December 9, 2019
Honourable Tyler Shandro
423 Legislative Building
10800-97 Avenue NW
Dear Mr. Shandro:
Our topic this month is sugar. Sugar is a relatively new food for humans. It has only been around for a thousand years or so and it was not available on a large or affordable scale until the development of the steam engine a few hundred years ago. For a long time people have had suspicions that this food possibly does more harm than good but for the most part it did not attract too much attention or concern. We have laws prohibiting many drugs, then we forbid the purchase of nicotine and alcohol before age 18. Some religious groups forbid alcohol, nicotine and in some cases even caffeine and yet we will give sugar to babies.
Let’s start our discussion by asking the question, “Is sugar a drug or is it a food?” Sounds like a simple enough question. Next month when we deal with addictions in depth, we will see that all addictions have one thing in common and that is that the addicting substance or behavior has the ability to stimulate the Nucleus Accumbens to secret the neurotransmitter Dopamine. All addictions share one common cause and that is the need for dopamine. It turns out that in fact sugar does have the ability to trigger some receptors in the Nucleus Accumbens which result in the release of dopamine and therefore sugar does satisfy the definition of an addictive substance. Period! But, does it satisfy the definition of a food? Sugar has only one claim to having any food value whatsoever and that is that it has calories. That is its only claim to having any food value whatsoever. It contains no vitamins, no minerals, no amino acids, no essential fatty acids, nothing but calories. Calories are a big deal if you are chopping wood all day but they are not a big deal if you just operate a mouse. By comparison, red wine not only contains calories, it also has some B&C vitamins, some minerals, bioflavonoids, and the super antioxidant resveratrol. Compared to sugar, wine is a superfood. Dark chocolate is just about as good. This is all great news at Christmas time. But as for our original question, “Is sugar a drug or a food?” I will let you decide on that one.
The next question that we must address is, “How harmful is sugar really?” What problems does it really cause? To answer this we probably need to lump sugar together with a few other refined carbohydrates such as refined flour and more recently high fructose corn syrup (HFCS).All of these carbohydrates break down into glucose and fructose. But how do we really answer this question? All nutritional studies are very complicated and expensive. Think of double blind studies that have to be carried out for decades to answer a single question about how things were decades ago. This is very very complicated and expensive but there is a very much simpler and inexpensive way to get all of the answers that we need. All the necessary work has been done decades ago.
To see the effects of refined carbohydrates on the body is very easy and it has been thoroughly documented in hundreds and even thousands of very well run clinics all over the globe. There are hundreds if not thousands of small communities that lived for centuries on some ancestral diets and had a well established state of health. Then in the late nineteenth and early twentieth centuries many of these areas were colonized by countries with modern western diets. When colonies were set up, the first order of business was to bring doctors and set up clinics for the new colonists and the local residents as well. This is what they found.
In ancient civilizations all over the world the findings were nearly always the same. From the Polynesians of the south Pacific who had domesticated chickens, pigs, and dogs, to the tropical hunter gatherers of sub Sahara Africa to the herdsmen of the Mediterranean and Middle East to stone age hunter-gatherers of Australia and North America the initial findings were very consistent. Nearly all of these groups consumed a lot of calories mostly from fats and proteins and for the most part they were quite healthy. Modern western diseases like heart disease, diabetes, obesity, hypertension, gout, and even cancers were very rare. Missionaries and physicians noticed this and many of them documented it with very thorough records.
Shortly after colonies were established and the modern diet with a lot of sugar was introduced to the local population, the missionaries and physicians started to notice serious changes. The previously healthy natives suddenly started to develop a lot of diseases that they had never had before but which were very common in the modern western civilizations. The first to appear was an epidemic of tooth decay. This was followed by a lot of obesity in people who had never been obese before. Then ten or twenty years later epidemics of heart disease and diabetes began to appear. Along with this came all the problems associated with the vascular and neurological damage that seems to accompany high blood sugar and high insulin levels that are associated with diabetes. This same cascade of morbidity was reported in small new colonies all over the world. Some native groups in North America went from zero diabetes to nearly 90% diabetes in just a generation.
So what can we conclude from all of this? It appears that introducing a highly refined carbohydrate diet produces a cascade of problems. In the first phase there is tooth decay, some gout problems and some weight gain. In the second phase we get basic Metabolic Syndrome which is characterized by five things: a large accumulation of abdominal fat, hypertension, high triglycerides, high blood glucose, and low HDL cholesterol. In the third phase we get full blown type II diabetes and all the vascular and neurological problems that go with it. (Blindness, liver failure, kidney failure, dementia, cardio-vascular disease, amputations)
This definitely makes a strong case for why we should be very suspicious that a high refined carbohydrate diet can be responsible for this entire package of problems. However, knowing this and proving it are two different problems. The way to definitively prove that refined carbohydrates are the cause of the entire package of problems is to take a group of people that have a high refined carbohydrate diet and all the health problems that come with it and completely remove the refined carbohydrates from their diets and see which problems improve or go away entirely. This is the gold standard of proof. This is loosely based on the scientific method which was first introduced by Sir Francis Bacon and his colleagues in the 1500’s and was the standard of proof for centuries and used to be taught in grade 4 and 5 science classes until very recently. There were six steps to it: problem, investigation, hypothesis, experimentation, results and conclusion. If the results did not support the hypothesis you had to adjust the hypothesis a bit. For our purposes here, if you can introduce a suspected cause and get the expected problem (Hypothesis)and then remove the cause and make the problem go away (Result) ; that is as good as it gets. The Big Pharma and Medical Establishment people might tell you that the double blind study is the gold standard of proof and anything else is anecdotal and unproven but honestly I have no idea how you could ever apply a double blind study to a problem like this. Double blind studies might have a place in a few small drug tests but for the bigger scientific challenges, the scientific method is the gold standard!
Why the colonized societies developed as much of this problem as quickly as they did is not clear but it probably has something to do with their genetic profile. The Europeans had a few centuries to evolve into a condition where they possibly handle refined carbohydrates better but still the Europeans have a huge problem with Metabolic Syndrome and diabetes as well. It is just that they have had the problem longer and it developed more slowly in their case.
So what is the practical application of all this? Well, if you want to prevent dementia, dialysis and heart disease, take diabetes seriously. If you want to prevent diabetes, take metabolic syndrome seriously. If you want to prevent metabolic syndrome, take tooth decay and weight gain seriously. And if you want to prevent tooth decay take high carbohydrate diets seriously.
Enough about addictions, metabolic syndrome, and diabetes. Moving on, there is another very serious problem caused by sugar and other refined carbohydrates and this one is our budget balancer for this month. The other really big problem with sugar and refined carbohydrates is that they both really upset the bacterial mix in our gut also known as our microbiome. I tell my little patients that if they want to have a healthy tummy that they have to take good care of the good germs in their tummies and get rid of the bad germs. Then I tell them that the good germs like broccoli and other vegetables and that the bad germs like sugar and other tasty treats. So it is important to eat lots of vegetables and keep the sugar and other refined carbohydrates to a minimum. However, a lot of people choose not to do this and a lot of people get in trouble.
What a lot of people do not realize is that the gut does a lot more than just digest our food. It also contains a lot of immune cells that are a big part of a healthy immune system and also there are a lot of nerve cells that produce a lot of essential neurotransmitters. Also, oddly enough, a lot of the good bacteria also produce neurotransmitters. The two main neurotransmitters produced in the gut are serotonin and dopamine. We mentioned dopamine earlier and explained how it was so important in addictions and we will get into that in depth next month.
Serotonin on the other hand is our “Happy” neurotransmitter and apparently a healthy gut produces 70-80% of our serotonin. That is amazing! When Serotonin is low we get depression and depression is the most widespread medical problem in our western society. Pharmaceuticals like Prozac and Paxil are selective serotonin reuptake inhibitors (SSRI’s) and all the do is keep what serotonin there is around a bit longer. But the secret to good serotonin levels and less depression is to have a healthy gut with the right kind of bacteria. Sadly, sugar feeds the bad bacteria which in turn crowd out the good bacteria and depression as well as leaky gut, inflammation, bowel disorders, food allergies and many other problems is the final result. Could the solution to all of these problems simply be, “Eat your vegetables!”
This is a fascinating area of healthcare and it is definitely a budget balancer and here is a Christmas bonus for you. One of the world’s foremost experts on this topic is already on your payroll so you can get world class state of the art information on this topic without spending another nickel. The lady in question is Marie Claire Arrieta Ph.D and she is a professor here at U of C. She wrote the book, “Let Them Eat Dirt”.
They say, “All things in moderation.” I don’t know if there is a safe amount of sugar. There probably is but it is probably different for each individual. Some people can drink a fair amount of wine with no trouble; others cannot. Some people smoke a pack of cigarettes a day all their life and never get cancer or emphysema; others are not so lucky.
So that is the scoop on sugar. Who would have thought that this very tasty food which we use in the celebration of nearly everything can figure into so many health problems. Have a great Christmas and a great healthcare system and a balanced budget in the new year. Again, there is no need for you to reply to this letter beyond a simple acknowledgement that it was received.
Dr. Murray Hennings, DMD
P.S. If you thought that the depression issue might not be a budget balancer by itself; here is a bonus. Each year in Canada over 50,000 people die in hospital from a problem that the acquired after they got to the hospital. This is 1,000 per week! This is probably worth a look too.