Think twice about sugar and spice
Few doctors will admit that sugar addiction exists, but it does, writes MARIKA SBOROS
MARY Poppins got it wrong. A spoonful of sugar doesn’t make the medicine go down. It makes people require more medicine in future, says cardiologist Dr Aseem Malhotra.
MARY Poppins got it wrong. A spoonful of sugar doesn’t make the medicine go down. It makes people require more medicine in future, says British interventional cardiologist Dr Aseem Malhotra.
Those who can’t stop eating sugar in all its different forms are sugar addicts, says Dr Malhotra, who will speak at the Old Mutual Health Convention in Cape Town this week.
Sugar addiction is controversial, with many doctors saying there’s no proof that it exists. Ditto for most orthodox dietitians. They won’t say people can eat as much of it as they like, of course. They will say sugar in moderation is necessary for a balanced, healthy diet.
In SA, few doctors will say it is an addiction despite growing numbers of international specialists raising the alarm.
US obesity specialist Dr Jacob Teitelbaum, author of Beat Sugar Addiction Now! (Fairwinds), calls the problem the “canary in the coal mine”, a sign of undiagnosed health problems such as failing adrenal glands or “bad” gut bacteria.
Dr Malhotra says sugar deserves its reputation as “Public Health Enemy No 1” because, unlike fat and protein, “there’s absolutely no nutritional value or biological requirement for sugar”. At the very least, it is a source of “completely unnecessary calories”.
He is science director of Action on Sugar, a UK-based group of 23 specialists working to reach consensus with the food industry and government on the harmful effects of a high-sugar diet, and to reduce hidden sugars in processed foods.
The Lancet global burden of disease studies, published in December 2014, he says, shows that poor diet causes more disease — obesity, heart disease, diabetes, cancer (increasingly also dementia) — than physical inactivity, smoking and alcohol combined, and sugar is a major factor.
Sugar can only currently be classified as “mildly addictive”, according to research, but that does not make it any less of a health threat than alcohol, tobacco, or cocaine, Dr Malhotra says. Sugar is a proven source of a powerful brain “buzz” that releases feel-good chemicals. Therein lies its greatest threat to health in body and mind, says South Africanborn US paediatric general surgeon Robert Cywes, who will also address the health convention.
Dr Cywes, an adolescent and adult bariatric surgeon and a world authority in the treatment and management of adolescent and adult obesity, says the global obesity epidemic is the proven consequence of sugar addiction. “People are not fat because they’ve been eating too much fat, as we were led to believe for nearly 40 years,” he says. “They are fat because they’ve developed an out-of-control relationship with a drug called carbohydrates.”
The white stuff extracted from sugar cane or beet that is spooned into tea or coffee every day is sugar as a simple carbohydrate. Carbohydrates are in fruit and vegetables, and starchy foods such as potato, rice, cereals, grains, bread, pasta and pizza. Even in so-called “healthier”, complex, unrefined versions, specialists point out that all carbohydrates turn to sugar in the bloodstream.
Sugar “certainly fulfils four criteria that suggest it should be regulated in the same way as tobacco and alcohol”, says Dr Malhotra:
It is toxic — directly to teeth; even in small amounts it corrodes enamel; in larger amounts the fructose component is toxic to the liver;
It is unavoidable — added to and hidden in most processed foods; It has the potential for abuse; and It has a proven negative effect on individual health and society.
Karen Thomson, former model, granddaughter of the late pioneering heart surgeon Chris Barnard and an organiser of the health convention, is a recovering addict.
She says her sugar addiction was “hardest to beat” after she had overcome addiction to alcohol and cocaine (she admits to “a very addictive personality”). It prompted her to found HELP (Harmony Eating and Lifestyle Programme), a 21-day in-patient programme, and The Sugar Free Revolution, an eightweek online programme in partnership with Harmony Addictions Clinic.
Most sugar addicts are “functional” — seldom, if ever, incapacitated or babbling incoherently after a hit — which leads many to the sceptical assessment that the problem is not on the level of narcotics addiction.
US specialist Dr Nitun Verma says there is a “lack of understanding of the nature of addiction”. He studied psychology and medicine at Stanford University and launched PeerWell, a healthcare company focused on health through lifestyle change.
Addiction, he says, is “a primary chronic disease affecting the brain’s reward circuitry”, resulting in the “pathological pursuit of a reward”. Behaviourally, addicts are “unable to consistently abstain and go through a cycle of bingeing, withdrawal and craving”.
“The magnitude of reward from sugar overconsumption means addiction can emerge, as the latest studies show,” Dr Verma says. This addiction also shows up in changes in the brain’s dopamine receptors — as shown in a study by US researchers published in Current Topics in Behavioural Neurosciences in 2011.
SUGAR appears not “as overtly psychologically intoxicating as alcohol or drugs”, Dr Verma says. However, research shows that a high intake of sugar produces a magnitude of reward that is “no less an addiction and threat to health than alcohol and smoking”.
Research shows all carbohydrate foods, even unrefined, trigger the nucleus accumbens, a brain region scientists have dubbed “ground zero” in addictions such as gambling or drug abuse.
Dr Malhotra points the finger to big food corporations as the “pushers” who “exploit the fact that sugar is cheap, tastes good and sells for their only interest: profit”.
“I take issue with their manipulations and excesses that include targeting the most vulnerable members of society, including children, with mass advertising associating sugary products with sport, which is an absolute scandal.
“Remember, they are there to sell food, not take care of your health.”
Bridget Surtees, a registered dietitian from Cape Town and consultant dietitian on the HELP programme, says cutting sugar from the diet is not easy because it is present and hidden in many foods, including for babies. And willpower is “difficult to exert over a substance that has a biochemical drive”.
Personal responsibility requires “knowledge based on correct information and choice”, Dr Malhotra says, “but we have neither because the food industry has corrupted both”. Governments have “a duty and responsibility to protect its citizens from the food industry’s excesses”.
“Governments that are serious about tackling the increasing burden of chronic disease threatening the sustainability of health systems in the West will make tackling sugar the number one priority.”
The best way to beat sugar addiction is eating food “your grandmother would recognise”, Dr Verma suggests.
“Change your food environment at home. Manage stress constructively so you don’t resort to food as a dietary antidepressant.”
Dr Malhotra says: “Just eat wholesome, real food. It’s so important for health in the short and long term.”
He wants this mantra implanted in everyone’s brain: “Food can be the most powerful form of medicine or the slowest form of poison.”