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Metabolic Inflammation: What is it?

Important Points:

  • Insulin resistance
  • Sugar
  • Type 2 Diabetes
  • Glucose

Metabolic Inflammation: What is it?

The modern diet contains a large amount of simple sugars. From bread, to donuts, to carbonated drinks, to chocolate, cookies and candy, everywhere you look, temptation abounds. The potential impact on health of diets rich in free sugars, particularly fructose, is of major concern. Does the sugar we take in have an impact on insulin resistance and obesity?

Sugar and Insulin resistance

Sugar has a bittersweet reputation when it comes to health. It occurs naturally in all foods that contain carbohydrates, such as fruits and vegetables, grains, and dairy. Consuming whole foods that contain natural sugar is safe. Plant foods also have high amounts of fiber, essential minerals, and antioxidants, and dairy foods contain protein and calcium.

Where does the problem with sugar come? – Added sugar, which is usually extracted or synthesized.

There is plenty of evidence to suggest that consuming too much sugar can have a negative effect on our metabolic health. Regular sugar consumption produces a constant release of the hormone insulin. Over a period of time, excess insulin can lead to serious problems, such as the synthesis of triglycerides, insulin resistance, fatty liver disease, type II diabetes, an increase in very low-density lipoprotein (the bad kind of cholesterol), and the accumulation of fat on all tissues.

Added sugar intake may contribute to and certainly does exacerbate insulin resistance. Added sugars cater to particularly energy-hungry but metabolically inefficient cells, including senescent cells, cancerous cells, and even quickly proliferating pathogenic bacteria in the gut.

There are several genetic and lifestyle factors that can contribute to how likely you are to develop insulin resistance. But even if you have a genetic risk, you can help yourself with regular exercise, a balanced diet, avoidance of added dietary sugars, healthy sleep patterns, and stress reduction activities.

 Risk factors for insulin resistance and prediabetes include:

  • Obesity
  • Aging
  • Physical inactivity
  • High cholesterol
  • High blood pressure
  • Sleep disorders or circadian rhythm disruption

It is said that one in three Americans—including half of those age 60 and older— have insulin resistance.

What exactly is Insulin Resistance?

Insulin resistance is when cells in your muscles, body fat, and liver start resisting or ignoring the signal of the hormone insulin when it signals to grab glucose out of the bloodstream and put it into our cells. Glucose, also known as blood sugar, is the body’s main source of fuel. We get glucose from grains, fruit, vegetables, dairy products, and drinks that bring break down into carbohydrates.

How does Insulin Resistance develop?

While genetics, aging, and ethnicity play roles in developing insulin sensitivity, the driving forces behind insulin resistance include excess body weight, too much belly fat, a lack of exercise, smoking, and even not getting enough sleep.

As insulin resistance develops, your body fights back by producing more insulin. Over months and years, the beta cells in your pancreas that are working so hard to make insulin get worn out and can no longer keep pace with the demand for more and more insulin. Then – years after insulin resistance silently began – your blood sugar may begin to rise and you may develop prediabetes or type 2 diabetes. You may also develop non-alcoholic fatty liver disease (NAFLD), a growing problem associated with insulin resistance that boosts your risk for liver damage and heart disease. 

What are the Signs and Symptoms of Insulin Resistance?

Insulin resistance can be triggered by a combination of factors linked to weight, age, and genetics, being sedentary, and smoking.

– Polycystic ovary syndrome (PCOS): Insulin resistance can worsen the symptoms of PCOS, which can include irregular menstrual cycles, infertility, and periods that cause pain.

A large waist. Experts say the best way to tell whether you’re at risk for insulin resistance involves a tape measure and moment of truth in front of the bathroom mirror. A waist that measures 35 inches or more for women, 40 or more for men (31.5 inches for women and 35.5 inches for men if you’re of Southeast Asian, Chinese or Japanese descent)increases the odds of insulin resistance and metabolic syndrome, a condition linked to insulin resistance.

Additional signs of metabolic syndrome. According to the National Institutes of Health, in addition to a large waist, if you have three or more of the following, you likely have metabolic syndrome, which creates insulin resistance.

  • High triglycerides. Levels of 150 or higher, or taking medication to treat high levels of these blood fats. 
  • Low HDLs. Low-density lipoprotein levels below 50 for women and 40 for men – or taking medication to raise low high-density lipoprotein (HDL) levels.   
  • High blood pressure. Readings of 130/85 mmHg or higher, or taking medication to control high blood pressure
  • High blood sugar. Levels of 100-125 mg/dl (the prediabetes range) or over 125 (diabetes).
  • High fasting blood sugar (or you’re on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.

Acanthosis nigricans: This skin condition can develop in people with insulin resistance. It involves dark patches forming on the groin, armpits, and the back of the neck.

What health conditions are related to Insulin Resistance?

The most common health condition related to Insulin Resistance is prediabetes and the resultant Type 2 Diabetes. Insulin resistance also doubles your risk for heart attack and stroke and triples the odds that your heart attack or ‘brain attack’ will be deadly.
Insulin resistance and metabolic syndrome are also linked with higher risk for cancers of the bladder, breast, colon, cervix, pancreas, prostate, and uterus.This is because the high insulin levels early in insulin resistance seem to fuel the growth of tumors and to suppress the body’s ability to protect itself by killing off malignant cells.

Furthermore, research has found a strong association between insulin resistance and memory function decline, increasing the risk for Alzheimer’s disease.

Can you prevent or reverse insulin resistance?

The good news is that yes, insulin resistance can be prevented and also reversed in some cases. Here is what you can do:

  • Get recommended amounts of physical activity and structured exercise
  • Get adequate sleep
  • eat when the sun is up (we are more insulin resistant at night and after a night of poor sleep, due to disrupted circadian rhythms that help regulate our metabolic state)
  • Reduce stress and therefore stress-related inflammation
  • Maintain a healthy weight
  • Increase your plant fiber intake.

All the above can help improve your insulin sensitivity. It has been shown that combining changes to both diet and exercise has the most impact on insulin sensitivity.

In a fascinating University of New Mexico School of Medicine study, published in the International Journal of Obesity, overweight people who lost 10% of their weight through diet plus exercise saw insulin sensitivity improve by an impressive 80%. Those who lost the same amount of weight through diet alone got a 38% increase. And those who simply got more exercise, but didn’t lose much weight, saw almost no shift in their level of insulin resistance.

Intermittent fasting is another way in which you can reverse your insulin resistance. This is because it gives your body a break from insulin and glucose signaling pathways that promote cell proliferation and inflammation, and may help increase your insulin sensitivity.

What therefore is the relationship between sugar and Insulin Resistance?

There is an association between diets high in sugars (predominantly sucrose) and risk of disease, and experimental studies have shown that high intakes of fructose (over 100 g/d) can reduce insulin sensitivity. The mechanisms for such associations or effects have not been convincingly demonstrated.

References:

  1. NCBI (2016): A review of recent evidence relating to sugars, insulin resistance and diabetes. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174139/

  • Endocrineweb (2019): Insulin resistance causes and symptoms. Retrieved from

https://www.endocrineweb.com/conditions/type-2-diabetes/insulin-resistance-causes-symptoms

  • Medical News Today (2019):What to know about insulin resistance. Retrieved from

https://www.medicalnewstoday.com/articles/305567.php

  • The Sugar Movement (2016): Sugar vs Fat. Retrieved from

https://thatsugarmovement.com/sugar-vs-fat/

  • Harvard Health Publishing (2017):The sweet danger of sugar. Retrieved from

https://www.health.harvard.edu/heart-health/the-sweet-danger-of-sugar

  • NCBI (2014): Weight Loss, Exercise, or Both and Cardiometabolic Risk Factors in Obese Older Adults: Results of a Randomized Controlled Trial

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835728/

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Sugar and cancer: Is there a link?

Important Points:

  • Sugar
  • Glucose
  • Cancer
  • Health risk
  • Nutrition

Sugar and cancer: Is there a link?

  • Sugar is the modern-day diet villain, but does it cause cancer?
  • Does sugar feed cancer cells making them grow more aggressively?
  • How does the sugar we consume through food and drink affect our health, and what can be done about this?

These are just a few questions we try to answer as we take a long hard look at sugar and its relationship with cancer. We hope to bust some myths and share what researchers are studying in the hope of finding new ways to treat people with cancer.

  1. Does sugar cause cancer?

Sugar feeds every cell in your body, but does sugar cause cancer or even help it to grow and spread? It’s true that sugar feeds every cell in our body, even cancer cell. Research shows that eating sugar doesn’t necessarily lead to cancer, but what sugar does to your waistline can lead to cancer.

  • Does sugar cause cancer cells to grow more aggressively?

Taking in too many sugar calories may result in weight gain, and being overweight or obese puts you at a higher risk for cancer and other diseases.  It is likely that overfilled fat cells, possibly occurring from chronic excessive sugar consumption and high insulin levels, produce cancer promoting hormones.  Insulin production itself is triggered by sugar consumption and is a known growth hormone.

  • What is sugar, and why do our bodies need it?

Sugar is the generic name for sweet-tasting, soluble carbohydrates many of which are found in food. Simple sugars include glucose (also known as dextrose), fructose, and galactose. Compound sugars or double sugars are molecules composed of two joined simple sugars, and common examples are sucrose, lactose, and maltose.

“Table sugar” is extracted from sugarcane or sugar beets and then granulated. It’s a compound sugar composed of glucose and fructose and, in the body, is hydrolyzed, or broken down, into these two components.

Glucose

When you search for sugar and cancer on the internet, you will find many warnings that sugar is the “white death” that feeds cancer cells.  The idea that sugar is responsible for kick-starting or fueling a cancer’s growth is an over-simplification of some very complicated biology.

Glucose is a basic fuel that can power every single one of our cells, but is not an essential nutritional nutrient because your body can make all of the sugar it needs without you eating any granulated sugar.

Sugar and cancer?

Cancer cells usually grow very rapidly and multiply at a high rate which takes a lot of energy. This means they need a lot of glucose as fuel. Cancer cells also need other nutrients such as amino acids and fats.

Here’s where the concept that sugar fuels cancer was born: if cancer cells need a lot of glucose, then cutting sugar out of our diet must help to stop cancer cells from growing and multiplying and could even stop it from developing in the first place. Unfortunately, all our healthy cells need glucose too, and there’s no way of telling our bodies to let healthy cells have the glucose they need while keeping it away from the cancer cells.

What then?

Although there’s no evidence that cutting carbohydrates from our diet will help treat cancer, important research has shown that understanding the abnormal ways that cancer cells make energy could lead to new treatments.

A scientist in the 1940s named Otto Warburg noticed that cancer cells use a different chemical process from normal cells to turn glucose into energy. While healthy cells use a series of chemical reactions in small cellular ‘batteries’ called mitochondria, cancer cells bypass their ‘batteries’ to generate energy more rapidly to meet demand. This discovery was named the Warburg Effect.

This shortcut for making energy might be a weakness for some cancers giving researchers an advantage for developing new treatments because:

  • First, it opens up the potential for developing drugs that shut down cancer cells’ energy-making processes without stop healthy cells’ energy making. Researchers are currently testing drugs that work in this way.
  • Second, the abnormal processes in cancer cells can also leave them less able to adapt when faced with a lack of other nutrients like amino acids. These potential vulnerabilities could lead to new treatments also.

As these approaches are still experimental, we don’t know yet if treatments that starve cancer cells are safe or if they work.

Why worry about sugar then?

If cutting out sugar doesn’t help treat cancer, why then do we encourage people to cut down on sugary foods in our diet advice?

There is an indirect link between cancer risk and sugar. Eating more than recommended amounts of sugar over time can cause you to gain weight, and robust scientific evidence shows that being overweight or obese increases the risk of 13 different types of cancer. In fact, obesity is the single biggest preventable cause of cancer after smoking, which we’ve written about many times before.

So, should you avoid sugar?

“Your body’s cells use sugar to keep your vital organs functioning,” says Erma Levy, a research dietitian in Behavioral Science. “But too much daily sugar can cause weight gain, and unhealthy weight gain and a lack of exercise can increase your cancer risks.”

So, how much sugar is safe to eat?  Women should have no more than six teaspoons per day (25 grams), and men should have no more than nine teaspoons per day (36 grams), says the American Heart Association. This equals to about 100 calories for women and 150 for men.

The biggest source of added sugar in the American diet is sugar-sweetened beverages. Other obvious sources include cakes, cookies, pies and ice cream. Some foods, such as pasta sauce, salad dressings, and canned vegetables, have hidden sugars, so it is very important to read food labels.

Your first clue that a product is high in sugar is if the word “sugar” is listed as the first ingredient. Some sugary foods don’t include “sugar” on the ingredient list. It is often disguised under different names, so if you don’t see “sugar” then look for these words:

  • fructose (sugar from fruits)
  • lactose (sugar from milk)
  • sucrose (made from fructose and glucose)
  • maltose (sugar made from grain)
  • glucose (simple sugar)
  • dextrose (form of glucose)

There are ways to moderate your sugar intake without avoiding it altogether:

  • Rein in your sweet tooth:  When eaten in small amounts, sugar can fit into a balanced diet. 
  • Opt for natural sugars:  Natural sugars, like molasses, agave nectar, honey and maple syrup, are packed with antioxidants that protect your body from cancer.
  • Avoid artificial sweeteners:  Some studies done with laboratory animals have found links between artificial sweeteners and cancer.

So, what is the future for the sugar-cancer link?

On the one hand, sugar itself doesn’t cause cancer, but there’s no way (at the moment) of specifically starving cancer cells of glucose without harming healthy cells too. On the other hand, the amount of added sugar people are consuming is alarming because it’s promoting weight gain. Being overweight or obese increases the risk of at least 13 types of cancer. Although throwing sugar out won’t stop cancer in its tracks, we can all reduce our risk of getting cancer by making healthy choices, and lowering the amount of added sugar in our diets is a good way to help maintain a healthy body weight.

Since sugar is not an essential nutrient, at the very least one should avoid consumption of all refined sugars which have essentially no nutritional value.

References:

  1. MD Anderson Cancer Centre (2019): Does sugar cause cancer? Retrieved from

https://www.mdanderson.org/publications/focused-on-health/FOH-cancer-love-sugar.h14-1589835.html

  • Web MD: Cancer and Sugar: Is There a Link? Retrieved from

https://www.webmd.com/cancer/features/cancer-sugar-link#1

  • Cancer Research UK (2017): Sugar and cancer – what you need to know. Retrieved from
https://scienceblog.cancerresearchuk.org/2017/05/15/sugar-and-cancer-what-you-need-to-know/
  • Wikipedia : Sugar. Retrieved from

https://en.wikipedia.org/wiki/Sugar