Sugar Promotes Heart Disease and Cancer

Sugar (Photo credit: oskay)

By Dr. Mercola

More than 1,660,290 new cancer cases are projected to be diagnosed in the US this year, and an estimated 580,350 Americans will die from the disease.1Another 600,000 Americans die of heart disease each year.2 At present, heart disease is the leading cause of death among both sexes.

Despite massive technological advances over the past half-century, Western medicine is still at a loss for how to rein in the prevalence of these top two killers.

It’s become increasingly clear that many of the conventional strategies, from diagnosis to treatment, are riddled with flawed assumptions and approaches that, in many cases, do more harm than good.

What’s worse, virtually none of the conventional strategies actually address the root cause of the problem, a flawed diet high in sugars and processed foods.

In fact, conventional dietary recommendations for the prevention of heart diseaseare diametrically opposed to what you actually need for optimal heart health! For over 60 years, saturated fats have been blamed for heart disease, resulting in the promulgation of a dangerous low-fat, high-sugar diet.

In reality, a diet that promotes health is high in healthful fats and very, very low in sugar and non-vegetable carbohydrates... Research coming out of some of America’s most respected institutions now confirms that sugar is a primary dietary factor driving chronic disease development.

Sugar, and fructose in particular, has been implicated as a culprit in the development of both heart disease and cancer, and having this information putsyou in the driver’s seat when it comes to prevention.

How Much Sugar Is in Your Diet?

Ever since I started this Web site back in 1997, I’ve been warning about the dangers of high sugar consumption. It’s important to realize that even if you don’tadd sugar to your foods, hidden sugar, typically in the form of high fructose corn syrup (HFCS), is in virtually all processed foods, from yogurts and sauces to breads and sodas.

Many favorite staples are also grain-based, such as bagels, pancakes, and breakfast cereals. All those grains are also quickly turned into sugar in your body, adding to your sugar burden.

Clinical trials have shown that those who consume HFCS tend to develop higher risk factors for cardiovascular disease within as little as two weeks, so if I had to pick out the worst culprit among sugars, it would be fructose.

Other studies indicate that if you limit your sugar, no matter what form you get it in, you effectively decrease your chances of developing cancer—including breast and colon cancers.

Soda Drinkers Have Increased Cancer Risk

According to recent research,3, 4 older women who drink a lot of soda or other sugary beverages may be at significantly increased risk for endometrial cancer—an estrogen-dependent type of cancer that affects the lining of a woman’s uterus.

The study included data for more than 23,000 postmenopausal women who were followed for 14 years.

Women who had the highest intake of sugary beverages had a whopping 78 percent higher risk for endometrial cancer, and the risk appeared to be dose dependent; rising right along with consumption. Study author Maki Inoue-Choi was not surprised by the results, and neither am I.

“Other studies have shown increasing consumption of sugar-sweetened beverages has paralleled the increase in obesity. Obese women tend to have higher levels of estrogens and insulin than women of normal weight, [and] increased levels of estrogens and insulin are established risk factors for endometrial cancer,” she said.5

Previous research has also shown that dietary fructose can promote cancergrowth in a number of different ways, including:

• Altered cellular metabolism
• Increased reactive oxygen species (free radicals)
• DNA damage
• Inflammation

Fructose Promotes Cancer Cell Proliferation

Studies have shown that different sugars are metabolized using different metabolic pathways, and this is of MAJOR consequence when it comes to feeding cancer and making it proliferate. Three years ago, researchers published findings showing that fructose is readily used by cancer cells to increase their proliferation.6 Cancer cells did not respond to glucose in the same manner.

In this case, the cancer cells used were pancreatic cancer, which is typically regarded as the most deadly and universally rapid-killing form of cancer. According to the authors:

“Traditionally, glucose and fructose have been considered as interchangeable monosaccharide substrates that are similarly metabolized, and little attention has been given to sugars other than glucose. However, fructose intake has increased dramatically in recent decades and cellular uptake of glucose and fructose uses distinct transporters.

Here, we report that fructose provides an alternative substrate to induce pancreatic cancer cell proliferation. Importantly, fructose and glucose metabolism are quite different; in comparison with glucose, fructose... is preferentially metabolized via the nonoxidative pentose phosphate pathway to synthesize nucleic acids and increase uric acid production.

These findings show that cancer cells can readily metabolize fructose to increase proliferation. They have major significance for cancer patients given dietary refined fructose consumption, and indicate that efforts to reduce refined fructose intake or inhibit fructose-mediated actions may disrupt cancer growth.” [Emphasis mine]

The study confirms the old adage that sugar feeds cancer because they found that tumor cells do thrive on sugar (glucose). However, the cells used fructose for cell division, speeding up the growth and spread of the cancer. This difference is clearly of major consequence, and should be carefully considered by anyone who is currently undergoing cancer treatment or seeking to prevent cancer.

This does not mean you should avoid fruits, the benefits of most fruits outweigh any concerns to fructose.   I would suggest to not juice your fruits and to eat them whole, and also realize we have bred many of these fruits to a very high level of fructose.   Fruits today are many times sweeter than they were historically, and should be consumed in moderation.

The real problem is the high fructose corn syrup that is added to practically every processed food and drink you see.

Remember: Exercise Is Another Potent Ally Against Cancer and Heart Disease

Controlling your blood-glucose and insulin levels—through diet, along with a comprehensive exercise program—can be one of the most crucial components to a cancer recovery program. These factors are also crucial in order to prevent cancer in the first place. Diet and exercise—particularly high intensity interval training—are also the dynamic duo that will help you stave off heart disease.

In fact, a recent meta-analysis that reviewed 305 randomized controlled trials found no statistically detectable differences between exercise and medications for heart disease, including statins and beta blockers. (Previous research has also shown that exercise alone can reduce your risk of cardiovascular disease by a factor of three,7 which isn’t too shabby.) Exercise is in fact so potent, the researchers suggested that drug companies ought to be required to include it for comparison when conducting clinical trials for new drugs. As reported by Bloomberg:8

“The analysis adds to evidence showing the benefit of non-medical approaches to disease through behavior and lifestyle changes... ‘In cases where drug options provide only modest benefit, patients deserve to understand the relative impact that physical activity might have on their condition,’ Naci and Ioannidis said in the published paper. In the meantime, 'exercise interventions should therefore be considered as a viable alternative to, or, alongside, drug therapy.'”

In a nutshell, being a healthy weight and exercising regularly creates a healthy feedback loop that optimizes and helps maintain insulin and leptin receptor sensitivity. And, as I’ve mentioned before, insulin and leptin resistance—primarily driven by excessive consumption of refined sugar and grains along with lack of exercise—are the underlying factors of nearly all chronic disease.

Connecting the Dots: Fructose—Uric Acid—Cancer and Chronic Disease Risk

The theory that sugar feeds cancer was actually born nearly 80 years ago. Shockingly, most conventional cancer programs STILL do not adequately address diet and the need to avoid sugars. The 1931 Nobel laureate in medicine, German Otto Warburg, Ph.D., first discovered that cancer cells have a fundamentally different energy metabolism compared to healthy cells. Malignant tumors tend to use a process where glucose is used as a fuel by the cancer cells, creating lactic acid as a byproduct.9

The large amount of lactic acid produced by this fermentation of glucose from cancer cells is then transported to your liver. This conversion of glucose to lactic acid generates a lower, more acidic pH in cancerous tissues as well as overall physical fatigue from lactic acid buildup.10, 11

This is a very inefficient pathway for energy metabolism, which extracts only about five percent of the available energy in your food supply. In simplistic terms, the cancer is "wasting" energy, which leads you to become both tired and undernourished, and as the vicious cycle continues, will lead to the body wasting so many cancer patients experience. Additionally, carbohydrates from glucose and sucrose significantly decrease the capacity of neutrophils to do their job. Neutrophils are a type of white blood cell that helps cells to envelop and destroy invaders, such as cancer.

While all forms of sugar are detrimental to health in general and promote cancer, but in slightly different ways and to a different extent, fructose clearly seems to be one of the overall most harmful. As mentioned above, fructose metabolism leads to increased uric acid production along with cancer cell proliferation.12 Again, ONLY fructose (not glucose) drives up your uric acidlevels.

Now, the connection between fructose, uric acid, and insulin resistance is so clear that your uric acid level can actually be used as a marker for toxicity from fructose. What this means is that if your uric acid levels are high, you’re at increased risk of all the health hazards associated with fructose consumption—including both heart disease and cancer. Subsequently, you’d be well advised to reduce your fructose intake. For more information about this, please see my previous interview with Dr. Richard Johnson, who is an expert on this topic. Two key recommendations however are:

• Keep your uric acid level below 4 mg/dl for men and 3.5 mg/dl for women, and
• As a standard recommendation, I strongly advise keeping your TOTAL fructose consumption below 25 grams per day

Reeling in Your Fructose Consumption May Be the Most Important Lifestyle Change You Can Make

Dr. Johnson has written one of the best books on the market on the health dangers of fructose, called The Sugar Fix, which explains how fructose causes high blood pressure, heart disease, obesity, diabetes, and kidney disease. It’s also safe to say that many cancers are also on the list of diseases that are directly linked to excessive fructose consumption. In addition to the studies already mentioned, fructose has also been found to promote metastasis in breast cancer,13 and shows genotoxic effects on the colon in animal research.14

Fructose also promotes a condition called intracranial atherosclerosis15—a narrowing and hardening of the arteries in your skull—and contrary to popular belief, it is the sugar/fructose in your diet that increases your risk for heart disease, NOT saturated animal fats.

At the basic dietary level, the prevention strategies for heart disease and cancer are identical. First and foremost, you need to address your insulin and leptin resistance, which is the result of eating a diet too high in sugars and grains—again, not fat, with the exception of trans fats from partially hydrogenated vegetable oils, which have been linked to increased heart disease risk, even in small amounts. To safely and effectively reverse insulin and leptin resistance, you need to:

• Avoid sugar, processed fructose, grains if you are insulin and leptin resistant, and processed foods
• Eat a healthful diet of whole foods, ideally organic, and replace the grain carbs with:
• Large amounts of vegetables
• Low-to-moderate amount of high-quality protein (think organically raised, pastured animals)
• As much high-quality healthful fat as you want (saturated and monosaturated from animal and tropical oil sources). Most people actually need upwards of 50-85 percent fats in their diet for optimal health—a far cry from the 10 percent currently recommended.

Restricting Fructose Consumption Is Crucial Part of a Healthy Lifestyle

Whether we’re talking about heart disease or cancer, reducing (or preferably eliminating) fructose and other added sugars, as well as limiting grain carbohydrates from your diet is a primary strategy on my list if you have insulin and leptin resistance. This dietary modification should also be part of your comprehensive treatment plan if you’ve been diagnosed with either cancer or heart disease.

Understand that excessive fructose consumption leads to insulin resistance, and insulin resistance appears to be the root of many if not most chronic disease, including heart disease and cancer. So far, scientific studies have linked excessive fructose consumption to about 78 different diseases and health problems.16

By severely reducing your intake of fructose and carbs in your diet, you help stave off any potential cancer growth, and “starve” any tumors you currently have. It also bolsters your overall immune function, because sugar decreases the function of your immune system almost immediately.

Related articles

• Sugar Promotes Heart Disease and Cancer
• Our Efforts to Prevent Heart Disease
• Saturated Fat NOT the Cause of Heart Disease
• FDA Sued, Forced to Remove Safety Status on Trans Fats
• New Cholesterol Treatment Guidelines Could Double the Number of People on Dangerous Statins
• The Hippocrates Health Institute Demonstrates How Food Can Be Used as Medicine

Dangers of Sugar Substitutes

 Cyclamate packets, Sugar substitute (Photo credit: Wikipedia)

By Dr. Mercola

With all the dire health effects associated with refined sugar and high fructose corn syrup (HFCS), many wonder what, if anything, is actually safe to use to sweeten your foods and beverages.

It’s certainly a good question. You do have to be cautious when choosing an alternative, as many sweeteners that are widely regarded as "healthy" are, in reality, anything but. A previous National Geographic article1 set out to compare eight different sugar substitutes, which fall into four general categories:

• Artificial sweeteners
• Sugar alcohols
• Natural sweeteners
• Dietary supplements

Sadly lacking from their review are any notations about adverse health effects of many of the sugar substitutes tested.

Despite copious scientific evidence of harm, artificial sweeteners, for example, are promoted in the featured article, and by “experts” in general, as safe because they “pass through your body undigested.” Needless to say, safety concerns will be front and center in this article.

The Case Against Artificial Sweeteners

Sweetener lesson 101: Avoid artificial sweeteners like the plague. While the mechanisms of harm may differ, they’re all harmful in one way or another. This includes aspartame (NutraSweet, Equal), sucralose (Splenda), saccharin(Sweet'N Low), acesulfame potassium, neotame, and others.

Twenty years ago I wasn’t sure, but now there's little doubt in my mind  that artificial sweeteners can be far worse for you than sugar and fructose, and there is plenty of scientific evidence to back up that conclusion. In fact, there’s enough evidence showing the dangers of consuming artificial sweeteners to fill an entire book -- which is exactly why I wrote Sweet Deception.

Aspartame is perhaps the most dangerous of the bunch. At least it’s one of the most widely used and has the most reports of adverse effects. There are also hundreds of scientific studies demonstrating its harmful effects.

This is why it’s so frustrating to see big companies like Coca-Cola Company purposely deceive you on this issue, which is exactly what they’re currently doing with their “public service” announcement-type ads, in which they “affirm” aspartame’s safety and benefits.

Center for Science in the Public Interest’s (CSPI) Executive Director Michael F. Jacobson issued the following statement in response to Coca-Cola’s new ad:2

“Aspartame has been found to cause cancer3—leukemia, lymphoma, and other tumors—in laboratory animals, and it shouldn’t be in the food supply. We certainly want Coca-Cola to shift its product mix toward lower- and no-calorie drinks, but aspartame’s reputation isn’t worth rehabilitating with this propaganda campaign.

The company would be better off phasing out its use of aspartame and accelerating its research into safer, natural sweeteners such as those extracted from the stevia plant.”

Don’t Fall for Coca-Cola’s Deceptive “Public Announcement” Ads

Besides pulling the wool over your eyes with regards to the lack of overall safety of aspartame, I think the FTC would be warranted to sue Coke and the other diet soda manufacturers for fraudulent advertising, seeing how:

1. There’s no scientific evidence showing that the use of diet sodas actually lead to weight loss.
On the contrary, studies have repeatedly shown that artificial sweeteners cause greater weight gain than regular sugar.4 Studies have also repeatedly linked artificial sweeteners with increased hunger. For example, one study published in the journal Physiology & Behavior in 19885 found that intense (no- or low-calorie) sweeteners can produce significant changes in appetite. Of the three sweeteners tested, aspartame produced the most pronounced effects.
2. Scientific evidence shows that aspartame actually worsens insulin sensitivityto a greater degree than sugar.
This is quite the blow for diabetics who obediently follow the recommendation to switch to diet sodas to manage their condition. Unfortunately, in large part due to misleading and deceptive advertising, many doctors and registered nutritionists are still under the illusion that artificial sweeteners are a safe and effective alternative for their diabetic patients.

Artificial sweeteners also appear to cause many of the same health effects associated with high sugar consumption.  Most recently, a report published in the journal Trends in Endocrinology & Metabolism6 highlighted the fact that diet soda drinkers suffer the same exact health problems as those who opt for regular soda, including excessive weight gain, type 2 diabetes, cardiovascular disease andstroke.7, 8 According to the authors:

“This paper... considers the hypothesis that consuming sweet-tasting but noncaloric or reduced-calorie food and beverages interferes with learned responses that normally contribute to glucose and energy homeostasis. Because of this interference, frequent consumption of high-intensity sweeteners may have the counterintuitive effect of inducing metabolic derangements.”

So the very reason anyone would consider using diet instead of sugared sweeteners has no basis in fact. Anyone using them would get the same problems as using regular sugar and expose themselves to the well documented risks of artificial sweeteners.

Be Critical of “All Natural” Sweetener Claims

With artificial sweeteners are out of the picture, let’s look at some all-natural sweeteners. Natural sweeteners such as honey and agave may seem like a healthier choice, but not only are they loaded with fructose, many are also highly processed. In that regard, you’re not gaining a thing. The health effects will be the same, since it’s the fructose that causes the harm.

Agave syrup can even be considered worse than HFCS because it has a higher fructose content than any commercial sweetener, ranging from 70 to 97 percent depending on the brand. HFCS, in comparison, averages 55 percent fructose. What’s worse, most agave "nectar" or agave "syrup" is nothing more than a laboratory-generated super-condensed fructose syrup, devoid of virtually all nutrient value.

Honey is also high in fructose, averaging around 53 percent, but contrary to agave it is completely natural in its raw form, and has many health benefits when used in moderation. Keep in mind you’re not likely to find high quality raw honey in your local grocery store. Most of the commercial Grade A honey is highly processed and of poor quality. All in all, it’s important to realize thatregardless of the source (be it HFCS, honey or agave), refined fructose:

• Tricks your body into gaining weight by fooling your metabolism, as it turns off your body's appetite-control system. Fructose does not appropriately stimulate insulin, which in turn does not suppress ghrelin (the "hunger hormone") and doesn't stimulate leptin (the "satiety hormone"), which together result in your eating more and developing insulin resistance.
• Activates a key enzyme that causes cells to store fat; this is the so-called “fat switch” revealed in Dr. Richard Johnson’s book by the same name.
• Rapidly leads to weight gain and abdominal obesity ("beer belly"), decreased HDL, increased LDL, elevated triglycerides, elevated blood sugar, and high blood pressure—i.e., classic metabolic syndrome.
• Is broken down in your liver just like alcohol, and produces many of the side effects of chronic alcohol use, including non-alcoholic fatty liver disease (NAFLD). Interestingly enough, research has shown that soft drinks increase your risk of NAFLD independently of metabolic syndrome9.
• Over time leads to insulin resistance, which is not only an underlying factor of type 2 diabetes and heart disease, but also many cancers.

What About Sugar Alcohols?

Sugar alcohols can be identified by the commonality of “ol” at the end of their name, such as xylitol glucitol, sorbitol, maltitol, mannitol, glycerol, and lactitol. They’re not as sweet as sugar, and they do contain fewer calories, but they’re not calorie-free. So don’t get confused by the “sugar-free” label on foods containing these sweeteners. As with all foods, you need to carefully read the food labels for calorie and carbohydrate content, regardless of any claims that the food is sugar-free or low-sugar.

One reason that sugar alcohols provide fewer calories than sugar is because they’re not completely absorbed into your body. Because of this, eating too many foods containing sugar alcohols can lead to abdominal gas and diarrhea. It’s also worth noting that maltitol, a commonly used sugar alcohol, spikes blood sugar almost as much as a starchy new potato. Xylitol, in comparison, does not have a great effect on your blood sugar, so from that perspective may be a better choice.

So, in moderation, some sugar alcohols can be a better choice than highly refined sugar, fructose or artificial sweeteners. Of the various sugar alcohols, xylitol is one of the best. When it is pure, the potential side effects are minimal, and it actually comes with some benefits such as fighting tooth decay. All in all, I would say that xylitol is reasonably safe, and potentially even a mildly beneficial sweetener. (As a side note, xylitol is toxic to dogs and some other animals, so be sure to keep it out of reach of your family pets.)

Three of the Safest Sugar-Alternatives

Two of the best sugar substitutes are from the plant kingdom: Stevia and Lo Han Guo (also spelled Luo Han Kuo). Stevia, a highly sweet herb derived from the leaf of the South American stevia plant, is sold as a supplement. It’s completely safe in its natural form and can be used to sweeten most dishes and drinks.

Keep in mind that the same cannot be said for the sugar substitute Truvia, which makes use of only certain active ingredients and not the entire plant. Rebaudioside A is the agent that provides most of the sweet taste of the plant. Usually it’s thesynergistic effect of all the agents in the plant that provide the overall health effect, which oftentimes includes “built-in protection” against potentially damaging effects, but what the FDA has approved as GRAS (generally recognized as safe) are just a couple of the active ingredients, including rebaudioside A used in Truvia.

In one toxicology review,10 the researchers point out that stevioside compounds and rebaudioside A are metabolized at different rates, making it impossible to assess the risk of rebaudioside A from toxicity assessments of stevioside (which has been used as food and medicine in Japan and South America for decades or longer). Additionally, in a human metabolism study, stevioside and rebaudioside A had different pharmacokinetic results. In layman’s terms, that means that your body reacts differently to the two compounds; each compound is metabolized differently and remains in your body for different lengths of time.

Truvia may turn out to be a very good substitute to sugar, but I’d have to see more details before giving it an enthusiastic thumbs-up – for the same reason the FDA uses as the basis for their refusal to consider Stevia GRAS: there’s just not enough evidence to prove its safety. Lo Han Kuo is another natural sweetener similar to Stevia, but it's a bit more expensive and harder to find. In China, the Lo Han fruit has been used as a sweetener for centuries, and it’s about 200 times sweeter than sugar. It received FDA GRAS status in 2009.

A third alternative is to use pure glucose. You can buy pure glucose (dextrose) for about $5-7 per pound. It is only 70 percent as sweet as sucrose, so you'll end up using a bit more of it for the same amount of sweetness, making it slightly more expensive than regular sugar—but still well worth it for your health as it does not contain any fructose whatsoever. Contrary to fructose, glucose can be used directly by every cell in your body and as such is a far safer sugar alternative.

Consider Dampening Your Sweet-Tooth...

Keep in mind though that if you have insulin issues, high blood pressure, high cholesterol, diabetes, or if you're overweight, you'd be best to avoid all sweeteners, including Stevia, Lo Han and dextrose, since any sweetener can decrease your insulin sensitivity. (Most important of all, remember that this goes for artificial sweeteners too!) If you're having trouble weaning yourself off sweet foods and beverages, try Turbo Tapping. It’s a clever use of the Emotional Freedom Techniques (EFT), specifically designed to resolve many aspects of an addiction in a concentrated period of time.

Tell Coke They're a Joke!

Obesity and related metabolic diseases are serious public health problems in the United States, and you are being sorely misled by companies pretending to have a solution that, in reality, only worsen the problem. I strongly urge you to let the Coca-Cola Company know how you feel by telling them to stop their deceptive marketing of soda products. Especially their fake “public announcement” ads for aspartame.

Join me in taking a stand against false advertising and let your voice be heard. If you’re on twitter, send a tweet to #CokeCEO to let the Coca-Cola Company know you are not happy with their deceptive advertising. If you’re on Facebook, please share your thoughts with them on their Facebook Page. Please also email the Coca-Cola Company to let them know how you feel!

Related articles

• Sugar Substitutes - What's Safe and What's Not
• Sugar Substitutes for Weight Loss: Friend or Foe?
• Why are artificial sweeteners bad for you?
• **ALERT** ASPARTAME Has Been RENAMED & is Now BEING MARKED AS A NATURAL SWEETENER ... WHAT YOU NEED TO KNOW
• The Brutally Honest Coca-Cola Commercial You Haven't Seen
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Lower Risk of Type 2 Diabetes Certain Fruits May Be Linked

Fruit and berries (Photo credit: Wikipedia)

By Dr. Mercola

You’re probably well-familiarized with my controversial stance on fructose. Compelling evidence shows that fructose is, by far, more harmful to your health than other sugars—especially when it’s removed from whole fruits and highly processed and genetically modified, such as high fructose corn syrup (HFCS) found in most processed foods.

I’ve also, as a general rule, warned you of eating too much fruit, as many fruits can be quite high in fructose.

This has caused some confusion and consternation among many readers, as fruit has long been promoted as an important part of a healthy diet. That said, there are considerations to take into account when it comes to fruit consumption—some of which are dependent on your individual and specific circumstances.

I will seek to clarify some of these points here. I believe there’s more than compelling evidence supporting the concept that high-fructose diets are a primary factor that is responsible for most chronic disease; insulin resistance, type 2 diabetes and obesity in those who eat a highly processed food diet..

I’ve long urged those struggling with these health issues, or who have hypertension, heart disease or cancer, to pay extra-careful attention to the fructose content of whole fruit in addition to other sources of fructose. Now, recent research indicates that some fruits may in fact be protective against type 2 diabetes.

Can You Reduce Your Risk of Type 2 Diabetes with Your Fruit Choices?

According to a new analysis of three cohort studies, published in the British Medical Journal,1 whole fruits—particularly blueberries, grapes, prunes and apples—may in fact reduce your risk of type 2 diabetes. Conversely, consumption of fruit juices was associated with greater risk. According to senior author Qi Sun, an assistant professor in the department of nutrition at the Harvard School of Public Health:2

"While fruits are recommended as a measure for diabetes prevention, previous studies have found mixed results for total fruit consumption. Our findings provide novel evidence suggesting that certain fruits may be especially beneficial for lowering diabetes risk."

The researchers analyzed the dietary records of nearly 190,000 people who had participated in three studies from 1984 to 2008. None of the participants were diagnosed with diabetes, cardiovascular disease or cancer at the outset of the studies.

They found that those who ate blueberries, grapes and apples at least twice a week were up to 23 percent less likely to develop type 2 diabetes, compared to those who ate these fruits once a month or less.

I find this quite surprising as, grapes and apples are particularly high in fructose (as you can see in the chart below). It’s unclear why the authors observed this benefit here but it’s likely that the phytonutrients found in the apples and grapes are more than compensate for any potential fructose toxicity.

Antioxidants and other phytonutrients combat inflammation, which is a hallmark of diabetes and most other chronic disease. Similarly, blueberries, which are much lower in fructose, have in other studies also been found to be of benefit for diabetics primarily due to their high antioxidant content.

One antioxidant in particular, called quercetin, could potentially help explain some of the results. Apples for example, while high in fructose, contains this flavonoid, which actually blocks some of the fructose metabolism according to expert Dr. Richard Johnson. If you haven't done so yet, I recommend viewing my "What Are Apples Good For?" information page for a listing of even more benefits of apples.

Red grapes, plums and many different berries, including blueberries. also contain quercetin. I have scheduled an interview with Dr. Johnson, in which we’ll delve into this at greater depth. So keep your eye out for that interview, which should be out before year end, if you want to learn more.

Don’t Be Fooled By Fruit Juices and Smoothies

In comparison, the featured study found that those who drank one or more servings of fruit juice each day had a 21 percent higher risk for type 2 diabetes compared to the others. This is a really important point, and I’ve often highlighted the potential harm of drinking fruit juices.

You’re simply getting FAR too much fructose, not to mention the rarely mentionedmethanol toxicity in any preserved juice. Furthermore, while whole fruits do contain fructose, they’re also rich in fiber, antioxidants, and a vast array of health-promoting phytochemicals.

Fruit juices, especially not pasteurized, commercially-available fruit juices have virtually none of these phytonutrients. The fiber in the whole fruits also plays a large in protecting you from a rapid and exaggerated rise in blood sugar. The fiber slows the rate at which sugar is absorbed into your bloodstream.

This also applies to fruit smoothies, which are often touted as a convenient strategy to boost your fruit and veggie intake. Unfortunately, they too contain excessive amounts of fructose, and perhaps even added sugars on top of that. As reported by the Guardian:3

“In the UK, Coca-Cola owns Innocent Smoothies while PepsiCo has Tropicana. Launching Tropicana smoothies in 2008, Pepsi's sales pitch was that the drink would help the nation to reach its five a day fruit and vegetable target.

"Smoothies are one of the easiest ways to boost daily fruit intake as each 250ml portion contains the equivalent of two fruit portions," it said at the time.

However, Popkin [professor at the department of nutrition at the University of North Carolina] says the five a day advice needs to change. Drink vegetable juice, he says, but not fruit juice. "Think of eating one orange or two and getting filled," he said. "Now think of drinking a smoothie with six oranges and two hours later it does not affect how much you eat.

The entire literature shows that we feel full from drinking beverages like smoothies but it does not affect our overall food intake, whereas eating an orange does. So pulped-up smoothies do nothing good for us but do give us the same amount of sugar as four to six oranges or a large coke. It is deceiving."

Revisiting Fruit Consumption

I recently interviewed Dr. Brian Clement of the Hippocrates Institute, where they teach raw veganism. Interestingly enough, they also strongly advise most people avoid eating fruits. One of the primary reasons for their stand against fruits is because of the hybridization of fruits, which has made them up to 50 times sweeter than their ancient ancestors. Many fruits have been selectively and purposely bred for increased sweetness, which has also resulted in reduced phytochemical content. This hybridization and subsequent deterioration of healthful nutrition in whole foods was highlighted in a New York Times4 article published earlier this summer.

The dramatically increased fructose content of otherwise natural and “wholesome” fruits is the primary problem with high fruit consumption, and this is why I’m leery of very high-fruit diets.

Many of the most beneficial phytonutrients found in fruits actually have a bitter, sour or astringent taste, but to satisfy the palate, farmers have, throughout time, opted to selectively breed the sweetest varieties. Today, the “candification” of food is being taken to a whole new level, and if you’re stuck on the idea that all fruit is good for you, you may end up in a real metabolic pickle... For example, according to a recent report in the Los Angeles Times,5 one fruit breeder has created a type of grape called the Cotton Candy grape, which is absolutely bound to be just as problematic as any other junk food!

“Bite into one of these green globes and the taste triggers the unmistakable sensation of eating a puffy, pink ball of spun sugar,” the article states. “By marrying select traits across thousands of nameless trial grapes, Cain and other breeders have developed patented varieties that pack enough sugar they may as well be Skittles on the vine. That's no accident. "We're competing against candy bars and cookies," said Cain, 62, a former scientist at the US Department of Agriculture who now heads research at privately owned International Fruit Genetics in Bakersfield.”

In light of these issues, let me restate my recommendations on fruit and fructose consumption as simply as possible:

1. If you’re insulin- or leptin resistant (are overweight, diabetic, hypertensive, or have high cholesterol), which includes about 80 percent of Americans, then it would be advisable for you to limit your fruit intake. As a general rule, I recommend limiting your fructose intake to a maximum of 15 grams of fructose per day from ALL sources, including whole fruit.
2. If you are not insulin/leptin resistant, (are normal weight without diabetes, hypertension or high cholesterol) and regularly engage in strenuous physical activity or manual labor, then higher fructose intake is unlikely to cause any health problems. In this case, you can probably eat more fruit without giving it much thought.
3. However if you are in category two above you might benefit from a further refinement. Fruit will still increase your blood sugar and many experts believe this will increase your protein glycosylation. So my approach is to consume the fruit typically after a workout as your body will use the sugar as fuel rather than raise your blood sugar.
4. Additionally ,if you’re an endurance athlete, you can probably get away with eating fairly large amounts of fruits, since your body will use most of the glucose during exercise, so it won’t be stored as fat. (That said, I still believe athletes would be well-advised to consider becoming fat adapted rather than relying on quick sugars. This is outside the scope of this article, however, so for more information, please see this previous article).
5. If you’re still unsure of just how stringent you need to be, get your uric acid levels checked, and use that as a guide. I’ll review this in more detail in the section below.

Using Your Uric Acid Level as a Marker for Fructose Toxicity

I’ve previously interviewed Dr. Richard Johnson about his research into the health dangers of fructose, specifically how fructose causes high blood pressure, obesity, and diabetes, revealed in his excellent book, The Sugar Fix. He’s also the chief of the division of kidney disease and hypertension at the University of Colorado.

Dr. Johnson’s research suggests that your uric acid levels can be effectively used as a marker for fructose toxicity; meaning, an indicator of just how significant of an impact fructose has on your individual body and health. As such, it can help you gauge justhow careful you need to be in your food selections.

According to the latest research in this area, the safest range of uric acid is between 3 and 5.5 milligrams per deciliter (mg/dl), and there appears to be a steady relationship between uric acid levels and blood pressure and cardiovascular risk, even down to the range of 3 to 4 mg/dl. What this means is that if you have a level of 4 mg/dl for men and 3.5 mg/dl for women, you probably are at a very low risk for fructose toxicity and can be more liberal with the fructose limits given above. The higher your uric acid though, the more you need to limit, or even avoid, fructose until your uric acid level normalizes.

Using this biochemical marker, I came to realize that I am particularly sensitive to fructose, and that it’s best for me, personally, to keep my fructose consumption as low as possible. This is most likely due to genetics and would explain why most of my paternal relatives have, or have died from, diabetes. That side of the family is probably particularly sensitive to fructose. Dr. Johnson has developed a program to help people optimize their uric acid levels, and the key step in this program is complete elimination of fructose, until your levels are within the ideal range of 3-5.5 mg/dl.

Helpful Fructose Chart for Common Fruits

Again, most people will need to limit your fructose to 25 grams of fructose per day from all sources, or less, while endurance athletes could have more. The chart below is excerpted from Dr. Johnson’s book, The Sugar Fix, which contains more details on the fructose content of common foods. His latest book, The Fat Switch, also gives further details on HOW fructose impacts your body, contributing to excess weight and chronic health problems.

Fruit Serving Size Grams of Fructose Limes 1 medium 0 Lemons 1 medium 0.6 Cranberries 1 cup 0.7 Passion fruit 1 medium 0.9 Prune 1 medium 1.2 Apricot 1 medium 1.3 Guava 2 medium 2.2 Date (Deglet Noor style) 1 medium 2.6 Cantaloupe 1/8 of med. melon 2.8 Raspberries 1 cup 3.0 Clementine 1 medium 3.4 Kiwifruit 1 medium 3.4 Blackberries 1 cup 3.5 Star fruit 1 medium 3.6 Cherries, sweet 10 3.8 Strawberries 1 cup 3.8 Cherries, sour 1 cup 4.0 Pineapple 1 slice (3.5" x .75") 4.0 Grapefruit, pink or red 1/2 medium 4.3

Fruit	Serving Size	Grams of Fructose
Boysenberries	1 cup	4.6
Tangerine/mandarin orange	1 medium	4.8
Nectarine	1 medium	5.4
Peach	1 medium	5.9
Orange (navel)	1 medium	6.1
Papaya	1/2 medium	6.3
Honeydew	1/8 of med. melon	6.7
Banana	1 medium	7.1
Blueberries	1 cup	7.4
Date (Medjool)	1 medium	7.7
Apple (composite)	1 medium	9.5
Persimmon	1 medium	10.6
Watermelon	1/16 med. melon	11.3
Pear	1 medium	11.8
Raisins	1/4 cup	12.3
Grapes, seedless (green or red)	1 cup	12.4
Mango	1/2 medium	16.2
Apricots, dried	1 cup	16.4
Figs, dried	1 cup	23.0

What About Fruit Juices?

One of the profound highlights revealed in the featured study was the dramatic difference in health outcome between eating whole fruits versus drinking fruit juice. It’s important to realize that fruit juice typically contains very high concentrations of fructose, which will cause your insulin to spike and may counter the benefits of the antioxidants.

Previous studies have already clearly demonstrated that drinking large amounts of fruit juice dramatically increases your risk of obesity. Children are at particular risk here, since so many children are given juice whenever they’re thirsty instead of plain water. For example, research has revealed that 3- and 4-year-olds who carry extra weight and drink just one to two sweet drinks a day double their risk of becoming seriously overweight just one year later.

Furthermore, when buying commercial fruit juice, you need to check the label, as the majority of fruit juices contain high fructose corn syrup and artificial flavors in addition to concentrated fruit juice. That said, even freshly squeezed fruit juice can contain about eight full teaspoons of fructose per eight-ounce glass! So, as a general rule, it’s wise for most to severely restrict your consumption of fruit juice, especially if your uric acid is above the ideals recommended. Also, if you suffer from type 2 diabetes, hypertension, heart disease or cancer, you’d be best off avoiding fruit juices altogether until you’ve normalized your uric acid and insulin levels.

Within Certain Limits, Fruit is OK for Most People

Going back to the issue of genetic variability, it seems that some people may be able to process fructose more efficiently, and the key to assess this susceptibility to fructose damage lies in evaluating your uric acid levels. I believe this is an ideal way for most people to personalize the recommendations on fructose intake.

Aside from that, I believe most will benefit from restricting their fructose to 25 grams a day; and as little as 15 grams a day if you’re diabetic or have chronic health issues. This includes fructose from whole fruits. So I’m not advocating fruit avoidance for everyone; I’m simply placing fruit in the category of a fructose-rich food that needs to be included when you’re calculating your fructose intake.

If you choose low-fructose fruits, such as blueberries, you can eat more of it than if you choose a fruit high in fructose. Other low-fructose fruits include fresh apricots, lemons, limes, passion fruit, plums and raspberries. Also remember that avocado is actually a fruit too. It’s very low in fructose, and high in healthful fat, making it an excellent choice. Endurance athletes and others who engage in strenuous activities and who are neither overweight nor have chronic health issues probably do not need to concern themselves too much with their fruit consumption however.

 http://articles.mercola.com/sites/articles/archive/2013/09/16/fruit-consumption-diabetes.aspx  Link back to original article on Mercola.com visit the site for great information.

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