CHAPTER SEVEN-SUGAR IS SUGAR IS SUGAR
Sugar is very important to discuss. I have already mentioned sugar a bunch of times. I have already shared the biggest secret that fat and cholesterol production starts with sugar. So now let us really learn about sugar.
We all have heard of sugar. It comes in many varieties. There are your simple sugars like glucose (the most popular) and fructose (found in fruit). Then you have the weirder ones like galactose, xylose, allose, and ribose. The big fancy way to refer to these sugars is by calling them monosaccharides since they only consist of a single sugar molecule. Some of these you may have heard of, others even your doctor has never heard of.
Now there are your more complex types of sugars where two sugars are attached to one another. The three most common are sucrose (table sugar), lactose (found in milk) and maltose. These sugars need to be broken down before our body can use them. They are referred to as disaccharides with the di referring to the fact there are two sugar molecules attached to one another.
Let us now talk a little bit about carbs and where they fit in. Carbs are basically glucose molecules all strung together like beads on a string. The beads would represent a glucose molecule. Sometimes these string beads are short. Sometimes there are millions of beads on a string.
Before we can use the glucose in a long string the string would need to be broken down into its single beads or glucose molecules. After the body has done this the glucose may now be treated in different ways. If there is an overabundance of glucose in the system, as is often the case, the glucose will be stored first in the liver and then in muscles. After the liver and muscles have their fill the glucose molecule will be used to make cholesterol and TGs and the extra TGs will be stored as fat on our bodies. It does not take long to fill up our livers and muscles with glucose. Since it does not take long to fill up our livers and muscles and since most people eat more glucose then they should, there is plenty of sugar left over to make cholesterol, TGs and to store as fat.
The current recommendation for carbohydrate intake is somewhere between two hundred to two hundred fifty grams of carbohydrates per day. No one, and I mean no one, should be consuming this amount of carbs in their diet. Obesity, heart disease, diabetes, and cancer (and I will discuss the link between carbs and cancer later) are being seen more and more in our society. We are even seeing in children younger than ten what were once thought to be diseases of adults; that is, obesity and diabetes.
Most of the medical profession is scratching their heads trying to figure out why this is so. The answer sadly enough is right before their eyes, but the medical physicians just cannot see it. We have more and more people on low fat, low cholesterol diets and this includes our children. When we follow a low fat, low cholesterol diet, we must consume more carbs. As we consume more carbs we send all the signals to our body to get fat and make more cholesterol. Eating less cholesterol sends the signal to make more cholesterol. We are shortening the life expectancy of our children by the continuous propagation of the low cholesterol, low fat diet.
To me, being a part of the medical profession that is promulgating this deadly diet is embarrassing. Why is it that more docs have not figured out that when one follows a low fat, low cholesterol diet, they wind up less healthy then when they started?
Again, it is because we are not trained to think for ourselves in medical school. We are told to just listen and leave all the thinking to the specialists, or the doctors on the 'special' committees.
Unfortunately, it is these specialists or committee members who are the blindest. They continue to espouse low fat, low cholesterol diets, continue to tell us that eating whole grains and fruits are good for you and continue to mistakenly believe that it is a lack of physical exercise which is the main contributor to the obesity epidemic. This is just plain wrong. Why is it that I have had many cases where I have dealt with morbidly obese patients who I start on a low carb diet, who lose significant amounts of weight before they even start an exercise regimen? Yes, these patients start to lose weight and lots of it, before they started exercising. If what the experts say is true this should not be happening. But it does, every single day in my practice.
Now do not get me wrong. I am not saying exercise is not important. It is and it is very important. It does accelerate weight loss when done correctly. But to tell a patient with knee pain to start walking when they are three hundred pounds is negligent. How about we take some weight off, say, fifty pounds and then have them start walking. This way there is less stress and strain on the hips, knees and ankles when they start walking. This just makes sense to me.
OK, I digressed again, let us get back to our discussion of sugar.
Another huge problem is that our medical professionals would like you to believe that the same sugar molecules are somehow different. For instance, that if the sugar molecule is from fruit, it is natural and that is OK. Or, if it comes from whole wheat, again, it is natural and that's fine.
Well, I am here to stop that myth. Please remember that sugar is sugar is sugar. Repeat it to yourself a hundred, no wait, a thousand times a day. I tell my patients this all the time. What that means is that a glucose molecule from whole wheat bread is no different than if it came from broccoli, or a snickers bar, or from table sugar, and on and on and on.
The fact is when glucose is presented to our cells our cells cannot distinguish where that glucose molecule came from, because all glucose molecules look exactly the same to the cell.
Glucose is no good to us unless it gets inside our cells, which is where all the modifications to it take place. The thing that allows glucose to get into the cell is something called insulin. The pancreas makes insulin and squirts it into our bloodstream every time the pancreas sees sugar. If glucose cannot get into the cell it will remain in the bloodstream. When glucose stays in the bloodstream it begins to attach to the cell’s outer surfaces causing distortions and malfunctioning of organs. This is why diabetics have problems like blindness, need dialysis and may have to have amputations.
Again, it is all about the sugar. I will be talking more about diabetes in a later chapter.
To think that our cells can tell where the glucose came from, say from a vegetable or a snickers bar, is ignorant. In order for the cell to do this it would need to be able to know what we ate. And then the cell would have to say to itself, "Ah hah, this glucose molecule came from a snickers bar, so I'm going to do bad things with it." Or the cell would say, "Alright, this glucose molecule came from broccoli so let's do good things with it." And what would happen if we ate a snickers bar along with broccoli would our cells be able to tell the difference between the glucose molecules now?
Of course not, but this is exactly what medical professionals suggest when they say snickers bars have bad sugar and broccoli has good sugar. There is no such thing. Sugar is sugar is sugar. And it is all treated the same way when it gets to the cell.
Now do not think for a second that I do not care what you are eating sugar wise. I would much prefer the green leafy vegetable to the snickers bar. My point is that when following a low carb diet, all sugars count.
One of the most interesting things that started happening when I first started placing patients on low carb diets (and from now on when I say low carb, you probably already figured out I also mean more fat, more cholesterol and more protein) was that they would say they were doing low carb, but their cholesterol and TGs would come back elevated. As a doctor I am unique as I actually listen to and believe my patients. Most docs would suspect their patients were lying, but I do not until the evidence presents itself to the contrary. Anyway, when the TG and cholesterol numbers came back elevated I began to ask about everything my patients were eating. No luck, all low carb.
I was perplexed and left scratching my head, then, Eureka! I got it.
I was asking them what they were eating, but I was not asking them what they were drinking. I know it sounds ignorant on my part and it was.
When I began to ask what my patients with the elevated TGs and cholesterol were drinking it almost always turned out to be some kind of fruit juice. When I asked them to stop drinking the juice I would always get these weird looks. Some would say "What do you mean, everyone knows fruit juice is good for you because it is a natural sugar." Guess what happened to the TGs and cholesterol numbers when the juice was stopped. Good guess, you figured out immediately that the TG and cholesterol numbers dropped, sometimes significantly. Here's why.
The sugar in fruit is fructose. It is not too much different in structure when compared to glucose. Fructose is easily changed to glucose by a simple method. (Called isomerization.) Once fructose is changed to glucose, it is treated the same way extra glucose is; it is converted to TGs and cholesterol. So the sugar in the fruits we eat can and will be converted into the very things fruit does not contain, that is, fats and cholesterol. Let us hear another big Oopps!
OK, here is one for you. What would you say if I told you that if you eat a piece of fruit and a snickers bar the sugar from the fruit will wind up in the fat cells a lot quicker than the sugar in the snickers bar. So we get fatter, quicker, by eating fruit. The reason: because the sugar in the snickers bar, mainly glucose, has to go through the liver before it can get to the fat cell. Since the number one storage fuel molecule in our fat cells is fructose and since the sugar in fruit is already fructose; less change is needed and the fructose from the fruit goes directly into the fat cell. Yes, we do get fat by eating fruit.
"But Hey," I hear everyone yelling, fruit is natural, so it has to be good. My comment, arsenic and cyanide are natural, but I would not eat them. Ok maybe a bad comparison, but is it? This so called natural sugar will allow us to get fatter, increase our TGs, lower our HDLs, worsen our diabetes, increase our blood pressure and increase our risk of cancer. And I can go on and on. I tell my patients fruit is a poison, especially to diabetics and I mean it when I say, don’t eat it!
Enough about sugar. Let us talk about something really interesting. Let's talk about what I like to call the dirty little hormone; Insulin.
There are risks and costs to a program of action. But they are far less then the long range risks and costs of comfortable inaction
-John F Kennedy
Dr. James E. Carlson B.S.,D.O.,M.B.A.,J.D.
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