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Are you addicted to sugar?

The
role of sugar intake in the
obesity pandemic

AJ van der Lely


Rotterdam
The Netherlands
Conflict of interest:

I am addicted to sugar
Just a small survey ..

Who believes that eating too much


sugar increases you’re risk of getting
obesity/diabetes ?
Annals of Internal Medicine
Nov 2016
Annals of Internal Medicine
Nov 2016
•• They identified 60
They identified 60 studies
studies that
that examined
examined the
the effects
effects of
of SSB
SSB
consumption
consumption onon obesity
obesity and
and diabetes-related
diabetes-related outcomes.
outcomes.

•• 26
26 articles described no
articles described no associations and 34
associations,, and 34 articles
articles described
described
positive
positive associations
associations..
•• Studies
Studies funded
funded by
by the
the SSB
SSB industry
industry were
were significantly
significantly more
more likely
likely to
to
find
find no
no associations
associations than
than independently
independently funded
funded ones
ones

•• 26
26 of
of 26
26 negative
negative studies
studies (100%)
(100%) had
had funding
funding ties
ties to
to this
this
industry
industry..

•• Only
Only 1
1 of
of 34
34 positive
positive studies
studies (2.9%)
(2.9%) had
had such
such ties
ties (relative
(relative
risk,
risk, 34.00
34.00 [95%
[95% CI,
CI, 4.93
4.93 to
to 234.47];
234.47]; P
P<< 0.001).
0.001). Annals of Internal Medicine
Nov 2016
What epidemiologists
won’t allow me to do is…
2008 obesity incidence
2008 longivity incidence
2008 use of soda’s
• High fructose corn syrup (HFCS) has undergone
enzymatic processing
• High fructose to convert
corn syrup some
(HFCS) hasofundergone
its glucose
intoenzymatic
fructose to produce atodesired
processing convertsweetness
some of its glucose
into fructose to produce a desired sweetness
• HFCS is much cheaper than sucrose
• HFCS is much cheaper than sucrose
• HFCS consists of 24% water and the rest is sugar
• HFCS consists of 24% water and the rest is sugar
• HFCS 55 in soft drinks contains 55% fructose and 42%
glucose;
• HFCS 55andinHFCS 42, 42%
soft drinks fructose
contains andfructose
55% 53% glucose
and 42%
glucose; and HFCS 42, 42% fructose and 53% glucose
Tappy L, Lê KA. ‘10
• Fructokinase action is 10 times faster than glucokinase
and fructose accumulates in the liver as fructose-1-
phosphate

• Perfusion studies of liver tissue show that fructose


leads to a depletion of ATP content up to 25%

• Fructose-1-phosphate is converted into trioses, which


become substrates DNL
• In summary, fructose metabolism is unique
and very different from glucose

• Fructose shows up as fat


Tappy L, Lê KA. ‘10
Johnson et al; ‘13
So in the late miocene, seasonal fruits were
life-saving when there was nothing to eat

All sugars (fructose) were converted into fat


that helped us to make it through the harsh
winters
With the same genetic background, we modern
humans started to eat more and more fructose
that makes us awfully fat which is disastrous
to some tissues, like the liver
So what about this sugar
addiction then?
What you probably will
recognize
Your appetizer:
Your main course:
So you can make ‘room’ for that …..
26 grams carbs/100 g

11 gram carbs/100 g

< 2 gram carbs/100 g

14 gram carbs/100 g
I think we should really try to
reduce our fast sugar intake,

They are bad !

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