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Sugar Vs. Fat

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For years, there has been heavy debate as to whether sugar or fat is the culprit in the obesity epidemic. In the 1970s, this debate reached its peak and fat was pinned as the cause of our general decline in metabolic health. However more recently, sugar has come back into the limelight, with links to obesity, type II diabetes incidence and fatty liver disease.

With a general failure in halting the obesity and diabetes epidemics under the current guidelines and the lack of evidence that low-fat diets improve obesity, cardiovascular risk and other general health problems1-18, it is now more important than ever to take a good look at the research done on sugar and fat to understand how these wee molecules affect our health.

What’s the story with fats?

For years, fats have been the bad guy, with many products boasting fat free or low fat alternatives. But how did this all get started? What scientific evidence is there to really substantiate the anti-fat argument? In short it comes down to this – the type of fat matters. Let me elaborate a little.

The links between fat intake and metabolic disease are more to do with the “bad fats”, such as trans fats found in processed food, biscuits, salad dressings…and the list goes on. In particular, trans fats have been strongly linked to coronary heart disease9,19-22. The jury isn’t quite out on saturated fats. Some studies suggest, that saturated fats significantly worsen insulin resistance10,23-29 and increase blood pressure10,30,31, while others indicate that some forms of saturated fat (in particular those derived from plants) are not as detrimental to our health9,32.

“Good fats” (monunsaturated and polyunsaturated) are found in foods such as seafood, avocado, nuts and olive oil. These have been shown to reduce low density lipoprotein (LDL), sustain high density lipoprotein (HDL) and improve insulin sensitivity9,10,12,32-37. Some research does suggest that there isn’t a link between these ‘good fats’ and cholesterol levels, however most of these studies only sampled a small number of people for a short period of time10,38-42.

How about low fat diets? Overwhelmingly, the majority of research suggests that there is no benefit of a low fat diet vs. a high fat diet for weight loss1-18. Furthermore, there is little evidence to suggest adverse affects of a general high fat diet10,43-45. Interesting stuff! 

What’s the story with sugars?

There is a lot of evidence to suggest that consuming too much sugar can have a negative effect on our metabolic health. Regular sugar consumption produces a constant release of the hormone insulin. If this continues, it can lead to serious problems, such as the synthesis of tryglycerides46-50, insulin resistance51,52, fatty liver disease53,54, type II diabetes55-59, an increase in very low density lipoprotein (the bad kind of cholesterol) and the accumulation of fat on all tissues49,50,60-63. Studies have also shown that our brains respond differently to fructose containing sugars than to glucose containing sugars49,64.

Some research however does cast sugar in a sweeter light. Several studies conclude that there is no clear evidence that added sugar is worse than any other source of calories for the development of diabetes or obesity65-69. However, many of these studies were either industry funded or had a strong financial interest to maintain high levels of sugar consumption49, so should be taken with a grain of salt!

So how about low sugar diets? Much of the research suggests that this way of eating is beneficial for reducing blood glucose levels50,70-78, weight loss and serum triglyverides50,62,79-81, often more so than low fat or low calorie diets50,78,82-84.

The verdict

All in all, most of the current evidence suggests that unsaturated fats are good for our general health, but that those cheeky trans fats should be avoided! The jury isn’t quite out on saturated fats. High-sugar consumption can also have a negative impact on our health by increasing the risk of type II diabetes, fatty liver disease and obesity. However there is a lot more work required to tease out the differences between various fat and sugar content diets. Remember, the more we understand about the types of foods we’re eating, the better quipped we will be to make awesome food choices!*

(*Amended 19/01/2016)

 

References

  1. Tobias, D. K. et al. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 3, 968–979 (2015).
  2. Howard, B. V. et al. Low-Fat Dietary Pattern and Risk of Cardiovascular Disease: The Women’s Health Initiative Randomized Controlled Dietary Modification Trial. Jama-J Am Med Assoc 295, 655–666 (2006).
  3. Anderson, K. M., Castelli, W. P. & Levy, D. Cholesterol and Mortality: 30 Years of Follow-up From the Framingham Study. Jama-J Am Med Assoc 257, 2176–2180 (1987).
  4. Siri-Tarino, P. W., Sun, Q., Hu, F. B. & Krauss, R. M. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am. J. Clin. Nutr. 91, ajcn.27725–546 (2010).
  5. Siri-Tarino, P. W., Sun, Q., Hu, F. B. & Krauss, R. M. Saturated fat, carbohydrate, and cardiovascular disease. Am. J. Clin. Nutr. 91, 502–509 (2010).
  6. Weinberg, S. L. The diet–heart hypothesis: a critique. J Am Coll Cardiol 43, 731–733 (2004).
  7. Ravnskov, U., Rosch, P. J., Sutter, M. C. & Houston, M. C. Controversy: Should we lower cholesterol as much as possible? BMJ : British Medical Journal 332, 1330–1332 (2006).
  8. Yancy, W. S., Westman, E. C., French, P. A. & Califf, R. M. Diets and clinical coronary events: the truth is out there. Circulation 107, 10–16 (2003).
  9. Willett, W. C. Dietary fats and coronary heart disease. J. Intern. Med. 272, 13–24 (2012).
  10. Riccardi, G., Giacco, R. & Rivellese, A. A. Dietary fat, insulin sensitivity and the metabolic syndrome. Clin Nutr 23, 447–456 (2004).
  11. Kratz, M., Baars, T. & Guyenet, S. The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. Eur J Nutr 52, 1–24 (2013).
  12. Swinburn, B. A., Boyce, V. L., Bergman, R. N., Howard, B. V. & Bogardus, C. Deterioration in Carbohydrate Metabolism and Lipoprotein Changes Induced by Modern, High Fat Diet in Pima Indians and Caucasians. The Journal of Clinical Endocrinology & Metabolism 73, 156–165 (2013).
  13. Bisschop, P. H. et al. Dietary fat content alters insulin-mediated glucose metabolism in healthy men. Am. J. Clin. Nutr. 73, 554–559 (2001).
  14. Garg, A., Grundy, S. M. & Unger, R. H. Comparison of Effects of High and Low Carbohydrate Diets on Plasma Lipoproteins and Insulin Sensitivity in Patients With Mild NIDDM. Diabetes 41, 1278–1285 (1992).
  15. Hughes, V. A. et al. Long-term effects of a high-carbohydrate diet and exercise on insulin action in older subjects with impaired glucose tolerance. Am. J. Clin. Nutr. 62, 426–433 (1995).
  16. Sarkkinen, E., Schwab, U., Niskanen, L. & Hannuksela, M. The effects of monounsaturated-fat enriched diet on lipid and glucose metabolism in subjects with impaired glucose tolerance. (Eur J Clin Nutr, 1996).
  17. Thomsen, C. & Rasmussen, O. Comparison of the effects of a monounsaturated fat diet and a high carbohydrate diet on cardiovascular risk factors in first degree relatives to type-2 diabetic subjects. European journal of Clinical Nutrition (1999).
  18. Campbell, L. V., Brokman, M., Chisholm, D. J. & Storlien, L. H. Comparison of the Effects on Insulin Sensitivity of High Carbohydrate and High Fat Diets in Normal Subjects*. The Journal of Clinical Endocrinology & Metabolism 72, 432–437 (2013).
  19. Keys, A. Serum cholesterol response to dietary cholesterol. Am. J. Clin. Nutr. 40, 351–359 (1984).
  20. Hegsted, D. M. Serum-cholesterol response to dietary cholesterol: a re-evaluation. Am. J. Clin. Nutr. 44, 299–305 (1986).
  21. Shepherd, J. et al. Prevention of Coronary Heart Disease with Pravastatin in Men with Hypercholesterolemia. New Engl J Med 333, 1301–1308 (1995).
  22. Sacks, F. M. et al. The Effect of Pravastatin on Coronary Events after Myocardial Infarction in Patients with Average Cholesterol Levels. New Engl J Med 335, 1001–1009 (1996).
  23. Maron, D. J., Fair, J. M. & Haskell, W. L. Saturated fat intake and insulin resistance in men with coronary artery disease. The Stanford Coronary Risk Intervention Project Investigators and Staff. Circulation 84, 2020–2027 (1991).
  24. Parker, D. R. et al. Relationship of dietary saturated fatty acids and body habitus to serum insulin concentrations: the Normative Aging Study. Am. J. Clin. Nutr. 58, 129–136 (1993).
  25. Mayer, E. J., Newman, B., JR, C. P. Q. & Selby, J. V. Usual Dietary Fat Intake and Insulin Concentrations in Healthy Women Twins. Diabetes Care 16, 1459–1469 (1993).
  26. Feskens, E. J., Loeber, J. G. & Kromhout, D. Diet and physical activity as determinants of hyperinsulinemia: the Zutphen Elderly Study. Am. J. Epidemiol. 140, 350–360 (1994).
  27. Marshall, J. A., Bessesen, D. H. & Hamman, R. F. High saturated fat and low starch and fibre are associated with hyperinsulinaemia in a non-diabetic population: The San Luis Valley Diabetes Study. Diabetologia 40, 430–438 (1997).
  28. Mooy, J. M., Grootenhuis, P. A. & De Vries, H. Determinants of specific serum insulin concentrations in a general Caucasian population aged 50 to 74 years (the Hoorn Study). Diabetic Medicine (1998).
  29. Mayer-Davis, E. J. et al. Dietary fat and insulin sensitivity in a triethnic population: the role of obesity. The Insulin Resistance Atherosclerosis Study (IRAS). Am. J. Clin. Nutr. 65, 79–87 (1997).
  30. Stamler, J., Caggiula, A. W. & Grandits, G. A. Relation of body mass and alcohol, nutrient, fiber, and caffeine intakes to blood pressure in the special intervention and usual care groups in the Multiple Risk Factor Intervention Trial. Am. J. Clin. Nutr. 65, 338S–365S (1997).
  31. Trevisan, M. et al. Consumption of Olive Oil, Butter, and Vegetable Oils and Coronary Heart Disease Risk Factors. Jama-J Am Med Assoc 263, 688–692 (1990).
  32. Hu, F. B. et al. Dietary Fat Intake and the Risk of Coronary Heart Disease in Women. New Engl J Med 337, 1491–1499 (1997).
  33. Storlien, L. H. et al. Influence of Dietary Fat Composition on Development of Insulin Resistance in Rats: Relationship to Muscle Triglyceride and ω-3 Fatty Acids in Muscle Phospholipid. Diabetes 40, 280–289 (1991).
  34. Pelikánová, T., Kohout, M., Válek, J., Bas̆e, J. & Kazdová, L. Insulin secretion and insulin action related to the serum phospholipid fatty acid pattern in healthy men. Metabolism 38, 188–192 (1989).
  35. Borkman, M., Storlien, L. H. & Pan, D. A. The relation between insulin sensitivity and the fatty-acid composition of skeletal-muscle phospholipids. The New England Journal of Medicine (1993).
  36. Vessby, B., Tengblad, S. & Lithell, H. Insulin sensitivity is related to the fatty acid composition of serum lipids and skeletal muscle phospholipids in 70-year-old men. Diabetologia 37, 1044–1050 (1994).
  37. Pan, D. A. et al. Skeletal muscle membrane lipid composition is related to adiposity and insulin action. Journal of Clinical Investigation 96, 2802–2808 (1995).
  38. Heine, R. J., Mulder, C., Popp-Snijders, C., van der Meer, J. & van der Veen, E. A. Linoleic-acid-enriched diet: long-term effects on serum lipoprotein and apolipoprotein concentrations and insulin sensitivity in noninsulin-dependent diabetic patients. Am. J. Clin. Nutr. 49, 448–456 (1989).
  39. Uusitupa, M. et al. Effects of two high-fat diets with different fatty acid compositions on glucose and lipid metabolism in healthy young women. Am. J. Clin. Nutr. 59, 1310–1316 (1994).
  40. Schwab, U. S., Niskanen, L. K. & Maliranta, H. M. Lauric and palmitic acid-enriched diets have minimal impact on serum lipid and lipoprotein concentrations and glucose metabolism in healthy young women. Journal of Nutrition (1995).
  41. Fasching, P. et al. No Effect of Short-Term Dietary Supplementation of Saturated and Poly- and Monounsaturated Fatty Acids on Insulin Secretion and Sensitivity in Healthy Men. Ann Nutr Metab 40, 116–122 (1996).
  42. Lovejoy, J. C. et al. Effects of diets enriched in saturated (palmitic), monounsaturated (oleic), or trans (elaidic) fatty acids on insulin sensitivity and substrate oxidation in healthy adults. Diabetes Care 25, 1283–1288 (2002).
  43. Ludwig, D. S., Peterson, K. E. & Gortmaker, S. L. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 357, 505–508 (2001).
  44. Chen, L. B. Mitochondrial-Membrane Potential in Living Cells. Annu Rev Cell Biol 4, 155–181 (1988).
  45. Lovejoy, J. C., Windhauser, M. M., Rood, J. C. & la Bretonne, de, J. A. Effect of a controlled high-fat versus low-fat diet on insulin sensitivity and leptin levels in African-American and Caucasian women. Metabolism 47, 1520–1524 (1998).
  46. Duffey, K. J., Gordon-Larsen, P., Steffen, L. M., Jacobs, D. R. & Popkin, B. M. Drinking caloric beverages increases the risk of adverse cardiometabolic outcomes in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am. J. Clin. Nutr. 92, 954–959 (2010).
  47. Welsh, J. A. et al. Caloric Sweetener Consumption and Dyslipidemia Among US Adults. Jama-J Am Med Assoc 303, 1490–1497 (2010).
  48. Welsh, J. A., Sharma, A., Cunningham, S. A. & Vos, M. B. Consumption of added sugars and indicators of cardiovascular disease risk among US adolescents. Circulation 123, 249–257 (2011).
  49. Stanhope, K. L. Sugar consumption, metabolic disease and obesity: The state of the controversy. Crit Rev Clin Lab Sci 1–16 (2015). doi:10.3109/10408363.2015.1084990
  50. Feinman, R. D. et al. Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base. Nutrition 31, 1–13 (2015).
  51. Bremer, A. A., Auinger, P. & Byrd, R. S. Sugar-sweetened beverage intake trends in US adolescents and their association with insulin resistance-related parameters. Journal of nutrition and … (2009).
  52. Yoshida, M. et al. Surrogate markers of insulin resistance are associated with consumption of sugar-sweetened drinks and fruit juice in middle and older-aged adults. J. Nutr. 137, 2121–2127 (2007).
  53. Assy, N. et al. Soft drink consumption linked with fatty liver in the absence of traditional risk factors. Can. J. Gastroenterol. 22, 811–816 (2008).
  54. Ouyang, X. et al. Fructose consumption as a risk factor for non-alcoholic fatty liver disease. Journal of Hepatology 48, 993–999 (2008).
  55. Bhupathiraju, S. N. et al. Caffeinated and caffeine-free beverages and risk of type 2 diabetes. Am. J. Clin. Nutr. 97, 155–166 (2013).
  56. de Koning, L., Malik, V. S., Rimm, E. B., Willett, W. C. & Hu, F. B. Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. Am. J. Clin. Nutr. 93, 1321–1327 (2011).
  57. Montonen, J., Järvinen, R., Knekt, P., Heliövaara, M. & Reunanen, A. Consumption of sweetened beverages and intakes of fructose and glucose predict type 2 diabetes occurrence. J. Nutr. 137, 1447–1454 (2007).
  58. Palmer, J. R. et al. Sugar-Sweetened Beverages and Incidence of Type 2 Diabetes Mellitus in African American Women. Arch Intern Med 168, 1487–1492 (2008).
  59. Schulze, M. B. et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. Jama-J Am Med Assoc 292, 927–934 (2004).
  60. Odegaard, A. O., Choh, A. C., Czerwinski, S. A., Towne, B. & Demerath, E. W. SugarSweetened and Diet Beverages in Relation to Visceral Adipose Tissue. Obesity (Silver Spring) 20, 689–691 (2012).
  61. Pollock, N. K. et al. Greater fructose consumption is associated with cardiometabolic risk markers and visceral adiposity in adolescents. J. Nutr. 142, 251–257 (2012).
  62. Volek, J. S., Fernandez, M. L., Feinman, R. D. & Phinney, S. D. Dietary carbohydrate restriction induces a unique metabolic state positively affecting atherogenic dyslipidemia, fatty acid partitioning, and metabolic syndrome. Progress in Lipid Research 47, 307–318 (2008).
  63. Al-Khalifa, A., Mathew, T. C., Al-Zaid, N. S., Mathew, E. & Dashti, H. M. Therapeutic role of low-carbohydrate ketogenic diet in diabetes. Nutrition 25, 1177–1185 (2009).
  64. Luo, S., Monterosso, J. R., Sarpelleh, K. & Page, K. A. Differential effects of fructose versus glucose on brain and appetitive responses to food cues and decisions for food rewards. Proc Natl Acad Sci U.S.A. 112, 6509–6514 (2015).
  65. Kahn, R. & Sievenpiper, J. L. Dietary sugar and body weight: have we reached a crisis in the epidemic of obesity and diabetes?: we have, but the pox on sugar is overwrought and overworked. Diabetes Care 37, 957–962 (2014).
  66. BravoStephen, LowndesJoshua, SinnettStephanie, YuZhipingRippeJames. Consumption of sucrose and high-fructose corn syrup does not increase liver fat or ectopic fat deposition in muscles. Applied Physiology, Nutrition, and Metabolism 38, 681–688 (2013).
  67. Yu, Z., Lowndes, J. & Rippe, J. High-fructose corn syrup and sucrose have equivalent effects on energy-regulating hormones at normal human consumption levels. Nutrition Research 33, 1043–1052 (2013).
  68. Wang, D. D. et al. The effects of fructose intake on serum uric acid vary among controlled dietary trials. J. Nutr. 142, 916–923 (2012).
  69. David Wang, D. et al. Effect of fructose on postprandial triglycerides: A systematic review and meta-analysis of controlled feeding trials. Atherosclerosis 232, 125–133 (2014).
  70. Accurso, A. et al. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutrition & Metabolism 2008 5:1 5, 1 (2008).
  71. Westman, E. C., Yancy, W. S., Jr & Mavropoulos, J. C. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr Metab ( … (2008).
  72. Rizza, R. A. Pathogenesis of fasting and postprandial hyperglycemia in type 2 diabetes: implications for therapy. Diabetes 59, 2697–2707 (2010).
  73. Gannon, M. C., Hoover, H. & Nuttall, F. Q. Further decrease in glycated hemoglobin following ingestion of a LoBAG30 diet for 10 weeks compared to 5 weeks in people with untreated type 2 diabetes. Nutr Metab (Lond) (2010).
  74. Gannon, M. C. & Nuttall, F. Q. Control of blood glucose in type 2 diabetes without weight loss by modification of diet composition. Nutr Metab (Lond) (2006).
  75. Nuttall, F. Q., Schweim, K., Hoover, H. & Gannon, M. C. Effect of the LoBAG 30 diet on blood glucose control in people with type 2 diabetes. Br. J. Nutr. 99, 511–519 (2008).
  76. Al-Khalifa, A., Mathew, T. C., Al-Zaid, N. S., Mathew, E. & Dashti, H. Low carbohydrate ketogenic diet prevents the induction of diabetes using streptozotocin in rats. Experimental and Toxicologic Pathology 63, 663–669 (2011).
  77. Dashti, H. M. et al. Beneficial effects of ketogenic diet in obese diabetic subjects. Mol Cell Biochem 302, 249–256 (2007).
  78. Hussain, T. A. et al. Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition 28, 1016–1021 (2012).
  79. Volek, J. S. et al. Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet. Lipids 44, 297–309 (2009).
  80. Volek, J. S. & Feinman, R. D. Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction. Nutr Metab (Lond) (2005).
  81. Jenkins, D. J. A. et al. Effect of a Low–Glycemic Index or a High–Cereal Fiber Diet on Type 2 Diabetes: A Randomized Trial. Jama-J Am Med Assoc 300, 2742–2753 (2008).
  82. Dyson, P. A., Beatty, S. & Matthews, D. R. A lowcarbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and nondiabetic subjects. Diabetic Medicine 24, 1430–1435 (2007).
  83. Samaha, F. F. et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. New Engl J Med 348, 2074–2081 (2003).
  84. Hession, M., Rolland, C., Kulkarni, U., Wise, A. & Broom, J. Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obes Rev 10, 36–50 (2009).
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