Ballard of sugar part 2

BY: DR. BAYNE FRENCH MD DC

Click here to read Part 1

TEN. Advanced Glycation Endproducts (AGEs):

An emerging topic in the pathogenesis of metabolic diseases related to modern nutrition is the role of Advanced Glycation Endproducts (Aragno et al. Nutrients. 2017). 

AGEs are toxic compounds that are FORMED when sugar interacts with our tissues.  They are toxic as described by Uribarri et al. (J Am Diet Association. 2013) “The pathological effects of AGEs are related to their ability to promote oxidative stress and inflammation by binding with cell surface receptors or cross-linking with body proteins, altering their structure and function".  

Sugar binds to our proteins, fats, and even our DNA in a process termed glycation. The common lab test, Hemoglobin A1c, which many of you may be familiar with, measures the glycation of hemoglobin molecules in our red blood cells. It is traditionally used to determine how well patients with diabetes are managing their blood sugars. I consider it a critical determinant of metabolic wellness and disease risk.

Like my ability to offend, glycation for all of us is an inevitability. The rate of aging parallels that of glycation.

So, how is glycation accelerated? Whenever blood sugar levels increase, the rate of glycation is amplified…human mammals turning the survival nutrient carbohydrate into a staple. Likely the most damaging example of this is the consistent consumption of sugar.

Recall that sugar (sucrose) is half glucose and half fructose.  Both molecules drive glycation and the formation of AGEs, but as has been known for decades, fructose is way more potent. Bunn et al. (Science. 1981) showed that fructose glycated 7.5 times more than glucose. A breakdown product of fructose, methylglyoxal, drives glycation 250 times faster than glucose.

But it just gets worse for sugar. Not only does it drive the formation of AGEs, it reduces our ability to detoxify them by interfering with enzyme function. Thus, sugar exerts a twofold contribution to the toxic event of glycation. 

I tip my hat to Dr. Lustig for many reasons. He wrote the outstanding book Metabolical, and I’m told prefers to play shuffleboard as a contact sport. He states, “All in all, when it comes to aging, fructose is worse than glucose, and therefore sugar is worse than starch”.

ELEVEN. Dr. Volek:

Dr. Volek is an interesting dude and I’m told has no use for riding lawn mowers. He published the FASTER study in Metabolism in 2016, where athletes who were very used to high carbohydrate exercise fueling were compared with athletes who were very used to lower carb fueling. Numerous items were measured.

The low carbohydrate fueling athletes had almost a 2% lower percent body fat and possessed over 3 kg more lean body mass.  The quintessential measure of physical conditioning, VO2 max, was equal between the groups.

The low carbohydrate group was able to burn fat 2.3-fold higher than the high carbohydrate athlete group which is very favorable for health and prolonged exertion.

TWELVE. Insulin:

There is no more potent modulator of metabolism than the hormone insulin.  All of our tens of trillions of cells have receptors (docking ports) on their surface for insulin. It is necessary for life. 

Insulin performs many beneficial effects on the body. However, myriad metabolic problems and subsequent diseases occur when it is chronically elevated.  Some major detrimental effects include:

• Disallowing the burning of fat, instead causing fat formation.
• Causing cells to proliferate, increasing the risk of cardiovascular disease (Fu et al. Mol Metab. 2021; Patil et al. Mo Med. 2012) and cancer (Leitner et al. Biochem J. 2022).

The most potent driver of insulin formation in the body is elevated blood sugars.

THIRTEEN. Dementia:

Dementia is the progressive loss of cognitive abilities.  It is increasing in incidence and Alzheimer's disease is the most common variant.

In my Pulitzer-worthy (snubbed again) article Sugar and its Role in Dementia. Avoid Getting Stupiderer, I cite and describe several studies, some gigantic, that describe the role sugar plays in robbing us of our mental abilities.

It’s all very complicated, but we’ll dive deep into it. Ready? Here goes…eating and drinking sugar on the regular leads to a smaller brain that is dumber. I know that was a lot to take in. Sorry to get so technical.

Well established and reported on repeatedly over decades is the association of high sugar consumption with cardiovascular disease (heart disease and stroke), systemic inflammation, type 2 diabetes, and Obesity. The incidence of dementia associated with all these conditions is increased. It is easy to surmise, then, that sugar indirectly leads to a heightened dementia risk.

Several studies however, report on the cognitive impact of sugar irrespective of other diseases: 

• Highest sugar consumers had the smallest brains and worst memory (Pase et al. Alzheimers Dement. 2017).

• Highest female sugar consumers had the highest Alzheimers risk (Liu et al. Nutr Neurosci. 2022). 

• Highest sugar consumers had the lowest Mini Mental Status Exam scores (Chong et al. Clin Interv Aging. 2019).

• Drinking sugary crap damages cognitive abilities (Liu et al. J Affect Disord. 2022; Sun et al. J Prev Alzheimers Dis. 2022).

• For every 10% increase in calories from sugar, dementia risk increased by 40% (Agarwal et al. J Alzheiemers Dis. 2003). The highest sugar consumers developed dementia an average of 7.1 years earlier. The average sugar consumed by these 800 study participants was 106 grams per day. Many absolutely irresponsible sugar-promoting companies within the endurance athletic world recommend consumption of at least 90 grams of sugar PER HOUR. 

• And lastly…Zhang et al. (BMC Medicine. 2024) studied over 200,000 people. Basically, the entire population of Montana. For good reason, it’s awful here. Anyway, multiple sources of sweet were studied and “sucrose was most robustly associated with all- cause dementia and Alzheimer's disease". Again, the highest sugar consumers had the highest dementia incidence.
  
  

FOURTEEN. Fatty Liver Disease (FLD):

"Increased echogenicity, suggestive of steatosis". This is Fatty Liver Disease, and common narrative on ultrasound reports of high-carb and sugar eating/drinking patients, including athletes.

Also known as NAFLD (Non-alcoholic Fatty Liver Disease), FLD represents another presentation of metabolic disease. It is epidemic, and increasing in incidence. It is associated with liver inflammation, scarring, cirrhosis, and liver cancer. There is no more potent driver of this liver disease than sugar. This occurs via a few mechanisms: 

1. Increased lipogenesis. This is the formation of fat. Fructose (which is half of sugar) and uric acid, which is made from fructose, both have a stimulatory effect on lipogenesis. More fat is made and then stored in the liver.

2. Impaired beta-oxidation. This is the burning of fat. The same processes that sugar causes to amplify the formation of fat will inhibit the burning of fat. More fat making and less fat burning drives the Obesity pandemic, and absolutely sucks for optimal athletic performance.

3. Uric acid. The only form of sugar that creates uric acid is fructose. Uric acid directly results in FLD. Sugar causes FLD directly via fructose and indirectly through the formation of uric acid. 

4. Damaged intestinal lining. Discussed more below. Fructose damages the tight junctions in our intestinal lining, making it more permeable. Bacterial toxins flood the liver, triggering the immune system, which leads to scarring and cirrhosis over time.  

5. Gut-training. This is the metabolically inane practice of increasing sugar consumption to invoke an intestinal adaptation whereby the density of transporting molecules for glucose and fructose is increased. This adaptation allows for more simple sugar absorption into the bloodstream.
   The hope that irresponsible, health-be-damned, metabolically clueless proponents of gut-training have is that more energy will then be produced. The liver is the first stop for this toxic sugar dump.

I have heard, and read over and over from said metabolically clueless proponents of high sugar consumption, that the ill-effects of sugar are not realized in those that exercise. The lunacy of this notion has yet to be eclipsed. It makes no biochemical or rational sense and there is not a shred of evidence for it. 

Let’s explore this further by looking at a Nirengi et al. 2018 study in Frontiers in Endocrinology: Sixty-nine elite rugby players who trained 18 hours per week were compared to twenty-nine individuals who did not play rugby. They didn’t play anything. They basically did nothing physical except move their bowels.

1 in 5 of the rugby players had evidence of Fatty Liver Disease. None of the non-athletes had liver disease. How can this be? The rugby players exercised so much. The athletes also had higher triglycerides (fat in the blood), worse cholesterol profiles, and higher total fat mass. The rugby players also ate 500-750 grams of carbohydrate per day. The non-athletes ate and drank much less.

A common defense by high-sugar proponents is that it is harmful only if you don’t exercise. This is something on which bullshit must be called.

FIFTEEN. Increased Gut Permeability:

Let’s cut to the chase…we have a microscopically thin barrier separating intestinal contents (crap in the making) from our bloodstream.  If this barrier is perturbed and leaky, your risk of developing numerous truly awful diseases is much heightened.

Sugar, particularly fructose, is particularly damaging to this thin lining.  Lambertz et al. (Front Immunol. 2017) discuss in great detail “fructose induced alterations of the tight junction proteins affecting the gut permeability, leading to the translocation of bacteria and bacterial endotoxins into the blood circulation”.

Did you know that you possess adherens junctions and desmosomes? You do. Lots of them.  These cute little proteins connect the cells on your thin barrier, disallowing bad stuff from entering your bloodstream, yet allowing other things to enter.  This makes it a selective barrier. 

Sugar is directly toxic to these proteins, creating an intestinal barrier that is leaky.  The action of sugar, particularly fructose, however, is much more sinister.  Fructose also damages our gut flora and leads to pro-inflammatory microbiota that release toxins.  There are many toxins, one of which is lipopolysaccharide (LPS), which then further damages the intestinal barrier.

This Leaky Gut Syndrome, and its consequences, are so serious that it will be the topic of the next two tomes that I write. The liver is the first target organ for the flooding of pathogens, fructose, and endotoxin resulting from this leak. As I will explain in detail, distant organs, like the brain, are also profoundly affected.

Conclusion:

The Chinese military strategist and excellent Bingo player Sun Tzu said, “know thy enemy…” If a long life-span and health-span are priorities of yours; or as an athlete, if peak performance, a long career, and injury avoidance are on your mind, knowing the enemy that drives inflammation and robs you of metabolic wellness is critical. 

Detailed above are 15 examples of how the regular consumption of sugar directly damages your biochemistry and sickens your metabolism. You are responsible for your health. Not your doctor or athletic fueling pontiffs. A healthy metabolism is largely achievable by anyone. It involves a lot of reading and thought. It requires shucking current dogma, challenging the “more is better” mantra, and recognizing inane advice as, well, inane.

Optimal Human Performance Is a Direct Result of Optimal Metabolic Wellness. If you are an elite athlete or someone who just wants to be good at an active life for a long, long time, this mantra applies to you. 

Detailed above are numerous nutritional biochemical reasons why sugar is toxic. The advice to consume massive amounts of it is irreprehensible, and those of you lobbying for this stoke my ire. 

I turned 55 last month. Yesterday, it would seem, I was 19, and running on high mountain ridgetops after elk until their tongues (and mine) hung out. I still do this, but the elk have interestingly gotten faster. 

I tell you this to emphasize what you already know…even the young readers among you have but such a short time to figure all this out. Your metabolic wellness and ability to avoid disease hinge on your understanding of basic nutrition. A great place to start is to disallow sugar from entering your body with regularity. As Shaboozey sings in Blink Twice, there’s no time for living a lie.