By Yuri Elkaim, BPHE, CK, RHN
Heart disease is still the #1 killer in the western world…
Accounting for 17% of all deaths (according to the WHO) and killing over 616,000 people in the United States alone in 2008.
In 2010, coronary heart disease alone was projected to cost the United States $108.9 billion. This total includes the cost of health care services, medications, and lost productivity.
As you can tell, heart disease not only kills but it weighs heavily on the health care system of a country.
For years it was believed that eating too much fat was the cause of heart disease. And for that reason, the 1980s saw a a new “low-fat” movement. However, heart disease still increased. And so too did obesity.
If fat was the problem then why were (are) people still having more heart attacks, getting fatter, and even developing Type 2 Diabetes?
Well, a big part of the answer is SUGAR.
As I’m about to show you in this article, sugar is a big reason why 1/3 of Americans have high blood triglyceride levels, making them (maybe even you) more susceptible to a heart disaster!
Don’t be fooled by low-fat products because if fat has been reduced or removed, then manufacturers know that something else has to take its place. In many cases, it’s sugar.
So why is sugar so bad?
Well, it’s a DRUG that literally destroys every cell and system in your body and although I won’t be touching on every one its deleterious health effects in this article, I will be discussing the rarely talked about relationship between sugar, insulin resistance, and heart disease.
After reading this article, I guarantee you’ll never look at sugar the same way again.
New Study Finds Sugar-Sweetened Beverages Increase Risk of Heart Disease
This really comes as no surprise (after you understand how all this works) but a March 2012 study in the journal Circulation with 42,883 men found a significant and positive association between drinking sugar-sweetened beverages and the risk of coronary heart disease.
In fact, the researchers revealed that for a one serving per day increase in sugar-sweetened beverage intake, the risk of CHD increased by 19%.
If you thought that drinking a pre-packaged fruit juice or soda pop was only doing damage to your waistline, then think again. This is just one of many studies showing sugar’s detrimental effects on the heart and cardiovascular system.
As we’ll look at below, fructose (which makes up roughly 50% of the sugar molecule sucrose as well as high-fructose corn syrup) is perhaps the main culprit here.
Why?
Well, among other reasons, the liver has a very tough time metabolizing fructose (as opposed to glucose). In fact, roughly 30% of fructose intake is converted to fat in the liver.
One of the ways this happens is through a process known as de novo lipogenesis (or “new fat creation”). And to give you an idea of how dramatically fructose impacts this process have a look at this graph comparing glucose and fructose on de novo lipogenesis (DNL).
Notice the dramatic rise in DNL after fructose consumption?
Crazy, right?
Fructose and Uric Acid
Not only does fructose (ie. sugar) add more fat (in the form of triglycerides) to your bloodstream – not a good thing by any stretch of the imagination – but also stresses your heart and vascular system by increasing blood pressure.
How does it do that?
Well, one of the by-products of fructose metabolism is uric acid. You may have heard of it before. It’s the precursor to and problematic compound associated with gout. But in this case, uric acid increases blood pressure by inhibiting an enzyme that allows nitric oxide (NO) – a powerful vasodilator – to do its job.
Thus, if NO can’t dilate your blood vessels, then they will naturally be “less open”, leading to an increase in pressure as blood travels through them.
Does that make sense?
The combination of increased fat production and the creation of uric acid are just 2 ways that sugar puts you at greater risk of heart disease.
Considering that in 2004 sugar-sweetened beverages made up approximately 7% of the total daily energy intake of Americans, it’s no wonder heart disease is still killing more Americans than any other disease!
What About Fruit?
Above, I mentioned that fructose is bad news. But that does that mean that fruit is bad for your heart too?
Well, first of all, fructose is only a portion of the sugar found in fruit. Some fruit have more, some have less. But either way, fruit is a natural whole food and if anything should be eaten in greater amounts to prevent heart disease.
Case in point…
A 2011 study assessed the effect of low glycemic index fruit intake in type 2 diabetes and whether or not it increased the risk of cardiovascular disease (CVD).
Temperate climate fruit, which are generally low GI, were the focus and included apples, pears, citrus fruit (oranges, tangerines and grapefruit), berries (strawberries, raspberries, cranberries, blackberries and blueberries) and the Prunus family (nectarines, peaches and plums).
Not surprisingly, the low GI fruit consumption was associated with lower blood pressure and CVD risk and supports a role for low GI fruit consumption in the management of type 2 diabetes and heart disease.
Boo ya!
This just goes to show that WHOLE foods are the secret to life-long health. Fruit aren’t problematic because of the large amount of fiber that they contain, which naturally slows down the amount of fructose that reaches the liver at any given time. Therefore, the liver can more easily process the fructose from fruit, meaning less of it is converted to fat.
Plus, fruit is loaded with antioxidants, which are very important for fighting off free-radicals and preventing oxidative damage in your arteries.
So go ahead – get your 8-12 servings of fruits and veggies!
The Beginning of the End
To further understand how sugar eventually leads to a greater risk of heart disease, we need to start at the beginning.
When you eat sugar (specifically glucose), it elicits a spike in blood sugar. The greater the glycemic index (load) of a food or meal, the greater that spike will be. Generally, refined grains (white bread, pasta, pastries, etc…), sweeteners, and sweets are the major culprits here.
But the body’s amazing.
Because it knows that high levels of sugar in the blood is dangerous, the pancreas produces and then secretes a hormone called insulin.
Insulin is a like VIP tour guide that takes excess blood sugar and brings to your muscle, fat, and liver cells. Without insulin, blood sugar (glucose) cannot enter the cells (for the most part).
So, in order for things to operate smoothly, your pancreas must first produce and secrete insulin and, second, your cells must be “sensitive” (or responsive) to it.
However, eating a lot of sweet/sugary foods creates a cascade of events that can eventually lead to a condition called “Insulin Resistance” or Diabetes.
When this happens, your cells are no longer sensitive to insulin.
The reason?
They’ve simply been exposed to too much of it over the years and thus no longer respond to this important storage hormone.
This creates a deadly scenario…
Sugar comes into your bloodstream but cannot be stored in your muscle, liver, or fat cells, which means elevated blood sugar.
If, your blood sugar remains for a prolonged period over time, disastrous consequences can arise like retinopathies, neuropathies, and ulcers. Essentially, too much sugar EATS AWAY at the blood vessels, nerves, and other tissues in your body.
This is bad news.
But that’s just the beginning.
For the sake of this article, let’s now assume that you have become insulin resistant (that you have Diabetes) like the 26 million other sufferers in the US alone.
How Insulin Resistance Can Hurt Your Heart
Under healthy conditions, insulin stores sugar in your cells. It’s a building or storage hormone. You might not like that about insulin but that’s the way it goes.
If you don’t want as much insulin circulating in your blood, and thus less sugar stored as fat, then don’t spike your blood sugar with poor quality foods and sweets.
Anyways…
When insulin resistance occurs, your cells NO longer respond to insulin. Therefore, no sugar can be stored. At first glance, those wanting to lose weight might think that’s a good thing but let me tell you why it’s not.
Aside from the fact that too much sugar in the blood WILL ruin your arteries, nerves, and other precious tissues…
It also increases triglycerides (fats) in the blood, raising your risk of heart disease.
Here’s a diagram/flow map showing how this works…
Now, let me help you make sense of this diagram.
Insulin resistance is manifested by hyperinsulinemia (too much insulin), increased glucose production in the liver, and decrease glucose disposal.
In fat cells (adipocytes) – the yellow globules above – insulin resistance triggers an increased release of hormone sensitive lipase (HSL), resulting in elevated rates of triglycerides breakdown (aka. lipolysis) into free fatty acids. These free fatty acids (FFA) then move to the liver.
In the liver (the big brownish-red organ above), FFAs can either be converted to ATP energy in the mitochondria OR…
Converted back into triglycerides for storage OR incoporated into dangerous VLDL particles.
Not only does insulin resistance increase your blood triglycerides via increased VLDL formation but it also activates all of the lipogenic (fat-forming) genes in your liver.
This essentially means that more processes occur to convert sugar into fat, rather than energy.
Similarly, HYPERGLYCEMIA (too much sugar) causes enzyme processes in the liver to favour the conversion of excess glucose to fatty acids. The trouble with this is that increased fatty synthesis increases production of malonyl-CoA, which then inhibits CPT-1, the protein responsible for fatty acid transport into the mitochondria.
As a result, more fatty acids are converted into triglycerides (yet again) rather than being burned as fuel in the cells’ mitochondria.
All of these events lead to one major problem…
High blood triglyceride levels in the blood (aka. VLDL), which is big time risk factor for heart disease.
The American Heart Association (AHA) recommends that a triglyceride level of 100 mg/dL (1.3 mmol/L) or lower is considered “optimal”. Thankfully, this level can easily be attained through lifestyle changes such as diet, weight loss, and exercise.
Wrapping Up
Who would have known that sugar – a molecule related to diabetes and weight gain – could be such a big problem for your heart as well?
But after reading this article, I’m sure you can see why sugar (yet again) should have a very very small place in your diet.
Disease doesn’t just happen. Genetic factors are extremely minimal (5-10%) in comparison to what really matters…
What you’re putting in your mouth and whether or not you’re moving your body.
If you want to avoid heart disease and diabetes (insulin resistance), then start by limiting your sugar intake. Doing so will also improve all other aspects of your health as well!
References:
Miniño AM, Murphy SL, Xu J, Kochanek KD. Deaths: Final data for 2008. National Vital Statistics Reports; vol 59 no 10. Hyattsville, MD: National Center for Health Statistics. 2011.
Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. Epub 2011 Dec 15.
Heidenreich PA, Trogdon JG, Khavjou OA, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123:933-44. Epub 2011 Jan 24.
Konig, L. et al. Sweetened Beverage Consumption, Incident Coronary Heart Disease and Biomarkers of Risk in Men. Circulation, March 12, 2012 online.
Jenkins, J. The relation of low glycaemic index fruit consumption to glycaemic control and risk factors for coronary heart disease in type 2 diabetes. Diabetologia, 54 (2), 271-279. 2011.
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