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Health & Wellness Blog

Are All Sugars Created Equal?

4/13/2016

8 Comments

 
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Absolutely not.  And one primary (albeit not exclusive) explanation lies in the physiology of the liver.  When food gets digested it gets absorbed into the portal system, a fancy network of veins that drain into the liver.  This is the body’s primary detox hub and a gateway into the arterial system.  The distinction is important:  If I squirt 1mg of epinephrine into my mouth I might shake for a moment then go about my day because absorption is heralded by regulation.  If I inject the same amount into an artery my heart would [metaphorically] blow up.  Poof.

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This concept governs carbohydrate physiology because the liver buffers the foods we eat.  Lining the cells of our digestive track are enzymes that both break down large complex sugars and facilitate movement into the body.  This is called diffusion, and it happens either passively or when the body decides it wants to invest energy into pulling them into the venous circuit as above. What happens next is the premise of this story:  Enzymes in the liver recognize and attack simple sugars uniquely.  Glucose gets funneled down the full cascade and gets converted into ATP/energy or glycogen for storage based on relative needs. Fructose, by virtue of its diminutive carbon count, bypasses a key regulatory brake in the system (phosphofructokinase) and gets shunted into fat production with enhanced rapidity at high levels.  Has anyone heard of a fatty liver?  Fat deposition begets insulin resistance which is the primary mechanism of type 2 diabetes.  We can thank Mother Nature for this because our bodies are simply less capable of handling certain sugars. This basic concept will become paramount in upcoming discussions on diet/nutrition.

8 Comments
Rob Viglione
4/14/2016 08:58:51 am

Are manufactured sweeteners treated differently by the body than naturally occurring fructose?

Reply
AJV
5/4/2016 03:26:30 pm

Yes! Long term studies are obviously lacking but a few preliminary thoughts: They’re incompletely absorbed in the gut (explained why “net” calories are low) and cause less of an immediate insulin spike (because the body doesn’t know what to do with them?). Insulin and “incretins” play a large role in our brain chemistry wrt satiation. In other words we lose that feedback and either directly or indirectly leads to insulin resistance. There are cancer postulations too that still need to be teased apart. All in all I think we’ll be hearing more and learning considerably more about them in upcoming years.

Reply
Robyne Thibodeau
4/20/2016 12:24:52 pm

Thank you so much for taking valuable time to share your knowledge and insight on a very important issue, that due to so many publications, fad-diets and health books etc.. people have trouble knowing what is truth or opinion out there. Great article!

Reply
AJV
5/4/2016 03:33:31 pm

Thanks Robyne!

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Rhiana Mongee
4/21/2016 11:47:03 am

I hear incorporating vinegar into our daily diet slows the breakdown of starch into sugar and lowers the Glycemic Index of a meal by deactivating the enzyme amylase. Is this true and is it healthy? Also, do artificial sweeteners confuse the body into storing fat?

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AJV
5/4/2016 06:14:02 pm

Thanks for the comment! I'd have to do a literature search on the first speculation but from a biochemistry angle is sounds like you're trying to "denature" amylase to present the absorption cells lining the gut with more complex polysaccharides. Yes that would effectively act to lower the glycemic index in theory. I’d question it though because amylase is made throughout the digestive tract and acetic acid (vinegar) wouldn’t affect either the salivary glands, bile composition etc. And the hydrochloric acid of the stomach cells is at a lower pH anyhow:) I’d stick with increasing fiber to lower effective glycemic index/glycemic load

Reply
Jody Mortensen
4/21/2016 02:24:49 pm

Very interesting article!

Reply
AJV
5/4/2016 03:33:01 pm

Thank you!

Reply



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    Author

    Dr Viglione is a concierge medicine doctor in Santa Barbara, CA 

1125 Coast Village Road
Montecito CA, 93108

Ph:  805-892-6500
​Fax:  805-209-0972

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