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Sugar leads to early death, but not due to obesity

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MedicalXpress has an article at https://medicalxpress.com/news/2020-03-sugar-early-death-due-obesity.html  which explores how sugar reduces longevity independently of diabetic-like metabolic issues.  Some highlights

 the shortened survival of fruit flies fed a sugar-rich diet is not the result of their diabetic-like metabolic issues.

early death from excess sugar is related to the build-up of a natural waste product, uric acid.

 like salt, sugar also causes dehydration. In fact, thirst is an early symptom of high blood sugar and diabetes. 

excess dietary sugar caused the flies to accumulate a molecule called uric acid.

diluting their formation with drinking water or by blocking the production of uric acid with a drug. In turn, this protected against the shortened survival associated with a sugar-rich diet.

does this mean we can eat all the sugary treats we want, as long as we drink plenty of tea? "Unfortunately not," says Dr. Cochemé, "the sugar-fed flies may live longer when we give them access to water, but they are still unhealthy. 

early death by sugar is not necessarily a direct consequence of obesity itself

They checked for applicability to humans and found.

"Strikingly, just like flies, we found that dietary sugar intake in humans was associated with worse kidney function and higher purine levels in the blood"

 

 

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This is not surprising at all. I highly, highly, highly recommend the following podcast from Dr. Peter Attia and Rick Johnson, M.D. - it's a very illuminating explication of the etiology behind a host of metabolic disorders and ways of taking practical measures to avoid them. I cannot recommend this episode strongly enough:

https://peterattiamd.com/rickjohnson/

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14 hours ago, TomBAvoider said:

... I cannot recommend this episode strongly enough:

https://peterattiamd.com/rickjohnson/

This was a good interview, thank you. It left the questions about eating whole fruit still hanging however, as Rick Johnson cited a study showing that eating whole fruit had no deleterious effects, yet then Atta moved on to restricting bananas and apples. My guess is that it applies to already impaired systems, but I didn't hear a convincing explanation. 

It prompted me to look at my own fructose consumption, which is at about 27g per day lately, mostly driven by the crushed tomatoes and red bell peppers I eat almost daily (blueberries are in third place).

Not sure where my liter and a half water kefir consumption fits in, since Cronometer doesn't account for it, but it should be significant. I guess I'll have to see what my blood tests show when I check this spring.

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I agree that fructose from fruit is not entirely clear - generally nutritionists claim that there isn't that much in fruit, plus it's bound in a matrix and released slowly when digested. However, that doesn't take into account a few things - for one, CRONies or at least some people (myself included) consume quite a bit of fruit, probably more than nutritionists assume. Also, if diabetics are really trying to control blood sugar, doctors recommend limiting fruit - if the fructose in fruit was irrelevant, nobody would make that recommendation.

I do consume quite a bit of fruit, but I also consume a lot of liquids just because of my diet. And I drink substantial amounts of tea, some coffee and so on. So I think I'm ok here, my BP is fine, my urine tests fine, liver enzymes etc. I do think that one blood test that might be useful is for uric acid - I had one years ago, I forget in what context, but it was fine, now I think it might be useful to monitor it. I have my yearly physical scheduled for the end of April - I suspect that will get cancelled. 

 

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I just looked and my uric acid is at 5.7 mg/dL which is above the 5.5 cutoff Johnson mentions. LabCorp gives the normal range as between 3.5 and 7.2. This was before adding water kefir, so I'd be curious how it comes out the next time I do a blood test.

My HSCRP is 0.03 mg/L with normal being 0.10 to 5.50.

BUN is 6.0 mg/L with normal being 8-20.

Interestingly, the first study I found on uric acid and mortality contradicts Johnson's claims. In men those with uric acid of about 7 appear to have the lowest mortality (see table 3):

U‐Shaped Association Between Serum Uric Acid Level and Risk of Mortality

I am now not convinced that Johnson's theory is the complete answer, or even totally on the right track.

Edited by Ron Put

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One thing one has to be careful with is that we (i.e. most people on this board) are a very, very different cohort from the "general population". Since the test ranges are drawn from the general population, conclusions based on that might not be valid for us. What may be an "unhealthy" number in the range for the general population may not apply to us - this is a very real scenario. As a result, I'm very, very tentative when I read studies that depend on findings from the general population whose diet, exercise, lifestyle, supplementation and medication regimens differ drastically from ours. There are not enough of us freaks to impact such findings - we most likely are not in almost any such studies, so the conclusions are drawn from a population that is not representative of us. What is more helpful to at least a subgroup of us, are the Fontana studies done on CRONies, because they deal with "our" group. YMMV.

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Check your HbA1c.  5.7 or higher is prediabetic and surely suboptimal.  I think 5.2 or lower is a good target.  Might also track post prandial response with a finger prick test kit to worst case indulgences such as smoothies with bananas or mangos.  I had a bad health damaging orange juice habit before I learned my tolerance for sugars had become particularly poor.  Now I limit my fruit indulgences to moderate portions when I'm in a glycogen depleted state and I have no troubles.

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I'd also keep an on BP longitudinally - I have this:

https://www.amazon.com/gp/product/B077CXGSJW/

and found it accurate. Taking one measurement at the doctor's office a couple of times a year is completely inadequate - you really don't know what your BP numbers are given the vagaries of how a nurse handles the apparatus, what you were doing just prior to measurement, possible white coat syndrome etc., etc., etc.

What you want is to take the measurement at the same time of the day under the same kinds of conditions over a period of time. That gives you a fair idea of your actual BP numbers.

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1 hour ago, Todd Allen said:

Check your HbA1c.  5.7 or higher is prediabetic and surely suboptimal....

Hi, Todd. I just looked at my HG_A1C (LC's designation) and it's an even 5.0, within LabCorp's "normal" range of 3.8-6.0. Glucose is at 85 mg/dL (normal 74-106).

I do have a sweet tooth at times and can easily eat two or three slices of good chocolate cake once in a blue moon (every three months or so), particularly if I have the munchies to go with it :)

Tom, I've been waiting for the Whitings BPM Connect to be approved by the FDA, but I might give up, since it's been a long time and I am still waiting for the Pulse Velocity feature on the scale I have to be turned on. I think my blood pressure is OK though, as it's normally about 100 over 70 when I check it.

Edited by Ron Put

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On 3/19/2020 at 9:19 PM, Ron Put said:

Interesting and it makes sense.

Presumably, this applies to added sugars, not to whole fruits, etc..

I would guess otherwise.  Whether the sugar is in a fruit or in a sugar bowl, it's sugar.  (Of course, fruits have useful soluble fiber.)--  Saul

  

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Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies

International Journal of Epidemiology, Volume 46, Issue 3, June 2017, Pages 1029–1056, https://doi.org/10.1093/ije/dyw319
Published:
 
22 February 2017

Results: For fruits and vegetables combined, the summary RR per 200 g/day was 0.92 [95% confidence interval (CI): 0.90–0.94, I2 = 0%, n = 15] for coronary heart disease, 0.84 (95% CI: 0.76–0.92, I2 = 73%, n = 10) for stroke, 0.92 (95% CI: 0.90–0.95, I2 = 31%, n = 13) for cardiovascular disease, 0.97 (95% CI: 0.95–0.99, I2 = 49%, n = 12) for total cancer and 0.90 (95% CI: 0.87–0.93, I2 = 83%, n = 15) for all-cause mortality. Similar associations were observed for fruits and vegetables separately. Reductions in risk were observed up to 800 g/day for all outcomes except cancer (600 g/day). Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality, and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk. An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal.

Conclusions: Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality.

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"Our findings suggest the presence of heterogeneity in the associations between individual fruit consumption and risk of type 2 diabetes. Greater consumption of specific whole fruits, particularly blueberries, grapes, and apples, is significantly associated with a lower risk of type 2 diabetes, whereas greater consumption of fruit juice is associated with a higher risk."

https://www.bmj.com/content/347/bmj.f5001

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On 3/20/2020 at 2:11 PM, Ron Put said:

I just looked and my uric acid is at 5.7 mg/dL which is above the 5.5 cutoff Johnson mentions. LabCorp gives the normal range as between 3.5 and 7.2. This was before adding water kefir, so I'd be curious how it comes out the next time I do a blood test.

I think it depends on the lab. My doctor tells me that 5.7 is absolutely normal according to LabCorp and I just subscribed to Lab Test Analyzer which claims that "normal" Uric Acids values are even higher, between 4-8.6mg/dL.  For what it's worth, my most recent test was at 3.6mg/dL, which was flagged as too low by Lab Test Analyzer.

Be that as it may, here is an interesting article on uric acid and longevity:

Uric acid pathologies shorten fly lifespan, highlighting need for screening in humans

"Gout is also associated with premature mortality in humans. Conversely, studies from the Institute for Aging Research led by Nir Barzilai at the Albert Einstein College of Medicine show that many centenarians are genetically predisposed to having low levels of uric acid."

Edited by Ron Put

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On 3/24/2020 at 8:04 PM, Saul said:

I would guess otherwise.  Whether the sugar is in a fruit or in a sugar bowl, it's sugar.  (Of course, fruits have useful soluble fiber.)--  Saul

  

It is not the same. refined sugar can in no way be the same as the sugar that fruit has naturally in it
 

 

 

 

Edited by Robin55

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Of course, when you eat a fruit, you're getting a lot of fiber as well as sugars; so the glycemic load isn't nearly as large as eating sugar from the sugar bowl.  You'll have less of a spike in serum glucose.

But different people respond differently -- e.g., some people will get a huge spike in serum glucose after eating a banana, but not so much after eating an apple.  Others may get an insignificant spike eating the banana, but a bigger one eating a honeycrisp.

Some will get very little of a spike, even after eating a spoonful from a sugar bowl.

  --  Saul

 

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