It’s no secret that sugar is bad for you. It spoils your teeth, packs on pounds around your belly, and provides zero nutrition. Unfortunately, these are the least of sugars crimes. The biggest reason why you should stop taking sugar is that it is one of the most pro-inflammatory foods. Current Research suggests that chronic, body-wide inflammation is associated with many modern diseases, like obesity, diabetes, and heart disease. So what role does a high-sugar diet play in chronic inflammation? In this article, we’ll delve into this and much more….

1. So, what is inflammation?

Inflammation is part of the body’s natural healing process.

Acute inflammation develops rapidly in response to an injury or infection. This type of inflammation tends to be good: It’s your body’s way of trying to fight off further damage while jump-starting healing. It usually lasts a few days to a few weeks.

Chronic inflammation is a long-term inflammation that occurs over months or years. It has several causes, including unhealthy lifestyle factors like diet. Over time, chronic inflammation can increase your risk of serious diseases.

Some foods, like sugar, can also cause inflammation in the body, which is normal. However, eating too many inflammatory foods may cause chronic low-grade inflammation. This can cause serious health problems, such as heart disease, diabetes, cancer, and

2. Sugar and inflammation

People who take diets rich in refined sugar may be increasing their risk of chronic inflammation. Research suggests that when people eat and drink less sugar, inflammatory markers in their blood decrease.

A high sugar diet can have harmful effects on health, such as increasing the risk of chronic diseases, weight gain, and tooth decay. It can also result in chronic inflammation, where the body’s immune system activates, which results in damage to healthy cells.

Inflammation resulting from lifestyle factors, such as obesity, smoking, and a sedentary existence can contribute to a range of diseases. These include heart disease, diabetes, rheumatoid arthritis, and Alzheimer’s.

3. Is too much-added sugar linked to inflammation?

A lot of research has been carried out on how sugar causes inflammation.  Diets high in added sugar are thought to signal the production of pro-inflammatory molecules in the body. Over time, that can create an environment of chronic, low-grade inflammation and lead to trouble in the future. Sugar also stimulates the production of free fatty acids in the liver. When the body digests these free fatty acids, the resulting compounds can trigger inflammatory processes.

Different kinds of sugar may contribute more or less to inflammation. For instance, some research has suggested that fructose may cause more inflammation than glucose. However, a systematic review found no difference in the inflammation from fructose and glucose, so more research is needed.

Also, the researchers saw no differences in inflammatory factors between the groups that consumed high fructose corn syrup vs. sucrose. The sample sizes were small, and the quality of the studies was low, so more research is necessary to confirm these findings.

Below are some of the common signs and symptoms of chronic inflammation:

• depression, anxiety, and other mood disorders
• body pain
• constant fatigue and insomnia
• constipation, diarrhea, acid reflux, and other digestive issues
• weight gain
• frequent infections

People with chronic inflammation may have an increased risk of diabetes, depression, and dementia.

Chronic inflammation in older adults may also have links with a higher risk of death. Doctors are working on how to reduce chronic inflammation.

4. How does added sugar affects your body?

When you consume excess added sugar and refined carbohydrates there will be a few changes in your body, which help explain why a diet high in sugar can lead to chronic, low-grade inflammation.

• Excess production of AGEs: Advanced glycation end products (AGEs) are harmful compounds that form when protein or fat combine with sugar in the bloodstream. Too many AGEs lead to oxidative stress and inflammation.
• Increased gut permeability: Bacteria, toxins and undigested food particles can more easily move out of the gut and into the bloodstream, potentially leading to inflammation.
• Higher “bad” LDL cholesterol: Excess LDL cholesterol has been associated with higher levels of C-reactive protein (CRP), a marker of inflammation.
• Weight gain: A diet rich in added sugar and refined carbohydrates can lead to weight gain. Excess body fat has been linked to inflammation, partly due to insulin resistance.

It is important to note that inflammation is unlikely to be caused by sugar alone. Other factors like stress, medication, smoking, and excess fat intake can also lead to inflammation.

5. Is natural sugar linked to inflammation?

It’s important to note that there is a difference between added sugar and natural sugar. Added sugar is removed from its original source and added to foods and drinks to serve as a sweetener or increase shelf life.

Added sugar is found mostly in processed foods and drinks, though table sugar is also considered an added sugar. Other common forms include high-fructose corn syrup (HFCS), sucrose, fructose, glucose, and corn sugar.

Among US adults, around 13% of total calories come from added sugar. This is high, considering that government guidelines advise that no more than 5% to 15% of calories should come from both solid fats and added sugar.

Natural sugar has not been linked to inflammation. In fact, many foods containing natural sugars, such as fruits and vegetables, maybe anti-inflammatory. Natural sugars include those naturally occurring in foods. Examples include fructose in fruit and lactose in milk and dairy products.

Consuming natural sugars should not be any cause for concern. That’s because they act very differently than added sugar when consumed and digested in the body.

Lifestyle Changes Can Reduce Inflammation

It is important to be aware of what we can do to minimize the inflammation in our bodies. Here are some simple tips to help reduce inflammation:

• Adopt a low glycemic diet: High sugar intake links to chronic inflammation, stroke risk, coronary heart disease risk, and type 2 diabetes risk. Soda, refined carbohydrates, and high fructose corn syrup are foods that can promote inflammation.
• Read food labels: If you are unsure about certain products, get into the habit of reading food labels. Look out for ingredients like sucrose, glucose, high-fructose corn syrup, maltose, and dextrose.
• Choose whole-grain carbs: These include oats, whole-grain pasta, brown rice, quinoa, and barley. They have lots of fiber and antioxidants, which can help control blood sugar and protect against inflammation.
• Eat more fruits and vegetables: Fruits and vegetables contain antioxidants, vitamins, and minerals, which can protect against and reduce inflammation in the body.
• Eat lots of antioxidant-rich foods: Fill your plate with foods rich in antioxidants, which naturally help counteract inflammation. These include nuts, seeds, avocados, oily fish and olive oil.
• Keep active: Regular physical activity, including both aerobic and resistance exercise, can help protect against weight gain and inflammation.
• Manage stress levels: Learning to manage stress levels through relaxation techniques and even exercise can help reduce inflammation.
• Add curcumin to food: A component in turmeric called curcumin improves several inflammatory diseases.
• Get enough fiber: Researchers have shown an association between high fiber diets and lower inflammatory factors, such as TNF-alpha and interleukin-6.
• Drink green and black teas: Scientists have associated compounds found in green and black teas with lower C-reactive protein in the blood.
• Eat more nuts: Almonds and other nuts may help to lower the risk of cardiovascular disease and diabetes. Cardiovascular diseases, such as atherosclerosis, are pro-inflammatory states. Diabetes is a chronic inflammatory disease.
• Add fish oil to the diet: Omega-3 fatty acids positively affect lower levels of inflammatory factors in the blood, such as C-reactive protein, interleukin-6, and TNF-alpha.

6. Does sugar cause inflammation?

Inflammation is a critical component of metabolic syndrome. However, chronic low-grade inflammation leads to diseases like type 2 diabetes, atherosclerosis, non- alcoholic liver diseases, and gout. Research suggests that eating lots of sugar can lead to chronic inflammation

In the United States, the amount of high fructose corn syrup people consume increased from 1978 to 1998 and then stabilized according to the  Nationwide Food Consumption Surveys. With greater awareness of the risks of added sugar, sugar intake in the U.S. has been declining. Nonetheless, people are still consuming too much sugar.

There are several things you can do to help fight inflammation, including exercising regularly and effectively managing your stress levels. Furthermore, cut down on processed foods and drinks, choose whole foods, and limit your intake of added sugar and refined carbohydrates.

References

1. Medical News Today (2017): Everything you need to know about inflammation. Retrieved from https://www.medicalnewstoday.com/articles/248423.php

2. Healthline (2017): Does Sugar Cause Inflammation in the Body? Retrieved from https://www.healthline.com/nutrition/sugar-and-inflammation

3. Medical News Today (2019): Does sugar cause inflammation in the body? Retrieved from https://www.medicalnewstoday.com/articles/326386.php

4. Mindbodygreene (2019): The Real Reason You Should Quit Sugar + How To Cut It Out Of Your Life For Good. Retrieved from https://www.mindbodygreen.com/0-24763/the-real-reason-you-should-quit-sugar-how-to-cut-it-out-of-your-life-for-good.html

5. NCBI (2014): Chronic inflammatory disorders and risk of type 2 diabetes mellitus, coronary heart disease, and stroke: a population-based cohort study. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24970784

7. NCBI (2019): Chronic Inflammation. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK493173/
8. Greatist (2019): Does Sugar Actually Cause Inflammation? Retrieved from https://greatist.com/health/sugar-and-inflammation

The interplay between immunity, inflammation, and metabolic changes is a growing field of research. Exciting new evidence is emerging with regard to their role in the regulation of metabolism and the activation of inflammatory pathways during the progression of metabolic disorders such as Type 2 Diabetes and Atherosclerosis.

1. The innate immune system

The innate immune system is an evolutionarily conserved system that senses and defends against infection and irritation. Innate immune signaling is a complex cascade that quickly recognizes infectious threats through multiple germline-encoded cell surface or cytoplasmic receptors and transmits signals for the deployment of proper countermeasures through adaptors, kinases, and transcription factors, resulting in the production of cytokines.

As the first response of the innate immune system to pathogenic signals, inflammatory responses must be rapid and specific to establish a physical barrier against the spread of infection and must subsequently be terminated once the pathogens have been cleared. Long-lasting and low-grade chronic inflammation is a distinguishing feature of type 2 diabetes and cardiovascular diseases, which are currently major public health problems.

2. How does the innate immune system work?

The ability of organisms to mount a response to infectious challenge without prior exposure is regulated by the coordinated interaction of components of the innate immune system. This preformed system is important to respond to exogenous stimuli such as bacterial, viral, and fungal infections. Beyond the initial response to a stressor, the innate immune system coordinates the resolution of inflammation, tissue repair, and the activation of the adaptive immune system to provide memory for future challenges.

While much of our understanding of innate immunity comes from models of infection, it is also clear that immune responses can be triggered by endogenous stimuli. Such mechanisms play a wide role in health and disease from the response to tissue injury, the direction of tissue remodeling, and the response to tumors.

3. The Innate Immune Response to Obesity

The increased prevalence of obesity and overweight in adults continues to rise and contributes to morbidity and mortality that is estimated to cost $147 billion dollars a year in the U.S. (Finkelstein et al., 2009) and up to 0.6% of the gross domestic product of European countries (Muller-Riemenschneider et al., 2008). More ominous is the high rates of childhood obesity which is a strong predictor of adult obesity (Lee et al., 2009). This has also shifted the prevalence of adult diseases such as type 2 diabetes and pre-diabetes into childhood and has generated new treatment and prevention challenges (Lee, 2006; Lee et al., 2006). Relevant to this review, increases in inflammatory biomarkers such as C-reactive Protein (CRP) and neutrophilia are seen in obese children as young as 3 years of age (Skinner et al., 2010). This indicates that many of the origins of obesity-induced inflammation may actually be initiated during childhood. Therefore, many people will face a lifetime threat to health from obesity.

The long term duration of obesity-induced inflammation makes it challenging to describe this unique type of inflammatory activation based on classical models of innate immunity. Applying such models may be inaccurate and insufficient to encompass the events that are triggered by obesity in metabolic tissues such as fat. Furthermore, it is clear that the inflammation generated by obesity is not as high in amplitude as those seen in acute infectious settings (Hotamisligil, 2006). These unique challenges have led to the coining of the term “metal inflammation” to describe the chronic low-grade inflammatory events that occur in obesity and its associated diseases.

A frequently asked question is why would obesity trigger an immune response? For the most part, this question remains unanswered, but one answer to this may lie in the fact that many of the key regulators of metabolism also play critical roles in regulating inflammatory responses.

4. Inflammation as a link between obesity and disease

The interest in obesity-induced inflammation relates to the understanding that inflammatory mechanisms are central to the pathogenesis of diseases such as heart disease that is modified by obesity.

It is impossible to cover the scope of all of these diseases so we will focus our attention on the inflammatory mechanisms of fatty liver disease and Type 2 Diabetes-related diseases with fundamental alterations in nutrient control derived from pro-inflammatory inputs. This will set the stage for future discussion of the innate immune components activated in obesity. I will highlight both clinical and pre-clinical studies in animal models of obesity that have built our understanding of the mechanisms that drive obesity-associated diseases.

4.1 Non-alcoholic Fatty Liver Disease (NAFLD)

The liver plays a critical role in the regulation of glucose and lipids levels in the blood. Obesity generates a number of physiologic changes in hepatocyte glucose production as well as lipid oxidation and storage. Unusual hepatic lipid accumulation is connected to many obesity-associated illnesses that include non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome. The metabolic changes that occur with hepatic lipid accumulation include hepatic insulin resistance which is related to inflammatory cytokine signals.

4.2 Type 2 Diabetes (T2D)

The regulation of glucose metabolism is securely coordinated between nutrient inputs regulated by the liver and gut, nutrient utilization and storage in muscle and fat, insulin secretion by the pancreas, and central signals from the hypothalamus that coordinate these responses. The dysregulation of almost all of these processes with obesity is now known to be associated with the activation of innate pro-inflammatory pathways. The net result of this is the generation of systemic insulin resistance and hyperglycemia.

5. Why obesity affects the innate immune system

The blend of a sedentary lifestyle and surplus energy intake has led to an increased occurrence of obesity which constitutes a major risk factor for several comorbidities including type 2 diabetes and cardiovascular diseases. Intensive research during the last two decades has revealed that a characteristic feature of obesity linking it to insulin resistance is the presence of chronic low-grade inflammation being indicative of activation of the innate immune system.

Recent evidence suggests that activation of the innate immune system in the course of obesity is mediated by metabolic signals, such as free fatty acids (FFAs), being elevated in many obese subjects, through activation of pattern recognition receptors thereby leading to stimulation of critical inflammatory signaling cascades, like IκBα kinase/nuclear factor-κB (IKK/NF- κB), endoplasmic reticulum (ER) stress-induced unfolded protein response (UPR) and NOD-like receptor P3 (NLRP3) inflammasome pathway, that interfere with insulin signaling.

Exercise is one of the main prescribed interventions in obesity management improving insulin sensitivity and reducing obesity-induced chronic inflammation. A deeper understanding of the effects of exercise on inflammatory signaling pathways in obesity is useful to optimize preventive and therapeutic strategies to combat the increasing incidence of obesity and its comorbidities.

References:

1. Journal of Biological Chemistry (2013): How Metabolism Generates Signals during Innate Immunity and Inflammation. Retrieved from http://www.jbc.org/content/288/32/22893.full.html
2. Physiological Reviews (2018): Innate Immune Signaling and Its Role in Metabolic and Cardiovascular Diseases. Retrieved from https://www.physiology.org/doi/abs/10.1152/physrev.00065.2017
3. NCBI (2012): Innate Immune Activation in Obesity. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888776/
4. NCBI (2015): Metabolic signals and innate immune activation in obesity and exercise. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25825956