Sugar has been vilified over the years with claims of its disastrous effects on our health. Are these claims true? Does taken a soda a day guarantee one ill health? What of the effects of excess sugar on obesity? In this article, we will explore these claims and determine whether indeed excessive sugar intake leads to obesity.
1. What is obesity?
Obesity rates have skyrocketed over the past century. In 1962, 46 percent of adults in the U.S. were considered overweight or obese. By 2010,that figure had jumped to 75 percent.
So, what exactly is obesity……
Obesity is a complex disease involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. It is a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.
Obesity is diagnosed when your body mass index (BMI) is 30 or higher. To determine your body mass index, divide your weight in pounds by your height in inches squared and multiply by 703. Or divide your weight in kilograms by your height in meters squared.
| BMI | Weight status |
| Below 18.5 | Underweight |
| 18.5-24.9 | Normal |
| 25.0-29.9 | Overweight |
| 30.0 and higher | Obesity |
For most people, BMI provides a reasonable estimate of body fat. However, BMI doesn’t directly measure body fat, so some people, such as muscular athletes, may have a BMI in the obesity category even though they don’t have excess body fat.
2. Sugar and obesity
Obesity is a complex problem with multiple causes. But among the likely suspects, sugar is a top favorite. As sugar consumption has increased, so too has the size of our waistlines.
Added sugars are a controversial and hotly debated topic. Consumption of added sugars has been implicated in increased risk of a variety of chronic diseases including obesity, cardiovascular disease, diabetes and non-alcoholic fatty liver disease (NAFLD) as well as cognitive decline and even some cancers. Support for these putative associations has been challenged, however, on a variety of fronts.
The sugars in your diet can be eithernaturally occurring or added. Naturally occurring sugars are found naturally in foods such as fruit (fructose) and milk (lactose). Added sugars are sugars and syrups put in foods during preparation or processing, or added at the table.
Numerous dietary and lifestyle habits can lead to weight gain and cause you to put on excess body fat.Consuming a diet high in added sugars, such as those found in sweetened beverages, candy, baked goods, and sugary cereals, is a contributing factor in weight gain and chronic health conditions, including obesity, heart disease, and diabetes.
Many people consume more sugar than they realize. It’s important to be aware of how much sugar you consume because our bodies don’t need sugar to function properly. Added sugars contribute zero nutrients but many added calories, which can lead to extra pounds or even obesity, thereby reducing impacting our health.
The ways in which added sugar intake leads to weight gain and increased body fat are complex and involve many factors.
3. Some ways why added sugar is fattening….
- It is high in empty calories
Added sugars are sweeteners added to foods and beverages to improve taste. Common types of added sugar include fructose, corn syrup, cane sugar, and agave.Excess sugar may cause you to pack on weight because it’s high in calories while offering few other nutrients.Though using small amounts of added sugar is unlikely to cause weight gain, regularly indulging in foods high in added sugars may cause you to gain excess body fat quicker and more drastically.- Impacts blood sugar and hormone levels
It’s well known that eating sugary foods significantly raises your blood sugar levels.Though enjoying a sweet food infrequently isn’t likely to harm health, daily consumption of large amounts of added sugar can lead to chronically elevated blood sugar levels.
Prolonged elevated blood sugar — known as hyperglycemia — can cause serious harm to your body, by causing insulin resistance and resulting including weight gain.
- May lead to overeating
Foods high in added sugars tend to be less filling. Eating foods rich in carbs — particularly refined carbs high in added sugars — yet low in protein can negatively impact fullness and may lead to weight gain by causing you to eat more at subsequent meals throughout the day or overeat at any one particular seating.
Animal studies indicate that fructose impacts signaling systems in your hypothalamus, increasing levels of hunger-stimulating neuropeptides — molecules that communicate with one another, influencing brain activity — while decreasing fullness signals. Additionally, your body is predisposed to crave sweetness. In fact, research shows that sugar consumption is driven by the pleasure derived from the sweet taste of sugary drinks and foods.
- Linked to obesity and chronic disease
Numerous studies have linked high intake of added sugars to weight gain and chronic conditions, such as obesity, heart disease, and diabetes.This effect has been observed both in adults and in children. Recently, a review of 30 studies in more than 242,000 adults and children found a significant link between sugar-sweetened beverages and obesity.
4. What are some of the health problems associated with obesity?
People with obesity are more likely to develop a number of potentially serious health problems, including:
- Heart disease and strokes. Obesity makes you more likely to have high blood pressure and abnormal cholesterol levels, which are risk factors for heart disease and strokes.
- Type 2 diabetes. Obesity can affect the way your body uses insulin to control blood sugar levels. This raises your risk of insulin resistance and diabetes.
- Certain cancers. Obesity may increase your risk of cancer of the uterus, cervix, endometrium, ovary, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate.
- Digestive problems. Obesity increases the likelihood that you’ll develop heartburn, gallbladder disease and liver problems.
- Gynecological and sexual problems. Obesity may cause infertility and irregular periods in women. Obesity also can cause erectile dysfunction in men.
- Sleep apnea. People with obesity are more likely to have sleep apnea, a potentially serious disorder in which breathing repeatedly stops and starts during sleep.
- Osteoarthritis. Obesity increases the stress placed on weight-bearing joints, in addition to promoting inflammation within the body. These factors may lead to complications such as osteoarthritis.
5. How can obesity affect your quality of life?
People who are obese often find themselves struggling with some issues that might diminish their overall quality of life. Some of these issues might include:
- Depression
- Disability
- Sexual problems
- Shame and guilt
- Social isolation
- Lower work achievement
6. How can you keep yourself from getting obese?
Whether you’re at risk of obesity, currently overweight or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems.
- Exercise regularly. You need to get 150 to 300 minutes of moderate-intensity activity a week to prevent weight gain. Moderately intense physical activities include fast walking and swimming.
- Follow a healthy-eating plan. Focus on low-calorie, nutrient-dense foods, such as fruits, vegetables and whole grains. Avoid saturated fat and limit sweets and alcohol. Eat three regular meals a day with limited snacking. You can still enjoy small amounts of high-fat, high-calorie foods as an infrequent treat.
- Know and avoid the food traps that cause you to eat. Identify situations that trigger out-of-control eating. Try keeping a journal and write down what you eat, how much you eat, when you eat, how you’re feeling and how hungry you are, stay in control of your eating behaviors.
- Monitor your weight regularly. People who weigh themselves at least once a week are more successful in keeping off excess pounds.
- Be consistent. Sticking to your healthy-weight plan all the time
7. So, is sugar friend or foe?
Interfering with your hormones, increasing hunger, and displacing healthy foods are just a few of the ways that added sugars can lead to weight gain.Aside from causing you to put on excess body fat, eating too much added sugar can significantly increase your risk of chronic conditions, such as obesity, heart disease, and diabetes. It is thus wise to consume added sugars with caution because a stitch in time save nine.
References
- Endocrineweb(2018):Insulin Resistance Causes and Symptoms, Retrieved from
https://www.endocrineweb.com/conditions/type-2-diabetes/insulin-resistance-causes-symptoms
- Healthline (2019):6 Ways Added Sugar Is Fattening. Retrieved from
https://www.healthline.com/nutrition/does-sugar-make-you-fat#section1
- American Heart Association (2018): Added Sugars. Retrieved from
https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/added-sugars
- NCBI (2016): Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133084/
- John Hopkins Medicine (2019): Obesity, Sugar and Heart Health. Retrieved from
https://www.hopkinsmedicine.org/health/wellness-and-prevention/obesity-sugar-and-heart-health
- Mayo Clinic: Retrieved from
https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742
“…from a thermodynamic perspective, it is clear that obesity is generally the consequence of small cumulative imbalances of energy intake and expenditure.”
2017, Obesity Pathogenesis: An Endocrine Society Scientific Statement
calories in > calories out
We overeat
Too much food, too little physical activity
Overeating
(Energy in > Energy out)
Obesity and the obesity epidemic
1880s: Max Rubner demonstrates the laws of thermodynamics holds true for living organisms and establishes the isodynamic law of calories
1890s: Atwater and Benedict show thermodynamics holds true for humans and pioneer the science of calorimetry
1900s: von Noorden declares caloric imbalance as the cause of obesity
“The ingestion of a quantity of food greater than that required by the body leads to an accumulation of fat, and to obesity, should the disproportion be continued over a considerable period.”
Louis Newburgh’s revelation:
“All obese persons are alike in one fundamental respect—they literally overeat.”*
Therefore…
Obesity is caused by either a “perverted appetite” (eating too much) or “lessened outflow of energy” (insufficient expenditure).
Why don’t obese people compensate by eating less or exercising more, which, after all, are under conscious control, too? Because they suffer, says Newburgh, from various human weaknesses such as overindulgence and ignorance.”
Focus of attention? Full-Body Energy Balance
Energy Imbalance? How Much?
“Weight management is all about balance— balancing the number of calories you consume with the number of calories your body uses or `burns off.’”
The Centers for Disease Control
20 lbs/decade?
2 lbs/year
1 lb of fat ~ 3500 kcal
(2 * 3500 kcal)/365 days
19.2 Kcal/day
The average American consumes about 2700 kcal/day
Are we really talking about a .007 positive energy imbalance causing 2/3 of all healthcare expenditure in the United States????
The average American is now 30 pounds heavier than in 1960 — an average weight gain of .53 pounds per year.
5 kcal/day or a .002 positive energy imbalance
There are no stranger phenomena than the maintenance of constant body weight under marked variation in bodily activity and food consumption.
Eugene Du Bois, Basal Metabolism in Health and Disease, 1936
Eating less doesn’t work
Weight loss achieved in trials of calorie-restricted diets is “so small as to be clinically insignificant.”
Cochrane Collaboration, 2002
Exercising more doesn’t work
“It is reasonable to assume that persons with relatively high daily energy expenditures would be less likely to gain weight over time, compared with those who have low energy expenditures. So far, data to support this hypothesis are not particularly compelling.”
AHA/ACSM 2007, Physical activity guidelines
The fatal flaw with the energy balance hypothesis?
Remember this?
“The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended.”
The World Health Organization
an analogy? Wealth?
“The fundamental cause of wealth is a money imbalance between dollars earned and dollars spent.”
The World Economic Forum
dollars in > dollars out
The Alternative Hypothesis
Obesity is a disorder of excess fat accumulation
(Not energy balance, not over-eating, not sedentary behavior)
Gluttony and sloth are compensatory effects; they are not causes
German/Austrian hypothesis, pre-World War II
Gustav von Bergmann (1908), Julius Bauer
A hormonal/regulatory hypothesis
“Like a malignant tumor or like the fetus, the uterus or the breasts of a pregnant woman, the abnormal lipophilic tissue seizes on foodstuffs, even in the case of undernutrition. It maintains its stock and may increase it independent of the requirements of the organism. A sort of anarchy exists; the adipose tissue lives for itself and does not fit into the precisely regulated management of the whole organism… a lipomatous subject may die of starvation and still remain lipomatous.” Bauer, Archives of Internal Medicine, 1941.
“The effect after meals of withdrawing from the circulation even a little more fat than usual might well account both for the delayed sense of satiety and for the frequently abnormal taste for carbohydrate encountered in obese persons… A slight tendency in this direction would have a profound effect on the course of time.”
Russell Wilder, Mayo Clinic,1938
The hormonal/regulatory hypothesis
“…now more or less fully accepted, chiefly in Germany, by a number of leading investigators of metabolic diseases…”
Hugo Rony, Obesity and Leanness, 1940
“The current energy theory of obesity, which considers only an imbalance between intake of food and expenditure of energy, is unsatisfactory.”
“It is the distribution of energy in the body too which counts, not alone the rough imbalance between its intake and output.”
“The adipose tissue is not merely a passive storing place for reserve fat, but a living and active part of the body, with its own physiologic and pathologic processes.”
“An increased appetite with a subsequent imbalance between intake and output of energy is the consequence of the abnormal anlage rather than the cause of obesity.”
Bauer (1941)
The alternative hypothesis is another victim of World War II.
Insulin is “the principal regulator of fat metabolism.”
Rosalyn Yalow, Solomon Berson, 1965
Frayn, K.N. 2010. Metabolic Regulation: A Human Perspective, 3rd edition
Suppression of fat mobilization
The release of fatty acids from fat cells “requires only the negative stimulus of insulin deficiency.”
When insulin is secreted or chronically elevated, fat accumulates in the fat tissue.
When insulin levels drop, fat escapes from the fat tissue and the fat depots shrink.
We secrete insulin primarily in response to the carbohydrates in our diet.
“Carbohydrate is driving insulin is driving fat.”
George Cahill, 2005
“The most striking finding is that adipose tissue is exquisitely sensitive to the inhibitory effect of insulin on FFA release….”
“…insulin regulation of plasma FFA turnover/ oxidation is maximally manifest at low physiological plasma insulin concentrations….”
Bonadonna et al. 1990. Dose-dependent effect of insulin on plasma free fatty acid turnover and oxidation in humans. Am. J. Physiol. 259:E736-750.
Refined grains, starches and sugars
Dysregulation of insulin signaling
Metabolic Dysfunction: Excess fat accumulation, obesity, and the obesity epidemic, metal inflammation, pain, cellular degradation
So why does dieting fail… statistically, only 1:167 patients succeed
“All diets that result in weight loss do so on one basis and one basis only: they reduce total calorie intake.”
Textbook of Obesity, 2012
Diets that work?
Insulin reduction?
Calorie restriction (with carbohydrate restriction)
Carbohydrate restriction (without calorie restriction — i.e., LCHF/Leto)
Intermittent Fasting (TRF)
Fasting…
Raymond Greene, The Practice of Endocrinology, 1951
Foods to be avoided:
- Bread and everything else made with flour…
- Cereals, including breakfast cereals and milk puddings
- Potatoes and all other white root vegetables
- Foods containing much sugar
- All the sweets…
You can eat as much as you like of the following foods:
- Meat, fish, birds
- All green vegetables
- Eggs, dried or fresh
- Cheese
- Fruit…except bananas and grapes
The AMA trivializes this science as a debate about fad diets.
“fat is mobilized when insulin secretion diminishes” and yet low carbohydrate diets are “bizarre concepts of nutrition that should not be promoted to the public as if they were established scientific principles.”
JAMA, June 4, 1973. Vol 224, No 10.