Fructose and glucose are both sugars, but they are not the same. High-fructose corn syrup was invented in the 1970s and began to replace regular sugar around 1975. The obesity epidemic coincides with the use of HFCS, and vegetable oils and ultra-processed grain also increased in the mid-1970s. The per capita consumption of HFCS — the mainstay of soft drinks and other sweetened beverages — has increased from 38.2 pounds in 1980 to 868 pounds in 1998. In 1942, the annual U.S. production of soft drinks was 90 8-oz. servings per person; in 2000, it was 600 servings.
Like glucose, fructose is absorbed directly into your bloodstream from the small intestine. However, fructose is 20 times more likely to cause fatty liver (the key problem of insulin resistance) compared to glucose alone. In fructose feeding studies, replacing glucose with a calorically equal amount of fructose results in a documented 5x increase in de novo lipogenesis and increased liver fat by 38% within eight days. Fructose induces insulin resistance in less than eight weeks, even at typical consumption doses.
Fructose increases the hunger hormone ghrelin, which makes you feel less full after eating, increasing consumption. It also preferentially activates the reward pathways.
Glucose activates the cortex, the basal ganglia, certain other parts, but not the limbic system, and results in a sensation of serotonin-induced happiness. By contrast, fructose stimulates the limbic system and is associated with increased dopamine release in the nucleus acumens, similar to other addictive drugs (glucose does not stimulate the nucleus acumens). Fructose results in a sensation of dopamine-induced pleasure.
Ask yourself why soda companies would spike HFCS with extra fructose, at an additional cost.
Not all food is created equal, and some are even more (ultra) processed than others, thus contributing to gut dysfunction. The purpose of ultra-processing food is to create branded, convenient (durable, ready to consume), attractive (hyper-palatable), and profitable (low-cost ingredients) food products.
Ultra-processed food is made from food-like substances and additives, with little intact natural food. These ingredients are not normally used in natural culinary preparations.
Additives include preservatives, antioxidants, and stabilizers to reduce normal degradation and lengthen shelf life. Some additives enhance the sensory qualities of foods or disguise unpalatable aspects of the final product (dyes and other colors, color stabilizers, flavors, flavor enhancers, non-sugar sweeteners). Processing additives (such as carbonating, firming, bulking, and anti-bulking, de-foaming, anti-caking, and glazing agents, emulsifiers, sequestrants, and humectants) increase gut permeability. Processing with heat extrusion can create de novo compounds, some of which are carcinogens. The preparation and milling of food into shelf-stable acellular materials increases the rapidity of gut absorption, contributing to hepatic dysfunction.
Ultra-processed foods makeup 57.9% of dietary intake and contribute 89.7% of the energy intake from added sugars. These empty-calorie foods contain minimal bioavailable essential nutrients and displace more nutrient-dense foods, which leads to an overfed and yet undernourished population.
Consuming ultra-processed food leads to metainflammation through gut dysfunction. Metainflammation is the root cause of most diseases of Western civilization: obesity, diabetes, heart disease, cancer, cognitive decline, autoimmune dysfunction, and chronic pain.
Many people consume far more carbohydrates in their diets than they actually need. Once, a patient asked me how much carbohydrates she should be eating every day because her dietitian told her she needs at least 250 grams per day or she could get brain injury from “hypoglycemia.” The Dietary Guidelines published by the USDA, The Institute of Medicine, and The American Heart Association recommend that carbohydrates make up 45 to 65 percent of total daily calories. Based upon 2,000 calories/day, between 900 and 1,300 calories should be from carbohydrates (225 and 325 grams of carbohydrates a day). Historically, the brain has been considered the only organ that requires glucose as a fuel source, utilizing approximately 100-140 g glucose per day. However, with keto-adaptation, the CNS reduces the obligatory glucose requirement by approximately 80%, resulting in a true utilization of 20-28 g glucose/d.
Endogenous glucose production through gluconeogenesis is approximately 2.8-3.6 g/kg/d, or approximately 210-270 g/d in a 70kg human, far greater than the obligatory requirement of 20-28g glucose/d of the keto adapted human. According to the Food and Nutrition Board of the Institute of Medicine of the US National Academies of Sciences, “The lower limit of dietary carbohydrate compatible with life apparently is zero, provided that adequate amounts of protein and fat are consumed.” This does not mean that patients should strive to eat zero carbohydrates; what it means is that half your calories don’t need to come from carbohydrates.
Dr Gurpreet Padda
For years, fat has been targeted as one of the main causes of obesity, but fat in someone’s diet isn’t what makes someone fat. The diet-heart hypothesis falsely attributed eating fat with the development of atherosclerotic heart disease. This anti-lipid agenda led to the low-fat craze, which replaced fat with tasty acellular carbohydrates, paradoxically resulting in a dramatic rise in the obesity rate and a worsening of heart disease, obesity, and diabetes.
Reducing fat intake is not the key to reducing obesity. Re-examining macronutrients in the diet as well as understanding satiety (feeling full) and controlling food intake is the key.
Replacing carbohydrates with avocado increased feelings of satiety, and this was caused primarily by PYY, a peptide hormone secreted by cells lining the ileum and the colon. PYY decreases food intake by inhibiting gut motility, acting as an “ileal brake” to cause a sense of satiety. According to the National Institutes of Health, “replacing carbohydrate with fats and fibers derived from avocados without increasing energy or energy-density enhanced the satiety value of meals in overweight and obese individuals as evidenced by greater hunger suppression.”
Conclusion:
Fat is a potent stimulator of PYY, enhancing satiety and reducing motivation to eat, keeping you full for 6-8 hours. By contrast, carbohydrates increase motivation to eat and don’t significantly increase PYY. Carbohydrates increase insulin, and in obese individuals cause reactive hypoglycemia, making them hungry in 2-3 hours.
That’s why people on whole natural food diets that are higher in fat tend to weigh less and have less heart disease and diabetes.
Lanjun Zhu, et al. Nutrients, 2019; 11 (5): 952
All calories are not created equal, and even the word itself has different definitions. A calorie in physics is the energy required to raise the temperature of 1 gram of water to 1 °C. The calorie you see on a food package, however, is actually a kilocalorie, or 1,000 calories, the amount of energy needed to raise the temperature of 1 kilogram of water 1 degree Celsius.
The original method used to determine calories in a given food directly measured the energy it produced. The food was placed in a bomb calorimeter, a sealed container surrounded by water. The food was completely burned and the resulting rise in water temperature was measured.
Calories in food and calories as measured in physics are not the same. Nutritional calories exclude non-digestible components, such as dietary fiber and artificial sweeteners, both of which could be burned in a bomb calorimeter to generate heat. Many of these human non-digestible components, like cellulose, are the primary energy source for other species.
These human nutritional calories are the energy available in food, which our body can use for chemical reactions or store in reserve as fat or glycogen; we count the calorie value that the body can extract from the food consumed, ignoring the thermic energy consumed in breaking the food down for consumption, the non-digestible components, and the interaction of that food as a signaling molecule
It’s what your body does with the information encoded in your food that is important, not just that there is the energy contained in the chemistry. Knowing the alphabet doesn’t make you a poet; it’s what you do with the individual words. Some are drunken sailors and others are poets, though they use the same letters.
Dr. Gurpreet Padda
A paradox happens when something that seems as though it should not be true actually turns out to be true, or vice versa. A paradox is happening in nutritional science where a high-calorie consumption of one food causes weight gain, while the same calorie value of another food seems to cause weight loss, leading some to suggest that calories don’t count. However, the laws of physics are not broken. In energy balance, calories matter.
A surplus of calories whether fat, protein, or carbohydrate will all lead to weight gain. What’s relevant is the quality of the calorie and the body’s response to those specific nutrients as signaling molecules beyond the direct caloric value.
The ability of the body to convert food into usable energy is based upon a highly complex process, starting with a mechanical breakdown of food, chemical, and enzymatic processes throughout the gut and significantly affected by the individual microbiome.
Food is both a nutrient and programming.
Food should be viewed as both a source of nutrient energy (globally translated as calories), but also a set of instructions to the body, a program directing the body to a specific action. Food is not completely degraded to its elemental parts during digestion; it maintains components of integrity, which then programs the cells. A corrupted program can lead to outcomes such as obesity or diabetes or even an autoimmune state. These instructions are not interpreted just by the body, but also the gut microbiome, which can independently translate the instruction set and create its own programming subroutine, which then affects the body.
Conventional nutritional advice ignores the instructional programming code carried in the food we consume, but these instructional programs cannot be ignored.
Satiety, or the feeling of feeling full, is the key to maintaining a healthy weight and living a healthy life long-term. Instead of calories, people should focus on eating real food. It’s easier to track not eating sugars and artificial sugars than actually counting their calories. Tracking and reliving the calories of carbohydrates you didn’t eat stimulates ghrelin, the hunger hormone.
It’s easier to track pounds of steak, fish, shrimp, and chicken than calories. A calorie is a calorie only if it is incinerated in a bomb calorimeter, and the heat is given off is measured. Biologically derived calories from different foods have entirely different metabolic effects on the human body.
It’s irrelevant how many calories a food portion contains because equal calorie portions of sugar, alcohol, meat or olive oil have widely differing effects on hormonal systems. These effects include insulin as well as satiety signals such as cholecystokinin or peptide YY. What matters is how our body responds to the ingestion and absorption of those calories, how they are metabolized, and the resulting level of satiety.
The standard advice of dietitians and physicians to those who want to lose weight is simple: eat less, move more. However, this advice doesn’t actually produce favorable odds for losing and maintaining a healthy weight.
Using the standard calorie reduction approach recommended by the dietitians produces a probability of attaining a normal weight at 1 in 167. Following this standard advice of eating less, move more generates a greater than 99% failure rate, and explains why most people don’t get sustainable weight loss.
These odds are not in your favor. They favor obesity, prediabetes, and diabetes. These odds favor expensive and chronic medication management.
It’s time to follow a new path to health.
Fildes A et al. Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records. Am J Public Health. 2015;105: e54–e59.
Individuals experience significantly different changes in blood glucose levels (as shown by using a continuous glucose monitor) after eating the same foods. Some patients with normal blood glucose levels experience after-meal glycemic spikes that are in the diabetic range.
A person’s gut microbiome more accurately predicts the individual spike in blood glucose after eating than just knowing a food’s calories or carbohydrates. Eran Segal and Eran Elinav from the Weizmann Institute of Science, Rehovot, Israel, developed an algorithm, described in the journal Cell, that used microbiome data as well as other factors, such as age, sex, height, hip circumference, and physical activity, to predict after-meal glycemic responses in people who did not have diabetes.
In essence, food labeling remains a mythical beast. It is the personalized dietary intervention that drives the individual insulin response.
DOI:https://doi.org/10.1016/j.cell.2015.11.001
Many people focus on the nutritional content of their food when choosing what to eat. However, only focusing on the nutritional content of food is short-sighted. We don’t process all of the elements of food into energy through simple carbohydrates, proteins (amino acids, peptides), and fat. Food transmits valuable instructional information to our body, prompting it into specific action.
Food is nutrition, instructions, addiction, and emotion.
Our food choices today impact the genes of children in the next generation. Nearly 8% of our genes are affected by environmental edits that stick with us for life. These edits can be transmitted to future generations.