Disappointing news – or not – about moderate drinking

heart

Many studies and reviews have supported the notion that moderate alcohol consumption is beneficial for heart health. Why not have a daily glass or two of wine at dinner, as it could ward off disease. And now they come and spoil the fun.

A joint group of Canadian, Australian and US scientists took a hard look at the evidence presented in previously published research and found little support for a heart protective effect of moderate alcohol consumption.

And here you are believing the previously good news, who can you really trust? But not all is lost so read on.

So what did they find?

The new assessment initially agreed with the previous findings as a fully adjusted pooled analysis of all the 45 studies reviewed found significantly reduced coronary heart disease mortality for current moderate drinkers, actually for all current drinkers.  So all good now, can I continue to have a glass or two of wine to dinner and feel healthier?

Unfortunately not, as the researchers found confounding factors in that they could see an influence of age, gender, ethnicity, and heart health at baseline. When correcting for such factors they claim that moderate consumption of alcohol was not significantly protective for people at ages 55 years or younger at baseline, or for studies controlled for heart health at the beginning of the study. They even claimed that the appearance of cardio-protection among older people may reflect systematic selection biases that accumulate over the life course.

Their hypothesis is that non-drinkers may, in fact, be former drinkers who quit or cut down for health reasons. So, of course the remaining healthy drinkers will fair better than their poor abstainers that are already sick. And the seniors who are healthy may be more likely to keep enjoying that glass of wine with dinner thus biasing the results.

However, the researchers stop short of turning the previous findings on its head. They only conclude that there remain grounds for skepticism about the hypothesis that alcohol use can be cardio-protective, and recommend that future prospective studies not only avoid biased abstainer reference groups, but also take steps to minimize other forms of selection bias across the life course, including that from competing disease risks.

So there is still hope?

red_wine_(boo_licious)Yes, there is still hope that a daily glass of wine might keep you healthy longer as the researchers can’t prove it one way or the other. Only that there are grounds for a healthy skepticism as there remain plausible alternative explanations for their observed review findings.

So let’s make it clear. For now, no one is saying that people who enjoy alcohol in moderation should stop. Should there be no direct benefits, at least the risks of low-level drinking would be small.

Let’s drink to that, but only in moderation!

New liquorice warnings

liquorice_candy_(US_Government)

Liquorice is a popular sweetener found in many soft drinks, food products, snacks and herbal medicines. It has a rich history as an old remedy that was used by ancient Egyptians and Assyrians made into a sweet liquid drink. There is a traditional belief that liquorice is a healthy natural substance without side effects driving its liberal consumption that can occasionally be hazardous.

If you have followed this blog for a while you might remember that we have covered the good and the bad of liquorice before. Now we also cover the ugly.

The good

Liquorice is extracted from the roots of the plant Glycyrrhiza glabra, a member of the pea family. Most liquorice roots are wild-harvested with collection occurring mainly in Central Asia (Iran, Turkmenistan, Afghanistan and China). Liquorice extract is produced by boiling liquorice root and subsequently evaporating most of the water. Large-scale extraction is limited to China and Iran. Glycyrrhizin, that is 50 times sweeter than sugar, is the main active component in liquorice extract and apart from sweetness also provides the desirable liquorice flavour. Moderate consumption of liquorice is associated with several health benefits in that it can quickly soothe sore throats and coughs among some other positive effects.

The bad

Unfortunately, it has long been known that excessive and prolonged consumption of glycyrrhizin intensifies the effects of the stress hormone cortisol by inhibiting the enzyme that inactivates cortisol and may interfere with the sodium and potassium balance. High levels may increase hypertension. Thus, it has been suggested to limit consumption of glycyrrhizin to 100 mg per day, the approximate amount found in 60–70 g of liquorice candy. However, it is not that easy to estimate intake of glycyrrhizin as various forms of candies, beverages, supplements and extracts contain very different amounts of the active components.

The ugly

Pregnant womenRecently new warnings were issued by the Finnish National Institute for Health and Welfare to women to avoid consuming large amounts of liquorice during pregnancy as it can have long-term harmful effects on the development of the foetus. A new Finnish study had shown that youths previously exposed to large amounts of liquorice in the womb performed less well than others in cognitive reasoning tests carried out by a psychologist. The difference was equivalent to approximately seven IQ points.

Those exposed to liquorice also performed less well in tasks measuring memory capacity, and according to parental estimates, they had more ADHD-type problems than others. With girls, puberty had started earlier and advanced further.

In this study a large amount was defined as daily consumption of more than 70 mg and compared to consumption of less than 35 mg glycyrrhizin.

The lesson

Although cortisol is essential to the development of a foetus, large increases initiated by excessive consumption of liquorice can be detrimental.

A bathtub of sugary soft drinks

bathtub

Consumption of sugar sweetened beverages equal a bathtub worth per year.

Can you believe it, when analysing data collected through the UK National Diet and Nutrition Survey, Cancer Research UK found that teenagers aged between 11 and 18 drink almost a bathtub full of sugary drinks on average in a year. To be more precise the average soft drink consumption for this group equalled 77L per year. That is actually a very small bathtub as they normally vary in size from 77L to say 170L. However, when taking a bath the water volume is most often just half that so drinking a bathtub of soft drinks per year is a fairly accurate estimate.

The figures shed light on the extreme sugar consumption of UK teenagers in that they eat and drink three times the recommended limit, with sugary drinks being their main source of added sugar. This contributes to the development of overweight and obesity and obese children are around five times more likely to grow into obese adults. The situation is similar in many other countries. Sales of sugar sweetened beverages in Australia equates to 75L per year for every adult and child, while overall consumption of sugar sweetened beverages per person in the USA has been estimated at 115L per year.

And on it goes. So what can be done?

Taxing sugar in soft drinks

In an effort to reduce the detrimental effects of consuming excessive volumes of sugary drinks, a tax has been suggested similar to the tax on tobacco. Several countries have already imposed a tax while others are in the process to do so.

Norway has had a generalised sugar tax on refined sugar products, including soft drinks, in more than 35 years. Hungary’s tax introduced in 2011 has seen 22% of people reduce energy drink consumption and 19% of people reduce their intake of sugary-sweetened soft drinks. France introduced a targeted tax on sugary drinks at a national level in 2012 and found that sales of soft drinks declined in the year following the introduction of the tax, following several years of annual growth. Annual sales of soft drinks in Mexico declined 6% in 2014 after the introduction of a tax in 2013.

South Africa, Ireland and the United Kingdom have all decided to introduce soft drink taxes in 2017-2018. The United States does not have a nation-wide soft drink tax, but a number of cities have or will soon introduce their own taxes. There has been a growing debate around taxing soft drinks in various cities, states and even in congress in recent years. This debate alone has raised awareness of the problem and soft drink consumption is on the way down.

Other countries are still debating the benefits of a sugar tax. In Australia there is an expert group proposal to introduce a tax of 40 cents per 100 grams of sugar, which would lift the price of a two-litre bottle of soft drink by about 80 cents.

What about diet beverages?

dietsodadrinker

Diet beverages might not be the solution to reduce the incidence of obesity.

The reduction in the consumption of sugar sweetened beverages is all good if it is replaced by water. But what about diet beverages? Sugar substitutes like aspartame are supposed to promote weight loss, but a number of clinical and epidemiologic studies have suggested that these products don’t work very well and may actually make things worse. This is quite confusing as energy intake is reduced. However, there has been some evidence that artificial sweeteners actually can make you more hungry and thus may be associated with increased energy consumption.

Now a research team has found a possible mechanism explaining why use of the sugar substitute aspartame might not promote weight loss. Their report show how the aspartame breakdown product phenylalanine blocks a gut enzyme called intestinal alkaline phosphatase (IAP). And IAP is normally protective in that it has been shown to prevent obesity, diabetes and metabolic syndrome.

The researchers also showed that mice receiving aspartame in their drinking water gained more weight, had higher blood sugar levels, which indicates glucose intolerance, and higher levels of the inflammatory protein TNF-alpha in their blood, which suggests the kind of systemic inflammation associated with metabolic syndrome.

So what to do?

It is quite clear that just a debate around the detrimental effects of excessive consumption of sugar sweetened beverages can have an effect. Add to that an increase in the price and the benefits are obvious as shown already in several countries.

But it is equally important that the new choice of beverage doesn’t add to the problem. The use of artificial sweeteners might not be as innocent as could be expected.

Scientific knowledge vs. consumer experience

Disparate views between
scientists and consumers
(Drawing: Robin Hutton)

Scientists have long recommended that we eat at least 400g of fruit and vegetables a day with some countries going even further. Australia recommends a daily intake of two fruit and five vegetable portions equivalent to 750g. But the experience of consumers is that this is almost impossible and anyway could be quite expensive depending on seasonality and regional availability.

Many scientists believe that genetically modified agricultural commodities will solve future food shortages following an increasing world population and harsher growing conditions due to global warming. The public is sceptical having experienced previous backlashes. Monocultures are expected to threaten species versatility and superweeds to overwhelm production systems.

Scientists warn about an ‘obesity epidemic’ that will overwhelm the future hospital system and issue nutrition recommendations. The general public experiences an increasingly busy lifestyle with work pressure inundating leisure time. There is little time for food preparation and a living environment conducive of exercise is missing.

What to do?

These are some of the topics discussed in a just released rather unique book that combine the views of sociological and public health expertise to provide a holistic discussion of food safety issues.

The book offers a comprehensive understanding of the current scientific knowledge concerning risks associated with food production, processing and consumption, with particular attention to the gap between scientific research and public perception.

The book is thematically arranged according to the application of theoretical approaches in sociological theory – the socio-cultural perspective, the risk society perspective and the governmentality perspective – each chapter focuses on a particular area of interest or concern in relation to food, for example:

  • the ‘obesity epidemic’,
  • the benefits or otherwise of dietary supplements,
  • caffeine consumption,
  • GM food,
  • alcohol,
  • organic food,
  • the consumption of fruit and vegetables, and
  • pathogens and contaminants.

The existing literature is covered in detail and the book offers illustrative empirical examples, whilst identifying gaps in knowledge and areas for further research.

Interested?

The book is available now from Routledge:

Risk book

 

 

 

 

 

 

Food and the Risk Society
The Power of Risk Perception
By Charlotte Fabiansson, Stefan Fabiansson

ISBN 978-1-472-47896-2
© 2016 – Routledge

282 pages

Hot potato

Not again! This time it is the simple potato that’s being demonised. This seems to never end in that scientists pick one food after another and try to find a bad apple in a complex diet. Sorry, so far there are no adverse effects reported for apples, but you just wait. Probably just a matter of time.

And the statistics used become more and more elaborate making it impossible to penetrate the reported findings. All based on dubious food frequency questionnaires in the first place.

So what’s new?

Scientists demonise potatoes.

Scientists demonise potatoes for causing hypertension.

I have to give it to them that the researchers of the new report used an impressive number of people, overall over 187,000 men and women from three large US studies covering more than 20 years of follow-up. They all belonged to a cohort of health professionals, the same groups that have been used previously to report potential public health impacts of a range of different foods.

Unfortunately, the major shortcoming of all those reports is their dependence on food frequency questionnaires to capture dietary intake details.

In this case they analysed consumption of 130 foods and beverages, including the frequency of potato consumption. This might be fine for common foods, but what about all other minor foods we eat less regularly? If they aren’t captured you have no idea of their influence. Also you need a pretty good memory to recall all you ate during the past year.

Try it yourself. How often did you consume apples or ice cream? It will be more of a guesstimate and you might not even want to admit that you ate ice cream three times a week.

And also they asked participants to self report if they had been affected by hypertension as diagnosed by a health professional since their hypothesis was that eating a lot of potatoes would lead to an increase in blood pressure.

And the findings?

The researchers predictably found that higher intakes of boiled, baked, or mashed potatoes, and French fries were associated with an increased risk of developing high blood pressure. But now it gets more confusing.

After taking account of several other risk factors for hypertension, the researchers found that four or more servings a week of baked, boiled, or mashed potatoes was associated with an increased risk of hypertension compared with less than one serving a month in women, but not in men.

But higher consumption of French fries was associated with an increased risk of hypertension in both women and men.

And even more confusing, consumption of potato crisps (chips if you’re American) was associated with no increased risk.

And finally, replacing one serving a day of baked, boiled, or mashed potatoes with one serving a day of a non-starchy vegetable was associated with a lowered risk of developing hypertension.

So what to believe?

Should potatoes be included in the vegetable group?

Should potatoes be included among other vegetables or not, who can say?

First the main rationale of the study. Potatoes are one of the world’s most commonly consumed foods – and have recently been included as vegetables in the US government healthy meals programs, due to their high potassium content. Not everyone agrees to this move. So the researchers set out to determine whether higher long term intake of potatoes could be linked to incident hypertension.

And they say their findings have potentially important public health ramifications, as they do not support a potential benefit from the inclusion of potatoes as vegetables in government food programs. Instead the findings support a harmful effect that is consistent with adverse effects of high carbohydrate intakes seen in controlled feeding studies.

But if you noticed that replacing a serving of potato with non-starchy vegetables lowered the risk of hypertension, the findings could actually be related to reduced vegetable consumption when consuming a lot of potatoes. Nitrate in vegetables is transformed to nitric oxide in the body. And nitric oxide is a vasodilator that reduce blood pressure.

Critics of the study

I am not the only critic of the study. In a linked editorial, other researchers argued that, although diet has an important part to play in prevention and early management of hypertension, dietary behaviour and patterns of consumption are complex and difficult to measure. Prospective cohort studies that examine associations between various dietary patterns and risk of disease provide more useful insights for both policy makers and practitioners than does a focus on individual foods or nutrients.

To be fair also the researchers acknowledge some study limitations and said that, as with any observational study, no firm conclusions can be drawn about cause and effect. But that didn’t deter the popular press to latch onto the findings, there are plenty of potato consumers to scare.

Related articles

Mould on your food

artisan_bakery

What to do with artisan bread going mouldy?

You’ve bought a fancy artisan wholemeal bread made from only natural ingredients, no preservatives it proudly states. It was expensive so you only eat half of the bread, saving the rest for another day. It was wonderful. Two days later when you intend to eat the other half it is all mouldy.

In poorer circumstances there is no option but eat what is on offer. But in an affluent society we have the option to throw it out, even if it hurts as it was so nice.  Or you could attempt to rescue the unaffected part.

What to do?

Let’s look at the facts

Moulds belong to a large and taxonomically diverse range of fungal species that characteristically grow hyphae. The hyphae are generally transparent, so they appear like very fine, fluffy white threads over the surface, especially on food. We have tamed some moulds to become beneficial, others cause food spoilage, and yet others are seriously harmful to human health.

On the beneficial side, the most well-known mould product is penicillin produced by the Penicillium mould and used as an antibiotic to kill bacteria. Moulds are also essential components in the manufacturing of several food products, such as some cheeses, sausages and soy sauce.

On the harmful side, several moulds produce compounds toxic to animals and humans called mycotoxins. The worldwide contamination of food and feed with mycotoxins is a significant problem. According to the Food and Agriculture Organisation of the United Nation 25% of the world’s crop harvests are contaminated with mycotoxins. There are currently more than 400 known mycotoxins.

Where to find mycotoxins?

mouldy_fruit

Moulds can grow on many different types of food.

Mycotoxins can occur in a wide range of different foodstuffs. These include cereal-based products – such as bread, breakfast cereals, pasta, pastries, biscuits and snacks – groundnuts (peanuts), tree nuts, oilseeds, dried fruits, spices, coffee, wine, apple juice and milk. Mycotoxins are typically highly resistant to temperature and processing, so destruction during conventional food production does not occur.

The mycotoxins of most concern from a food safety perspective include the aflatoxins (B1, B2, G1, G2 and M1), ochratoxin A, patulin and toxins produced by Fusarium moulds, including fumonisins (B1, B2 and B3), trichothecenes (mainly nivalenol, deoxynivalenol, T-2 and HT-2 toxin) and zearalenone.

A threat to health

Mycotoxins can cause a variety of acute and chronic adverse health effects.

  • Aflatoxins, and in particular aflatoxin B1, are genotoxic and carcinogenic, and can cause liver cancer in humans.
  • Ochratoxin A causes a number of toxic effects in animal species. The most sensitive and notable effect is kidney damage. It may also have effects on foetal development and on the immune system.
  • Patulin has been shown to have various toxic effects and can harm the immune system and gastrointestinal tract.
  • Fumonisins have been related to oesophageal cancer in humans, and to liver and kidney toxicity in animals.
  • Trichothecenes can be acutely toxic to humans, causing sickness and diarrhoea, but at much higher levels than those typically present in food. Reported chronic effects in animals include suppression of the immune system.
  • Zearalenone is oestrogenic and has been shown to exhibit hormonal effects, such as infertility, particularly in pigs.

What to do with the mouldy food?

All of us have observed mould growth on food – be it on the piece of bread above or on a plum left sitting on the kitchen counter for an extended period of time. But you have no idea if this is a mycotoxin-producing mould harmful to health or just an annoyance spoiling the food.

There is a simple rule of thumb. For firm foods cut off the piece affected by the mould and eat the rest, while mouldy soft foods should be discarded.

Hard cheeses are good examples of firm foods that can be rescued. Moulds need moisture to grow and in dry cheeses like cheddar and parmesan there is not enough moisture for the mould to penetrate beyond the surface. Thus it is fine to remove a two centimeter piece of the cheese around the mould avoiding to cut into the mould.

Similarly, firm fruits and vegetables (such as cabbage, bell peppers and carrots) are fine to eat after removal of the mould.

And by all means remember that for some foods, like certain soft cheeses and processed meats, mould growth is part of the manufacturing process and they are perfectly fine.

On the other hand, mould on the surface of fluid foods such as yoghurt usually means that its mass of thread-like filaments have penetrated the item. Better discard the lot.

But how about our artisan bread, it is fairly dry but not really hard? This case is a little trickier. It might be sufficient to remove a solitary mould and eat the rest of the bread. However, with more extended mould growth the risk is higher. It might pay off to throw away the lot.

A final word of warning

pollution(Eric_Huybrechts)

Global warming will support further mould growth (Photo: Eric Huybrechts)

It is generally acknowledged that aflatoxins are genotoxic carcinogens. As a matter of fact they are amongst the most potent mutagenic and carcinogenic substances known.

A number of epidemiological studies have shown clear associations between aflatoxin exposure and incidence of liver cancer in areas with high prevalence of chronic hepatitis B, which is itself a risk factor for liver cancer.

Unfortunately, global warming will exacerbate the situation as mycotoxins occur more frequently in hot and humid climates favouring the growth of moulds.

The future might be bleak unless action is taken now to curb greenhouse gas emissions.

Too much fat or too much sugar

Added sugar cause more problem than high fat (Photo: Health Gauge)

Replacing fat with sugar is a bad choice (Photo: Health Gauge).

New research findings justifies another look at this topic we have covered before, but this is not easy with very polarised views. It used to be simple in the past. What’s now considered flawed research stated that fat, particularly saturated fat, was bad for our health. It increased cholesterol levels and caused heart disease with early death. Low-fat diets were in vogue and industry produced plenty of low-fat alternatives for the proselytes.

Unfortunately, industry substituted fat with sugar and that didn’t help the situation much. Actually, it now seems to have made what was considered a bad situation even worse.

Fight between old and new science

In a previous blog I put my toe into the sugar debate, an issue that has recently turned nutrition on its head. Now overindulgence in sugar is the culprit behind several diseases and increased mortality. So in the one corner we have the old die-hard supporters of the low-fat diet, while in the other corner we have the fresh newcomers daring to promote a low-carb high-fat diet.

Although the low-fat supporters have lost considerable ground the umpire seems to still be sitting on the fence. The 2015-2020 Dietary Guidelines for Americans target both saturated fats and added sugars as nutrients to limit and seem to give them equal weight in their advice:

  • Consume less than 10% of calories per day from added sugars, and also
  • Consume less than 10% of calories per day from saturated fats.

Let’s just pause for a moment to consider this new advice. The energy stored in our food is measured in terms of calories. Technically, one calorie is the amount of energy required to raise the temperature of 1 gram of water 1º Celsius. However, in the food area a calorie is actually 1000 technical calories. Although the technical calorie unit is part of the metric system, it has been superseded in the International System of Units by the joule and used in some countries as the new energy measure. A food calorie is approximately 4.2 kilojoules. Confused, I thought so. So for convenience let’s stick to the common use of calorie in the food area and forget that technically it is actually kilocalories.

Now to be clear, sugar contains less than 4 calories, whilst fat contains 9 calories per gram. Thus, according to the above recommendations you could consume double the amount of added sugar compared to saturated fat to keep within the given proportion of energy allocated to each of the two nutrients. So although the recommendation looks evenhanded in reality it is not.

New studies support the low-carb camp

New scientific findings

New scientific findings give further support to the low-carb camp.

Back to the science. With the tables turning, low-fat diets are out and high-fat diets are very much in. Since the eat-less-saturated-fat advice has been around for decades, there should be proof around either way you would think. However, it took quite some time to disprove the fat hypothesis since it was considered heresy.

This has changed and a new article cites several meta-analyses of randomised controlled trials that did not find a connection between saturated fats and heart disease or overall death rates.

But it goes further with low-carb comparisons. A recent study suggested that low-fat diets might not be the way to go after placing about 150 adults on either a low-carb or a low-fat diet for a year. Participants on the low-carb diet lost more weight and lowered their risk for heart disease more than participants who followed a low-fat diet.

Another study involved 17 people at risk for heart disease and diabetes. They were put on a low-carb, high-fat diet for three weeks. Then, they turned the table and increased carb intake while reducing total fat and saturated fat intake every three weeks for 18 weeks, keeping total caloric intake the same. The more carbs and less fat in the diet resulted in an increase in markers linked to obesity, type 2 diabetes, and heart disease. I know, a very small group of people, but anyway.

So is the fight over?

No, we are still waiting for the knock-out blow. Life is never that simple.

As for saturated fats, these fats are a diverse class of compounds. Some saturated fats elevate bad cholesterol, others have no effect, and some actually increase good cholesterol. Fats in foods are always a mixture. While some foods high in saturated fats, such as processed meats, might be connected to heart disease, other foods high in saturated fat such as dairy have no such effect. And there is also the supposition that some polyunsaturated fats might induce inflammation that in turn can influence the heart disease rate.

And similarly to fats, not all carbs are equal. The monosaccharide, fructose, and the disaccharide sucrose, common table sugar, with half fructose (together with glucose), produce greater degrees of metabolic abnormalities than does glucose alone found in long chains of starch in certain foods and cellulose in plant walls.

If you need to lose weight science is pretty clear. If you eat too little fat, your metabolism won’t be as efficient and will create some waste because of an excess of carbs and/or protein. A slower metabolism and a higher load of waste will interfere with weight loss. On the other hand, high-fat food dampens appetite and can help you eat less and thus lose weight.

Sugar can be fattening indirectly by causing you to eat more. Eating too much sugar will encourage insulin production. If you produce too much insulin it actually causes blood sugar to dip and you feel tired. As you need an energy boost you eat more, and you tend to give in to cravings for more sugar. Of course, that only makes the whole cycle happen again.

But we don’t eat fat or carbohydrates in isolation, we eat them in the form of complex foods with a lot of other necessary components. If you forget weight loss and just want to maintain a healthy diet there is room for good forms of both fat and carbohydrates. With fat you get important fat-soluble vitamins and essential fatty acids, and with complex carbohydrate foods you get minerals, water-soluble vitamins and antioxidants like flavonoids.

What about everything in moderation?

Find the right balance for healthy eating (Photo: Mauro Cateb).

Find the right balance for healthy eating (Photo: Mauro Cateb).

We have said it before, why not everything in moderation as the saying goes. Or did go!

Even that has now been criticised as being too vague and difficult to measure. ‘There are no good or bad foods,” and “all foods can fit into a healthy diet” are variations on the moderation theme. But what exactly is moderation? A new study found that definitions of moderate consumption were related to personal consumption behaviours. Results suggest that the endorsement of moderation messages allows for a wide range of interpretations of moderate consumption.

Healthy eating is about finding a balance between two extremes – deprivation and overindulgence. It is about adhering to strategies and habits that can be maintained long term as part of a lifestyle to avoid a yoyo effect between these extremes.

Call it what you like as long as you don’t give in to your ghrelin urge too often. An occasional binge can be justified to keep you happy. That’s what life is all about, isn’t it?

The war on sugar

The sweetness of ice cream can be overwhelming.

The sweetness of ice-cream can be overwhelming.

The sweet tooth seems to require a treat now and then. But why are most food manufacturers overdoing the sweetness thingy. You have an ice-cream treat and although it initially tastes nice, after half is consumed you feel the sugar molecules crawling in your mouth with the sugar taste lingering for several hours. The same with a blueberry cheesecake. The sweetness is just overwhelming.

I could go on and on. I am not after sugar replacements, I just want the sweetness to be toned down.

Trend to reduce sugar intake

Actually, reducing sugar intake has become a key concern amongst many consumers. In a recent 2,500-strong European consumer survey, a quarter of those asked preferred low sugar food products, findings that seem to confirm the continuing shift in consumer efforts to reduce sugar intake. They also found that more than 60% of those surveyed actively monitored their dietary sugar intake. This might be influenced by the World Health Organisation recommendation to reduce sugar intake to less than 10% of total energy intake, or the more extreme aim to get down to less than 5% for improved health.

Excessive sugar consumption continues to be criticised by the media and health professionals alike, resulting in today’s sugar backlash. This has led to sugar replacing fat and salt as the new dietary pariah in many countries. There is thus a key opportunity for companies to address consumer preferences and adapt their products to carry a low or reduced sugar level. But food manufacturers aren’t listening. Of course, taste differences that consumers are not used to can make or break a popular product – something manufacturers are hesitant to risk. However, why not give us some alternatives?

But still a persistent problem

In reality we seem to go backwards in many respects and the USA is a horror example not to follow. In the last 40 years, fructose, a simple sugar derived from fruit and vegetables, has been on the increase in American diets. Because of the addition of high-fructose corn syrup to many soft drinks and processed baked goods, fructose alone now accounts for 10% of caloric intake for US citizens. But note that this is the average with peaks much beyond this especially in adolescents.

Fructose in soft drinks a culprit.

Fructose in soft drinks a culprit.

And then you should know that a recent study found that, matched calorie for calorie with the simple sugar glucose, fructose causes significant weight gain, physical inactivity, and body fat deposition. The link between increases in sugar intake, particularly fructose, and the rising obesity epidemic has been debated for many years with no clear conclusions as people are not only consuming more fructose through their diets, but also consuming more calories in general.

Thus researchers studied two groups of mice, one group was fed a diet in which 18% of the calories came from fructose, mimicking the intake of adolescents in the USA, and the other was fed 18% from glucose, while both groups had exactly the same amount of calories derived from sugar. The only difference was the type of sugar, either fructose or glucose. The results showed conclusively that the fructose-fed mice displayed significantly increased body weight, liver mass, and fat mass in comparison to the glucose-fed mice.

Given the dramatic increase in obesity among young people and the severe negative effects that this can have on health throughout life, it is important to consider what foods are providing our calories.

More ill effects from too much sugar

A new study highlights one more reason to avoid sugary beverages, processed foods and other energy-dense carbohydrate-containing foods. Regular consumption of sugary beverages was shown to be associated with a 3 times greater risk of prostate cancer. By contrast, healthy carbohydrate-containing foods like legumes, non-starchy vegetables, fruits and whole grains were collectively associated with a 67% lower risk for breast cancer.

A common warning though for these type of studies, the results point only to associations, not necessarily to cause-and-effect, but at least the findings are in line with previous studies. Malignant cancer cells seem to feed on sugar, and diets high in refined carbohydrates may lead to a range of adverse health effects primarily due to their impacts on body fatness and on the dysregulation of insulin and glucose, both of which are factors that may increase cancer risk.

Better control of your brain

So what to do about the sweet tooth. Well, actually it has nothing to do with our teeth per se but rather brain chemistry. Excess sugar consumption has been shown to repeatedly elevate dopamine levels which control the brain’s reward and pleasure centres in a way that is similar to many drugs of abuse including tobacco, cocaine and morphine.

Go for a pill or healthy food? (Photo: Chris de Rham)

Go for a pill or healthy food, your choice (Photo: Chris de Rham).

An Australian research team even went further in showing that if sugar is consumed at current levels in the modern western diet, it can induce structural changes in the brain that impact behaviour by influencing how neurons communicate.

Now you could try medication as the Australian research team observed that the smoking cessation drug varenicline, which is FDA approved, had a similar effect in reducing sugar consumption. Or you could go the more natural way.

Some hope in the war on sugar

There are some tentative steps in industry product reformulation through the development of new sugar-reduced products that you could go for. Or you could just reduce the portion size.

There are also potential government action that might provide future help. A few governments have taken the bold move to introduce a sugar tax as recent years have brought more attention to the role of carbohydrates in our diets and the differences between healthy and unhealthy carbs.

As usual it is your choice.

The odd danger of barbecuing

barbecue

Wire bristles from barbecue cleaning brushes can cause a health emergency.

And you thought that cleaning the barbecue was a safe exercise, think again. New research has examined the incidence of injuries caused by ingesting wire bristles from grill brushes. Yes I am serious, this can actually be a problem!

We usually highlight chemical risks in this blog and there are a few linked to barbecuing. Polycyclic aromatic hydrocarbons easily come to mind as one of the more problematic process contaminants formed during careless barbecuing. They are suspect carcinogens to be avoided if at all possible. Physical risks are less common. Sure you can burn your hands over the barbecue fire when cooking your food. But wire bristles?

Although the peak season for barbecuing is over in Australia as of the writing of this blog in early April, it is soon approaching in the northern hemisphere. Thus the US researchers prompted physicians and consumers to take notice of their findings before the summer grilling season. The researchers reviewed literature and used the Consumer Product Safety Commission’s National Electronic Injury Surveillance System and the consumer reported injury database SaferProducts.gov to derive a national weighted estimate of emergency department visits for wire bristle injury from 2002 to 2014. They estimated that there were 1698 cases presented to emergency departments in that time. However, they further considered it likely that the issue is under reported. Because of the uncommon nature of wire bristle injuries, people may not be as mindful about the dangers and implications. Awareness among emergency department physicians, radiologists, and otolaryngologists is particularly important so that appropriate tests and examinations can be conducted.

mouth

Be careful with what you put into your mouth.

The most common location of injury was the oral cavity and the oropharynx which includes the throat and tonsils. In all databases, injuries involving the esophagus and head and neck were more frequent than abdominal injuries.

So another reason to exercise caution when cleaning grills with wire-bristle brushes. It might pay off to examine brushes prior to each use and discarding if bristles are loose. And why not inspect cooking grates prior to cooking to be on the safe side even for this odd problem.

The leptin hormone is your friend

Leptin regulates body fat amount (Photo: fantasyhealthball)

Leptin regulates body fat amount (Photo: fantasyhealthball)

Fat acts as an energy storage container normally comprising about 20 to 25% of the human body weight. Twenty years ago scientists identified a hormone called leptin produced by fat cells at levels proportional to the amount of fat in the body, thus informing the brain of how much fat is around.

Leptin is supposed to preserve the body’s fat mass within a relatively narrow range. Low leptin levels increase appetite and reduce basal metabolism, whereas high leptin levels blunt appetite and promote fat breakdown.

Appropriately the word leptin says it all if you’re Greek, it means thin. If all is working fine, which it doesn’t for all, it should inhibit hunger, thus keeping you thin. On the contrary, the hunger hormone ghrelin instead increases appetite. Together they regulate the energy balance to keep body weight under close control (you wish).

Scientists identify the leptin pathway

In some way leptin-induced brain activity lead to fat breakdown, but until now it has been unclear how the brain signals back to the fat tissue to achieve this effect. Now, a breakthrough study by scientists from Portugal and the USA has identified sympathetic nerves in white fat tissue and found that direct stimulation of these neurons is sufficient to induce fat breakdown. This is called a neuro-endocrine loop.

The local activation of these neurons releases norepinephrine, a neurotransmitter, that in turn triggers a cascade of signals in fat cells leading to fat hydrolysis. Without these neurons, leptin is unable to drive fat-breakdown.

One factor in the obesity epidemic

Now, unfortunately, some people are affected by central leptin resistance, a condition in which the brains of those people are insensitive to leptin leading to increases in weight and ultimately one reason for overweight and obesity. Since the sympathetic nervous system is autonomous there is no way of consciously influencing its activity. Sorry.

But scientists now have an entry point for developing a treatment of the condition, at least one piece of the puzzle to come to grips with the multifactorial obesity epidemic.

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