Almost everyone eats it, but it's a "breeding ground" for disease
Almost Everyone Eats it, But it's a
Fructose is not the same molecule. Glucose is a 6-member
"Breeding Ground" for Disease
ring, but fructose is a 5-member ring. Sucrose (table sugar)
By Dr. Mercola, fév 2012 -
is 50 percent glucose and 50 percent fructose, and HFCS is 42-55 percent fructose.
If you received your fructose only from vegetables and fruits
(where it originates) as most people did a century ago, you'd
Evidence is mounting that sugar is the primary factor
consume about 15 grams per day. Today the average is 73
causing not just obesity, but also many chronic and lethal
grams per day which is nearly 500 percent higher a dose and
our bodies simply can't tolerate that type of biochemical
Dr. Robert Lustig, one of the leading experts on childhood
abuse. Furthermore, in vegetables and fruits, the fructose is
obesity, and arguably the number one enemy of the sugar
mixed in with fiber, vitamins, minerals, enzymes, and
lobby, has published a well written article in the prestigious
beneficial phytonutrients, all of which help moderate the
scientific journal Nature
arguing that su
negative metabolic effects. So it's not that fructose itself is
He believes that the negative health effects of sugar
"poisonous"—it's the biologically inappropriate doses you're
consumption can no longer be ignored, any more than the
exposed to that make it hazardous to your health and well-
health effects of tobacco and alcohol could.
According to Dr. Lustig, via the website Diet Doctor
How High Fructose Corn Syrup has Decimated
"The problem with sugar isn't just weight gain . A growing
body of scientific evidence is showing that fructose can
We now know, without a doubt, that it's the excessive sugar
trigger processes that lead to liver toxicity and a host of
content in the modern diet that is taking such a devastating
toll on people's health. According to GreenMedInfo.com,
scientific studies have linked fructose to about 78 different
A little is not a problem, but a lot kills -- slowly."
diseases and health problems. Select the hyperlinks
For the first time in history, "lifestyle" diseases -- diabetes,
heart disease, and some cancers -- are killing more people
than communicable diseases. And treating these entirely
illnesses costs more than one-seventh of the
U.S. GDP. It stands to reason then that simply preventing
these diseases could save the US health care system around
One of the primary, and likely most effective ways of
preventing these diseases would be to curb the outrageous
Dr. Lustig rightfully argues that sugar used to be available to
our ancestors only as fruit or honey—and then only for a few
months of the year—compared to today, when sugar
(primarily in the form of high fructose corn syrup) is added
to virtually all processed foods and drinks; even items you
normally would not think of as being high in sugar.
Tragically, many even contain more than 50
percent sugar! "Nature made sugar hard to get; man made
Fructose is NOT the Same as Glucose
Glucose is the form of energy you were designed to run on.
Every cell in your body, every bacterium -- and in fact, every
living thing on the Earth -- uses glucose for energy.
High fructose corn syrup (HFCS) was invented in Japan in
1966 and introduced to the American market in 1975. Food and beverage manufacturers quickly began switching their
sweeteners from sucrose (table sugar) to corn syrup when they discovered that high fructose corn syrup (HFCS) could
save them a lot of money. Sucrose costs about three times as
much as HFCS. HFCS is also about 20 percent sweeter than table sugar, so you need less to achieve the same amount of
sweetness. In the mid 1970s, dietary fats were blamed for heart disease, giving rise to the "low-fat craze," which resulted in an
explosion of processed nonfat and low fat convenience foods—most of which tasted like sawdust unless sugar was
added. Fructose was then added to make all these fat-free
products more palatable. Yet as the low-fat craze spread, rates of heart disease, diabetes, and obesity skyrocketed. Clearly, there was a major flaw in the plan, and it's not
difficult to see that trading fat for sugar is not
a wise move. The problem is that excessive fructose consumption leads to
insulin resistance, and insulin resistance appears to be the
root of many if not most of the diseases listed above. Insulin
resistance has even been found to be an underlying factor of
recommend this lower level of 15 grams a day simply
because if you consume processed foods or sweet beverages
How Fructose Increases Insulin Secretion and
at all, you're virtually guaranteed
to consume "hidden"
Worsens Your Insulin Sensitivity
sources of fructose that can have a major impact on your
Interestingly, recent research published in the Proceedings
of the National Academy of Sciences
shows that fructose can When I have mentioned this in the past many people have activate taste cells found on your pancreas, a reaction that
strongly disagreed with me as they believe fruit is fine
can increase your body's secretion of in. And, while
because it is natural. And it may be ok for some people,
this is of particular concern for people prone to diabetes, if
especially those doing long and intense exercise sessions.
statistics are any indication, this could include virtually
However, there is an easy way for you to find out your risk. If
your uric acid is above 5.0 would be wise to follow the rule. The higher above 5.0 your uric acid is, the worse your risk
At present, one in four Americans already have either
for damage. If your uric acid is between 3.5 and 5 you should
or some form of diabetes, and type 2 diabetes is
be fine. I believe I must have a genetic polymorphism for
directly linked to your diet, so anyone on a high-fructose diet uric acid as mine is always above 5.5 even with intense
exercise and less than five grams of fructose a day, so I
In this study, the researchers were able to demonstrate that
fructose activates the same proteins in your pancreatic cells
The authors of that paper offer an in-depth review of the
that your tongue uses to taste sweets. And when these cells
many health hazards of fructose, due to its pro-inflammatory
are exposed to both glucose and fructose, they secrete more
insulin than they do when exposed to glucose alone.
"Accumulation of AGEs has been found in healthy aging
persons, and this accumulation is higher during high
"Most sugars join the [metabolic assembly line] at a point
glucose concentrations. Microvascular and macrovascular
where a supervisory enzyme can control the flow of goods.
damage, seen in diabetes, is attributed to the accumulation
But fructose comes in farther down, where it can lead to an
of AGEs in tissues, but it is also associated with
overproduction of fat. And because fructose . doesn't
atherosclerosis, Alzheimer's disease, end stage renal
stimulate the same insulin response that glucose does, the
disease, rheumatoid arthritis, sarcopenia, cataracts, and
hormone isn't doing the other regulatory things it usually
other degenerative ophthalmic diseases, Parkinson's
does, like moderating appetite."
disease, vascular dementia and several other chronic
Limiting Sugar is Also Vital for Longevity
diseases. For instance, Bar et al. have demonstrated
By increasing your insulin and leptin levels (and
differential increases of AGEs products in Alzheimer's
subsequently decreasing receptor sensitivity for both of these dementia and vascular dementia compared to controls. It
vital hormones), excessive sugar/fructose consumption not
has also been suggested that AGEs are involved in the loss
only increases your risk of type 2 diabetes, it also accelerates
of bone density and muscular mass associated with aging."
aging in general. In fact, limiting sugar in your diet is a well-
How to Tame Your Sugar Cravings
known key to longevity, because of all the molecules capable
If you're struggling with sugar addiction, I recommend
of inflicting damage in your body, sugar molecules are
trying an energy psychology technique called ,
which has helped many "soda addicts" kick their sweet habit.
Two years ago, the journal Nutrients published an excellent
If you still want to use a sweetener occasionally, here's what
report on the impact of fructose on aging. is a
particularly potent pro-inflammatory agent that creates
advanced glycation end products, commonly known as "AGEs."
AGEs are a complex group of damaging compounds that
form when sugar reacts with amino acids. Besides oxidation,
glycation and the subsequent formation of AGEs is one of
the major molecular mechanisms causing ongoing damage
been touted as a healthy alternative by many, but don't fall
in your body, which leads to disease, (premature) aging and,
for it. It's a highly processed sap that is almost all fructose,
eventually, death. According to the authors:
"[T]he data are supportive that endogenous AGEs are
associated with declining organ functioning. It appears
that dietary AGEs may also be related. As of today,
restriction of dietary intake of AGEs and exercise has been
shown to safely reduce circulating AGEs, with further
reduction in oxidative stress and inflammatory markers."
In short, if you want to live a long healthy life, you need to
restrict your consumption of sugar, particularly fructose. As
a standard recommendation to limit glycation, I strongly
advise keeping your TOTAL fructose consumption below 25
Most people would be wise to limit their fructose to 15 grams or less however, especially if you have elevated uric acid
This Popular Drink May Be Almost as
levels, which can be used as a predictor for .
Hazardous to Your Health as Soda
This includes keeping track of your fructose intake from
whole fruits. To evaluate the fructose content of many
Dr. Richard Johnson is the chief of the division of kidney
Dr. Johnson suggests that the ideal uric acid level is probably
disease and hypertension at the University of Colorado, and
around 4 mg/dl for men and 3.5 mg/dl for women.
author of The Sugar Fix, one of the best books on the market
This is actually the only major biochemical marker that I
need to optimize at this point in my life, which most likely
As one of the physicians on the cutting edge of sugar
suggests that I am particularly sensitive to fructose intake
metabolism research today, his focus is on how the
and that it’s best for me to keep my levels as low as possible.
overabundance of sugar in the American diet --
This is most likely due to genetics and would explain why
particularly fructose -- is causing obesity, hypertension,
most of my paternal relatives have, or have died from,
diabetes, and a number of other health problems.
diabetes. That side of the family is most likely particularly
The answer to the question in the headline is fruit juice. But
before I explain why fruit juice may be as hazardous to your
So I would STRONGLY encourage everyone to have their
health as soda, let me first give you some background
uric acid level checked to find out how sensitive you are to
fructose. (I’ll discuss this strategy further, in just a moment.)
Fructose has become one of my newest health passions for a
As you know, two-thirds of the US population is overweight,
number of reasons. It is really not well understood how
and most of these people likely have uric acid levels well
pervasive a negative influence this sugar has on people’s
above 5.5. Some may even be closer to 10 or above.
health, but even more importantly, it is something that we can easily change, by influencing the food industry to
Dr. Johnson has developed a program to help people
optimize their uric acid levels, and the key step in this
program is complete elimination of fructose
One of the leading researchers in this field is Richard
Johnson, MD, who is the chief of the division of kidney
Results of the Latest Clinical Trial
disease and hypertension at the University of Colorado. I’ve previously interviewed Dr. Johnson about his research into
“We’ve just finished a clinical trial where we gave a low
the health dangers of fructose, specifically how fructose
fructose diet to overweight and obese adults from Mexico
causes high blood pressure, obesity, and diabetes.
Here, we continue this discussion, and Dr. Johnson also
“We tried two different low fructose diets, but first, before
shares new details of the research he’s been involved with
we go into that, we think that the effects of fructose are
independent of its energy intake. So,table sugar (sucrose) --
An interesting aside is that at the end of this interview, I was
which contains fructose and glucose -- although there is a
very pleasantly surprised to learn that I had written some of
caloric component, we think that the effects of fructose are
the articles on fructose that he reviewed when he first
not specifically related to the calories but rather to its
mechanism, of which uric acid is a driving part.
It really gave me great joy to know that all the hard work and … [Uric acid levels] being too high seems to really increase effort I have put in over the years really is making a
the risk for diabetes and high blood pressure, kidney disease
difference, not only getting people healthy, but also
and obesity. And in fact, there are more and more papers
motivating high integrity scientists to do the right thing.
It is worth noting that Dr. Johnson actually endorses
One of the questions that Dr. Johnson sought to answer in
his latest trial was whether or not you need to reduce ALL
to us getting to know each other, but I recently sent him my
fructose in your diet, or just reduce the fructose primarily in
added sugars like high fructose corn syrup and table sugar.
artificial sweeteners. He’s a true physician and was eager to
After comparing the two low fructose diets -- one that was
review the material and update his knowledge on the subject. strictly low fructose, and the other that had low fructose but There aren’t many doctors out there with this type of
allowed natural fruits – they discovered that both diets had
integrity. I really like Dr. Johnson and believe he’s an
remarkable effects in reducing metabolic syndrome.
authentically well-intentioned good guy.
Both diets improved triglycerides, insulin resistance and blood
It is not often that a health researcher can open up my eyes
to a completely novel and new risk factor for health, as he
did with uric acid and fructose, and I will always be grateful
A Novel Idea -- Using Uric Acid as a
to him for that and for his willingness to enlighten us in
Marker of Susceptibility to Fructose
Uric Acid as a Marker for Fructose
Going back to the issue of genetic variability, it seems that
some people may be able to process fructose more efficiently, and the key to assess this susceptibility to fructose damage
One of the surprising facts discussed in our first interview
lies in evaluating your uric acid levels.
was how detrimental the impact of fructose is on your uric
Dr. Johnson agrees that using uric acid levels as a marker to
acid levels. It appears as though that process is essential to
identify your susceptibility could be a reasonable approach.
the damage that fructose causes, and it’s actually an
So, for example, if you’re passionate about fruit and typically
excellent marker for toxicity from fructose.
eat large amounts of fruit, but have a uric acid level above 5
According to the latest research in this area, the safest range
(or better yet, 4 if you’re a man, and 3.5 if you’re a woman),
of uric acid is between 3 and 5.5 milligrams per deciliter, and then you may want to consider lowering your fruit
there appears to be a steady relationship between uric acid
consumption until you’re able to optimize your uric acid
levels and blood pressure and cardiovascular risk, even down levels.
“We have some evidence from our laboratory that uric acid actually regulates the sensitivity to fructose,”
“So the higher your uric acid, the more sensitive you are to
the effects of fructose. … So I agree with you. If you measure your serum uric acid
and it’s very significantly high, you probably will get into
more trouble with fruit juices and large amounts of fruit
That seems to be the take home message from our current
Revisiting Fruit Consumption
So it appears as though whole fruits, even though they
contain fructose, may not be nearly as problematic as
fructose from added sugars. One of the reasons for this is believed to be because whole fruits contain high amounts of
natural antioxidants, as well as other synergistic compounds that may help counter the detrimental effects of fructose.
“When I originally wrote my book, I was concerned that if
you eat large amounts even of natural fruits you could get
Johnson says, “and I have had cases where
people were eating very large amounts of natural fruits.
When I cut it out or reduced it, they’ve had dramatic weight
loss. So I’ve had a number of people like this who are eating
almost a pure fruit diet, and I don’t think that that’s particularly good, but I think that the normal individual
eating two to four natural fruits a day probably is going to
The key here though is WHOLE fruits, but I still remain
convinced that many people, especially those that have insulin resistance, such as those with:
should be particularly careful about limiting their fructose
How to Know if Fruit May Be a
Problem for You
However the NEW appreciation is that if you have your uric
acid level checked and have a level of 4 for men, or 3.5 for
women, you probably are at a very low risk for fructose
toxicity and can be more liberal with these limits.
The higher your uric acid though, the more you need to limit or even avoid fructose until your uric acid level normalizes.
What About Fruit Juices?
typically contains very high concentrations of
fructose, which will cause your insulin to spike and may counter the benefits of the antioxidants. Previous studies
have already clearly demonstrated that drinking large
Children are at particular risk here, since so many children
are given juice whenever they’re thirsty instead of plain
For example, research has revealed that 3- and 4-year-olds
who carry extra weight and drink just one to two sweet
drinks a day double their risk of becoming seriously
We are now studying it and we do think that there is an
When buying commercial fruit juice, you need to check the
We don’t know how important it is yet, but we do know that
label, as the majority of fruit juices contain high fructose
you can make fructose from glucose, especially if you’re
corn syrup and artificial flavors in addition to concentrated
diabetic or if you’re severely insulin resistant.
Since a lot of people who are very, very overweight and are
But even freshly squeezed fruit juice can contain about eight
trying to lose weight, some of them can be insulin resistant.
full teaspoons of fructose per eight-ounce glass!
This does throw a new twist into the story… We’re trying to
Naturally, some fruits are less problematic than others, as
the amount of fructose and antioxidants vary from fruit to
But certainly if you’re not insulin resistant, dextrose or
“For example, pear juice and apple juice are very, very low
According to Dr. Johnson’s data, which he claims is
in vitamin C but very, very high in fructose,”
“unequivocal,” starch and dextrose (glucose) do NOT cause
“ and so those particular kinds of juices maybe worse than
obesity or diabetes, whereas fructose does.
orange juice or grapefruit juice which have high amounts of
Interestingly, animal studies have discovered that if an
animal eats lots of fructose, over time they become diabetic.
Now, apples contain other compounds like quercetin, which
Part of this process, however, is that once they become is an antioxidant that may block some of fructose’s effects.
insulin resistant, they activate the polyol pathway and begin
So, you know, the verdict is still out in terms of which juice
to make fructose from other
sources of food as well!
is better and which juice is worse.
This is quite remarkable, and a strong testament to the need
But in general, with apple juice and pear juice, I would be
more concerned about those types of juices because they are
It’s also offers an explanation for how and why the obesity
very, very high in fructose and relatively low in
epidemic has flourished the way it has since the introduction
of HFCS into most of our processed foods.
For all these reasons, it is wise for most to limit their intake
“It’s a little bit more complicated than we had originally
of fruit juice, especially if your uric acid is above the ideals
Johnson says, “but the bottom line is: If you’re
trying to avoid gaining weight; if you’re trying to avoid
If you suffer from any of the four health problems I just
becoming obese or diabetic, the best thing you can do is to
listed above, you would be best off avoiding fruit juices
cut back on foods that raise uric acid, particularly sugar,
altogether until you’ve normalized your uric acid and insulin
fructose and high fructose corn syrup (HFCS).
That’s by far the best approach. Starch in general appears
to be safe unless you’re severely insulin resistant, in which
Is Glucose a Safer Alternative
case perhaps isn’t quite as safe as we had originally
Although you cannot buy “glucose” commercially, it’s available under the name of “dextrose.”
Defining Insulin Resistance
It’s relatively inexpensive, priced at about a dollar a pound.
Ideally you’ll want to have a fasting insulin level below 2. In
It’s not as sweet as table sugar or fructose, but it also doesn’t
addition, Dr. Johnson recommends using a simple glucose
seem to cause the same health problems – at least for those
who are not diabetic or insulin resistant.
“The fasting glucose, under 100, suggests that you’re not
insulin resistant,” he says. “If your fasting glucose is between
100 and 125 mg/dl, you probably are insulin resistant to a
“It is absolutely true that if you take a laboratory animal
mild extent, or you have impaired glucose tolerance.
and you feed it glucose or dextrose or starch, it will not get into trouble. It will stay skinny. It will stay healthy. Rice
You have what we would call mild insulin resistance and
diets are high in starch and historically have been
slightly elevated glucose levels for what you would expect.”
I agree with Dr. Johnson that this is typically true, however
In contrast, if you give sugar or fructose to an animal,
it’s still possible to have low fasting glucose yet have
they’ll rapidly develop features of metabolic syndrome,
obesity, and so forth. And you can pair-feed animals, so one
Dr. Johnson explains: “Yes, if you have hyperinsulinemia, in
animal gets exactly the same number of calories as the
general what happens is that as you become insulin
other one, but it’s only the sucrose- or sugar- or fructose-fed
resistant, your insulin levels go up to help keep your blood animals that develop the features of metabolic syndrome.
sugar down. So if you have a particularly robust insulin
This makes one believe that starches safe, and this is in fact
response, you could keep your glucose in the normal range
Now, as we’ve done more studies, (obviously if you’re a
So, in this case, you’re essentially pre-diabetic and need to
diabetic, glucose is not good because in diabetes you cannot
take steps to improve your insulin sensitivity, and the most
handle glucose metabolism)… one of the things that we’re
potent way is to reduce or eliminate fructose.
just discovering in the laboratory -- actually it’s been
known but we’re trying to figure out how important it is --
A Word on Agave
people who are diabetic, and people who are severely
insulin resistant… can make fructose from the glucose
I got a lot of push-back after I published my report on agave,
through a pathway called “the polyol pathway.”
which many health conscious people believe is a safe, all-
natural, healthy sweetener. However, agave can contain
anywhere between 55 to 90 percent fructose!
Some companies were very upset with our article and refuted
the information so much so that we actually purchased three
of the most popular “natural” agave products and had them independently tested, at our expense, at a commercial
laboratory. The results came back last week and they support what I said, that they were high in fructose. The range was 59 to 67
percent fructose. I am in the process of writing an entire
report on it that should be published in the next few weeks. Fructose content is also high in honey, which contains about
70 percent on average. In addition, many, if not most of the commercial supplies of
agave are processed in a way that’s not too dissimilar to the
processing of high fructose corn syrup. “We have not done any specific research with agave or with
honey,” Johnson says. “But I do believe that those two
compounds, because they’re so high in fructose, probably will engage the same pathways that we see when we give
fructose or sugar to animals. So I would not recommend those as sweeteners to use daily.”
I strongly recommend you listen to this interview in its
entirety, or read through the transcript. In it, Dr. Johnson also discusses the potential benefits, as well as the risks, of
using the drug allopurinol (traditionally used to lower uric
acid levels in patients with severe gout) to treat heart disease, diabetes and even obesity. We also discuss the lifestyle adjustments that can work together synergistically to optimize your health benefits, and
delve into two additional studies that Dr. Johnson recently
submitted to Science
, and Nature.
Hopefully they will be accepted for publication by both of these prestigious
scientific journals. I have written about the dangers of sugar for a long time, and of course, variables like exercise and calorie intake play
a role in obesity, but I am fully convinced that if we can
educate the public about the primary role fructose holds in creating obesity, we can actually reverse and eventually help
to eliminate the obesity epidemic. So please, keep learning, and keep sharing this information
with your family and friends. I also highly recommend
reading Dr. Johnson’s book, solution to several devastating health problems. Although, as
I stated earlier, he supports the option of using artificial
sweeteners which I do not recommend. The trend will not magically reverse itself – it will require
each and every one of you to become educated, savvy consumers, and it will require that you bring back home
cooking; using fresh, whole, organic foods.
Competition Policy Research Center, Fair Trade Commission of Japan Inaugural Symposium How Should Competition Policy Transform Itself? Designing the New Competition Policy (November 20, 2003) Todd J. Zywicki Director, Office of Policy Planning Federal Trade Commission, U.S.A. Competition Policy and Regulatory Reform: Means and Ends I. Introduction I would like to
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