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The Other Side of the Story

Lustig’s idea sounds appealingly logical, but many experts don’t buy his toxic-sugar theory. David Katz, M.D., M.P.H., is one such expert. He has written and spoken extensively on the subject. “That talk, what made it so viral was the extreme position,” says Katz, director of the Yale University Prevention Research Center and an EatingWell advisor. “Vilifying a certain nutrient is a good-versus-evil worldview. It’s easy to get people excited if you say the most extreme thing.”

ABC News Nightline correspondent John Donvan interviews pediatric endocrinologist Robert Lustig about the dangers of consuming fructose

Though Lustig is a respected physician, he isn’t a fructose researcher (he has only one original scientific paper on the subject, based on government-generated not lab-generated data). Most of his 90-plus published scientific papers focus on overweight children. And before his infamous lecture, only two mentioned fructose at all; since 2009, he’s published six papers that mention fructose, mostly editorials, reviews and commentaries on his theory.

But he’s not the only one to theorize that fructose is causing some of our modern health problems. In 2004, George Bray, M.D., at the Pennington Biomedical Research Center in Louisiana, and Barry Popkin, Ph.D., at the University of North Carolina at Chapel Hill, noticed that rising rates of obesity paralleled an increase in sugar consumption and they loosely attributed this to the harmful way our body metabolizes fructose. Other studies have since more strongly linked consuming sugar-sweetened beverages like sodas and juices with obesity, at least in children and adolescents, and for years researchers have been giving animals extremely high doses of fructose to create metabolic syndrome.

Why, then, is Lustig famous for the theory?

“Lustig takes a very evangelical and sensational approach to the data,” says John Sievenpiper, M.D., Ph.D., a researcher at St. Michael’s Hospital and McMaster University in Ontario who has analyzed many of the fructose studies; he comes to a conclusion that is the opposite of Lustig’s. “He puts up these really wonderful, very seductive models. But, really, they’re just hypotheses.”

Hypotheses are unproven ideas that scientists can test, and many scientists have already tested whether consuming a lot of fructose alters the cholesterol and fats in the blood, the fats in the liver, blood pressure. Data from animal models, on which Lustig’s hypothesis is firmly based, is clear: when animals consume very high levels of fructose, say, 60 percent of their calories, they do seem to have the symptoms of metabolic syndrome: high levels of triglycerides in their blood, high blood pressure, insulin resistance and weight gain.

But, say Sievenpiper and others, there are obvious problems with transposing animal experiments to human health: in animal studies, the researchers give the animals three times more than the highest amount of fructose most humans ever eat. Plus, animals process carbohydrates very differently from humans (their livers are naturally geared to make fat from carbohydrate).

Description: daily consuming one (or more) sugar sweetened beverages, which also contain a lot of fructose, raises risk of heart disease.

daily consuming one (or more) sugar sweetened beverages, which also contain a lot of fructose, raises risk of heart disease.

In addition, human studies, at this point, don’t even all point to the same answer. Supporting Lustig’s theory are a few epidemiological studies (these studies follow large groups of people over time) that show increased health risks for people who frequently consume drinks high in sugars. The Nurses Health Study, one of the biggest epidemiological studies around, found that drinking a small glass of fruit juice daily (full of fructose) is associated with higher incidence of type 2 diabetes; daily consuming one (or more) sugar-sweetened beverages, which also contain a lot of fructose, raises risk of heart disease. The Framingham Heart Study showed that people who drank more than a can of soda a day were more likely to have metabolic syndrome.

Sweet Choices

Confused in the sugar aisle? Use this handy comparison chart to help you decide which sweetener to choose and how to use it.

Sweetener

Science says…

Best for…

To use in baking

Granulated Sugar

(a.k.a., sugar, table sugar)

1 cup = 720 cal.

Composed of 50% glucose, 50% fructose, this pure white sugar has been processed so has few minerals and antioxidants.

Making sugar cookies, meringue toppings and delicate, fluffy cakes.

Follow the recipe as written.

Agave Nectar

1 cup = 960 cal.

 

Agave contains up to 90% fructose the most of any of the sweeteners mentioned here.

 

Giving smoothies and iced drinks a touch of sweetness.

 

For 1 cup sugar use:

3/4 cup agave, reduce liquid by 2 Tbsp. for each cup replaced and lower oven temperature by 25°F.

 

Honey

1 cup = 960 cal.

Delivers slightly more fructose than glucose. Honey’s antioxidant quantity varies greatly based on type; buckwheat honey typically delivers the most.

Providing a delicate, sweet flavor to dressings, marinades and slaws.

For 1 cup sugar use:

3/4 cup honey, reduce liquid by 2 Tbsp. for each cup replaced and lower oven temperature by 25°F.

Molasses

1 cup = 960 cal.

 

 

About 50% each glucose and fructose, dark molasses has the highest antioxidant levels of all sweeteners (per serving, similar to levels in nuts and berries).

 

Adds distinct flavor and a hint of sweetness to baked beans, homemade BBQ sauces, brown bread and ginger cookies. Has a toasty, slightly bitter flavor.

 

For 1 cup sugar use:

1 1/3 cups molasses, reduce liquid by 2 Tbsp. for each cup replaced and lower oven temperature by 25° F.

 

Brown I Sugar

1 cup = 720 cal.

50% glucose and 50% fructose. Made by adding molasses back to white sugar, brown sugar has more calcium and iron than white (but only trace amounts).

Bringing caramel flavor to cookies and brownies, darker cakes like carrot cake and quick bread; topping oatmeal and fruit crisps and crumbles.

For 1 cup sugar use:

1 cup packed brown sugar

Turbinado

(a.k.a. raw sugar) 1 cup = 720 cal.

 

50% glucose and 50% fructose. The brown color comes from small amounts of molasses that haven’t been stripped out.

 

Topping cookies and quick breads with a sugary crackle.

 

For 1 cup sugar use:

1 cup turbinado

 

Pure Maple Syrup

1 cup = 800 cal.

About 50-50 glucose and fructose (depending on grade), it contains small amounts of poly-phenols antioxidants that help quell inflammation.

Flavoring pork with a glaze or as part of a marinade or salad dressing. And for pouring on pancakes, waffles and French toast.

For 1 cup sugar use:

3/4 cup maple syrup and reduce liquid by 2 Tbsp. for each cup replaced.

1 Date Sugar

1 cup = 480 cal.

Made from ground dates, it delivers all the nutrients in dates, including potassium and calcium and is similar in antioxidants to molasses.

Baking banana bread and bar cookies.

For 1 cup sugar use: 2/3 cup date sugar

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