Fifty years of dietary guidelines have emphasized “low fat” and “low cholesterol” eating, so manufacturers obliged by creating foods with increasing sugar and wheat/gluten content while promoting exercise and widespread use of statins to lower cholesterol. Yet Americans have become overweight, obese, and typically less healthy at an alarming rate. The newest 2015-2020 U.S. dietary guidelines, eighth edition, are attempting to address this issue by limiting “added sugar.”1
More from Dr. Richer: Improve and protect your next patient with diabetes
Why should optometrists care about the amount of sucrose, high-fructose corn syrup (HFCS), and the myriad of camouflaged, masked, and concealed simple carbohydrates in food? Because it matters far beyond our growing diabetes epidemic, and it matters far beyond even eye care. This was the two-hour topic of discussion at last year’s 2014 “Sugar, More Than Meets The Eye” Nutrition Special Interest Group Symposium sponsored by the American Academy of Optometry in Denver.
Sugar and systemic disease
This symposium was anything but sugar coated. Dennis Ruskin, OD, FAAO; A Paul Chous, MA, OD, FAAO; Kimberly Reed, OD, FAAO; and myself addressed the human toll and root cause evaluation of the science of sugar with respect to diabetes/cardiovascular disease, Alzheimer’s disease, and cancer.
Dr. Ruskin, a Canadian opened with a frontal assault on the U.S. food industry and government regulatory agencies for not including “percent daily value” for sugar—like there is for fat and sodium—on “Nutrition Facts” food labels.2 (See Figure 1.)
Obesity doesn’t cause metabolic syndrome—obesity is a marker for metabolic syndrome, according to the work of University of California at San Francisco, pediatric endocrinologist Robert Lustig, MD. Dr. Lustig’s “Sugar: The Bitter Truth” lecture is a YouTube hit with approximately six million views.3
Dr. Chous provided a spirited discussion on his area of expertise: diabetic retinopathy and diabetes-accelerated cardiovascular disease. This included the DiFUSS trial (Diabetes Visual Function Supplement Study) recently published in the British Journal of Ophthalmology.4
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Dr. Kimberly Reed next talked about the damaging effect of sugar upon the “microbiome.” This is the three- to six-pound community of trillions of cells living along the gastrointestinal track, and considered our “second brain” source of neurotransmitters. The microbiome also manufacturers B vitamins and protects us against the entry of foreign toxins. The microbiome-damaging influence of sugars includes fungal candida overgrowth that entraps an increasing percentage of the population. Insulin resistance in the brain also exists, may be reversible, and some diabetic medications such as metformin may be helpful. So-called “Diabetes 3” is now recognized as a subcategory of Alzheimer’s disease (AD).5 According to a recent Mayo Clinic study, those on high carbohydrate diets quadruple their risk of mild AD.6