refined castor sugar. But here’s the kicker – over the past few decades, sugar intake has been increasing. Whether it be caused by consumers expectations for free refills of their enormous soft drink containers at fast food restaurants, or the inclusion of sugars in just about every prepackaged or processed food, refined sugars are making up more and more of our diets. Alongside this, children and adults are exercising less and less, preferring instead to sit in front of TV screens, content to only exercise their thumbs. As a society, we are eating ourselves to death.
Of course, not everyone is taking it lying down. Although HFCS is probably only as bad for you as refined sugar, as mentioned above, it is fast gaining notoriety amongst the general public. More and more people I speak to relate how they spend longer in the supermarket aisles, scanning ingredient labels to cut down on their intake. Raising public awareness is good. The medical profession, who spend increasing amounts of time dealing with the consequences of metabolic syndrome and our sugar addiction, are also making noise. At the annual American Medical Association conference, delegates are suggesting that a tax be levied on sugary sodas . Although I can already hear your outraged comments over this suggestion, I’m sure similar anger was present when taxes were proposed on alcohol and tobacco. As a society we have accepted that those socially damaging behaviors merit sin taxes – why should obesity be any different?
In the meantime, there are things that you can do personally to help stop the tide of this epidemic. Get some exercise. It doesn’t even need to be that much. Take the stairs instead of using the elevator at work. Walk to the corner store instead of driving. If you need to drive, park all the way on the far side of the lot. Drink more water. Eat more fresh vegetables. That kind of thing. You know your heart, and your waistline, will thank you for it.