Carbohydrates: Heroes or Villains?

“Let your food be your medicine and let your medicine be your food.” Hippocrates

Did your grandmother teach you, as mine did, that you are what you eat? We used to chuckle about her obsession with whole wheat, and felt she was going overboard when she counseled us to avoid sugar. Grandma lived to a ripe old age, and she was sharp-witted and ambulatory to the very end. Now, years after her death, science is “discovering” the truth in Grandma’s views on health.

It is my observation that at least 80% of the health problems in America are related to diet. I will even go so far as to say that many people who are disabled with chronic or episodic depression would notice a new life, with energy and focus, if their diets were looked at and adjusted, and if time were allotted for the body to repair itself. And those who suffer from chronic illness have hope, if their diet is carefully evaluated and adjusted. Let’s look at some possible applications of these principles.

Sugar Is Not Our Friend

The study of sugar and its effects on humans is so diverse; it’s hard to know where to start. Let’s start with Endocrinology 101. It’s a little complex. Are you ready for it? I think it might be most easily understood if we can compare it to something with which we are somewhat familiar.

In dry areas, rainfall that isn’t used immediately to moisten the soil is channeled into tributary streams, which often empty into reservoirs. The reservoirs store the water behind strong, secure dams. Huge turbines, combined with the power of the water, generate energy. If water levels are too high to be contained in the reservoirs, a spillover occurs, or there is a break in the dam. The resultant flooding can create a dangerous situation.

In our bodies, sugar that isn’t utilized immediately to create energy is stored. Sugar, fed in a sudden dose to the body, reacts in a similar manner to that of an overflowing reservoir, particularly when it is eaten without the fiber and minerals and other nutrients which are with sugars in their natural state. When we eat a candy bar (or cookie, cake, pie, chocolate), the glucose (one of many sugars) level rises quickly in the blood. This prompts the rapid release of insulin from the pancreas. The insulin takes the glucose to the cell through insulin receptors and utilizes it in one of three places: 1) about 50% is used for immediate energy (as in the huge turbines of the dam); 2) about 10% is stored in the muscle and liver as glycogen (like the water in the reservoir) and 3) approximately 40% is stored as fats—triglycerides and cholesterol (like a spillover from the dam which could create a dangerous situation). (1) (This becomes important as we discuss the epidemic of obesity and diabetes in a later article).

Simply put, sugar causes the body to release insulin and stress hormones, which “flood’ the body. And unfortunately, in sugar consumption, the flooding never ends. If the refined sugar is not followed by a meal (with slow release of glucose from complex carbohydrates), the insulin will drop the blood glucose level too low. This prompts the adrenal gland to release the stress hormones (cortisol, which is our natural steroid and adrenaline) to the muscles and liver, which in turn release glucose from glycogen to raise the blood sugar level. (2) Sometimes the low blood glucose causes “hypoglycemia” symptoms which are superficially relieved by eating more refined sugar. Both glycogen release and new sugar intake raise the blood glucose. If it increases it too high or too fast, we see a subsequent release of insulin and the cycle goes on.

With long term exposure to high glucose levels, the cell walls become thicker and lose their insulin receptors. The cell then resists the intake of glucose, which is called insulin resistance. This means the blood glucose goes up and blood insulin goes up, but the subsequent drop in blood glucose does not take place. Consistent high blood glucose causes glucose to stick to proteins, called “glycosylation.”(3) The effects of glycosylation will be discussed later in an article on diabetes and obesity. High insulin levels block the conversion of triglycerides into energy, thus raising triglyceride levels in the blood, and making it difficult to lose weight. (4) Still with me? There’s more. . .

Another harmful effect of high sugar in the bloodstream is an increase of calcium loss through the urine, which over the long term may contribute to osteoporosis. When the same amount of sugar was given to people with a history of calcium oxalate kidney stones, the increase in calcium excretion was even greater. (5) Many people have noticed an increase in joint, muscle or headaches soon after sugar intake. And conversely, many people who have discontinued sugar in their diet have noticed greater energy and less muscle and joint pain after a few weeks.

Flooding the body with insulin and stress hormones is a major part of the adverse effects of sugar consumption, but (continuing to use a water metaphor) it is only a drop in the bucket! Some of the sugar that is ingested is not absorbed, providing a good meal for harmful bacteria, Candida and other fungi in the intestinal tract. (6) Cancer cells have many times more insulin receptors compared to normal cells and require more glucose for growth. (7) High sugar intake is associated with increased cancer risk. (8)

Because sugar is often eaten without accompanying fiber, this leads to constipation and hemorrhoids. Lack of fiber also permits the food to stay longer in the gut, creating more putrefactive breakdown and toxin absorption.

So, is the concern with sugar a crazy, wild idea? Our family enjoys desserts, but we try to keep our sugar consumption much lower than we did in the past, and we limit it to a small portion, made with as few processed ingredients as possible, AFTER we have completed a nutritious meal. No more binging on ice cream as a mid morning or mid afternoon snack!

Historically, sugar was sold in “pharmacies” in pioneer times, in little cone-shaped packets, which were carefully shaved in small amounts to adjust flavors. It was sold right along with medicinal herbs. In colonial times, the price of sugar was—unbelievably!–$2.40 a pound. In the “Little House on the Prairie” series of books, Pa would have to travel miles to town to get a Christmas candy for Laura, Mary, and Carrie’s stockings. Society’s consumption rate for sugar now is astronomically higher than it was during pioneer times. Prices are so low that it’s not uncommon nowadays to find sugar for $1.50 for five pounds. Today it’s difficult to think of any kind of celebration without sweet foods of some kind! It’s also difficult to think of other options which are enticing or represent us well as a good host or a thoughtful neighbor. After all, shouldn’t we bake a batch of brownies to bring to the new move-in family? Or what treat do we take to the Cub Scout pack meeting? Granted, it’s tough to think of alternatives which are healthy and yet fun. No one flocks to the broccoli as readily as they will pick up and bite into a cookie. But sugar does affect us, and it is wise to be aware of the affect it has on our body.

Before we leave the topic of sugar, it is also worth mentioning that most cavities in teeth are directly related to sugar intake. (9) Dr. Weston Price, former head of research programs at the American Dental Association, documents his observations that native Polynesians faces narrowed after the introduction of sugar and refined flour into their diet. This caused bad bites and crowded, crooked teeth compared to earlier generations. (10) I have wondered if our high sugar consumption is one reason we have to have so much orthodontic work in the United States.

What About Artificial Sweeteners?

What about artificial sweeteners? It must be recognized that many people use artificial sweeteners to lose weight, but studies consistently show that people on artificial sweeteners gain more weight than do people who avoid sweeteners entirely. We know from the data of the artificial sweeteners’ own studies that people gain weight from “diet” pop. So weight loss isn’t just related to calories. The sweeteners have adverse affects on the body as well, many of them worse than the effects sugar has. Most of the foods that contain artificial sweeteners are foods that should be limited anyway Why not replace unnaturally sweet foods with naturally sweet fresh fruits? The accompanying nutrients and fiber in fresh fruits make them ideal for digestion and utilization of the glucose.

Having said that, I should explain some things about artificial sweeteners. Saccharine (Sweet ‘N Low and Sugar Twin) was the first to come on the market and presently carries a government mandated warning label that it is known to cause cancer in laboratory animals. Aspartame (NutraSweet) is broken down in the body to wood alcohol, subsequently broken to formaldehyde, a fixative and a known carcinogen (cancer causing agent). Formaldehyde is then broken down into formic acid, which is the same strong caustic used by fire ants to administer their sting. (11) Sucralose (Splenda) was approved in 1999 as a general sweetener, so it has not stood the test of time, although it is the least controversial of the three sweeteners. Stevia is an herbal sweetener, and provides the best transition alternative to getting off sweets altogether. You can find Stevia at health food stores, or in the health section of some grocery stores. Agave nectar is also more healthful than processed sugars.

When carbohydrates are broken down for energy formation, certain vitamins and minerals are needed for proper processing. If we remove those very nutrients, such as with “polished” white rice and white “enriched” flour in the refining process, vitamin and mineral depletion takes place. “Enriched” means that 24 nutrients have been removed (12) and about 5 have been added back. White flour, made whiter with bleach (the same bleach we use to whiten our clothes in the laundry) is then used for bread and pasta preparation. One has to search to find flour that doesn’t have the added (and unwanted!) ingredient of bleach!

Now that we have addressed the issues of the harmful effects of processed, refined carbohydrates (I wonder if this could be some of what John A. Widstoe referred to when he talked of “adulterated and dangerous foods upon the market?”), let’s turn our attention to carbohydrates that are not “refined.”

Here Come the Carbs

An important principle needs to be clarified at this point. Animals handle carbohydrates with fiber differently than when carbohydrates are consumed without fiber present. When cows were fed molasses without fiber, they developed neurological problems and died. When fiber was added to the same sugar volume, the illnesses were not seen. (14) It seems to me that the same is true in humans—that the eating of the whole fruit or vegetable imparts a protective effect against the damage caused by refined, processed carbohydrates.

Legumes, including beans, peas, lentils, soy and peanuts are moderately high in carbohydrates, but have lots of fiber. Fruits, when eaten in the whole state, contain good amounts of fiber. (If more vegetables than fruit are eaten, more fiber is ingested with the higher vitamins and lower carbohydrates.) Most of the time, when we think of whole grains, we just think of whole wheat or brown rice. But the category of whole grains includes oatmeal, millet, quinoa, barley and cornmeal. Many people appear to be sensitive (almost addicted) to breads which have yeast and sugar added to the original grain. Low amounts of carbohydrates are also found in vegetables, nuts and seeds.

The change to a more healthful eating style needn’t be drastic, and it needn’t be instant, unless our bodies have become so ill that treatment is urgent. Learning how to cook and eat more healthfully is a process. We were all raised in the Twinkie generation—it takes time to see and implement a better, more healthful way.

Healthful Hints:

  1. Avoid refined, processed carbohydrates (especially sugar), including white flour and white rice. Seek opportunities to use whole, fresh foods.
  2. Eat whole fruits as desserts.
  3. Eat vegetables, fruits, whole grains, legumes, nuts and seeds (“wholesome herbs…, every fruit…, all grain… is ordained for the use of man”).

* * *

1.Harper’s Biochemistry, 1988, 21st Edition, p. 555.

2.ibid. p. 196.

3.Cecil Textbook of Medicine, 19th Edition, Volume 2, p. 1297.

4.Harper’s Biochemistry, 1988, 21st Edition, p. 555.

5.Lemann, J. Jr., W. F. Piering, and E. J. Lennon. 1969. Possible role of carbohydrate-induced calciuria in calcium oxalate kidney-stone formation. N Engl J Med 280: 232-237.

6.Horowitz, B. J., Edelstein, S. and Lippman, L., Sugar Chromatography Studies in Recurrent Candida vulvovaginitis, J. Reproduct. Med., 1984; 29:441-443.

7.Rossi, Fannelli, F. et. Al. Journal Parenteral and Enteral Nutrition, vol. 15, p. 680, 1991.

8.Horribin, DF, Medical Hypotheses, vol. 11, no. 3, p. 319, 1983.

9.Dr. Harold Loe, retired Director of the National Institute of Dental Research, interview published in Dental Products Report, 1993.

10.Dr. Weston Price, Nutrition and Physical Degeneration.

11.Aspartame Consumer Safety Network, P.O. Box 780634 Dallas, TX 75378. (214) 352-4268.

12.Udo Erasmus, Fats that Heal Fats that Kill, p. 76.

13.Mella, C.M., Margolles, E. and Loew, F.M., Epinephrine Induced Hyperglycemia in Bulls and its Relationship to Polioencephalomalacia. Can. J. comp. Med. Vol 39, July 1975, pp. 321-3.

10 Comments

  • June 24, 2008 - 9:44 am | Permalink

    WOW! – This article by far is the best explanation I’ve ever read on sugar and its effects on the body. Thanks for pointing out the Artificial sweetner issue. It does not seem to help me loose any weight either.

    My question is: Even when I am full after a meal, I still crave sweets. What can I do to reduce the need for chocolate cake or anything sweet?

    Thank You Doc

    Ben Hanania

  • June 27, 2008 - 8:41 pm | Permalink

    Ben, thanks for your comments. Craving sweets is unfortunately a common problem. Most people just need to eliminate all refined sweets for about 2 weeks and the cravings will go away (until you eat that one more sweet-then in all comes back). The only healthy sweet that any of us should eat is fruits. The fruits seem to taste sweeter to us as we stay away from sugar. There are harmful sweeteners—the most common being aspartame (Nutrasweet) and Splenda. Healthy sweeteners include stevia and xylitol, although they still trigger sweet cravings. Again, the only sweet things that we should ingest are fruits. However, if that’s not an option for you, the best time to eat a small piece of cake or other dessert is right AFTER eating a healthy, balanced meal. Keep your portions small, try to get by with just a bite or two, and see if you can work your way down to eating just the healthy stuff.

  • July 2, 2008 - 11:57 am | Permalink

    Thank You Doc,

    I have taken your advice and bought a bunch of fruit the other day to replace my chocolate fix. I hope I can go 2 weeks. I really need to cut the bad stuff from my diet. I will report back on my progress.

    Thanks again

    Ben

  • Jay Goldthwaite
    July 2, 2008 - 6:36 pm | Permalink

    Another great article that truly educates with a foundation of truth. Thanks! I would also like to see the author go into depth about allergies – particularly allergies in nuts and grains. They are whole foods, and yet more and more people have adverse results from even small amounts of them. Since some people are obviously allergic to them, perhaps many others are mildly allergic and don’t know it. If so, I wonder what diet might be recommended to find out? That would be interesting.

  • LHarper
    July 3, 2008 - 11:18 am | Permalink

    Dr. Gardner,
    What do you think about limiting carbohydrates to treat diabetes? I have type 2 and have been able for years to use diet controlled with full grains until now and am on a low dose of medication. I’ve researched and read about lowering carb intact and I am amazed how it has worked for me to use that for even better blood sugar controls of 90-110 throughout the day with only 1/4 of my medications. I still have some dawn phenomena that prevents me from getting of medication totally.

  • Dr. Stan Gardner
    July 3, 2008 - 6:08 pm | Permalink

    Ben, glad you’re on the right track! Keep it up-

    Jay, I’ll be talking about allergies, including nuts and grains, shortly. Please keep checking back.

  • KWoodward
    July 4, 2008 - 6:43 pm | Permalink

    Dr. Gardner,
    I have Primary Biliary Cirrhosis and everything you have said in this article makes so much sense. I know that if I cut out the sugar in my diet I wouldn’t itch nearly as much and I would be so much healthier. This is a wake up call for me. thank you.

  • July 8, 2008 - 3:02 pm | Permalink

    Dr Gardner,

    What can I replace splenda with – I only use it with tea or coffee. What’s the healthier alternative?

    Thanks

    Ben

  • July 11, 2008 - 8:15 am | Permalink

    Ben, Splenda can be replaced with stevia or xylitol. Anything that the rest of you have found that have worked? Dr. Gardner

  • Lewis Hall
    July 13, 2008 - 12:32 pm | Permalink

    What about honey in place of sugar?

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