Death and Sickness By Fructose, Death and Sickness By Sugar

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Some experts may tell you they don't have any problem with you freely enjoying sugar,  artificial sweeteners, 'zero sugar', 'sugar free' food and drink. They are right: they won't have a problem - you might!

Sugar-sweetened beverages, obesity. A new American Cancer Society study concludes that sugar-sweetened beverages have become more affordable in nearly every corner of the globe, and are likely to become even more affordable and more widely consumed. The study concludes that without policy action to raise prices, global efforts to address the obesity epidemic will be hampered. "Overall in the countries we studied, a person in 2016 could buy 71 percent more sugar-sweetened beverages with the same share of their income than they could in 1990," said Jeffrey Drope, Ph.D., study co-author. "Sugary drinks became even more affordable in developing countries, where 2016's income could buy 89 percent more sugar-sweetened beverages than in 1990. That's essentially half-price."

"Although the increase in affordability is partly due to economic progress that resulted from rapid global economic development, it is also attributable to a lack of action taken by policy makers to affect the price of sugar-sweetened beverages," write the authors. "We argue and the scientific literature strongly suggests that this environment of increasingly affordable sugar-sweetened beverages will inevitably drive increased consumption of such products and will certainly hamper global efforts to address the overweight and obesity epidemic."

The authors also reviewed price trends for bottled water comparing them to sugar-sweetened beverages to provide a control, and found that bottled water is typically more expensive and less affordable than sugar-sweetened beverages. Because rising incomes are a positive sign of growth, the authors say "the logical intervention is for governments to affect prices through excise taxation, as they have done with other unhealthful products such as cigarettes." Preventing Chronic Disease

Artificial sweeteners linked to risk of weight gain, heart disease and other health issues. Artificial sweeteners may be associated with long-term weight gain and increased risk of obesity, diabetes, high blood pressure and heart disease. Consumption of artificial sweeteners, such as aspartame, sucralose and stevia, is widespread and increasing. The longer observational studies showed a link between consumption of artificial sweeteners and relatively higher risks of weight gain and obesity, high blood pressure, diabetes, heart disease and other health issues. University of Manitoba George & Fay Yee Centre for Healthcare Innovation, Children's Hospital Research Institute of Manitoba. CMAJ (Canadian Medical Association Journal)

Cancer and sugar-sweetened beverages link - Sugar intake or sugar-sweetened beverage consumption has been demonstrated to have a positive association with obesity, diabetes and cardio-metabolic diseases, as well as some cancers. As more people are surviving cancer, the consumption of added sugar will be an increasingly important risk factor. "The objective of this study was to closely evaluate the risk factors of sugar consumption from sugar-sweetened beverages among cancer survivors and people not diagnosed with cancer, and to our knowledge, no other studies have examined sugar-sweetened beverage intake in cancer survivors," notes Melinda Sothern, PhD, Professor of Public Health at LSU Health New Orleans. "Recently growing evidence suggests a link between sugar-sweetened beverage consumption and the risk of pancreatic and endometrial cancer, as well as the risk of colon cancer recurrence and death among cancer survivors." The survey measured the consumption of sodas, fruit-flavored drinks, sweetened fruit juices, sports drinks, energy drinks, sweetened teas and coffees and other sugar-sweetened drinks. It also ascertained cancer, smoking and obesity status, as well as demographic characteristics including age, gender, race, educational level and poverty/income ratio. Full coverage in Translational Cancer Research.

Soda company sponsorship of health groups - The nation's two largest soda companies sponsored at least 96 national health organizations from 2011 to 2015, dampening the health groups' support of legislation to reduce soda consumption and impeding efforts to combat the obesity epidemic. In addition, in the same five-year period, the Coca-Cola Company and PepsiCo lobbied against at least 28 public health bills intended to reduce soda consumption or improve nutrition.

The companies "used relationships with health organizations to develop positive associations for their brands," said lead author Daniel Aaron, a medical student at the BU School of Medicine who co-wrote the study with Michael Siegel, MD, professor of community health sciences at the School of Public Health.

"The soda companies can neutralize potential legislative opposition by invoking reciprocity and financial dependence from national health organizations," he said. "Rather than supporting public health, organizations may become unwitting partners in a corporate marketing strategy that undermines public health."

The sponsorship totals include two diabetes organizations -- the American Diabetes Association and the Juvenile Diabetes Research Foundation - a finding that the authors called "surprising, given the established link between diabetes and soda consumption."

The study also identifies 28 bills or proposed regulations, including soda taxes and restrictions on advertising, that were opposed by the soda companies or their lobbying groups. Siegel and Aaron said these efforts demonstrate the companies' "primary interest of improving profit, at the expense of public health." Aaron and Siegel compared the ties between soda companies and health groups to corporate sponsorships of tobacco and alcohol companies.

"Previous studies of alcohol company sponsorship and tobacco sponsorship suggest that corporate philanthropy is a marketing tool that can be used to silence health organizations that might otherwise lobby and support public health measures against these industries," Siegel said. For example, Save the Children, a group that supported soda taxes, dropped the effort in 2010 after receiving more than $5 million from the Coca-Cola Company and PepsiCo in 2009, the study says.

The study recommends that health organizations reject sponsorship offers from soda companies and find alternative sources of funding.
Boston University. American Journal of Preventive Medicine

Sugary beverages, health warnings
Teens are more than 15 percent less likely to say they would purchase soft drinks and other sugary drinks that include health warning labels, according to a new study led by researchers at the Center for Health Incentives and Behavioral Economics in the Perelman School of Medicine at the University of Pennsylvania. The study is among the first to examine how warning labels on sugary drinks influence teens, and builds upon research published by the team earlier this year which showed that parents were less likely to select sugary beverages for their kids when labels warning about the dangers of added sugar - which can contribute to obesity, diabetes and tooth decay - were present. The study has significant implications for policies being considered in several states and cities to require sugary drinks to display health warning labels. "The average teen in the United States consumes at least one sugar-sweetened beverage every day, which could account for more than twice the recommended daily serving of sugar," said lead author Christina Roberto, PhD, an assistant professor of Medical Ethics & Health Policy at the Perelman School of Medicine at the University of Pennsylvania. "The rate of sugar consumption in the U.S. is astounding and contributes significantly to obesity, type 2 diabetes, and other dangerous and costly health conditions." The authors note that the warning labels also contributed to teenagers' understanding of the potentially negative effects on health of regularly consuming sugary beverages, with participants viewing the labels indicating they were more likely to understand that these drinks don't contribute to a healthy lifestyle. Additionally, the majority of participants (62 percent) said they would support a warning label policy for sugary drinks.

Health rapidly improves with sugar reduction
Reducing consumption of added sugar, even without reducing calories or losing weight, has the power to reverse a cluster of chronic metabolic diseases, including high cholesterol and blood pressure, in children in as little as 10 days.

"This study definitively shows that sugar is metabolically harmful not because of its calories or its effects on weight; rather sugar is metabolically harmful because it's sugar," said lead author Robert Lustig, MD, MSL, pediatric endocrinologist at UCSF Benioff Children's Hospital San Francisco. "This internally controlled intervention study is a solid indication that sugar contributes to metabolic syndrome, and is the strongest evidence to date that the negative effects of sugar are not because of calories or obesity."

Jean-Marc Schwarz, PhD of the College of Osteopathic Medicine at Touro University California and senior author of the paper added, "I have never seen results as striking or significant in our human studies; after only nine days of fructose restriction, the results are dramatic and consistent from subject to subject. These findings support the idea that it is essential for parents to evaluate sugar intake and to be mindful of the health effects of what their children are consuming."

Metabolic syndrome is a cluster of conditions -- increased blood pressure, high blood glucose level, excess body fat around the waist, and abnormal cholesterol levels -- that occur together and increase risk of heart disease, stroke, and diabetes. Other diseases associated with metabolic syndrome, such as non-alcoholic fatty liver disease and type 2 diabetes, now occur in children -- disorders previously unknown in the pediatric population.

"This study demonstrates that 'a calorie is not a calorie.' Where those calories come from determines where in the body they go. Sugar calories are the worst, because they turn to fat in the liver, driving insulin resistance, and driving risk for diabetes, heart, and liver disease. This has enormous implications for the food industry, chronic disease, and health care costs," said Lustig.
University of California San Francisco and Touro University California. Obesity

Sweetened drinks linked to increased heart failure risk
Consumption of at least two daily servings of sweetened drinks was associated with a 23% heightened risk of developing heart failure compared with no consumption (study included men only). Heart failure is thought to affect more than 23 million people worldwide, nearly 6 million of whom live in the US, and more than half a million of whom live in the UK. Only around half of those diagnosed with heart failure are still alive five years later. No distinction was made between drinks sweetened with sugar, fructose/glucose, or artificial sweetener. Sweetened drinks are popular around the globe. Their regular consumption has been associated with changes in blood pressure, insulin levels, and inflammatory markers, as well as weight gain--factors implicated in metabolic syndrome, diabetes, coronary heart disease and stroke. "
The best message for a preventive strategy would be to recommend an occasional consumption of sweetened beverages or to avoid them altogether." Heart

Fructose not only results in a lower level of satiety, it also stimulates the reward system in the brain to a lesser degree. This may cause excessive consumption accompanied by effects that are a risk to health. Various diseases have been attributed to industrial fructose in sugary drinks and ready meals.

Research is increasingly finding indications that isolated, industrially manufactured fructose - which is increasingly used in sugary drinks, sweets and ready meals - is problematic for the human body. It is suspected that fructose promotes the development of various disorders such as obesity, diabetes, fatty liver disease and gout.
Professor Christoph Beglinger, Professor Stefan Borgwardt, Dr Bettina Wölnerhanssen, Dr Anne Christin Meyer-Gerspach. University of Basel. PLOS ONE

Fructose vicious circle
'Walk through any supermarket and take a look at the labels on food products, and you'll see that many of them contain fructose, often in the form of sucrose (table sugar)' -- that's how Wilhelm Krek, professor for cell biology at ETH Zurich's Institute for Molecular Health Sciences, summarises the problem with today's nutrition. Prepared foods and soft drinks in particular, but even purportedly healthy fruit juices contain fructose as an artificial additive - often in high quantities. In recent decades fructose spread throughout the food market, due to a reputation as being less harmful than glucose. In contrast to glucose, fructose barely increases blood glucose levels and insulin secretion. This avoids frequently recurring insulin spikes after any glucose consumption, which are judged harmful. In addition, fructose is sweeter to the taste.

But there's a downside: the liver converts fructose very efficiently into fat. People who consume too much high-fructose food can in time become overweight and develop high blood pressure, dyslipidaemia with fatty liver and insulin resistance -- symptoms that doctors group together under the name metabolic syndrome.

Researchers have discovered a previously unknown molecular mechanism that points to fructose as a key driver of uncontrolled growth of the heart muscle, a condition that can lead to fatal heart failure

When a person has high blood pressure, the heart has to grow as it is harder to pump the blood through the circulatory system. These growing heart muscle cells require a considerable amount of oxygen. However, since not enough oxygen is available to adequately supply the increased growth, the cells switch to an alternative energy supply. Instead of drawing energy from fatty acids, they rely more on an anaerobic process called glycolysis -- literally, the 'splitting of sugars'. If the heart muscle cells can access fructose in addition to glucose, this can set off a fatal chain reaction.

People should avoid overly sweet soft drinks and fruit juices -- these often have sugar added -- as well as ready-made meals and other foods to which large amounts of fructose are added as a flavour carrier

'Just this surplus of fructose can help trigger the mechanism we have described if one of the stress factors is present, such as cardiac valve disease or high blood pressure,' Mirtschink emphasises.
ETH Zurich's Institute for Molecular Health Sciences. Nature

Sugar-sweetened beverage habit linked to non-alcoholic fatty liver disease
A daily sugar-sweetened beverage habit may increase the risk for non-alcoholic fatty liver disease (NAFLD). "Our study adds to a growing body of research suggesting that sugar-sweetened beverages may be linked to NAFLD and other chronic diseases including diabetes and cardiovascular disease," said first author Jiantao Ma, Ph.D. Sugar-sweetened beverages are a major dietary source of fructose, the sugar that is suspected of increasing risk of NAFLD because of how our bodies process it.
Nutrition Research Center on Aging (USDA HRNCA) at Tufts University. Journal of Hepatology

Sugar sweetened beverages linked to overall poor diet
High consumption of sugar-sweetened beverages, which has been linked to increased risk of type 2 diabetes, is part of a poor overall diet. Consumption of several beverages has been associated with risk of type 2 diabetes; high coffee and tea consumption has been associated with a decreased risk and high consumption of sugar-sweetened beverages (SSB) with an increased risk.
Lund University, Malmö, Sweden. European Association for the Study of Diabetes (EASD)

Sweet Poison - Sugary drinks linked to high death tolls 
"Many countries in the world have a significant number of deaths occurring from a single dietary factor, sugar-sweetened beverages. It should be a global priority to substantially reduce or eliminate sugar-sweetened beverages from the diet," said Dariush Mozaffarian, M.D., Dr.P.H., senior author of the study and dean of the Friedman School of Nutrition Science & Policy at Tufts University in Boston.

"Some population dietary changes, such as increasing fruits and vegetables, can be challenging due to agriculture, costs, storage, and other complexities. This is not complicated. There are no health benefits from sugar-sweetened beverages, and the potential impact of reducing consumption is saving tens of thousands of deaths each year," Mozaffarian said.

Diet soda and waist increases - Those who drink diet soda thinking it will help them shed unwanted belly fat may see their waistlines expand instead.

Fowler said. "The increases in abdominal fat were more than three times as great in daily diet soda users as in non-users, during the very time in life when increasing waist circumference is associated with increased risk of these serious medical conditions, and mortality itself."

These findings raise a red flag for seniors because fat around the waist - the proverbial tire around the middle - includes not only fat just under the skin but also fat that accumulates around internal organs, known as viscera. Many studies have linked visceral fat with increased inflammation and risk of metabolic disease, diabetes, heart attack, stroke, cancer and mortality. When waistlines expand in older age, visceral fat increases disproportionately, and risk rises.

Helen P. Hazuda, Ph.D., professor of medicine in the School of Medicine at The University of Texas Health Science Center at San Antonio, Sharon P. Fowler, M.P.H., adjunct faculty in the School of Medicine at the Health Science Center, Ken Williams, M.S., adjunct faculty in the School of Medicine. Journal of the American Geriatrics Society

High-fructose diet slows recovery from brain injury
Revealing a link between nutrition and brain health, the finding offers implications for millions living with a traumatic brain injury, or TBI. "Americans consume most of their fructose from processed foods sweetened with high-fructose corn syrup," said Fernando Gomez-Pinilla, a professor of neurosurgery and integrative biology and physiology at UCLA's David Geffen School of Medicine. "We found that processed fructose inflicts surprisingly harmful effects on the brain's ability to repair itself after a head trauma." The sweetener interfered with the ability of neurons to communicate with each other, rewire connections after injury, record memories and produce enough energy to fuel basic functions.

"Our findings suggest that fructose disrupts plasticity -- the creation of fresh pathways between brain cells that occurs when we learn or experience something new," said Gomez-Pinilla, a member of the UCLA Brain Injury Research Center. "That's a huge obstacle for anyone to overcome -- but especially for a TBI patient, who is often struggling to relearn daily routines and how to care for himself or herself."

Earlier research has revealed how fructose harms the body through its role in contributing to cancer, diabetes, obesity and fatty liver. Gomez-Pinilla's study is the latest in a UCLA body of work uncovering the effects of fructose on brain function. His team previously was the first to identify the negative impact fructose has on learning and memory.

"Our take-home message can be boiled down to this: reduce fructose in your diet if you want to protect your brain," Gomez-Pinilla stressed.

Sources of fructose in the western diet include honey, cane sugar (sucrose) and high-fructose corn syrup, an inexpensive liquid sweetener. Made from cornstarch, the liquid syrup is widely added as a sweetener and preservative to processed foods, including soft drinks, condiments, applesauce and baby food.

Fructose also occurs naturally in fruit, which contains antioxidants, fiber and other nutrients that prevent the same damage. 
University of Claifornia - LA Health Sciences. Journal of Cerebral Blood Flow and Metabolism

Fructose  weight gain, body fat
Because of the addition of high-fructose corn syrup to many soft drinks and processed baked goods, fructose currently accounts for 10 percent of caloric intake. Male adolescents are the top fructose consumers, deriving between 15 to 23 percent of their calories from fructose - three to four times more than the maximum levels recommended by the American Heart Association. Researchers found that, matched calorie for calorie with the simple sugar glucose, fructose causes significant weight gain, physical inactivity, and body fat deposition. One thing is certain: high intake of fructose by itself adds pounds.
Beckman Institute for Advanced Science and Technology at the University of Illinois. Scientific Reports

Fat, sugar cause bacterial changes that may relate to loss of cognitive function
A study indicates that both a high-fat and a high-sugar diet, compared to a normal diet, cause changes in gut bacteria that appear related to a significant loss of "cognitive flexibility," or the power to adapt and adjust to changing situations. This effect was most serious on the high-sugar diet, which also showed an impairment of early learning for both long-term and short-term memory.

The findings are consistent with some other studies about the impact of fat and sugar on cognitive function and behavior, and suggest that some of these problems may be linked to alteration of the microbiome - a complex mixture in the digestive system of about 100 trillion microorganisms.

What's often referred to as the "Western diet," or foods that are high in fat, sugars and simple carbohydrates, has been linked to a range of chronic illnesses, including the obesity epidemic and an increased incidence of Alzheimer's disease.
"We've known for a while that too much fat and sugar are not good for you," Professor Kathy Magnusson said. "This work suggests that fat and sugar are altering your healthy bacterial systems, and that's one of the reasons those foods aren't good for you. It's not just the food that could be influencing your brain, but an interaction between the food and microbial changes."
Oregon State University. Neuroscience

Added sugars, high blood pressure and heart disease
Dietary guidelines should emphasise the role played by added sugars, particularly fructose, in the fight to curb the prevalence of cardiovascular disease. Cardiovascular disease is the number one cause of premature death in the developed world. And high blood pressure is its most important risk factor, accounting for almost 350,000 deaths in the US in 2009 and costing more than $50 billion US dollars every year.

Dietary approaches to lower high blood pressure have historically focused on cutting salt intake. Most salt in the diet comes from processed foods, which also happen to be a rich source of added sugars.

"Compelling evidence from basic science, population studies, and clinical trials implicates sugars, and particularly the monosaccharide fructose, as playing a major role in the development of hypertension [high blood pressure]," say researchers.
They point the finger in particular to high fructose corn syrup, which is the most frequently used sweetener in processed foods, particularly fruit-flavoured and fizzy drinks.

Around 300 years ago, people only consumed a few pounds of sugar a year, researchers add, whereas current estimates suggest that average consumption in the US is 77-152 pounds a year--equivalent to 24-47 teaspoons a day. 

And a daily intake of more than 74 g of fructose is associated with a 30% greater risk of blood pressure above 140/90 mm Hg and a 77% increased risk of blood pressure above 160/100 mm Hg.

A high fructose diet has also been linked to an unfavourable blood fat profile, higher fasting blood insulin levels, and a doubling in the risk of metabolic syndrome.

Of particular concern, they say, is that UK and US teens may be consuming added sugars up to 16 times the recommended limit. They emphasise that naturally-occurring sugars found in fruit and vegetables are not harmful to health. Eating fruit and vegetables is almost certainly beneficial.

"Just as most dietary sodium does not come from the salt shaker, most dietary sugar does not come from the sugar bowl; reducing consumption of added sugars by limiting processed foods containing it, made by corporations, would be a good place to start," write the authors. And they go on to warn: "The evidence is clear that even moderate doses of added sugar for short durations may cause substantial harm."
BMJ-British Medical Journal

Sugary drinks, risk factors for heart disease
Beverages sweetened with low, medium and high amounts of high-fructose corn syrup significantly increase risk factors for cardiovascular disease, even when consumed for just two weeks.

The study demonstrates a direct, dose-dependent relationship between the amount of added sugar consumed in sweetened beverages and increases in specific risk factors for cardiovascular disease.

The data reinforce evidence from an earlier epidemiological study showing that the risk of death from cardiovascular disease -- the leading cause of death in the United States and around the world -- increases as the amount of added sugar consumed increases. University of California, Davis. American Journal of Clinical Nutrition

Energy drinks, hyperactivity
Children who consume heavily sweetened energy drinks are 66% more likely to be at risk for hyperactivity and inattention symptoms. The finding has implications for school success and lends support to existing recommendations to limit the amount of sweetened beverages. The authors also recommend that children avoid energy drinks, which in addition to high levels of sugar also often contain caffeine. In addition to hyperactivity and inattention, heavily sugared beverages also impact childhood obesity.
Yale University School of Public Health. Academic Pediatrics

Association between energy drinks and traumatic brain injury
Teens who reported a traumatic brain injury in the past year were seven times more likely to have consumed at least five energy drinks in the past week than those without a history of TBI. "We've found a link between increased brain injuries and the consumption of energy drinks or energy drinks mixed with alcohol," said Dr. Michael Cusimano, a neurosurgeon at St. Michael's Hospital. "This is significant because energy drinks have previously been associated with general injuries, but not specifically with TBI." Dr. Cusimano said energy drink consumption could interfere with recovery efforts for teens who have sustained a TBI. "Energy drinks contain high levels of caffeine and change the chemical state of the body, which can prevent people from getting back on track after a TBI," said Dr. Cusimano. "Brain injuries among adolescents are particularly concerning because their brains are still developing." Previous research at St. Michael's Hospital found that TBI is associated with poor academic performance, mental health issues, violence, substance abuse and aggression in both teens and adults -- factors that can interfere with rehabilitation, said Dr. Cusimano.

Energy drinks, sleep problems - Many energy drinks have high caffeine content; when consumed in excess, caffeine can accelerate the heart rate, increase anxiety, and contribute to insomnia. Energy drinks contain very large amounts of caffeine, and the Food and Drug Administration (FDA) does not require caffeine quantities to be displayed on beverage labels," says Levant. "Because of this, some people may drink more caffeine through energy drinks than they might have intended to throughout a day, and drinking large amounts can cause problems--especially with sleep." Dr. Ronald F. Levant, a professor of psychology at The University of Akron. Health Psychology

High sugar consumption, poor functioning
The report shows that children from more functional families were 67 per cent less likely to consume more than four intakes of sugary foods and drinks a day, compared with children from less functional families.

"Effective family functioning is a safeguard against the well-known negative impact of lower levels of education in relation to sugar consumption" Professor Wagner Marcenes continued. "A significant number of children whose mothers had a lower level of qualification but whose family functioning was effective were more likely to consume less than four intakes of sugary foods compared with their counterparts whose family functioning was impaired. "

The study is a major two generation family study involving more than 50 researchers. It is believed to be the first study which demonstrates that high sugar consumption is related to poor family functioning.

Professor Marcenes explains: "We live in a very materialistic world but material resources alone cannot fulfill us. We also need to meet our psychological needs. A functional family is a major source of pleasure in life, providing comfort and reward. In contrast, dysfunctional families are a major source of frustration and stress - and this can lead to high sugar consumption in the search for the 'feel-good' effect."

Dr Sucharita Nanjappa, University of Dundee, who co-authored this report and was involved in many different aspects of the study says: "This study gathered information on the whole family's day to day experiences. This has the potential to lead to interventions that are based on identifying, encouraging and developing the family's own positive resources to help improve the health of its members - through the acquisition of healthy lifestyle."

Eating too much sugar is linked to a long list of negative health effects, including diabetes, heart disease, obesity and tooth decay.

Recently, a committee of scientists has advised the World Health Organization (WHO) and governments that no more than 5 per cent of daily calories should come from added sugar (about seven teaspoons). This is far less than the current average intake of sugar worldwide.

Professor Wagner Marcenes concludes: "Public health needs to move beyond the naïve belief that health education based on risk awareness raising programmes alone will lead to behavioural change across the population. If this were the case, doctors and nurses would not smoke, drink above the limit and eat sweets.

"It is crucial to understand why we crave for sugar and to identify factors that help people to deal with sugar craving. We need to focus on the wider determinants of health behaviour and lifestyle, such as socio-psychological factors."
Queen Mary University of London, University of Dundee. Caries Research

Cut illness and death from cardiovascular disease and curb the rising tide of obesity
Daily consumption of a sugary drink (150 calories) is associated with a significantly increased risk of type 2 diabetes whereas daily consumption of a handful of nuts (30 g of walnuts, 15 g of almonds and 15 g hazelnuts) or four tablespoons of extra virgin olive oil (around 500 calories) is associated with a significantly reduced risk of heart attack and stroke.
The evidence indeed supports the mantra that 'food can be the most powerful form of medicine or the slowest form of poison', researchers write. BMJ. Open Heart

Public health scientists and sugar industry
Public health scientists and a government committee working on nutritional advice receive funding from the very companies whose products are widely held to be responsible for the obesity crisis. Findings from the special report raise important questions about the potential for bias and conflict of interest among public health experts as the UK faces a growing obesity epidemic.

David Stuckler, professor of political economy and sociology at Oxford University, says the engagement of companies ... with the work of public health organisations "falls into the category of efforts to crowd out public regulation, to try to weaken public health by working with it".

The BMJ also reports evidence that the Responsibility Deal is not working. Not only do industry's pledges made under the deal not add up to the government's target of a 5% reduction in calorie consumption, but the UK's most comprehensive survey of shopping habits shows that between 2006 and 2014 the number of calories in the national weekly shop has increased by almost 12 %.
BMJ-British Medical Journal

Lowering sugar-sweetened beverages (SSBs) helpful
Senior author Jennifer Sacheck commented, "Importantly, not only are most SSBs high in sugar and devoid of nutritional value, but they are displacing other foods and beverages that offer high nutritional quality, which are critical for children's growth and development, further exacerbating the potential harmful health effects of SSBs."
Friedman School of Nutrition Science and Policy at Tufts University. The Journal of Nutrition

Research exposes the health risks of fructose and sugary drinks
There is compelling evidence that drinking too many sugar-sweetened beverages, which contain added sugars in the form of high fructose corn syrup or table sugar (sucrose), can lead to excess weight gain and a greater risk of developing type 2 diabetes and cardiovascular disease.

"Since we rarely consume fructose in isolation, the major source of fructose in the diet comes from fructose-containing sugars, sucrose and high fructose corn syrup, in sugar-sweetened beverages," according to Frank Hu, MD, PhD, Professor of Nutrition and Epidemiology at Harvard T.H. Chan School of Public Health. "Our findings underscore the urgent need for public health strategies that reduce the consumption of these drinks."

Sweeteners such as high fructose corn syrup, produced from corn starch, have been widely used as a low-cost alternative to sucrose in foods and beverages. 

"This is particularly concerning as the research shows that consuming one or more sugar-sweetened beverages a day has been linked to greater weight gain and obesity in numerous published studies," said Hu. "Regular consumption of sugar-sweetened beverages can lead to weight gain because the liquid calories are not filling, and so people don't reduce their food intake at subsequent meals."

The paper reveals that consuming one or two servings a day has been linked to:

  • as high as a 26 percent greater risk of developing type 2 diabetes,

  • a 35 percent greater risk of heart attack or fatal heart disease, and

  • a 16 percent increased risk of stroke

The research team also explored how fructose is metabolized in the body and its link to weight gain and the development of metabolic and cardiovascular conditions. "Part of the problem is how fructose behaves in the body," said Hu. Glucose, another component of sugar, is readily absorbed from the gastrointestinal tract into the bloodstream where it is transported through the action of insulin into the body's cells to be used as fuel. Fructose, on the other hand, is metabolized in the liver where it can be converted to fatty compounds called triglycerides, which may lead to fatty liver disease and insulin resistance, a key risk factor for developing diabetes and cardiovascular disease. Overconsumption of fructose can also lead to too much uric acid in the blood, which is associated with a greater risk of gout, a painful inflammatory arthritis.

The researchers point out that since fructose and glucose typically travel together in sugar-sweetened beverages and foods, it is important to reduce total amounts of added sugars, especially in the form of sugar-sweetened beverages. They outline a number of alternatives to sugar-sweetened beverages that include water, coffee, and tea. Journal of the American College of Cardiology

Carbonated drinks linked with out-of-hospital cardiac arrest of cardiac origin
Carbonated beverages are associated with out-of-hospital cardiac arrests of cardiac origin. The study suggests that limiting consumption of carbonated beverages may be beneficial for health. "Some epidemiologic studies have shown a positive correlation between the consumption of soft drinks and the incidence of cardiovascular disease (CVD) and stroke, while other reports have demonstrated that the intake of green tea and coffee reduced the risk and mortality of CVD," said principal investigator Professor Keijiro Saku, Dean and professor of cardiology at Fukuoka University in Japan. "Carbonated beverages, or sodas, have frequently been demonstrated to increase the risk of metabolic syndrome and CVD, such as subclinical cardiac remodeling and stroke. However, until now the association between drinking large amounts of carbonated beverages and fatal CVD, or out-of-hospital cardiac arrests (OHCA) of cardiac origin, was unclear."
European Society of Cradiology

Some experts may tell you they don't have any problem with you freely enjoying sugar,  artificial sweeteners, 'zero sugar', 'sugar free' food and drink. They are right: they won't have a problem - you might!

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