Should cardiologists be selling fructose?

By November 4, 2009Uncategorized

Conspiracy theorists love to believe that the moon landings were staged perhaps somewhere like the Universal back lot, that computer virus software is written by the anti-virus companies and that JFK was really assassinated by Kevin Rudd’s cat (or something like that). I don’t know why they bother with all the lateral thinking when real-life conspiracies abound.

Big Sugar makes many products that will cause heart disease. But unless you are wilfully ignorant, you’re unlikely to be suffering under the impression that a Coke and a Mars Bar is a healthy breakfast.

Recently, Nestle upped the ante when it started pushing Fruit Fix (a product that is 72% sugar), as a healthy alternative to fruit. It nudged it a bit further when it got the Heart Foundation to endorse it as health food. But we’re still not in conspiracy territory. That’s merely deceptive.

We cross the boundary into potential conspiracy candidate with Nestle’s Optifast shake diet. The primary ingredients of Optifast are skim milk powder and fructose.

Fructose is one half of table sugar. It is definitively associated with the causes of heart disease and this was starkly proven in some human trials conducted by the University of California earlier this year. The investigators divided 32 overweight men and women into two groups, and instructed each group to drink a sweetened beverage three times per day. One group’s drinks were sweetened with fructose and the other group were drinking glucose (the other half of sugar).

After just 10 weeks, the fructose group had experienced a major metabolic shift that did not occur with the glucose group. They had a significant worsening of blood glucose control and insulin sensitivity. Their LDL cholesterol and oxidised LDL readings increased dramatically. Liver synthesis of fat had increased by 75%. And visceral fat had increased by 14%. In short, they had been turned into heart attacks waiting to happen.

By definition, Optifast is sold to people who are overweight. So Nestle is selling them a “cure” to their condition, which significantly increases health risks across the board, but particularly for heart disease. Brand diversification? Yep. Wildly irresponsible? Certainly. Surprising? Not really, it is Nestle we’re talking about.

No, to be a true conspiracy, we need a hidden benefit to the purveyor. Sure, Nestle makes money out of Optifast but aside from that, how does it benefit from giving fat people heart attacks? Now if a cardiologist was flogging Optifast to weight-challenged folks, then we’d be talking genuine gold-plated conspiracy theory.

Well as it happens, in little ol’ Brisbane, cardiologists do dispense Optifast to overweight people. The Wesley Weight Management Clinic (WWMC) is owned by “a group of Cardiologists who are based at The Wesley Hospital”.

WWMC proudly proclaim that it “uses a nutritionally balanced meal replacement called Optifast 800”. The Optifast 800 range of shakes contains about 18g of fructose per serve. And WWMC advises people to consume five serves a day instead of their normal meals.

If a punter were to follow the program as laid out, they would be consuming about 90g of fructose per day. Or put another way, almost half of their energy intake would be coming from fructose. To get that much fructose from sugar, they would need to consume 43 teaspoons of sugar a day. Would you like some food with your sugar diet?

The University of California study fed its subjects 25% of their calories from fructose for just 10 weeks and produced truly frightening results. WWMC tells its paying customers to consume 45% of their calories from fructose for six months. They will lose weight. If you replaced everything you ate with a small chocolate milk five times a day, you’d lose weight, too. But what kind of damage are they doing at the metabolic level?

I’m not seriously suggesting that these cardiologists are setting out to create business for their day jobs. I never ascribe to conspiracy that which could be adequately explained by ignorance. I suspect it started out as a nice little earner. And it’s just unfortunate that it turns out that what they’re serving up is something the research says is the worst possible thing you could give to a heart-attack candidate.

I have, of course, pointed this out to WWMC, but it seems disinclined to change its ways. I expected a note telling me that, of course, it was reviewing its program in the light of the latest research and fructose would soon be off the menu. I didn’t get that. Instead, it said: “we believe that Optifast 800 is the most suitable product on the market and do not believe the fructose content would constitute a ‘high fructose diet’ implicated in the research.”

One wonders how high the fructose content would have to be before WWMC became worried about it. Ah well, I guess doctor always knows best.

Also published in Crikey

Join the discussion 2 Comments

  • A Bit of Balance Please

    by Neil Holt Managing Director Wesley Weight Management Clinic

    The obesity epidemic of the last 30 years is not due to a single cause and there is no magic solution: it is misleading to say otherwise. Obesity is caused by the consumption of too much of everything: food, snacks, sugary drinks and alcohol. Reduced activity levels play a role, but overconsumption is the real culprit. Many overweight adults consume in excess of 3000 calories per day when weight maintenance requires 1700 – 2200 calories.

    Wesley Weight Management Clinic is not a conspiracy, it is well balanced clinical program designed to help people achieve and maintain a healthy weight. We are staffed by Doctors, Dietitians, Exercise Physiologists and Psychologists ensuring people lose weight and learn the skills to maintain a healthy weight. Our services are evidence based, ethical and high quality and we publish our results.

    Meal Replacements – Optifast 800

    Meal replacements, when used under supervision, are very beneficial at the start of weight loss. We have used Optifast 800 safely for 10 years. Moving clients safely from 3000 calories per day to 800 – 1000 calories per day places then in a negative energy state and they lose weight. In combination with moderate exercise, women can lose up to a 1kg per week and men up to 2 kg per week.

    Optifast 800 contains milk protein (14gm), fat (3gm), milk sugars (lactose 8-12gm), fructose (8-10gm), vitamins and minerals. Each sachet has 160 calories, the same energy content as 2 slices of bread. Our clients safely consume 5 sachets per day or 800 calories which provides them with all their essential daily vitamins and minerals and controls their hunger. Importantly they are losing weight.


    Fructose is present in Optifast 800, but there is no more than in 1 apple. 5 sachets of Optifast 800 have no more than 50gms of fructose, a quarter of the levels of people consuming 3000 calories per day including 2 cans of soft drink.

    It is wrong to say that the fructose in Optifast 800 is dangerous. In fact 50gms of fructose a day is beneficial, particularly to diabetics. It is only a danger to your health at artificially high levels of consumption, as seen in some published trials conducted in a similar way to toxicological studies. No food would be considered safe under these conditions – even pure water triggers adverse health at high repeat dose levels.

    Our results using Optifast 800

    We have recorded the weight loss results of more than 6000 clients at their weekly visits. We have the largest database on weight loss in Australia and we publish our results on our website and in credible health journals and forums. The main reason for recording weekly progress is to ensure safe and sustainable weight loss. All clients who use Optifast 800 are medically counseled by a Doctor and their blood is tested prior to commencing Optifast 800. Those who are not suited to meal replacements are prescribed a meal plan with a set calorie level.

    Optifast 800 used in our clinic is safe, effective and well tolerated by clients. All clients transition off Optifast 800 back to normal healthy meal plans. They are taught healthy food choices, correct portion size and good exercise – habits that will last them a lifetime.

    Our results show that our clients lose weight, lose fat, reduce their waist lines, maintain lean tissue (muscle), lower their blood pressure, lower their total cholesterol, lower their LDL (bad cholesterol) lower their blood triglycerides, lower their blood glucose and lower their cardiovascular risk (risk of heart attack) by up to 47%.

    In conclusion, we unashamedly stand by our clinic, our staff, our clients and our results. David Gillespie assertions in relation to our clinic, our stakeholders, our staff and our clients are factually incorrect and his conclusions wrong.

    Like good health, it’s all about balance.

    Full version:

  • Harry says:

    Neil Holt says, “Obesity is caused by the consumption of too much of everything: food, snacks, sugary drinks and alcohol. Reduced activity levels play a role, but overconsumption is the real culprit”.

    That’s great Neil…you’ve really got a handle on things – we gat fat because we eat ‘too much’.

    Only problem is, Neil, we’re eating ‘too much’ across the population to a degree not seen before in known history. Now, unless you want to claim that we’ve all suddenly become wanton gluttons, or spontaneously lost the capacity to exert will power, you have to provide a powerful explanation to account for the reasons for this society-wide over consumption.

    Simply repeating that obesity is caused by eating ‘too much’ has no explanatory or practical efficacy, Neil.

    The real question is, why are we eating too much? David Gillespie argues (with solid evidentiary support) that it is the over-consumption of fructose (and the attendant lack of appetite suppression) that is responsible. Others (e.g. Gary Taubes et. al.) have argued persuasively that it is the over consumption of dietary carbohydrate (especially sugars) that up-regulate fat storage and stimulate appetite.

    These are ‘explanations’, Neil. They express clear hypotheses with actionable conclusions.

    “We’re fat because we eat too much” is merely a restatement of the first law of thermodynamics, and as such, is good for sweet Fanny Adams.

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