Not so safe drinks

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Of late, there has been much todo about what I would dub ‘shake’ diets.  

You know the sort of thing, you buy a packet of powder which is intended to be mixed with water to produce a ‘meal replacement’.  These fabulous shakes will make you thin and beautiful just like [insert celebrity name].
There are quite a lot of these products on the market now and I haven’t looked at most of them in detail, but one product does publish its nutritional information on the web, so I thought I’d share it with you.
According to their website Each Celebrity Slim meal replacement shake sachet contains a nutritionally balanced combination of protein, carbohydrates, fats, vitamins, minerals and soluble fiber, to sustain your energy while you lose weight.”  But if you look closely at the label you will also see that each Celebrity Slim sachet contains 24.6g of sugar in each 55g serve (44.7%)!  They must have forgotten to mention that the product is almost half sugar in the marketing blurb.
A glance at the ingredients list tells us that the primary constituent of the sachet is Skim Milk Powder and the second most prevalent ingredient by weight is Fructose!  A few more items down the list (ordered in terms of percentage by weight) is Glucose Syrup Solids.  Some of the sugars must be glucose but it would appear that a significant majority are pure fructose.
If you are following the diet you are supposed to replace two meals per day with a sachet.  If you do that you would ingest 49.2g of sugar (mostly pure fructose) from the ‘diet’ food alone.  
There’s not many Calories in one of these shakes – just 208 – about the same as a 300ml Chocolate Milk (which by the way only contains 22.5g of sugar as sucrose and lactose).    
I suspect if you replaced two meals a day each with a small chocolate milk you might lose quite a bit of weight, but the extreme calorie restriction and the appetite inducing effect of the fructose would make it a very hard regime to stick to.  …. Perhaps that’s the reason for this warning Many dieters find they get sugar cravings or their hunger is difficult to control.”  followed by a sales pitch for ‘Fat Burner tablets’ (whatever they are).

Safe Drinks

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In Sweet Poison I suggest glucose is the only truly safe sweetener (for people who are not diabetic).  But quite a few parents (who are not having much luck with the ‘if water doesn’t appeal you’re not thirsty’ line) have emailed asking what (if any) drinks they can buy which are sweetened only with glucose.

I have managed to identify two so far but I would be very happy to hear from people who have found more.  The ones I have found are Staminade Powder and Lucozade Energy.
Staminade make a powdered version of their Lemon Lime Sports Drink.  This version is sweetened only with Dextrose (another name for glucose).  Mix it up with some water (or soda water) and you get quite a pleasant slightly sweet drink.  Kids love it.  But be careful.  Only the powdered version will do.  All of the pre-mixed flavours are sweetened with sugar.
If you prefer your drinks pre-mixed and bubbly then Lucozade Energy is the way to go.  This ‘sports’ drink is sweetened only with glucose syrup (in Australia).  Be careful if you live in the UK or US because, in those places, Lucozade comes in a variety of flavours.  With the exception of Lucozade Original Energy, the rest are sweetened with fructose.
Please let me know if you find more.

No added cane sugar

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I’ve noticed of late a tendency for food advertisers to claim ‘No Added Cane Sugar’.  No doubt they do this on the advice of lawyers that they wouldn’t get away with ‘No Added Sugar’ and on the advice of marketers that the punters wont know the difference.

One example hitting the airwaves at the moment is Jalna Yoghourts.   They say: 
Jalna Yoghourts and Yoghourt On The Go are made from all-natural ingredients from wholefoods, with no added cane sugar or artificial sweeteners. Fructose, a natural sugar in fruit, and lactose, a natural sugar in milk, are the only sugars in Jalna dairy foods.
A quick check of the label on Jalna Premium Vanilla Creamy Yoghourt tells me that it contains 24g of ‘sugars’ in every serve (200g).  According to the US Department of Agriculture, 200g of plain unsweetened yoghurt will contain 9.32g of lactose.  So the other 14.6g in the Jalna must be fructose.  To get that much fructose from sugar you would need to eat 29.2g (or just under seven teaspoons) of it.  Not bad for ‘No added Sugar’ – which is what the label actually says (maybe it’s a typo).
So if there is no added sugar, where is all the fructose coming from?  The ingredients list includes ‘fruit juice concentrate‘.  The fructose is just being added straight in without all that annoying glucose that comes in sugar.  
Be careful out there in the dairy aisle,  Jalna yoghurts are amongst the lowest in overall sugar content, so you can imagine what some of the others are like.

Fructose and Babies

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A very interesting piece of research has just been published in Obesity on suckling rats.  Just in case you haven’t picked your copy from the News-agent, I thought I’d mention it here.

Now I know that a bunch (herd?) of suckling rats is quite different from from breast-feeding humans.  For starters we have two less legs (and quite a few less breasts).  But in the past, rat experiments involving fructose have produced identical results to subsequent human trials, so this research should not be dismissed out of hand.

The rat pups were divided into four groups:

  1. The Control group were left in peace to suckle from their mother’s teat;
  2. The Formula  group were given yummy rat milk substitute;
  3. The Fructose group were given the same as the Formula group but had some fructose mixed in.
  4. The Galactose group were also given the same as the Formula group but they got some extra galactose.

At three weeks, the pups were weaned and put on to a normal rat food diet until they turned eight weeks old (about 5 years old in human terms).  At that point the researchers changed the rat food for half the Control group by ensuring that they received 65% of their calories from fructose.  This continued until the study ended after 12 weeks.  By then the rats were the equivalent of eight years old.  So some rats were just fed fructose for the first three weeks of their lives (while suckling) and then given a normal diet and they were compared to rats that had a normal diet until they were the equivalent of 5 years old when they were switched to a high fructose diet.

The rats that started life with fructose added to their formula were fatter than all of the other groups right through to the end of the study.  Remember these rats were on healthy diets from weaning onwards and had no exposure to fructose beyond the suckling period.  They were even fatter than the poor rats that were put on a 65% fructose diet (which is a lot even by our fructose infused standards).

Worse than that, the group fed fructose during suckling also had the worst results for insulin resistance and muscular fatty acid uptake.  These last two are sure signs of insulin resistance in humans (and rats) which ultimately leads to Type II diabetes.

The study concludes that “Consuming fructose during suckling may result in lifelong changes in body weight, insulin secretion, and fatty acid transport involving CD36 in muscle and ultimately promote insulin resistance.”  Suckling equates to the breast-feeding period in humans.  If these results translate to us, it suggests that a child receiving fructose during the first year of its life may be programmed from day one for obesity and Type II Diabetes.

This study builds on a much earlier study done by the New Jersey Medical School (in 1997) which I mentioned in Sweet Poison.  They noticed that suckling rats exhibit an immunity to fructose.  But in the that study, the researchers were also able to make the pups take up more of the fructose by introducing it earlier in their diets (during suckling), thereby effectively destroying what little protection they had against the stuff.

Now all of this would be merely interesting (at least for rat aficionados) were it not for the fact that some humans do feed babies fructose during the breast feeding period.  As far as we know, breast milk does not contain fructose but some of the substitutes for it definitely do.  Many Soy formulas (about 20% of the US market) contain sucrose (which is 50% fructose) instead of lactose (which contains no fructose).

And these new results back up a 2005 study by the Children’s Hospital of Philadelphia involving 653 formula fed babies (after they had grown up) which concluded that:

“In formula-fed infants, weight gain during the first week of life may be a critical determinant for the development of obesity several decades later. These results contribute to the understanding of chronic disease programming and suggest new approaches to obesity prevention.”

I know this latest study is just a bunch of fat rats but it doesn’t look good for formula fed babies if the formula contains fructose or if breastfeeding is being supplemented with fruit juices or other sources of fructose.

Disclosure

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A week or so ago, Access Economics released an update to its brilliant 2006 study on what obesity costs Australia.  The report is chock full of useful statistics on Australian health and the costs of treating all our maladies.

I was however a little disappointed in one aspect of the document.  Like its the original report, the update says on the front cover that it has been prepared by Access Economics as a ‘report to Diabetes Australia‘.  You might think that means that Diabetes Australia paid for it, right?  … Wrong.  Buried on the fifth page of the tome is this ‘[this report] was funded by an unrestricted grant from sanofi-aventis …’.  
You won’t find this out from the Access Economics report but Sanofi-Aventis is the world’s third biggest biggest drug-maker and the manufacturer of Acomplia a new anti-obesity drug.   Acomplia is featured and comprehensively (and favourably) reviewed on page 109 of the report as the primary component of a section labeled ‘Pharmacological and Surgical Interventions‘ (the bit where they make suggestions as to what to do about obesity).  Unfortunately, the authors forgot to point out that Acomplia is manufactured by the people who paid for the report.
Acomplia has been approved for use in Australia and the United Kingdom (but not on the NHS) It is not approved for use in the US because of serious concerns about psychological problems in patients taking the drug during trials.  Sanofi-Aventis has withdrawn its application for FDA approval as an anti-obesity drug and will instead resubmit it as a treatment for Type II Diabetes in 2009.
If you’re interested in keeping track of the progress of Acomplia, then surf over to this site.

Feedback: Catherine from Sydney

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I’ve been very pleased to receive feedback from some people who have been quick off the mark in reading Sweet Poison.  Catherine from Sydney wrote:

I just found the video of your interview on Sunrise, and I was so excited when Mel mentioned that you had written Sweet Poison, so I found your website immediately.”  She then went on to mention two ‘healthy’ cereals and says, “It’s just that I’ve noticed I have been putting on weight since I started eating both of those cereals, and I couldn’t understand why – as I also walk 7kms at least 3 times per week, and occasionally attend gym!” 
One of the cereals Catherine mentioned is Norganic Crunchola Apple Blueberry.  According to its label, it delivers 22.33 grams of sugar in every 100 gram serving (about the size an adult would have).  The serving also contains 390 Calories, 90 of which come from the sugar.  Catherine’s seven kilometre walk burns just 300-500 Calories on average (depending on how fast she walks and how much she weighs).  So on the three days that she goes walking she may be ahead of the game (and will probably get hungry if the cereal is all she ate), but the fructose Calories will never be used or counted by her appetite control system.  
If Catherine eats that for breakfast every day, after a week she will have consumed 156.31 grams of sugar from the cereal alone.  After a year it will be 8.1 kilograms!  Eight kilograms of sugar contains four kilograms of fructose which will never be used for anything other than creating fat.  Catherine’s liver will convert that fructose into just under 1.8 kilograms of body fat as soon as she eats it.   It’s no wonder she has been putting on weight despite eating a ‘healthy’ cereal and exercising frequently.
Catherine finished by saying “The answer to that is probably in your wonderful book – which I did find today at Angus and Robertson’s at [XXXXX] – so I’m looking forward to diving into it tonight!” … happy reading!

Tested on humans

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If fructose were a new drug would it be certified as safe for use by humans?  It’s a thought that occurred to me more than once as I dug into the history of fructose studies (usually involving rodents).

Intentionally feeding people fructose to see if it kills them may be detrimental to the wealth of researchers, which is why very few human trials have been successfully concluded.  In Sweet Poison I mention one study which had to be abandoned after several of the recipients developed dangerous heart conditions.  After that little adventure, researchers have preferred to stick to subjects who don’t have lawyers (such as mice and cats).
But a wave of courage has engulfed some brave scientists this year and a couple of new human trials are seeing the light of day.  The June edition of the Journal of Nutrition reported on a study conducted by researchers at the University of Texas this year which revealed “the surprising speed with which humans make body fat from fructose.”  Admittedly the study only involved six (brave) volunteers but the results clearly support the very many rodent studies that ended in the same place.
The 28 June issue of New Scientist reports that Peter Havel at the University of California had more luck on the volunteer front.  He persuaded 33 overweight and obese people to try a 10 week diet which was either 25% fructose or 25% glucose.   The poor souls on the fructose diet ended up with increased (1.5kg) tummy fat, higher fatty triglycerides (which leads to heart disease) and 20% higher insulin resistance (which leads to to Type II Diabetes).  None of this happened to the group on glucose. 
Interestingly, Dr Havel’s study was paid for by PepsiCo who declared (after receiving the results) … “This is a very interesting and important study, but it does not reflect a real-world situation nor is it applicable to PepsiCo since pure fructose is not an ingredient in any of our food and beverage products.” hmmm … well I guess strictly that’s true …

Fructose and Pancreatic Cancer

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In Sweet Poison (at page 126), I reported on the results of two recent large scale studies which linked pancreatic cancer with fructose.  The 2002 study analysed data from the Nurses Health Study (an 18 year data collection exercise involving 88,802 nurses) and concluded that women who were overweight, sedentary and had a high fructose intake were almost three times as likely to develop pancreatic cancer.  The 2006 study by the Karolinska Institute found that people drinking two or more (full strength) soft drinks a day were at 90 per cent greater risk of developing pancreatic cancer than those who didn’t.  

A more recent study that I didn’t mention in the book appears to reinforce the possibility of a strong link between this dreadful disease and fructose.   Researchers at the University of Hawaii and University of Southern California analysed food consumption data for 162,150 participants in the Hawaii-Los Angeles Multiethnic Cohort Study.   They were looking for a relationship between a food’s glycemic index (or how fast and how bright it burns in the human furnace) and the risk of developing pancreatic cancer.
They couldn’t establish that link or even a link between pancreatic cancer and the amount of added sugar in a person’s diet.  But what did fall out of the work was a ‘significant association’ between overall fructose consumption and the risk of developing the disease.  This 2007 study was reliant on the results of questionnaires completed by participants and needs to be treated with caution (we’re always taller, thinner and eat less when answering questionnaires).   But it does back up the other research I mentioned and certainly indicates an interesting area for more explicit studies.
If you want to read the study, you’ll need to pick up a subscription to the American Journal of Clinical Nutrition and seek out the November 2007 issue (Vol 86, No. 5 at page 1,495).  If you’re happy with the extract, here’s the link.

In the beginning …

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Stuff just keeps happening … I signed off on the editor’s final cut of Sweet Poison in May, but fructose poisoning is a hotbed of new research with new and interesting work hitting the streets every day.

This blog is an attempt by me to highlight some of the interesting new, news in the world of fructose poisoning.  I’ll keep it brief and hopefully not too dull.  And I’ll always aim to sift the chaff from the wheat by making sure I only direct you to well regarded sources.
Cheers
David.