Sugar and diabetes

 sugar-and-diabetesAlthough the exact causes of diabetes are still not fully understood, excessive sugar consumption is known to indirectly play a role. A high sugar intake may not by itself cause diabetes, but it can be a major contributing factor to weight gain and obesity — factors that clearly promote diabetes.

Researchers around the world have come to the conclusion that the consumption of refined sugar is detrimental to the health of people without diabetes and disastrous for those with it.

A review of 88 published studies shows a clear and consistent relationship between drinking sugary (non-diet) soft drinks and poor nutrition, increased risk for obesity — and increased risk for diabetes.

There is no denying that sugar-loaded soft drinks are having “a negative impact on health”, Dr Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University in New Haven, Connecticut, US, said in a telephone interview with Reuters Health.

Results of a study of more than 91,000 women followed for 8 years provides one of the most striking links between soft drinks and health outcomes, the investigators note in the American Journal of Public Health (April 2007).

In the study, women who drank 1 or more sodas per day — an amount less than the US national average — were twice as likely as those who drank less than 1 soda per month to develop diabetes over the course of the study.

When diet soda replaced regular soda in the analysis, there was no increased risk, “suggesting that the risk was specific to sugar-sweetened soft drinks”, note the authors.

Different Results from Industry

However, there was a “remarkable difference” in results from industry-funded and non-industry-funded studies on soft drink consumption and health outcomes, Brownell said, “with the industry-funded studies much more likely to find the results favourable to industry”.

“The bigger issue here, in this arena in particular but in science in general,” Brownell said, “is how you can get a distorted view of reality if industry-funded studies are considered in the mix — and usually they are — especially, when industry uses these studies in advertising, lobbying, and in talking to the press.”

Two Different Types of Diabetes

There are 2 types of diabetes: Type 1 develops when insulin-producing cells in the pancreas — which help to regulate blood-sugar levels — have been destroyed.  Type 2 usually appears when the body no longer responds normally to its own insulin and/ or does not produce enough insulin.

Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body’s system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. A person who has Type 1 diabetes must take insulin daily to live.

The most common form of diabetes is Type 2 diabetes. About 90-95% of people with diabetes have Type 2, according to American statistics. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities.

People who are overweight are particularly likely to develop Type 2 diabetes. However, Type 2 diabetes is increasingly being diagnosed in children and adolescents today.

Many Health Complications

Diabetes can cause a cascade of medical problems that can lead to heart attacks, strokes and other medical problems.  In people with diabetes, their blood sugar stays too high, and sugar in those high levels is toxic. Over the years, that high blood sugar damages nerves and small and large blood vessels. Those problems can ultimately result in blindness, kidney failure, amputations, premature heart attacks and strokes.

For example:

  •  Every 30 seconds, a leg is lost to diabetes somewhere in the world.  In fact, up to 70% of all leg amputations happen to people with diabetes (Star, 13.11.05).  In Malaysia itself, there are thousands of amputation cases a year.  About 85% of the amputees are diabetics (Star, 15.10.06).
  •  About 1.2 million Malaysians could be suffering from diabetic retinopathy, a common diabetic eye disease that can lead to blindness (NST, 11.10.07).
  •  At least 57% of Malaysians suffering from kidney diseases are also diabetic patients. There were about 15,000 patients in the country seeking haemodialysis treatment, with an average of 3,000 new kidney failure cases reported annually, said Island Hospital consultant physician and nephrologist Dr Goh Huck Keen (Star, 7.4.08).

Diabetes can also have a major effect on disability and quality of life as people age.  According to a study in 2002, older women with diabetes were twice as likely as non-diabetic women to be unable to perform tasks such as walking a quarter of a mile, climbing 10 steps or cooking their own meals.

How many affected:
 
1 in 20 of the world’s adult population now has some form of diabetes (Phyllis A. Balch in Prescription for Dietary Wellness). Diabetes struck 246 million people worldwide in 2006 [“Insulin Delivery Systems Market analysis (2007-2010)”, RNCOS].  There were 6 diabetes deaths every minute in the world (WHO, 2004).
An estimated 25% of the world’s nations have not made any specific provision for diabetes care in national health plans although the human and economic costs of diabetes could be significantly reduced by investing in prevention, particularly early detection to avoid the onset of diabetes complications (Diabetes Australia — NSW).
In Malaysia, some 3.5 million people are diabetic (NST, 12.6.06). About 98% of diabetics here have Type 2 diabetes (Star, 3.4.07).

Find out more about sugar and diseases in the CAP Guide How Sugar Destroys Your Health

RELATED ARTICLES:
Sugar and cancer
Sugar and obesity
Why sugar subsidy should be withdrawn immediately

Sugar and obesity

sugar-and-obesityFor years, dietary experts blamed fat as the root of obesity.  Millions of people diligently reduced their fat intake, but they were still fat.  Researchers then began to realise that many people who were taking fat out of their diets were replacing it with sugar — for example, cookies that were free of fats but loaded in sugar and calories.
 
“The problem is that with sugar, you’re getting a very large number of calories with a comparatively small volume of food. And we know that calories do count.

“A tablespoon of sugar, for example, contains between 50 and 60 calories but very little else from the standpoint of nutritional content,” says Dr Robert Keith, an Alabama Cooperative Extension System nutritionist in the US.

Many studies have now linked sugar to overweight and obesity, including childhood obesity. 

  •  A recent study published in Pediatrics and led by researchers at Columbia University Mailman School of Public Health in the US, concludes that childhood obesity epidemic is fueled by consumption of sugar-sweetened beverages, now increasingly a large part of children’s and teens’ diets.  (Source: Medical News Today, 3 June 2008)
  •  In Fat Land: How Americans Became the Fattest People in the World, Greg Crister writes: “In 2001 researchers from the Department of Medicine at Children’s Hospital Boston tracked 548 ethnically diverse Massachusetts schoolchildren (average age 11) for 19 months, looking at the association between their weight at the beginning of the period, intake of carbonated drinks, and weight at the end of the period.
  •  The results were revealing: 57% increased their intake of carbonated drinks over the 19-month period. The calories of just 1 extra soft drink a day gave the child a 60% greater chance of becoming obese. (Source: The Ecologist, November 2003)
  •  In 1999, the American Journal of Clinical Nutrition published a revealing graph, which indicated the growth rates of new food products (mainly fructose-laden convenience foods, snacks and sweets) and of the US average Body Mass Index over the previous 35 years.  The 2 growth rates were practically identical. (Source: The Ecologist, November 2003)

In spite of such findings, the sugar industry continues vehemently to deny any link between sugar and obesity, hounding those who dare to suggest otherwise.  “Many of the experts we spoke to refused to be quoted, fearing further pressure from the industry,” says The Ecologist (November 2003).

“British Sugar’s website even goes as far as to claim: ‘Of the various foods and drinks available in the shops, sugar has been shown to be less likely to encourage overeating than some others, especially fat-containing foods.  Surveys have shown that people who eat more than the average amount of sugar tend to be slimmer than those who eat less.’”

How Sugar Causes Obesity

The body works to maintain a certain level of blood sugar (glucose) in the blood at all times.  Sugary foods and drinks increase the amount of sugar in the blood.  The more processed the food, and the more refined and simply constructed the sugar, the quicker it is absorbed into the blood.

As blood sugar levels rise, the pancreas releases the hormone insulin, which works to remove the sugar from the blood into the body’s cells.  Once sugar leaves the blood it will either be used straight away to provide energy, be converted to glycogen for later use as a source of energy, or stored as fat.  

Simply put, as the amount of sugar in the blood increases, there is less need to use it to provide energy and more of the sugar is converted into fat.

How many affected:

Around 400 million people worldwide are obese today.  This includes 20 million children under age 5 (WHO, 2007). In Malaysia, 48% of men and 62% of women are fat (2006).

Find out more about sugar and diseases in the CAP Guide How Sugar Destroys Your Health

RELATED ARTICLES:
Sugar and cancer
Sugar and diabetes
Why sugar subsidy should be withdrawn immediately

Why sugar subsidy should be withdrawn immediately

sugar-priceThe Government should stop subsidising the price of sugar since sugar is nothing less than a toxic substance.
The recent 20 sen increase in each kilo of sugar means that the government will still end up subsidising a sinful sum of RM1 billion in 2010, based on a subsidy of 80 sen per kilogram. Malaysians consume an average of 26 teaspoons of sugar per day. This sweet indulgence has resulted in nearly 1.2 million Malaysians with diabetes, more than 98% with Type 2 diabetes, which is strongly linked to high sugar consumption.
Sugar should be sold at its market price because:
 
— It is not a basic necessity and its consumption is most harmful to one’s health.
 
— With the total withdrawal of subsidy, the price of sugar will increase by 80 sen per kilogram but this should not lead to a drastic increase in the price of sugar-based food and drinks.
 
— Based on our calculations, the cost of the main ingredients in a cup of teh tarik and Milo is about 28 sen and 45 sen respectively, though they are sold at RM1.00 and RM1.20 respectively.
 
— The subsidy mainly benefits the manufacturers of fizzy drinks and sugar-based food products.
 
— Countries like the Philippines, Indonesia and Thailand have a per capita income that is lower than Malaysia yet they pay more for their sugar.
 
— The RM1 billion subsidy can be better used to help fund programmes to eradicate poverty and for the improvement of public health.

We would like to reiterate that it makes no sense to subsidise the very substance that is injurious to our health when the money can be better spent elsewhere.

In the 1970s Malaysians consumed 17 teaspoons of sugar a day and this rose to 21 teaspoons in the 1980s. Now, they are consuming an average of 26 teaspoons of sugar per day.

Most people find it hard to believe or accept that we can be consuming an average of 26 teaspoons of sugar a day because we may be thinking  of the sugar we add by ourselves into our food, but an increasing amount of sugar that is consumed by Malaysians is contained in processed drinks and food.

Some soft drinks contain an average of 7 teaspoons of sugar per can. Consumers are often unaware of how much sugar they are consuming in total per day. Over 60 ailments have been linked to sugar consumption, including obesity, diabetes, heart disease, cancer, asthma, and allergies. Some of these killer diseases are showing worrying upward trends in just a few years.

The price of sugar in Malaysia is amongst the lowest in this region.  Sugar is priced at RM1.60 per kilogram and RM1.75 in East Malaysia. However the price of sugar in our neighbouring countries like Singapore is RM3.13, the Philippines RM2.85, Thailand RM2.31 and Indonesia RM2.62 to RM2.79 respectively.

Urgent action is needed to curb our high national sugar consumption.

Besides REMOVING the subsidy on sugar, the Government should also take the following measures to reduce the consumption of sugar among Malaysians:

— Impose a sin tax for sale of high-sugared, high-fat and high-salt foods;

— Bring to a halt the advertisement of highly-sugared and other junk foods and drinks during children’s television viewing hours. Children are susceptible to media pressure.

— Educate school children on the dangers of excessive sugar intake through health education, home science and cookery lessons.

— Educate the public on the dangers of sugar intake through the media (television, radio and press).

— Encourage children to avoid sweet drinks in schools by providing drinking water in water dispensers around school premises. Sweet drinks should not be sold in school canteens.

— Have a total ban on the sale of junk food in school canteens.

— Ban food hawking within a fixed perimeter around schools so that schoolchildren are not tempted to consume unhealthy foods.

— Put an end to child-height confectionary displays at supermarkets and grocery stores which are usually placed near checkout counters to attract children.

— Initiate the removal of vending machines dispensing junk food and sugary drinks from areas such as hospitals, airports and schools.

Read more on how sugar is responsible for more than 60 diseases in the CAP Guide, How Sugar Destroys Your Health

Sugar and cancer

sugar-and-cancerSugar feeds cancer.  The affinity of cancerous tissue for sugar (glucose) is well known. 
A study that monitored the diets of 80,000 healthy women and men from 1997 to 2005, found that the risk of developing pancreatic cancer is related to the amount of sugar in the diet. 131 people in the study eventually developed cancer of the pancreas.  Most at risk were those who drank high quantities of fizzy or syrup-based (squash) drinks.
  •  The group who said that they drank such products twice a day or more ran a 90% higher risk than those who never drank them.
  •  People who added sugar to food or drinks (eg: coffee) at least 5 times a day ran a 70% greater risk than those who did not.
  •  People who ate creamed fruit (a product resembling runny jam) at least once a day also ran a higher risk — they developed the disease 50% more often than those who never ate creamed fruit.
  •  A Swedish study in the March 2007 edition of Diabetes Care, shows that women with high blood sugar (hyperglycaemia) may be more likely to develop cancer, even if they don’t have diabetes. The study, by researchers from Sweden’s Umea University Hospital, also found that both men and women with the highest blood sugar levels were more likely to have pancreatic cancer, urinary tract cancer, and malignant melanoma (the most deadly type of skin cancer) than those with the lowest blood sugar levels.
  •  Women with the highest blood sugar levels upon joining the study were more likely to be diagnosed with cancer before its end.
  •  Cancer of the lining of the uterus (endometrial cancer) was more common in women with the highest blood sugar levels.
  •  Breast cancer was more common for women younger than 49 with high blood sugar levels.

How many affected:
 

According to the American Cancer Society’s projections, more than 12 million new cases of cancer would have been diagnosed around the world in 2007 and 20,000 people a day, or 7.6 million people, would have died from the disease.

Its report, “Global Cancer Facts and Figures”, says that some 5.4 million cancer cases and 2.9 million deaths would have occurred in industrialised countries. In developing nations, some 6.7 million cancer cases and 4.7 million deaths would have taken place, with lung, stomach and liver cancer being most prevalent in men, and women suffering most from breast, uterine and stomach cancer.

In Malaysia, every year at least 40,000 people get cancer, and this is only a conservative figure (NST, 22.11.05).  1 in 4 Malaysians can be expected to get cancer in his or her lifetime (Malaysian National Cancer Registry, 2002).

Find out more about sugar and diseases in the CAP Guide How Sugar Destroys Your Health