Sugary drinks, such as sodas, juices, and energy drinks, are popular choices among Americans. Unfortunately, as these fructose-laden drinks become more and more a staple of our diet, we are seeing the devastating long-term health consequences that come from consuming large amounts of sugar. Brookhaven Heart always wants to provide our patients with the best resources so they can make an informed decision about their health. A large part of maintaining cardiovascular health is diet.
A new paper released by the Journal of the American College of Cardiology has directly linked consuming sweetened beverages to a greater risk of developing type 2 diabetes and cardiovascular disease.
What Is Fructose?
Fructose, sucrose, and glucose are all simple sugars. The differences among these types of sugars are where they are found and how they are metabolized. Simple carbohydrates are defined as either being monosaccharaides or disaccharides. Glucose and fructose are monosaccharaides, meaning they are made up of only one sugar unit. Sucrose, also known as table sugar, is a disaccharide, meaning it is made up of two sugar units linked together.
With both glucose and fructose being both monosaccharaides, you would think they would be almost identical. However, glucose and fructose could not be more different. Glucose is the body’s preferred energy source, not fructose. While fructose is present in many naturally sweet fruits and honey, it is not supposed to make up a high percentage of our diet. For many years, the main sources of dietary fructose came from fruits and vegetables. The amount of fructose found in natural foods is minuscule when compared with the amount that is placed in sweetened drinks. Most sugary drinks are sweetened with high-fructose corn syrup, a corn-derived version of fructose mixed with equal parts of glucose.
How Does the Body Use Fructose?
The metabolic process of breaking down fructose is very different from glucose. Glucose is metabolized throughout the body by the enzymes glucokinase and hexokinase. When you eat glucose, your body breaks the glucose down to be used for energy or stored in the muscle cells or liver for later use. Insulin is secreted due to the increased glucose in the bloodstream, and the insulin helps the glucose enter the cells to provide your body with energy.
Fructose is metabolized through a process called fructolysis, which takes place primarily in the liver, not throughout the body. As the liver processes fructose, it is converted into glucose so the rest of the body can use it for energy. However, when the liver is overloaded with fructose, it stores it as fat through a process called lipogenesis. The fat stored in the liver and throughout the body can cause a long list of health problems including heart disease, non-alcoholic fatty liver disease, and insulin resistance.
Fructose Causes Overeating
While many people try to blame a lack of control or willpower for their inability to stop eating, there may be a hormonal imbalance at work that plays a significant part. Unlike glucose, fructose does not stimulate the release of insulin or production of leptin, which is a hormone that helps you to feel satisfied after eating a meal.
Drinking large amounts of fructose can further cause you to overeat by turning off the hormone that lets you know when you are full.
Leptin is a hormone that is found within your fat cells. When you are full, leptin is released to tell the brain that you should stop eating. Leptin’s primary role in the body has to do with regulating calories in versus calories out. However, when you consume fructose, you are not allowing the leptin to signal to your brain that it is full. Drinking a sugary soda full of fructose along with a meal can cause you to eat more calories by disabling your body’s ability to tell you it has had enough.
Frank Hu, MD, Ph.D., Professor of Nutrition and Epidemiology at Harvard T.H. Chan School of Public Health and lead investigator of the paper released by the Journal of the American College of Cardiology, describes the link between overeating and sugary drink consumption. “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.” Sugary drinks do not contain fiber, protein, or fat that also increase satiety. The lack of leptin production along with sugary drinks lacking any nutritional value lead to inevitable obesity and all the health risks that go along with it.
How Much Is Too Much?
Drink manufacturers and corn producers have been pushing the premise that sweet drinks can be a part of a healthy diet as long as consumed in moderation. Unfortunately, that is far from the truth. Recent studies have shown that just one or two sugary drinks per day have been linked to:
- 26 percent greater risk of developing type 2 diabetes
- 35 percent greater risk of heart attack or fatal heart disease
- 16 percent increased risk of stroke
- Increased risk of developing gout, an inflammatory arthritis
With half of the United States’ population consuming, at least, one sugary drink per day, and a large portion of our population having two to four drinks per day, this impending health crisis has the potential to have catastrophic consequences on our healthcare system and economy.
Fructose and Obesity Related Illness
Several studies have linked fructose to increased weight gain, insulin resistance, type 2 diabetes, non-alcoholic fatty liver disease, and heart problems. Many of these health problems stem from being overweight or obese. It is important that we understand how dietary fructose can cause these illnesses so we can begin to change the way society views soft drinks, and to create health-based initiatives to change the way manufacturers include fructose into foodstuffs.
Insulin resistance is a process by which the body does not effectively use insulin to place glucose inside the cell. As a result, free-floating glucose remains in the bloodstream and can cause major health issues such as type 2 diabetes. Scientists have linked increased weight as a risk factor for developing insulin resistance.
Since fructose has continually been correlated with weight gain, consuming excessive fructose puts you at high risk of developing insulin resistance.
Symptoms of insulin resistance include:
- Lack of menstruation
- Excessive hairiness
- Skin tags
Type 2 Diabetes
Type 2 diabetes is the most common form of diabetes, and its prevalence is on the rise. If you have type 2 diabetes, your body does not utilize insulin properly. Your pancreas attempts to create more insulin, but over time is unable to create enough to compensate. Type 2 diabetes can be controlled with diet and embracing a healthier lifestyle. One of the biggest risk factors for type 2 diabetes is being overweight or obesity. With consuming excessive fructose, you substantially increase your risk of being overweight and, therefore, putting you at high risk to develop type 2 diabetes. Symptoms of type 2 diabetes are not very prominent, which can delay diagnosis. Some symptoms include:
- Excessive thirst or hunger
- Sudden weight gain or loss
- Frequent urination
- Blurred vision
- Poor wound healing
- Non-Alcoholic Fatty Liver Disease
As discussed earlier, the liver is the only organ that metabolizes fructose.
Fructose is much more likely to be converted into fat when compared with other simple sugars, such as glucose or sucrose through lipogenesis.
When overloaded with fructose, the liver has no other choice but to start storing it throughout the body, around organs, and inside the liver. When the liver becomes fatty, it can become inflamed, which leads to permanent damage. When an individual consumes large amounts of fructose, they are much more likely to be overweight, which puts them at higher risk for non-alcoholic fatty liver disease. There are no symptoms associated with non-alcoholic fatty liver disease other than a general feeling of fatigue. This can make it difficult to diagnose until the disease has progressed. Thankfully, if diagnosed early, non-alcoholic fatty liver disease can be reversed with lifestyle and diet changes.
When the liver converts fructose into fat, it also elevates triglycerides, releases LDL (“bad” cholesterol), which has a clear link to cardiovascular diseases.
Recent studies have shown a link between a diet that is high in fructose and higher risks of developing heart disease.
Symptoms of cardiovascular disease vary depending on the issue. Some individuals have chest pain or shortness of breath and others don’t have any symptoms at all. One of the best ways you can lower your risk for cardiovascular disease is to cut sugary beverages completely from your diet.
While hypertension has long been a consequence of obesity, there have been rat-modeled studies that show a direct correlation between fructose consumption and hypertension. In this study, rats were fed a high fructose diet, and their systolic blood pressure was measured after two weeks. The result was a 20 +/- point increase in systolic blood pressure in the fructose-fed rats.
While there still needs to be human-based studies on the effect of hypertension and the effects of a high-fructose diet, it is well known that the resulting obesity and weight gain from consumption of fructose is enough to make a link to hypertension and high blood pressure.
How to Lower Fructose Consumption
The key to lowering fructose consumption is reducing the number sugary drinks, such as soda, juice, and energy drinks. While we put a lot of trust in the individual’s personal decision-making process, there are some circumstances in which we need to limit availability for the health of our population. For example, taking soda machines out of public schools. A study surrounding soft drink availability and consumption concluded that when the sugar-sweetened beverages were not available, this led to significant decreases in soft drink consumption for certain student groups. In three separate studies, there has been a confirmed link between childhood obesity and drinking sugary beverages. The first step in winning the war on obesity is starting in our schools to limit access to sugary drinks devoid of any nutritional value.
If you are a daily soda drinker, there are a few easy ways in which you can lower your fructose consumption. First, replace soda with a healthier alternative like water or tea. If you are craving some type of carbonation, try sparkling water with a twist of lemon or lime. Many times, a flavored sparkling water is enough to curb any longing for soft drinks. If you are finding it difficult to cut out soda completely, there are many alternatives on the market that are sweetened naturally with a plant-derived sugar substitute called stevia. Reducing the amount of fructose in your diet will help you feel better, help you to lose weight, and will reduce your risk of serious obesity-related illnesses.
The occasional sugary drink or treat should not have a large impact on your health. However, if you are a habitual drinker of sugar-sweetened beverages, you are putting yourself at great risk of developing serious health problems. The team at Brookhaven Heart is here to assist you in developing a diet plan to help promote optimal health. If you need assistance, you need to call us right away to schedule your appointment with our heart specialists. The first step in changing your health is identifying the problem and taking steps to change the situation. We believe that the most successful patients are those that have adequate support. We are happy to share information and resources on alternatives to sugary drinks and how to put together a healthy diet plan.