THE SUGAR-BELLY CON­NEC­TION

Found in the most in­no­cent-look­ing food, sugar is en­emy num­ber one. Now it’s time to re-ed­u­cate your taste buds

Women's Health - Shrink Your Sugar Belly - - CONTENTS -

We all know that cut­ting sugar from our diet is good for our health and waist­line, but how many of us know why? The an­swer lies in the dif­fer­ence be­tween the fat on your belly and what’s stored on the rest of your body. The non-belly fat – the pinch­able stuff on our thighs and back­sides – is called sub­cu­ta­neous fat. It’s ac­tu­ally pretty friendly in healthy doses, act­ing as a stor­age de­pot for en­ergy. But belly fat is a dif­fer­ent mat­ter. It’s ac­tu­ally ac­tive, so much so that it’s now re­garded as an or­gan in its own right. It churns out nasty sub­stances that im­pair healthy body func­tion – and it likes to add to it­self. We re­fer to this lurk­ing nasty as the “sugar belly”.

How does belly fat de­velop? It all be­gins with your body’s abil­ity to bal­ance two sub­stances: glu­cose and in­sulin. Your mus­cles and brain rely on glu­cose for en­ergy, while in­sulin is a hor­mone re­leased by your pan­creas to help move that glu­cose from your blood­stream into the mus­cle and brain cells that use it. The more glu­cose in your blood, the more in­sulin your body needs. And it’s in this sim­ple chem­i­cal re­la­tion­ship that sugar-belly prob­lems start.

Dur­ing di­ges­tion, your body breaks down food into its in­di­vid­ual com­po­nents: amino acids (from pro­tein), fatty acids (from fat) and glu­cose (from car­bo­hy­drates).

When your body takes in quickly di­gested car­bo­hy­drates, your blood­stream be­comes quickly flooded with a large amount of glu­cose – re­sult­ing in the pro­duc­tion of a cor­re­spond­ing quan­tity of in­sulin in or­der to trans­port it.

Which carbs are di­gested quickly? Sugar is one of the speed­i­est. But so are re­fined car­bo­hy­drates like white flour, as well as many pro­cessed whole-grain prod­ucts. For in­stance, white bread and the kind of whole­wheat bread typ­i­cally used for sand­wiches are di­gested at about the same rate and cause about the same rise in blood-glu­cose lev­els, there­fore re­quir­ing the same amount of in­sulin to clear the blood­stream of glu­cose.

Over time, re­peated, ex­treme spikes in in­sulin have sev­eral detri­men­tal ef­fects on your body’s abil­ity to cor­rectly di­gest and store food. First, your cells be­come less re­spon­sive to it. This con­di­tion, known as in­sulin re­sis­tance, re­sults in your pan­creas pro­duc­ing even more in­sulin to com­pen­sate.

We’re de­signed to han­dle fruc­tose in small amounts, not the 15kg of sugar a year that the av­er­age South African con­sumes

Glu­cose lev­els stay high and, in large amounts, glu­cose can dam­age blood ves­sels and nerves. On top of that – and here’s the link to your sugar belly – all that ex­tra in­sulin float­ing around causes your body to store more fat than it nor­mally would. It also pre­vents your body from us­ing fat for en­ergy be­tween meals and once it en­ters, it’s not com­ing out. Think of it as a tat­too – easy to get on your body in mo­ments of aban­don, and damn hard to get off.

Think this is bad? You haven’t heard the worst of it. Be­cause your body is held back from us­ing your stored fat for fuel, you be­come more hun­gry, more of­ten. Then you pro­duce more in­sulin and you store more fat. The more fat you have, the more re­sis­tant your cells be­come to in­sulin. It’s a vi­cious cir­cle!

And this brings us to sugar – the cherry on the whole mis­er­able cake. In­sulin re­sis­tance pro­motes fat stor­age ev­ery­where on your body. It’s fruc­tose, on the other hand, that con­trib­utes to belly fat specif­i­cally, ac­cord­ing to stud­ies. It’s found nat­u­rally in fruits and some veg­eta­bles that are pack­aged with vi­ta­mins, min­er­als, phy­to­chem­i­cals and fi­bre. Not that fruit salad is the prob­lem.

The real is­sue is that the amount of fruc­tose we’re con­sum­ing in added sug­ars, such as ta­ble sugar (cane or white sugar), is swelling our tum­mies and men­ac­ing our health. Our bod­ies were de­signed to han­dle fruc­tose in small amounts (ie: in a few serv­ings of fruit or a lit­tle honey a day), not the 15kg of sugar a year the av­er­age South African con­sumes. And in this form, you aren’t get­ting any of the good stuff – like fi­bre or vi­ta­mins – along with it.

Don’t as­sume heart dis­ease and di­a­betes are years away; too much fruc­tose takes a toll on even young hearts, ac­cord­ing to a study pub­lished in the Jour­nal of Nutri­tion. It found that teens who con­sumed the most fruc­tose had higher blood pres­sure and blood­sugar lev­els than those who ate the least and it linked high-fruc­tose di­ets to in­creases in vis­ceral fat.

FROM SUGAR BELLY TO FATTY LIVER

Lo­cated on the right side of your ab­domen, tucked be­hind your lower ribs, lies your liver – the body’s al­chemist. One of its most crit­i­cal jobs is to turn tox­ins – both formed nat­u­rally in the body and man-made, such as med­i­ca­tion and al­co­hol – into harm­less sub­stances. This hard­work­ing or­gan uses about 20 per­cent of the kilo­joules you take in to fuel it­self and its work, which in­cludes con­vert­ing pro­teins and sug­ars from food into en­ergy for your body.

Re­cent re­search sug­gests that kilo­joules from dif­fer­ent types of food are metabolised dif­fer­ently in the body. Ev­ery sin­gle one of your body’s 10-tril­lion cells can metabolise glu­cose. But only the liver can metabolise fruc­tose all by it­self. Su­crose, or ta­ble sugar, is half fruc­tose, which puts quite a bur­den on the liver; the glu­cose it con­tains is pro­cessed by the rest of the body.

Worse still, th­ese sug­ars are found in foods that – at face value – come across as “healthy”. Let’s say your stan­dard break­fast is a coffee-shop 1 045kJ straw­ber­ry­banana smoothie. That whole­some-sound­ing mix might have all the vi­ta­mins and min­er­als of the fruits in­volved, but also packs in 41g of sugar, al­most all of it added, and the yo­ghurt base con­tains straight-up fruc­tose. The added sug­ars are com­ing from the straw­berry-ba­nana fruit base, which im­plies whole fruit, but is not. The in­gre­di­ent list re­veals “purée” of both straw­berry and ba­nana, along with reg­u­lar sugar (su­crose).

Your liver works harder to break down that fruc­tose than if you ate a 1 045kJ bowl of, say, oats topped with half a sliced ba­nana and some straw­ber­ries. This is be­cause th­ese foods con­tain much less sugar and the fi­bre in the oats slows down the ab­sorp­tion of sugar into the blood­stream. Since the smoothie’s sug­ars come in liq­uid form, they hit your liver fast. Imag­ine wad­ing into the sea, when out of nowhere a huge wave smashes into you, knock­ing you off your feet. That’s how a large in­flux of fruc­tose hits your liver.

Keep cram­ming in enough fruc­tose for long enough and glob­ules of fat will be­gin to form in the cells of your liver. Be­fore 1980, doc­tors rarely saw this fatty build-up, known as non­al­co­holic fatty liver dis­ease (NAFLD). Now, it af­fects one in five of all adults worl­wide, ac­cord­ing to a study in the jour­nal Deutsches Ärzteblatt In­ter­na­tional.

It’s worth not­ing that the rise in NAFLD has hap­pened at ex­actly the same time as the in­crease in obe­sity, and that the con­di­tion af­fects be­tween 70 to 90 per­cent of peo­ple whose weight is graded at that level. In fact, ex­perts con­sider NAFLD a hall­mark of a con­di­tion char­ac­terised by the clus­ter of obe­si­tyre­lated con­di­tions known as meta­bolic syn­drome.

This fat build-up in the liver isn’t ob­vi­ous on your body, ei­ther. An Amer­i­can Jour­nal of Clin­i­cal Nutri­tion study found that peo­ple who ate 4 180 ex­tra kilo­joules of sug­ary foods for three weeks saw just a two per­cent in­crease in body weight, but a 27 per­cent in­crease in liver fat.

When you lose weight, liver fat re­turns to nor­mal lev­els. But if NAFLD isn’t caught in time, the liver can be­come in­flamed, which can lead to a more se­vere liver con­di­tion known as non­al­co­holic steatohepati­tis. If the in­flam­ma­tion be­comes se­vere, scar tis­sue re­places healthy tis­sue, im­pair­ing the liver’s abil­ity to per­form its cru­cial func­tions. When that hap­pens, it’s called cir­rho­sis. (Cir­rho­sis only hap­pens with re­ally se­vere al­co­holism, right? Now, it ap­pears, an ex­ces­sively sug­ary diet could play a role, too.) A fat-rid­dled liver may be­come re­sis­tant to the ac­tion of in­sulin. As the pan­creas churns out more and more of this fat-stor­age hor­mone to prod the liver into do­ing its job, in­sulin lev­els in­crease – and so does body fat.

FRUC­TOSE: THE QUICKER FATTERUPPER

As you’ll re­call, one of the liver’s jobs is to con­vert the sug­ars in food into fuel for the body. It’s also tasked with turn­ing ex­cess en­ergy into body fat. This process is called li­po­ge­n­e­sis and, at least the­o­ret­i­cally, re­search sug­gests the body may turn fruc­tose into body fat more ef­fi­ciently com­pared to su­crose and glu­cose.

An early study that looked for a link be­tween fruc­tose con­sump­tion and body fat was con­ducted on mice. Ger­man re­searchers al­lowed them to freely drink plain wa­ter or fruc­tose-sweet­ened wa­ter – the ro­dent ver­sion of soft drinks – for 10 weeks. Though the fruc­tose-sip­ping mice reg­u­larly ate fewer kilo­joules from solid food, they gained weight and ended up with 27 per­cent more body fat than the mice that drank plain wa­ter. Be­cause fruc­tose doesn’t need in­sulin to en­ter the cells, it floods the body and is quickly stored as fat.

An­other study, this one on peo­ple, ad­dressed the ques­tion of whether fruc­tose re­ally does cause the body to pack on fat. US re­searchers fed “break­fast” to six vol­un­teers – four men and two women. The break­fast was ac­tu­ally lemon­ade that con­tained three dif­fer­ent com­bi­na­tions of sugar – 100 per­cent glu­cose, an equal mix of glu­cose and fruc­tose, and 25 per­cent glu­cose and 75 per­cent fruc­tose.

Im­me­di­ately after­ward, the team mea­sured the con­ver­sion of the sug­ars to fat in the liver. Four hours later, the vol­un­teers ate lunch – turkey sand­wiches, salty snacks and bis­cuits. Each vol­un­teer’s lunch con­tained dif­fer­ent amounts of sug­ars based on body weight. Then the re­searchers mea­sured how the food

Cir­rho­sis only hap­pens with re­ally se­vere al­co­holism, right? Now, it ap­pears, an ex­ces­sively sug­ary diet could play a role too

was metabolised. The re­sults: li­po­ge­n­e­sis rose 17 per­cent when the vol­un­teers had the fruc­tosec­on­tain­ing drinks, com­pared to eight per­cent for the glu­cose drink. Sim­ply put, their bod­ies made fat more ef­fi­ciently. Fur­ther, af­ter metabolis­ing fruc­tose in the morn­ing, the liver in­creased the stor­age of fats eaten at lunch. As the study’s lead re­searcher, Dr El­iz­a­beth Parks, put it: “The car­bo­hy­drates came into the body as sug­ars. The liver took the mol­e­cules apart and put them back to­gether to build fats. All this hap­pened within four hours of the fruc­tose drink. As a re­sult, when the next meal was eaten, lunch fat was more likely to be stored than burnt.” Al­though this re­search is pre­lim­i­nary, it raises ques­tions about start­ing your day with a fruc­tose-filled sug­ary drink.

Most likely, th­ese re­sults un­der­es­ti­mated the ef­fect of fruc­tose be­cause the test sub­jects were healthy and lean, and could process the fruc­tose quickly. So the fat-pack­ing po­ten­tial of fruc­tose may be worse if you’re over­weight, be­cause this process is al­ready revved up.

YOUR BRAIN ON ICE-CREAM

There’s ev­i­dence that a steady diet of sug­ary, pro­cessed foods can mess with in­sulin in our brains, trig­ger­ing what some ex­perts are call­ing type-3 di­a­betes, bet­ter known as Alzheimer’s dis­ease. Scary stuff.

US re­searchers un­cov­ered the link be­tween in­sulin re­sis­tance and a high-fat diet in brain cells. In a pa­per pub­lished in Cur­rent Alzheimer Re­search, they re­viewed ev­i­dence sug­gest­ing that Alzheimer’s is a meta­bolic dis­ease in which the brain’s abil­ity to use glu­cose and pro­duce en­ergy is im­paired. The ev­i­dence, they con­cluded, sug­gests that Alzheimer’s has “vir­tu­ally all of the fea­tures of di­a­betes, but is largely con­fined to the brain”. In one study, they in­ter­fered with the way rats’ brains nat­u­rally re­spond to in­sulin. The rats went on to de­velop all the brain dam­age seen in Alzheimer’s, and

were un­able to learn their way through the kind of maze they nor­mally had no prob­lem nav­i­gat­ing.

Peo­ple with type-2 di­a­betes have been found to be sig­nif­i­cantly more likely to suf­fer from Alzheimer’s. While the dis­ease doesn’t nec­es­sar­ily cause Alzheimer’s, both dis­eases may share the same root: in­sulin re­sis­tance.

YOUR STONE-AGE SWEET TOOTH

So, why do our brains want more sugar than our bod­ies can han­dle? It some­times seems as though Mother Na­ture has left us with a tick­ing time-bomb com­pul­sion to self-de­struct in the tasti­est way pos­si­ble, when you con­sider how easy it is to lay your hands on the stuff. The an­swer lies back in the be­gin­nings of our species – un­sur­pris­ingly in an era be­fore cor­ner cafés.

It’s thought that our an­ces­tors as­so­ci­ated a sweet taste with en­ergy-dense, im­mune-sys­tem-pro­tect­ing fruit. With sur­vival of the en­tire hu­man race hinge­ing on get­ting enough to eat, ev­ery kilo­joule lit­er­ally rep­re­sented a mat­ter of life and death, and a sweet taste trig­gered a re­as­sur­ing “this is safe to eat” mes­sage in an­cient brains.

For a while, kilo­joule-dense fruit and honey were vir­tu­ally all we knew of sweet tastes. In the Pa­le­olithic era (a pe­riod of half a mil­lion years that ended 10 000 years ago), fruits and veg­eta­bles made up well over half of our diet. But ev­ery­thing changed with the dawn of farm­ing. As hu­mans be­gan to rely on ce­real grains, our con­sump­tion of fruit and veg­eta­bles dropped.

Our bod­ies were de­signed to crave a sugar that is sup­pos­edly hard to come by, store it quickly, and use it fast

And sugar – de­rived from sugar cane, which was grown in tiny quan­ti­ties at first – be­gan its re­lent­less se­duc­tion of our taste buds. Our bod­ies were de­signed to crave a sugar that is sup­pos­edly hard to come by, store it quickly, and use it fast.

Our sugar-belly prob­lem comes from when we’re liv­ing in high-tech times – where one can ac­cess count­less spoon­fuls of the stuff in a sin­gle lunchtime – but still have brains that are hard-wired to seek sugar. We sim­ply end up stor­ing more than we use. We’re not climb­ing trees to pluck pre­cious, high-hang­ing fruit; we’re call­ing up for free de­liv­ery.

This is where the Shrink Your Sugar Belly eat­ing plan comes in, clev­erly ex­ploit­ing your body’s nat­u­ral at­trac­tion to sugar while still al­low­ing its healthy nu­tri­tional needs to be ful­filled. As you’ll find, some­thing as sim­ple as the daily con­sump­tion of a pro­tein-packed break­fast helps rein in your ap­petite dur­ing the day and re­duces your urge to snack.

THE EMO­TIONAL CON­NEC­TION

We love sweet. Our taste buds, our eyes, our emo­tions – they all crave the re­ward of sugar. We love the taste, the way it makes us feel and the con­nec­tion that sweet­ness pro­vides. Hor­ren­dous day? Ice cream. Crush­ing wor­ries about your love life? Ice cream. Feel­ing fat and friend­less? You get the idea. Eat­ing in re­sponse to emo­tions like bore­dom, lone­li­ness or anx­i­ety – what’s called emo­tional eat­ing – is real.

In fact, in a study of 40 women of vary­ing sizes, those who scored higher on a sci­en­tif­i­cally de­signed food-ad­dic­tion scale showed more ac­tiv­ity in the parts of the brain as­so­ci­ated with ad­dic­tion when they were shown a tempt­ing im­age of a milk­shake. One sign of us­ing sugar to man­age emo­tions is that re­spond­ing to a sugar crav­ing doesn’t al­le­vi­ate it. Try­ing to sat­isfy the crav­ing only prompts a de­sire for more… and more.

Habit ties us into an emo­tional at­trac­tion, too. If you’re used to hav­ing a muf­fin for break­fast, bis­cuits in the af­ter­noon or dessert af­ter din­ner, some­thing starts to feel wrong if you skip it.

WHERE’S YOUR SUGAR LURK­ING?

We all know to steer clear of fizzy drinks be­cause of their ob­vi­ous sugar con­tent. But you wouldn’t have that same trep­i­da­tion over a chicken sand­wich on whole­wheat bread – de­spite the fact that the bread alone can have up to two tea­spoons of added sugar per slice. (If you want to con­tinue shrink­ing your sugar belly af­ter the eat­ing plan, you should be con­sum­ing no more than nine tea­spoons of added sugar a day – but try stick to six.) It’s one thing to know­ingly con­sume a sugar bomb. It’s an­other to learn that many foods you con­sider healthy can be sugar bombs, too. Ul­ti­mately, there are two types of sug­ars in food: the kind you know about and the kind you don’t.

Some­thing as sim­ple as break­fast, and pack­ing it with pro­tein, reins in your ap­petite

STRAIGHT-UP SUGAR Found in sweets, drinks, break­fast ce­re­als, en­ergy bars and desserts, this type of sugar is loud and proud. While it’s of­ten listed as “sugar”, it might also be called by dif­fer­ent names. Even if you’re aware that th­ese foods pack sugar, you may not re­alise just how much. For in­stance, doesn’t a chilled fruit drink sound bet­ter than Coke? A 500ml bot­tle of Coke has just over 13 tea­spoons of sugar. The same amount

of or­ange juice has just over nine – bet­ter, but not by much. If you’re fol­low­ing the sugar-belly-shrink­ing lim­its, that’s your whole day’s al­lowance in one bot­tle!

SE­CRET SUGAR Wan­der around your su­per­mar­ket. Pick up bot­tles, jars and boxes at ran­dom and look at the in­gre­di­ent lists. There will be a list of val­ues ti­tled “of which sug­ars”. But more of­ten than not, you’re likely to find sugar listed as an in­gre­di­ent, even if you don’t recog­nise its alias. True to their name, Se­cret Sug­ars lurk in foods you don’t even think of as sweet. Th­ese in­clude pasta sauce, packet noo­dles, salad dress­ings, tomato sauce, bar­be­cue sauce and some deli meats and sausages. There are also sweet­en­ers that you may not re­alise are sugar. It’s frus­trat­ing, but once you’re fa­mil­iar with the many words for sugar in an in­gre­di­ent list, you’ll be bet­ter pre­pared to con­trol your sugar choices.

SUGAR MIM­ICS This is sugar in its sneaki­est form: foods that don’t taste like sugar but mimic its ac­tion in the body. Foods like chips, bagels, pota­toes, white rice and pasta may not con­tain sugar per se, but they might as well – they’re di­gested as rapidly as sugar. And they have the same ef­fect on the body: glu­cose floods the blood­stream, trig­ger­ing a rise in the fat-stor­age hor­mone in­sulin and dis­rup­tions in other hor­mones that keep your ap­petite un­der con­trol. So, as you’ll be find­ing out, Sugar Mim­ics have the same harm­ful ef­fects as Straight-Up and Se­cret Sug­ars.

You may know that a steady diet of re­fined car­bo­hy­drates, stripped of their fi­bre and nu­tri­ents, is as­so­ci­ated with obe­sity and dis­ease. Not your prob­lem? You start the day with whole­wheat toast or bran ce­real. You snack on whole-grain crack­ers and hum­mus. Oc­ca­sion­ally, you splurge on a whole­grain bagel. Whole-grain is healthy, right? Not quite. If your whole-grain in­take con­sists of foods made with whole-grain flour, like some ce­re­als and crack­ers, you can also grow a sugar belly.

In the process of mak­ing whole­wheat or whole­grain flour, ker­nels are pul­verised prac­ti­cally to dust, so they’re di­gested by your body about as quickly as white flour or ta­ble sugar. This means they can spike your blood sugar and in­sulin lev­els, lead­ing to hunger and prompt­ing you to reach for more of th­ese foods. You’re caught in an un­end­ing cy­cle of crav­ings and con­sump­tion.

But that cy­cle can be bro­ken, and this book can help you do it. Ev­ery­thing you’ve read in th­ese last few pages is pretty de­press­ing, but the good news is that the so­lu­tion lies in the de­li­cious, fill­ing recipes and smart tips to be found in the rest of this book. Isn’t it time to get off the sugar merry-go-round and quench those for­mi­da­ble crav­ings once and for all? In the next chap­ter you’ll learn how to hit “Fac­tory Re­set” on your taste buds over just 20 days. But be­fore that, let’s find out ex­actly what’s to come…

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