In The Sugar Fix, Dr. Richard Johnson, who oversees a pioneering research program, reports on discoveries about how fructose impacts the body—and directly connects the American obesity epidemic to a frightening escalation in our fructose consumption.
It comes as no surprise that the sugar is found in processed foods like candy, baked goods, canned foods, and frozen meals in the form of high-fructose corn syrup, but it is also hidden in less obvious foods like peanut butter, egg products, and soups. Many fruits and vegetables contain high levels of it naturally. Dr. Johnson shows how to cut way back on the sweetener by making effective substitutions. The daily meal plans included here contain no more than 25 grams of fructose, one-quarter of the amount the average American now ingests.
Rather than the low-carb approach of so many recent diets, Dr. Johnson recommends a much easier to enjoy and stick to formula: 50% carbs, 25% fat, and 25% protein. The immediate benefit of this diet is to help anyone shed excess weight. The additional benefits are even more impressive—reduced risk for such serious health problems as high blood pressure, elevated blood fats, and insulin resistance, conditions directly linked to heart disease, diabetes, kidney disease, and stroke.
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RICHARD JOHNSON, MD, has been a practicing physician and clinical scientist for over a quarter of a century. Previously chief of nephrology and director of renal transplantation at Baylor College of Medicine in Houston, Dr. Johnson is now chief of nephrology, hypertension, and transplantation at the University of Florida in Gainesville.
CHAPTER 1
THE FRUCTOSE FACTOR
A Sugar Like No Other
A century ago, few Americans were overweight. Heart disease and diabetes were rare medical conditions. Today, people who are plump and paunchy outnumber those who are thin and fit in the United States and many other parts of the world. Heart attacks are the leading cause of death. The incidence of diabetes has exploded into a full-blown epidemic.
What happened? How could such dramatic changes to overall health occur during this relatively brief period in human history? I believe the rise of obesity and these formerly rare diseases can largely be traced to a single factor. Unlike a disease-carrying microbe, however, this culprit is hiding in plain sight--on the shelves at your local supermarket, in the cooler at the convenience store, and very likely in your refrigerator and kitchen cupboard.
The goal of this book is to help you understand, identify, and avoid this menace. What's more, I am going to show you how to reverse the damage it may have already caused in your system.
You don't need to be a doctor or scientist to see the most obvious signs of this scourge's handiwork. Simply walk through a shopping mall or playground- -that is, if you haven't already noticed the problem in your bathroom mirror. In other words, consider how the American physique has changed over the years.
In the 19th century, few people in this country worried about their waistlines. It's not that our ancestors didn't care about their weight. The fact is, fat people were extremely rare, typically found among the upper class. After all, only the wealthy could afford to overindulge in rich, decadent foods back then. In 1890, for example, a survey of more than 5,000 white males in their fifties found that just 3.4 percent were obese.
However, that once-lean population has gone the way of hoop dresses and top hats. Today, 32 percent of Americans are obese. What's more, according to the Centers for Disease Control and Prevention, an additional one-third of Americans are overweight, meaning they are not quite obese but still have an unhealthy amount of body fat. When you do the math, it adds up to an alarming problem: Two-thirds of Americans are either obese or overweight. However, unlike in the 19th century, weight problems afflict all segments of the population--rich and poor, young and old, every race and educational background. The nation's schoolyards may offer the most disturbing view of this epidemic: One in three children in the United States is overweight or obese.
Doctors and public health authorities are alarmed by the nation's growing girth for good reason. Carrying around excess weight increases the risk for deadly conditions such as heart disease, diabetes, and kidney disease. What's more, being fat in a culture that idolizes slender and beautiful celebrities can be psychologically crippling. But what's most worrisome, and most puzzling, is why obesity rates are rising so rapidly. On the eve of the American bicentennial--in 1975, when the nation had been in existence for nearly 200 years--the obesity rate in the United States reached 15 percent. Since then, in a period of just 30 years, the obesity rate more than doubled.
Why? What has caused America to become so flabby so fast?
Frustrated dieters often blame their genes. Perhaps you have tried to lose weight in the past, but you couldn't shed those extra £ds. Or maybe you managed to trim down, but the weight eventually returned. If so, in the back of your mind, you may have been tempted to blame your parents. After all, if you have your mother's eyes or your father's smile, doesn't it make sense that you got your chunky thighs or bulging belly from them, too?
In fact, scientists have isolated genes that may be linked to obesity. But we merely inherit a tendency for one body shape or another from our parents. Whether or not you become overweight and obese depends largely on the lifestyle choices you make--that is, what foods you eat and how much exercise you get. Further, when you consider the bigger picture, it's hard to imagine how genetics could possibly be blamed for the current rapid rise in obesity. After all, the human genetic code dates back millennia. Has some mutation in the human genome occurred across the US population during the past 3 or 4 decades that is causing widespread uncontrollable weight gain? That's highly unlikely. In fact, such a genetic alteration would have to be occurring in populations all over the world, because obesity rates are rising in countries across the globe.
Instead, something must have changed in our environment that is exploiting the human tendency to accumulate body fat. A couple of obvious candidates come to mind. For instance, you no longer need to be wealthy to eat a waist- expanding diet. Thanks to advances in farming, manufacturing, and shipping, delicious high-calorie foods are cheap and widely available. Meanwhile, Americans burn fewer calories each day than our ancestors did, due to the rise of laborsaving devices, from the lawn mower to the laptop computer.
But while there is no doubt that Americans eat too much and don't exercise enough, I believe that some other mechanism has contributed to the disturbing and unprecedented weight gain that has swept across the United States in recent years. Reams of data that have emerged from research labs over the past decade indict a specific food: a common form of sugar called fructose that most of us eat every day.
Americans consume 30 percent more fructose today than in 1970. Our rising consumption of this sugar began at roughly the same time that obesity rates in the United States were climbing sharply. In the pages that follow, I will explain why I believe these corresponding trends are intimately linked- -why feeding on so much fructose is fueling a public health catastrophe in the United States, and how you can lose weight and safeguard your overall health by limiting your exposure to this dangerous sweetener.
The Fructose Connection
Fructose has always been part of the human diet, since the first hungry forager plucked an apple from a tree or berries from a bush. That's because fructose, as the name suggests, is the main form of sugar found in fruit. Honey is another abundant natural source. What's more, half of every crystal of refined sugar consists of fructose, too.
If you have read much about fructose lately, that's probably because it is the critical component in a controversial sweetener called high-fructose corn syrup (HFCS), which is used in a wide variety of processed foods and beverages. Most brands of soda and many kinds of candy contain HFCS. If you were to start reading product labels, you'd find that HFCS is also in many foods that might surprise you, such as pasta sauce, yogurt, soups, ketchup and other condiments, and sandwich bread. In 1970, the average American consumed less than 1/2 £d of HFCS per year. By 2000, per capita consumption of the corn-based sweetener had risen to more than 42 £ds per year.
Critics call HFCS "Frankensyrup" and other damning names, blaming it for the current outbreak of obesity, especially among children in the United States. In later chapters, I'll examine HFCS more closely and sort out some of the claims its defenders and detractors have made. For now, though, here's the important point: There is mounting scientific evidence that consuming too much fructose, no matter where it comes from, can make you fat and increase your risk for high blood pressure, heart disease, diabetes, and kidney disease.
Fructose and Your Waistline
In the past generation, scientists from all over the world have begun to closely examine fructose and its effects on human health. My colleagues and I at the University of Florida are actively involved in this research. We have made a...
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