This Is What We’re Up Against … Scholastic Version

My wife recently tore a page out of Scholastic Parent & Child magazine and left it on my desk. As I sipped my morning coffee, I read a headline — Is Sugar to Blame? — with the subtitle There are many misconceptions about type 2 diabetes.  Below that was a brief article in Myth vs. Truth format.

You already know what’s coming, don’t you? That’s right:  an article exonerating sugar, along with other nonsense. Look at these three Myth-Truth entries and ask yourself if perhaps they should’ve caused some cognitive dissonance in the writer’s brain:

Myth:  Type 2 diabetes only affects adults.
Truth:  The disease used to be called adult-onset diabetes because it mainly occurred in people over 40. Not anymore. In the past two decades, the number of children and adolescents diagnosed has been rising steadily.

Myth:  It’s caused by eating too much sugar.
Truth:  A combination of genetics and lifestyle factors cause type 2 diabetes. But many sugary foods can lead to being overweight, which increases risk.

Myth:  Only overweight people develop type 2 diabetes.
Truth:  People of normal weight can develop the disease.

So let’s see if we can follow the logic here:  This disease used to pretty much only show up in people over 40.  Now it’s rising rapidly among kids.  But it’s not caused by eating too much sugar; it’s caused by genetics and/or being overweight.  And by the way, plenty of people who aren’t overweight also develop the disease.

Conclusion:  Our genetics must’ve undergone one hell of a mutation in the past 20 years. Either that, or some mysterious change in “lifestyle factors” caused a rapid rise in diabetes among teens and adolescents. Perhaps we’ll eventually learn that video games or just-above-the-butt tattoos are to blame. Trouble is, I can’t imagine the biological mechanism by which either of those would cause diabetes, and I’m pretty sure the people running the genome project would’ve noticed a sudden genetic mutation.

So I believe if our brains are functioning, we’re stuck looking for an alternate conclusion.  Here’s mine:  whoever wrote this garbage for Scholastic Parent & Child doesn’t have a flippin’ clue.

Correlation doesn’t prove causation, but I sincerely doubt the fact that type 2 diabetes has risen right along with our consumption of high-fructose corn syrup is a mere coincidence.  (Oh, excuse me … it’s “corn sugar” now, not high-fructose corn syrup.)  And in this case, we can definitely imagine the biological mechanism that leads to diabetes. For that, we’ll turn to a paper co-authored by Dr. Richard Johnson. (See his speech on fructose and uric acid in this post.)  Here are a few quotes from the opening of the paper:

We propose that excessive fructose intake (>50 g/d) may be one of the underlying etiologies of metabolic syndrome and type 2 diabetes. The primary sources of fructose are sugar (sucrose) and high fructose corn syrup. First, fructose intake correlates closely with the rate of diabetes worldwide. Second, unlike other sugars, the ingestion of excessive fructose induces features of metabolic syndrome in both laboratory animals and humans.

Beginning with studies in the 1950s, it was recognized that diets high in sucrose can rapidly induce features of metabolic syndrome in rats, including hyperglycemia, insulin resistance, hyperlipidemia, hypertension, weight gain, and hyperuricemia. Further studies documented that these metabolic changes were due to the fructose content.

Later in the paper, Johnson and his co-authors present details on the biochemistry involved.  Don’t worry about wrapping your brain around all this stuff; the point is that they’re citing clinical evidence and chemistry, not simply blaming unspecified “lifestyle factors.”

Moreover, there is evidence that fructose-induced insulin resistance is mediated by fructose-induced hyperuricemia. Lowering uric acid using either xanthine oxidase inhibitors or uricosuric agents can prevent the development of metabolic syndrome induced by fructose. At least two mechanisms may account for these findings. First, it is known that insulin-mediated endothelial nitric oxide (NO) release can account for one third of insulin’s action possibly by increasing blood flow to skeletal muscle and peripheral tissues and enhancing glucose uptake. Mice incapable of generating endothelial NO develop full features of metabolic syndrome. Uric acid inhibits endothelial NO in cell culture and in the animal, and the mechanisms involve uric acid-induced oxidant production, C-reactive protein production, stimulation of arginase, and direct scavenging. Asymptomatic hyperuricemia in humans is also associated with endothelial dysfunction, and lowering uric acid with allopurinol improves endothelial function in diabetics. The second proposed mechanism is by a direct effect of uric acid on the adipocyte. There is evidence that insulin resistance is mediated in part by inflammation and oxidative stress within the adipocyte. Sautin et al. have recently shown that uric acid induces this phenotype in cultured adipocytes. In addition, Cheung et al. reported that xanthine oxidoreductase knockout mice fail to become fat due to a defect in adipogenesis. These studies therefore implicate xanthine oxidase and uric acid in metabolic syndrome.

Bottom line:  there’s strong evidence that excess fructose causes the body to produce excess uric acid, whicn in turn induces insulin resistance, among other horrors.

With all the research out there, Scholastic Parent & Child tells parents not to blame sugar (and HFCS) for the rise in childhood diabetes?  You’ve got to be kidding me.

My first thought was that they must’ve gotten their talking points from that creepy lady at the Corn Refiners Association.  Then I noticed the sources listed at the end of the article:  The American Diabetes Association the National Diabetes Education Program.

Well, of course … we’re talking about the same people who explain in their literature how carbohydrates rapidly turn into blood sugar, then tell diabetics to be sure to eat lots of carbohydrates.

The article also suggested that parents who are worried about diabetes should visit diabetes.com for more information. So I did. Here are a few gems from that site:

When you have type 2 diabetes, high levels of sugar build up in your blood. This can lead to serious health complications. That’s why controlling your blood sugar is key to managing diabetes.

Ah, very good so far. Of course, you’ll next explain to diabetics how to adopt a diet that will keep their blood sugar low, right?

There’s no such thing as a “diabetic diet.” Still, you may be confused about what to eat. Here’s the low-down on some common misunderstandings about foods:

Carbohydrates. Some meal plans want you to count grams of carbohydrates (sugar and starch). Your dietitian can help you learn to count carbohydrates.

Sugar. Most experts say small amounts of sugar are fine, as long as they are part of your meal plan.

Oh, I see … if you’re a diabetic and plan to eat sugar, it’s fine. Your body says to itself, “Well, looky here … this sugar was listed right there on the day’s schedule, so I won’t bother dumping it into the bloodstream. I only do that with sugar I didn’t expect.”

Healthy eating, along with medicine if prescribed and regular physical activity, can help lower your blood sugar. Eating healthy is key to reducing your risk of health complications from diabetes.

Changing the way you eat can be hard. So make changes slowly. Start by adding high-fiber foods including fruits and vegetables. These fiber-rich foods may help stop spikes in blood sugar. Eat less meat and fewer sweets.

Meat is bad (no explanation as to why), sweets are bad (unless you plan on eating them), but other foods that jack up your blood sugar are great:   In other sections, the diabetes.com site recommends six servings per day of low-fat breads, beans, crackers, tortillas or pretzels, plus two to four servings of fruit — those would be providing you with fructose, of course. 

So there you have it.  Sugar doesn’t cause diabetes, and if you develop diabetes, you should base your diet on foods that jack up your blood sugar … but be sure to check your blood-sugar level, and if it goes too high, see your doctor.  So say the experts at diabetes.com, the American Diabetes Association, and Scholastic Parent & Child magazine.

This is what we’re up against.  I feel sorry for well-intentioned parents who believe this nonsense.