Don’t Let Them Eat Cake: Bosses Sugar-Shame Office Treats

By Rolfe Winkler   Sept. 17, 2018 10:42 a.m. ET          

           Most mornings, Jamie Glass starts work fueled by a Starbucks  venti mocha, turbocharged with two pumps of toffee-nut syrup. Her lunch is sometimes four chocolate chip cookies.

The 55-year-old marketing consultant loves sugar. Her boss hates it.

Cody Broderick, 38, would like Ms. Glass and the rest of the office to snack on the organic fruits and vegetables he sets out. Rather than an afternoon coffee break, the head of in What Language LLC, a translation service in Salt Lake City, recommends a short sprint around the office or a set of push ups.

“Oh my God, I can’t get rid of these people!” said Ms. Glass. She left a boss in New York City who also wanted to cap the office sweet tooth.

Most employees like the free doughnuts, cake and other confections that get parked “in the usual place” at work. But exploding rates of obesity and diabetes make sugar more like cigarettes to some employers. Tempting treats are the new secondhand smoke.

The rules at Health IQ in Mountain View, Calif., sounded pretty sour when they went viral earlier this year: “There is no sugar, candy bars, soda (diet or otherwise) allowed in our office. If you bring some it will get thrown away.”

Chief executive Munjal Shah said the rules, more flexible than they sounded, were relaxed after the social media outrage. The company, however, still wags a finger at secondhand sugar.

“Don’t tempt me with your kids’ leftover chocolate cake,” said Mr. Shah, who leads a startup that sells cut-rate life insurance to health-conscious buyers.

The shaming goes both ways. Hy-Deia Walker, 24, who works in development at a nonprofit in New York, said the amount of sugary treats in her office is overwhelming. Every birthday is celebrated with a cake, she said, and there are always leftover cookies and sugary snacks after client meetings.

Refuse a cupcake, Ms. Walker said, and some co-workers “give you a look like you’re being dramatic.” On her own birthday, she brought in a fruit plate. Colleagues arrived with a red velvet birthday cake. Ms. Walker cut herself a tiny slice, she said, and deliberately forgot to take home leftovers.

At in What Language, staffers fall into a similar divide. “The sales people are more on the healthy side, and the project management team wants doughnuts,” said Cyle Adair, director of business development. He keeps almonds and protein bars by his desk.

Abel Atwater, director of project management, described his colleague as “a health nut who eats rabbit food.” Mr. Adair said Mr. Atwater is nicknamed “Charleston Chew Man,” after the old-timey candy bar with the nougat center.

In June, the Centers for Disease Control and Prevention published the first national study looking at the food people get at work. No surprise that a lot of the workplace food was free, with much of it high in so-called empty calories from sugars and fats.

U.S. taxpayers spent roughly $660 each in 2016 treating obesity-related illnesses covered by Medicare and Medicaid, according to estimates by Adam Biener, assistant professor of economics at Lafayette College.

Office crackdowns, though, can’t keep workers from their fix. Jennifer Rice, 47, a nurse at Abbott Northwestern Hospital in Minneapolis, said that after the hospital banned the sale of sugar-sweetened drinks, colleagues discovered a fully stocked vending machine in the basement of a nearby office building.

Workers at the Abbott Northwestern Hospital in Minneapolis began frequenting this vending machine in the basement of a nearby office building two years ago, after the hospital banned the sale of sugar-sweetened drinks.

The University of California, San Francisco, took a more circuitous path. In 2015, Well-Being Services Executive Director Leeane Jensen persuaded more than two dozen food outlets at the hospital and across campus to stop selling sugar-sweetened drinks. Going along were such franchises as Subway, Panda Express and Jamba Juice, which stopped selling juices that weren’t all fruit- or vegetable-derived.

The nearby Starbucks resisted. “Our menu is designed to reflect a range of choices from wholesome to indulgent, which allows customers to make nutritional choices that are right for them,” a company spokeswoman said.

At UCSF’s Jamba Juice on a recent Sunday, employee Anthony Patchill said he has warned customers from ordering a Protein Berry Workout smoothie. His location uses only unsweetened soy milk.

“It just tastes like nothing,” Mr. Patchill said.

Not all of the sugar-shaming stems from concern about worker health or the well-being of customers. Sometimes, it is to help the boss avoid calories.

Rudy Chung, 41, a partner at two small music companies in Los Angeles, told employees to please avoid their afternoon runs to the baked goods store next door after too many sweets piled up at the office during last year’s holiday season. The initiative didn’t last. “It was probably me that caved,” he said.

Another boss, Erin Wynn, 52, said it was tough to stay healthy leading a 50-person team of mostly millennials at WeLocalize Inc. in New York City.

Everywhere she looked. Ms. Wynn said, were bowls of candy, leftover cake and “bagels, bagels, bagels.”

She finally told workers in 2014 to stop. “I don’t care if you have it yourself, just don’t put it all over the office,” she said. “I can’t help myself.”

One of her employees at the time was Ms. Glass, now working for inWhatLanguage. After hearing the boss’s order four years ago, Ms. Glass recalled, she sped to the aptly named Black Market nearby for a stash of candy.

Write to Rolfe Winkler at rolfe.winkler@wsj.com

What drinking diet soda does to your body and brain

Gina Echevarria and Jordan Bowman

Artificial sweeteners are one of diet soda's main ingredients. But studies have shown that the artificial sweeteners within diet sodas can cause a series of health problems. We decided to take a look at what happens to the body when you only drink diet soda. Following is a transcript of the video.

In the early 1960s, a new kind of beverage took the stage.It wasn't a new shape, or color, or flavor. No, this was diet soda. And It. Was. Awesome.

With fewer calories and less sugar, diet soda promised to be a healthier alternative to regular soda. But like most promises in life that sound too good to be true, it probably is.

Can you tell the difference between a glass of regular and diet soda? Turns out, neither can your body. And that's where the trouble starts.

Until recently, everything we ate contained some amount of calories. When we ate something sweet, for example, the brain sent signals to our pancreas. Which started producing insulin, that stored the sugar molecules in our cells for energy.

So, when we drink diet soda, the sweetness tricks our body into thinking it's real sugar. But when those energy-packed calories don't arrive, the insulin has nothing to store.

Scientists think that repeatedly tricking our body this way could explain why study after study keeps finding the same thing: that drinking diet soda is associated with metabolic syndrome. Metabolic syndrome is a mix of conditions that includes: increased blood pressure, high blood sugar, and weight gain. Which can increase the risk of diabetes, 

heart disease, and stroke.

In fact, one study found that diet soda drinkers had a higher risk of stroke and dementia than regular soda drinkers. And for another 8-year-long study between 1979-1988, participants who started out at a normal weight and drank an average of 21 diet beverages a week faced DOUBLE the risk of becoming overweight or obese by the end of the study, compared to people who avoided diet beverages completely.

And while drinking diet soda with a meal may sound like a tasty, calorie-free alternative to plain water, a growing body of research is starting to find that this may be the WORST time to drink it. Because the fake calories in the diet soda could ultimately disrupt how many of the real calories we metabolize. Potentially leaving excess calories behind that we then store as fat.

Another issue could be the fact that artificial sweeteners in diet sodas can be tens to hundreds of times sweeter than sugar. So when we taste it, our brains anticipate more calories than what we give it. It's like when you go to a party expecting loads of food and you end up with a handful of veggies and vegan cheese. You're left unsatisfied and hangry. In the same way, artificial sweeteners can leave our brains wanting more, which studies have shown leads to increased appetite, and potential weight gain, in fruit flies, mice, and humans.

So if the reason you're drinking diet soda is to drop a few pounds, maybe stick to water.

 

 

Diabetes defeated by diet: How new fresh-food prescriptions are beating pricey drugs

Meg TirrellJodi Gralnick

At first glance Sami Inkinen, an elite triathlete and co-founder of the real estate company Trulia, and Rita Perkins, a grandmother of eight in central Pennsylvania, have little in common.

But they do share one thing: Both have grappled with diabetes.

"I thought, This is absolutely nuts," Inkinen recalled of his diagnosis with prediabetes. "It was really a personal experience and a shocking experience that a world-class triathlete can become type 2 diabetic or prediabetic."

For Perkins it was less of a surprise. Diabetes ran in her family, she said, and her weight had reached 300 pounds before she lost about 100 just through increased walking. But her diet was still bad, and she struggled to control her blood sugar.

Now things have turned around for both Perkins and Inkinen. And their paths were both through food.

In Shamokin, Pennsylvania, about 75 miles northwest of Allentown, Geisinger Health System is trying something new for some of its diabetes patients.

Instead of relying solely on drugs to manage the disease, doctors are writing prescriptions for certain patients to enter its Fresh Food Farmacy program: 15 hours of education about diabetes and healthier living, followed by 10 free nutritious meals a week for participants and their families.

"In health care we spend an awful lot on drugs and devices because it's business," said Dr. Andrea Feinberg, Geisinger's medical director of health and wellness. "But we spend a very small amount on preventive medicine. … It's sort of like we're upside down and backward."

The program targets people with diabetes and food insecurity, those for whom it's not always clear where the next meal will come from.

"We understand the relationship of food insecurity and the impact that poverty has on developing certain lifestyle conditions, like type 2 diabetes," Feinberg said. She added that the goal is "to diminish complications of diabetes and also close the meal gap to end hunger."

The program, started 18 months ago, is a partnership with the Pennsylvania Food Bank. So far, it's enrolled 150 patients, feeding a total of about 450 people a week.

Food as a specialty drug for diabetes and the heart

Rita Perkins, her husband and three grandchildren who live with them are among those families. For Perkins the program has been transformative.

Each week, she visits the Farmacy and picks out food with guidance from a nutritionist. Perkins said the food, along with what she learned in the course about managing diabetes, has changed not just her approach to eating but also her family's.

"Before, I'd never buy this stuff; I would never buy fresh fruit," Perkins recalled. "Money was tight. And now since I get this stuff for free, I can put it on the table for the kids."

Since she started the program, Perkins said her weight has dropped to 134 from 179. She walks all over town and said her doctors are evaluating the doses of her diabetes medications. Her blood sugar, measured by an A1C test, has been a steady 5.8 percent for the last six months (normal A1C, according to the National Institutes of Health, is below 5.7 percent).

"If a new diabetes drug became available that could double the effectiveness of glucose control, it would likely be priced considerably higher than $6 per week (and if it wasn't, the pharmaceutical firm's stockholders would be in revolt)."-Andrea Feinberg , Geisinger's medical director of health and wellness

Those results aren't atypical. On average, patients in the program have seen their A1C levels drop from a pre-enrollment level of 9.6 percent to 7.5 percent, Feinberg and colleagues wrote in an April article in NEJM Catalyst that they called "Prescribing Food as a Specialty Drug."

"Clinically, we see great outcomes," Feinberg told CNBC. "The impact is that we really know long-term that we'll see a decrease in incidence of heart disease, the No. 1 killer here in the United States, because if you improve the diabetes, improve your cardiac risk factors, you have less heart disease as well."

The program also should save money. With operational costs of $2,400 per patient each year, early findings show costs for patients in Geisinger Health Plan dropped by 80 percent: from an average of $240,000 per member per year, to $48,000 per member per year.

"If a new diabetes drug became available that could double the effectiveness of glucose control, it would likely be priced considerably higher than $6 per week (and if it wasn't, the pharmaceutical firm's stockholders would be in revolt)," Feinberg and her colleagues wrote.

Indeed, spending on diabetes drugs in the United States reached $53.7 billion last year, more than double what it was in 2013. The number of prescriptions in that time rose 18 percent, to 227 million, according to data from industry researcher IQVIA.

Ketogenic diet led to drop in blood glucose, weight and drug usage

Almost 3,000 miles away, in San Francisco, Inkinen got his startling diagnosis: He was pre-diabetic even as he set records in endurance sports (in 2014 he and his wife rowed across the Pacific Ocean, from California to Hawaii, he said on his blog: 2,750 miles in 45 days and 3 hours, setting a speed world record for two people.)

His solution? The ketogenic diet, a high-fat, low-carbohydrate way of eating that's enraptured many in Silicon Valley.

"There is a way to reduce insulin resistance without exercise, without dieting or without bariatric surgery, using the traditional ketosis," Inkinen told CNBC. "But to deliver this type of treatment, you would need technology and the ability to continuously monitor and deliver care."

Inkinen's online real estate information company, Trulia, was sold in 2014 to Zillow for $3.5 billion. So naturally, the next step for Inkinen was to start a new company. He teamed with a doctor and a scientist, Stephen Phinney and Jeff Volek, and founded Virta Health.

Virta connects patients virtually with doctors and coaches who help tailor the ketogenic diet to their lifestyles and monitor certain biomarkers daily.

In a trial of about 260 patients, published last year in JMIR Diabetes, Virta's treatment led to reductions in blood glucose, weight and use of diabetes medication after 10 weeks. After a year A1C levels were down an average of 1.3 percent, diabetes medication usage was down 48 percent, and body weight was down 12 percent.

To cardiologist Ethan Weiss, who sits on Virta's scientific advisory board, the outcomes are strong enough to recommend the program to his patients.

"For people with type 2 diabetes headed toward bariatric surgery, to have this result, that they're coming off almost all insulin, coming down on almost all other diabetes medicines, losing weight, feeling like they control their diet, I think it's an awesome thing to recommend," said Weiss, an associate professor of medicine at the University of California San Francisco.

While most of the metrics move dramatically in the right direction — Inkinen says 60 percent of patients see their diabetes reversed in a span of between two and nine months — Weiss notes one data point that may not. Levels of LDL, or so-called bad cholesterol, appear to rise on the ketogenic diet. But he notes a distinction in the type of LDL that goes up, saying it may not be the type that leads to clogged arteries. And he says LDL levels can be controlled with drugs called statins, like Lipitor, if that's a concern (though he said to him it's not).

Virta's program, which costs $370 a month after a $500 initiation fee if patients pay out of pocket, also saves money, according to Inkinen, who estimates an average savings of $9,600 per patient in the first 24 months in drug and medical costs. After the first year the cost drops to $199 a month.

The company is working to expand to more coverage from insurers and employers, with the goal of reversing diabetes in 100 million people by 2025.

That's about the number of Americans with diabetes or prediabetes, according to the Centers for Disease Control and Prevention.

As usage — and costs — of diabetes medicines rise, both Geisinger and Virta are showing that food, along with a healthy dose of education and support, can go a long way in changing the course of this disease.

Artificial sweeteners can still lead to obesity and diabetes, study claims

Brett Molina
USA Today

Maybe switching from regular soda to diet doesn't help as much as we thought.

A new study from the Medical College of Wisconsin and Marquette University links artificial sweeteners to obesity and diabetes, claiming sweeteners change how the body processes fat and uses energy.

Researchers fed groups of rats diets high in sugar or artificial sweeteners including aspartame and acesulfame potassium. After three weeks, blood samples showed significant differences in concentrations of biochemicals, fats and amino acids.

"We observed that in moderation, your body has the machinery to handle sugar," said Brian Hoffmann, lead researcher on the study and assistant professor of biomedical engineering at the Medical College of Wisconsin and Marquette University. "It is when the system is overloaded over a long period of time that this machinery breaks down. We also observed that replacing these sugars with non-caloric artificial sweeteners leads to negative changes in fat and energy metabolism."

Findings were presented on Sunday during the 2018 Experimental Biology meeting held in San Diego.

Before you scramble to dump out all those artificial sweeteners, researchers note this study doesn't clearly say whether they are better or worse than sugar.

"As with other dietary components, I like to tell people moderation is the key if one finds it hard to completely cut something out of their diet," Hoffmann said in a statement.

This is not the first research suggesting artificial sweeteners might have a negative impact on your health. Last year, a study claimed drinks with artificial sweeteners could increase a person's risk of dementia or stroke.

Four years ago, a separate study published in Nature said sweeteners have an equally direct impact on causing diabetes as sugar.

 

This health start-up was throwing away employees' candy — but says that was a step too far

Imagine bringing sodas or chocolate bars to work, only to have a fellow employee toss your junk food in the trash after spotting it in the kitchen.

That's what was happening at a venture-backed start-up called Health IQ, and it was a policy that its workers wanted, according to CEO Munjal Shah. Health IQ's careers page promoted an office with no sugar, candy bars or soda and said, "If you bring some it will get thrown away."

But now the company is lightening up a bit, and this week toned down the rhetoric on its website. The change of heart came after a developer named David Heinemeier Hansson, who is the creator of Ruby on Rails, tweeted to his 280,000 followers over the weekend that he couldn't work at Health IQ due to his candy bar habit.

"I did work out this morning," he tweeted. "But I'm also going to eat a f---ing Twix today. I know, I know, not HealthIQ employee material."

Commenters to the tweet responded by describing the culture as "cultish" and "fit supremacist."

Health IQ, which sells life insurance to what it describes as "health conscious people," was started by Shah after a health scare he experienced while at Google. The company wanted to create a culture with deeply ingrained health habits, including promoting regular use of the gym, which it said was "right in the middle of the office."

Shah admits that Health IQ might have taken it too far, and acknowledged that the company did a poor job in communicating itself to the outside world. Health IQ's "Join the Movement" page now says the following:

"We've received some feedback recently on our Careers page and how we describe our culture and workplace, and we realize we may have missed the mark."

But Health IQ is far from alone among technology companies in pushing healthy behaviors to its employees.

Wellness is a growing trend in Silicon Valley and beyond, with many employers dangling financial rewards in exchange for employee participation in so-called "biometric screenings" or Fitbit challenges that encourage internal competition.

Workplace wellness: A way to save costs

Some employers are going even further and designing their offices with walking paths and additional stairs, said Jennifer Benz, founder of Benz Communications, a San Francisco-based firm that advises companies like Nvidia and Adobe on their benefits strategy. That's in addition to subsidized gym memberships and organic, healthy food options.

For many employers, it's worth the investment.

Health and wellness perks help with recruitment and retention, and there's some evidence to suggest that they can lower costs for employers. When workers indulge in unhealthy habits and get chronically sick, lost productivity and expensive medical bills can quickly add up.

The flipside, particularly at companies that stress diversity, is that employees are in very different situations. Think about a new mother who's juggling sleepless nights compared to a single developer just out of college. People also have varying dietary needs.

Shah, who spoke with CNBC on Monday, said that his employees had input into the company's policies and tested them for more than a year. The ban on sugar, he said, was suggested by one employee who had trouble resisting leftover birthday cake on the kitchen table. As an alternative, the company provides things like nuts, fruit and popcorn. Anyone can keep chocolate or other sweets at their desk.

The fundamental motivation is not to discriminate but to provide a more unified workplace, he said, by encouraging employees to take time during the day to meditate or take a walk. He said he would pay them for that time off for hourly and salaried employees.

Shah also said he's putting more thought into the nuances and the potential unintended consequences of this type of culture. For example, studies have found that there's a huge stigma at American workplaces against people who are overweight or obese and that companies with a significant focus on being healthy may be further alienating them.

For Shah, the company's next chapter will involve a lot more inclusion.

Not that he's getting rid of all the health hoopla. On its careers page, Health IQ still promotes mid-day yoga and fitness classes, healthy snacks and "weekly office-wide standups where each person spends ten seconds on what they've accomplished that week."

HEALTH TRENDS AND PREDICTIONS FOR 2018

As 2017 draws to a close, Aetna International’s Global President of Population Health, Dr Sneh Khemka, takes a look at the shape of the global healthcare market in 2018. His vision for 2018 embraces changes in disease patterns, antibiotic resistance, the ticking time bomb of undiagnosed disease, and the increased impact of healthcare technology.

Trends in global healthcare

1) Rapidly increasing global middle class. 
The world’s middle class is growing (in particular across the Middle East and Asia), creating more strenuous healthcare demands. This has resulted in new expectations from healthcare systems, demanding of digital, more convenient and sophisticated access. Due to this, challenges of how to deliver will continue to arise.

2) A change in global disease patterns. 
Partly due to the rapidly expanding middle class, there has been an increase in lifestyle related, as opposed to infection-related diseases. This is putting significant strain on local healthcare systems, as people are living longer and needing more expensive, long-term treatment.

3) Antibiotic and opioid crises.
Though world news is now attuned to the global antibiotic crisis, the opioid crisis is also sweeping developed countries as addiction to prescription medication is seeing an increase. Both are critical global crises, and urgently need to be addressed.

4) Undiagnosed diabetes.
High obesity rates have led to undiagnosed cases of diabetes around the world. In order to overcome this crisis, healthcare systems will need to acknowledge this worrying epidemic, currently manifesting as pre-diabetes and as metabolic syndrome, both of which most people are unaware they have.

5) Mental healthcare in developing economies.
In developed economies, there is distinct awareness of mental health issues and systems in place to cope with them. Yet, in developing economies, there is still a need for healthcare providers to work with governments to overcome social taboos and understand how mental health effects conditions, as well as economical productivity.

6) Global disparity of healthcare leading to unwarranted variation.
There is large divergence in the quality of healthcare provision and access around the world. 70% of people in the world have too little access to healthcare, whilst 5% of people have too much access. For example, America spends 19% of its GDP on healthcare, indicating the possibility that there are far too many and unnecessary services provided to people; while developing nations are often less than 3% of GDP – so how to address the inequalities?

Technology

1) Technology is on the frontline of patient care. 
It is essential to most healthcare systems around the world. However, although technology has advanced in healthcare, affordability has not. There are now increasingly expensive demands for enhanced solutions. This leads to ethical questions of how, and at what cost, we should extend life using technology - it is not easy to determine where technological intervention should end and where the human life cycle should kick in.

2) The data revolution is changing healthcare into a data-driven industry.
Healthcare has access to a wealth of data from wearable devices, to online analytics. Doctors can use this data to see what factors keep people healthy, rather than what makes them unhealthy. For example, aggregated data from online search engines are currently the best predictor of a viral epidemic. Data and technology also makes it easier for healthcare professionals to diagnose, treat and cure illnesses. This is evident in program such as IBM Watson, as it can search through 15 million journals to inform doctors about rare diseases and treatments.

Are Honey Nut Cheerios Healthy? We Look Inside the Box By DANNY HAKIMNOV. 10, 2017

I had a bowl of Honey Nut Cheerios recently. It’d been awhile. Regular Cheerios are more my thing. But sometimes I finish my box faster than my kids do and find myself straying to their side of the cupboard.

Honey Nut is America’s best-selling breakfast cereal, and by a comfortable margin. Roughly 151 million boxes and other containers of various sizes were sold over the past year, well ahead of the second best-selling breakfast cereal, Frosted Flakes, according to IRI, a Chicago based market research firm.

I had no idea. The only thing I could think about when I ate it again for the first time in years was how incredibly sweet it is. I looked at the back of the box and could see why. Three of the top six ingredients are sweeteners: sugar, brown sugar and honey.

Previously, I assumed Honey Nut Cheerios was a slightly sweeter Cheerios, but you learn things when you finally get around to reading the back of the box. It actually has about nine times as much sugar as plain Cheerios, per serving. An  of a number of popular cereals — a report that linked sugary cereals to the “nation’s childhood obesity epidemic” — put Honey Nut Cheerios’s sugar content second only to Fruity Pebbles. The same group found that one cup of the cereal had more sugar than three Chips Ahoy! cookies.

I asked General Mills about this, over a period of several days. They did not come to the phone, but responded with a series of communiqués.

“You mentioned that three of the top six ingredients in Honey Nut Cheerios are sugar, brown sugar and honey,” Mike Siemienas, a spokesman for the company, wrote in a statement. “What you didn’t mention is that the number one ingredient is oats. To be so singularly focused on one ingredient — sugar — is irresponsible and doesn’t help consumers look at the total nutrition offered.”

Honey Nut Cheerios debuted in 1979. The cereal’s forebear, Cheerios, originally called Cheerioats, was born in 1941 and has a more favorable nutrition profile. The plain version is low in sugar, “and you’re getting some oat fiber that can help lower your cholesterol modestly,” said Bonnie Liebman, director of nutrition at the Center for Science in the Public Interest.

Unfortunately, that makes the contrast with its spinoffs difficult. Those include far more sugary options like Pumpkin Spice Cheerios and Apple Cinnamon Cheerios. The newest offering, Chocolate Peanut Butter Cheerios, has what looks like sugar flakes on it, but it actually has a lower sugar content than Honey Nut Cheerios.

“The company has capitalized on the good name of the original,” Ms. Liebman said. “We’ve been saying for years that Honey Nut Cheerios has more sugar than honey and more salt than nuts, in fact it’s got no nuts at all, it’s just got almond flavor.”

The center has quarreled with General Mills before. It sued the company over health claims made about another Cheerios offshoot, Cheerios Protein.

General Mills refers to cereals like Honey Nut Cheerios as “presweetened” — putting the sugar, brown sugar and honey into your cereal so you don’t have to. Back in 2009, the company made news by announcing an initiative had already been underway to drop the sugar figure into single digits in such cereals marketed to children. In the last decade or so, Honey Nut Cheerios has fallen to nine grams of sugars per serving, from 11. Or so it seems.

I undertook a review of highly sensitive corporate documents. And by that, I mean I looked at pictures of old cereal boxes on eBay, because apparently there’s a market for vintage, flattened cereal boxes. I found a box from 2003 that showed the serving size of Honey Nut Cheerios to be one cup, weighing 30 grams and having 11 grams of sugars. Today, a serving is three-quarters of a cup, and just 28 grams, with nine grams of sugars.

The serving size of regular Cheerios remains one cup. If Honey Nut Cheerios still had a one cup serving size, the sugar content would be in the double digits.

General Mills said little about what had happened, or when.

“There are several reasons that changes in serving size may occur including recipe improvements that may change the density of the cereal or regulation changes,” Mr. Siemienas wrote.

Serving sizes are regulated by the Food and Drug Administration, and can change if a cereal’s density changes. It appears that at some point in the last 10 or 15 years, General Mills tweaked the ingredients of Honey Nut Cheerios in a way that lowered the overall weight per serving, which had the effect of helping lower the stated sugar content. It has not been all smoke and mirrors; the percentage of sugar has decreased slightly as well, though rounding makes it difficult to say by how much.

“They’ve tested and tested and tested to try to find out how much sugar they can take out without it affecting sales,” said Marion Nestle, an emerita professor of nutrition and food studies at New York University. “They must surely be at the cut point.”

She said “you really want” kids “eating a whole grain, higher fiber cereal.”

Speaking for myself, I eat a lot more cereal than three-quarters of a cup. I poured that amount into a bowl. It looked sad. And small. It was an appetizer’s worth of Cheerios.

Don’t worry, General Mills. I’ll continue to eat Cheerios. But I had to have a difficult conversation with a 12-year-old recently. I broke the news that Honey Nut would not be returning to the cupboard. We’d be sticking with regular Cheerios.

“Can I just pour honey on it?” he asked.

He was joking. I think.

 

How Big Sugar Killed a 1968 Study That Pointed to a Heart Disease Link

Industries have been trying to influence the scientific debate around products for decades, a tactic that can sometimes have unintended consequences.

By Deena Shanker
November 21, 2017, 2:00 PM EST Updated on November 21, 2017, 8:31 PM EST

It’s no secret that big industries have long devoted tremendous resources to shaping scientific debates that may threaten profits, from Big Oil countering how fossil fuels cause climate change to Big Tobacco pushing back on how smoking will kill you.

This corporate stratagem, manifesting itself as subsidized scientists or lobbyists masquerading as researchers, can also lead to unexpected results. So when it comes to sugar and whether the sweet stuff does a lot more than rot your teeth, a discarded 50-year-old research project may have come back to haunt Big Sugar.

An investigation published Tuesday in the journal PLOS Biology reveals internal emails obtained from public libraries that illustrate how, almost 50 years ago, the International Sugar Research Foundation (ISRF) terminated funding for its own study—one that, according to the PLOS Biology report, was on the verge of linking sugar with bladder cancer and coronary heart disease.

“The sugar industry has maintained a very sophisticated program of manipulating scientific discussion around their product to steer discussion away from adverse health effects and to make it as easy as possible for them to continue their position that all calories are equal and there’s nothing particularly bad about sugar,” said Stanton A. Glantz of the University of California at San Francisco, one of the PLOS Biology study’s authors.

In a copy of a statement obtained by Bloomberg News, the Sugar Association—the current lobbying arm for the industry—called the new report “a collection of speculations and assumptions about events that happened nearly five decades ago.” According to its own review, the industry group said in the statement, the study in question ended because it was delayed, over-budget and overlapped with organizational restructuring. 

Four years later, though, an ISRF report interpreted the near-finished project’s findings, according to the new study: Rats with conventional microbiomes fed a high-sugar diet had elevated serum triglyceride levels, “suggesting the triglycerides were formed from fatty acids produced in the small intestine by the fermentation of sucrose.”

In other words, the ISRF was saying, a high-sugar diet may have impacted the rats microbiomes and raised their triglycerides. 

“[The study] would have added to the evidence that sugar was influencing heart disease risk by increasing triglycerides,” said Glantz. “My sense is that this would have represented a substantial contribution at the time. Sugar was saying, ‘Don’t worry about the sugar-heart disease connections’; this paper would have said, ‘Yes, worry.’”

The sugar industry has resisted efforts to declare a link between sugar consumption and heart disease. On Tuesday, the Sugar Association also said that to “allude to a potential connection between sugar and cancer is irresponsible and misleading.” But Cristin Kearns, a lead author of the new study, said the findings were “just one more piece of information that would have added to the picture that was forming.”

The implications of what happened to Project 259 go beyond its particular findings, she said. “The sugar industry probably knows more about the health effects of their products than they’re letting on.”

SHE TOOK ON COLUMBIA'S SODA INDUSTRY...THEN SHE WAS SILENCED.

The debate over taxing sugary drinks has turned into a ferocious global
policy brawl. In Colombia, proponents faced intimidation and censorship.

By ANDREW JACOBS and MATT RICHTELNOV. 13, 2017

BOGOTÁ, Colombia — It began with menacing phone calls, strange malfunctions of the office computers, and men in parked cars photographing the entrance to the small consumer advocacy group’s offices.

Then at dusk one day last December, Dr. Esperanza Cerón, the head of the organization, said she noticed two strange men on motorcycles trailing her Chevy sedan as she headed home from work. She tried to lose them in Bogotá’s rush-hour traffic, but they edged up to her car and pounded on the windows.

“If you don’t keep your mouth shut,” one man shouted, she recalled in a recent interview, “you know what the consequences will be.”

The episode, which Dr. Cerón reported to federal investigators, was reminiscent of the intimidation often used against those who challenged the drug cartels that once dominated Colombia. But the narcotics trade was not the target of Dr. Cerón and her colleagues. Their work had upset a different multibillion-dollar industry: the makers of soda and other sugar-sweetened beverages.

Their organization, Educar Consumidores, was the most visible proponent of a proposed 20 percent tax on sugary drinks that was heading for a vote that month in Colombia’s Legislature. The group had raised money, rallied allies to the cause and produced a provocative television ad that warned consumers how sugar-laden beverages can lead to obesity and diet-related illnesses like diabetes.

The backlash was fierce. A Colombian government agency, responding to a complaint by the nation’s leading soda company that called the ad misleading, ordered it off the air. Then the agency went further: It prohibited Dr. Cerón and her colleagues from publicly discussing the health risks of sugar, under penalty of a $250,000 fine.

The battle over taxing sugar-sweetened beverages is becoming one of the world’s most ferocious policy brawls — a clash of science, politics and money in dozens of countries and cities.

“The industry sees sugary-drink taxes as an existential threat,” said Dr. James Krieger, executive director of Healthy Food America, which tracks beverage tax initiatives. In the United States, the industry has spent at least $107 million at the state and local levels since 2009 to beat back soda taxes and beverage warning labels, a new study found. Compared to the domestic tactics, Dr. Krieger said, overseas, “it’s much dirtier, much more bare-knuckled.”

The harassment of Dr. Cerón and her colleagues was never proven to be carried out by the industry, and federal prosecutors declined to investigate. In response to questions from The New York Times, Coke and Pepsi said they were not involved, and Postobón, the soda company that filed the complaint about the organization’s ad, deferred comment to The National Business Association of Colombia. The association, which represented national and international beverage makers on the soda tax issue, said it had nothing to do with the episodes.

The International Council of Beverages Associations, the parent organization of trade groups around the world fighting the taxes, would not directly answer the question about whether its allies in Colombia were connected to the alleged harassment, but it condemned such actions.

“We reject under any circumstance the improper influence or harassment of any individual or organization for any purpose, at any time, in any way,” Katherine W. Loatman, executive director of the organization, said in a statement.

The experience in Colombia may be the most extreme, but a juggernaut of industry opposition has killed or stalled soda tax proposals around the globe, including in Russia, Germany, Israel and New Zealand.

Nevertheless, the idea is gaining momentum; such levies have been enacted in 30 countries, including India, Saudi Arabia, South Africa, Thailand, Britain and Brunei. More than a billion people now live in places where such taxes have driven up the price of sugar-sweetened beverages.

The battles have been particularly intense in emerging markets as the industry seeks to make up for falling soda consumption in wealthier nations. Latin America has surpassed the United States as the world’s biggest soft-drink market, according to the World Health Organization, with sales of carbonated soft drinks doubling there since 2000 while they declined in the United States.

The beverage industry asserts that soda taxes unfairly burden the poor, cause higher unemployment by squeezing industry sales, and fail to achieve their policy goal: reducing obesity. Studies of soda taxes have shown they lead to a drop in sales of sugar-sweetened beverages — a 10 percent sales decline, for example, over the first two years of Mexico’s tax — however, such measures are so new that there is not yet evidence of their impact on health.

“Slapping a tax on our products and walking away won’t do anything about obesity in this country or globally,” said William Dermody, spokesman for the American Beverage Association, an industry trade group.

But public health organizations, including the W.H.O., cite soda taxes as one of the most effective policy tools for cutting consumption of what nutritionists call a “liquid candy” that has contributed to an epidemic of obesity and related health conditions around the world. Dr. Kathryn Backholer, an expert on the issue at Deakin University in Australia, said taxes on soda were “low-hanging fruit” in the fight against obesity, diabetes and other weight-related diseases because such drinks are easily categorized to tax and sensible to target because they “have little or no nutritional value.”

Dr. Backholer and other experts said the turning point for soda tax proponents came in 2014, when Mexico — Coca-Cola’s biggest consumer market by per capita consumption — approved a 10 percent tax.

Mexico also showcased how dirty the fight could get.

Last year, numerous advocates of a proposal to double Mexico’s tax to 20 percent received strings of upsetting and fraudulent texts from unknown numbers. One man got a message saying his daughter had been seriously injured; another found a text saying his wife was having an affair; a third received a link to a funeral home. Spyware was found on the phones. The proposal failed.  READ MORE

 

Americans Are Retiring Later, Dying Sooner and Sicker In-Between U.S. life expectancy is declining, new calculations show.

By Ben Steverman - Bloomberg - October 23, 2017

The U.S. retirement age is rising, as the government pushes it higher and workers stay in careers longer.

But lifespans aren’t necessarily extending to offer equal time on the beach. Data released last week suggest Americans’ health is declining and millions of middle-age workers face the prospect of shorter, and less active, retirements than their parents enjoyed.

Here are the stats: The U.S. age-adjusted mortality rate—a measure of the number of deaths per year—rose 1.2 percent from 2014 to 2015,  according to the Society of Actuaries. That’s the first year-over-year increase since 2005, and only the second rise greater than 1 percent since 1980.

At the same time that Americans’ life expectancy is stalling, public policy and career tracks mean millions of U.S. workers are waiting longer to call it quits. The age at which people can claim their full Social Security benefits is gradually moving up, from 65 for those retiring in 2002 to 67 in 2027.

Almost one in three Americans age 65 to 69 is still working, along with almost one in five in their early 70s.

Postponing retirement can make financial sense, because extended careers can make it possible to afford retirements that last past age 90 or even 100. But a study out this month adds some caution to that calculation.

Americans in their late 50s already have more serious health problems than people at the same ages did 10 to 15 years ago, according to the journal Health Affairs.

University of Michigan economists HwaJung Choi and Robert Schoeni usedsurvey data to compare middle-age Americans’ health. A key measure is whether people have trouble with an “activity of daily living,” or ADL, such as walking across a room, dressing and bathing themselves, eating, or getting in or out of bed. The study showed the number of middle-age Americans with ADL limitations has jumped: 12.5 percent of Americans at the current retirement age of 66 had an ADL limitation in their late 50s, up from 8.8 percent for people with a retirement age of 65.

At the current retirement age of 66, a quarter of Americans age 58 to 60 rated themselves in “poor” or “fair” health. That’s up 2.6 points from the group who could retire with full benefits at 65, the Michigan researchers found.

Cognitive skills have also declined over time. For those with a retirement age of 66, 11 percent already had some kind of dementia or other cognitive decline at age 58 to 60, according to the study. That’s up from 9.5 percent of Americans just a few years older, with a retirement age between 65 and 66.

While death rates can be volatile from year to year, Choi and Schoeni’s study is part of a raft of other research showing the health of Americans deteriorating.

Researchers have offered many theories for why Americans’ health is getting worse. Princeton University economists Anne Case and Angus Deaton, a Nobel Prize winner, have argued that an epidemic of suicide, drug overdoses and alcohol abuse have caused a spike in death rates among middle-age whites.

Higher rates of obesity may also be taking their toll. And Americans may have already seen most of the benefits from previous positive developments that cut the death rate, such as a decline in smoking and medical advances like statins that fight cardiovascular disease.

Declining health and life expectancy are good news for one constituency: Pension plans, which must send a monthly check to retirees for as long as they live.

According to the latest figures from the Society of Actuaries, life expectancy for pension participants has dropped since its last calculation by 0.2 years. A 65-year-old man can expect to live to 85.6 years, and a woman can expect to make it to 87.6. As a result, the group calculates a typical pension plan’s obligations could fall by 0.7 percent to 1 percent.

 

Soda Tax Fizzles In Chicago As Cook County Officials Cast Decisive 15-1 Repeal Vote

In a shocking move that completely upends Chicago's endless pursuit of higher taxes and an overly-regulated nanny state, the Cook County Finance Committee took the unprecedented step of voting to actually repeal their unpopular 'soda tax' last night.  The 15-1 vote followed an outcry from local residents and small business retailers who say their soda sales crashed 90% after the original ban was passed.  Per ABC:

The vote to repeal the sweetened beverage tax was one spawned by revolt from people and business owners across the county, many who packed the board meeting Tuesday afternoon.

"I'm about 10 percent of where my soda sales used to be. It's really hurt me deeply in the pocket and my workers also. I'm very happy you are understanding this and going to repeal this tax," said Ken Blum, a blind vendor.

"I believe what we heard over the last ten and eleven months is that our residents are fed up, and they finally said enough. Tax fatigue has sunk in," said Cook County Board Commissioner Sean Morrison.

"I have heard from the people in my district overwhelmingly, the business owners, the retailers, as well union members in this building who are opposed to this tax," said Commissioner John Daley.

"Let me tell you I'm overjoyed and elated that this tax is going to go away. I mean the people in my district by an overwhelming majority don't want this tax," said Commissioner Richard Boykin.

by Tyler Durden

Oct 11, 2017 6:40 PM

California hits Gatorade in Court

SACRAMENTO, Calif. (AP) — Gatorade has agreed not to make disparaging comments about water as part of a $300,000 settlement reached Thursday with California over allegations it misleadingly portrayed water's benefits in a cellphone game where users refuel Olympic runner Usain Bolt.

The game, downloaded 30,000 times in California and 2.3 million times worldwide, is no longer available.

The dispute between the sports-drink company and California Attorney General Xavier Becerra was settled in less than a day after Becerra filed a complaint in Los Angeles County.

Becerra's complaint alleges the game, called Bolt!, misleadingly portrayed the health benefits of water in a way that could harm children's nutritional choices. The game encouraged users to "keep your performance level high and avoid water," with Bolt's fuel level going down after drinking water but up after drinking Gatorade, the complaint alleged.

The settlement should serve as a warning to companies that falsely advertise, Becerra said.

"Making misleading statements is a violation of California law. But making misleading statements aimed at our children is beyond unlawful, it's morally wrong and a betrayal of trust," he said in a statement.

Gatorade agreed to the settlement but has not admitted wrongdoing.

"The mobile game, Bolt!, was designed to highlight the unique role and benefits of sports drinks in supporting athletic performance. We recognize the role water plays in overall health and wellness, and offer our consumers great options," spokeswoman Katie Vidaillet said in an email.

In addition to agreeing not to disparage water, Gatorade agreed not to make Bolt! or any other games that give the impression that water will hinder athletic performance or that athletes only consume Gatorade and do not drink water. Gatorade also agreed to use "reasonable efforts" to abide by parent company PepsiCo's policy on responsible advertising to children and to disclose its contracts with endorsers.

Of the settlement money, $120,000 will go toward the study or promotion of childhood and teenager nutrition and the consumption of water.

The game was available in 2012 and 2013 and for a limited time in 2017.

 

Sugar not so sweet for mental health

Aug. 9, 2017

A new study suggests sugar intake may increase the likelihood of developing "common mental disorders", but some researchers are taking the findings with a pinch of salt Photo: AFP

Sugar may be bad not only for your teeth and your waistline, but also your mental health, claims a study that was met with skepticism by other experts.

Researchers at University College London (UCL) compared the reported sugar intake of more than 8,000 people in a long-term British study, to their mood.

The study participants, civil servants, were monitored from 1985-1988, and filled out a questionnaire every few years thereafter.

Researchers examined data from that study for an association between sugar intake and "common mental disorders" (CMD) such as anxiety and depression.

The UCL team found "an increased likelihood" for men with a higher intake of sweet foods and drinks to develop CMD after five years, and a general "adverse effect" on mental health for both sexes.

And they concluded, in a study published in the journal Scientific Reports, that "lower intake of sugar may be associated with better psychological health."

But dietician Catherine Collins, a spokeswoman for the British Dietetic Association, said this recommendation was "unproven".

Problems with the study, she said, included that sugar consumption was self-reported, and that sugar intake from alcohol was not counted.

The researchers, she said, appeared to confuse naturally-occurring sugar from foodstuffs such as milk, and "free sugars" added to hot drinks or in sweets.

"The dietary analysis makes it impossible to justify the bold claims made by the researchers about sugar and depression in men," Collins said via the Science Media Centre in London.

"Reducing intake of free sugars is good for your teeth, and may be good for your weight, too. But as protection against depression? It’s not proven."

Nutrition expert Tom Sanders agreed the results should be interpreted "with caution".

"From a scientific standpoint it is difficult to see how sugar in food would differ from other sources of carbohydrate on mental health as both are broken down to simple sugars in the gut before absorption," he said.

© 2017 AFP

Why One Cardiologist Has Drunk His Last Diet Soda

Sep 14, 2017

By Harlan Krumholz

Dr. Harlan Krumholz (@HMKYale) is a cardiologist and the Harold H. Hines, Jr. Professor of Medicine and Epidemiology and Public Health at Yale University School of Medicine.

Drinks and foods marketed to help us maintain weight may have been helping us to gain it, says WSJ Health Expert Harlan Krumholz. Photo: iStock Photo

I used to pound down diet drinks. Low-calorie had to be good, right? It was an invitation to enjoy as much as I wanted, guilt-free. Diet soda was a source of caffeine, and a companion.

And this was all consistent with my identity as a cardiologist. I am very interested in the prevention of heart disease—for my patients for the public, and for myself. So while I never saw diet soda as a health drink, I felt it helped keep my weight under control.

New research, however, has raised the very real possibility that the non-sugar sweeteners that put the “diet” in diet drinks (and many low-calorie foods), may have been conspiring against me.

Rather than help me maintain a healthy weight, they may have been predisposing me to weight gain and metabolic abnormalities. This research is suggesting that drinks and foods using artificial sweeteners like aspartame may be doing exactly what we thought they should be preventing. At the very least, they do not seem to help people keep weight off.

The study in the Canadian Medical Association Journal searched the literature for randomly controlled studies involving non-nutritive sweeteners. They found a mere seven trials, with a total of only 1,003 people, that evaluated consumption of the substances for more than six months.

The bottom line was that they generally failed to find that sweeteners helped people lose weight. Since most people use sweeteners for the purpose of controlling or losing weight, if they were considered drugs instead of a food substance they would be deemed ineffective based on the best evidence available.

The researchers also looked at 30 observational studies, those that did not involve changing people’s diets, but merely cataloging the diet and determining changes over time. They found that people who consumed these sweeteners were more likely to have increases in weight and waistline, and a higher incidence of obesity, hypertension, metabolic syndrome, Type 2 diabetes and cardiovascular events.

One could argue that people who consume diet foods may have already been predisposed to gaining weight and to these other conditions. Many discount these nonexperimental studies—I know I have done so for years. But now I am taking another look as studies are starting to indicate that diet sweeteners could be hurting, instead of helping weight-loss efforts.

Colleagues at my institution argued in 2015 that such sweeteners are far from inert. They showed an impact on hormone secretion, cognitive processes and gut microbiota—and concluded that all of these effects could counter weight control intentions. Another recent peer-reviewed publication presented animal studies that are disturbing. The effects of these sweeteners seem to vary based on the type, dose and timing. What was clear is that these substances again were linked to weight gain and metabolic disturbances.

A study of one substance called sucralose found that its sweetness affected a different part of the brain than sugar. The point was that even though people perceive the sweetness of sugar and sucralose similarly, the brain sees them differently, which may have implications for hunger and reward.

It is reasonable to ask why these substances were not evaluated as drugs in the first place. Millions of people are exposed to them every day, and yet their long-term effect is uncertain. Could they be actually causing the health problems they were intended to prevent? I don’t know the answer at this point, but it seems to me that the burden of proof is on the manufacturers to show benefit and demonstrate safety through clinical trials.

Meanwhile, I’ve stopped my daily habit of diet drinks and I am slowly removing these substances from the rest of my diet (given their ubiquity, that is not easy). If, in the end, we discover that large-scale consumption of diet drinks and foods helped fuel the obesity epidemic, it would be more than ironic. It would be tragic.

Read the latest Health Report.

The Scary Connection Between Cake and Cancer

Amy Capetta

Yahoo Beauty May 26, 2017

While millions of people claim that desserts are their favorite guilty pleasure, scientists report that certain cancer cells may have an even bigger sweet tooth.

Medical researchers from the University of Texas at Dallas discovered that one specific type of cancer — squamous cell carcinoma (SqCC) — is “remarkably more dependent” on sugar for its energy supply, as compared with other cancers.

Since various studies over the years have found that many cancer cells feed off sugar (in the form of glucose), the investigative team decided to examine the differences in metabolism between two major subtypes of non-small cell lung cancer: adenocarcinoma (ADC) and SqCC. They noted that about one quarter of all lung cancers are SqCC, which have been difficult to treat with targeted therapies.

The investigators collected data regarding 33 types of cancers from more than 11,000 patients. And here’s what they found: A protein responsible for transporting glucose into cells was present in significantly higher levels in lung SqCC than in lung ADC. The protein, called glucose transporter 1 or GLUT1, takes up glucose into cells, where the sugar provides a fundamental energy source and fuels cell metabolism.

The danger of dessert

What is the scary connection between cake and cancer?

These results, which were published in the journal Nature Communications, could lead to new forms of treatment, such as a GLUT1 inhibitor, along with specific dietary recommendations.

According to the American Cancer Society, lung cancer, both small cell and non-small cell, is the second most common cancer in both men and women (after skin cancer). Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined.

And in addition to squamous cell lung cancer, the research team found that GLUT1 levels were much higher in other types of SqCC: head and neck, esophageal, and cervical cancers.

Other research has also indicated a link between sugar and cancer. A 2016 study published in the online issue of Cancer Research stated that high amounts of dietary sugar — which are found in the typical Western diet — may increase the risk of breast cancer and metastasis to the lungs. Also, medical investigators from New York University discovered that consuming sugary drinks, processed foods, and high-carb meals could triple a man’s risk of prostate cancer.

“For many years, it has been thought that most cancers are universally addicted to sugars,” Jung-whan “Jay” Kim, senior study author and assistant professor of biological sciences at the University of Texas at Dallas, tells Yahoo Beauty. “We were very surprised to find that this specific type of lung cancer is particularly reliant on sugar (glucose) for its growth. Identifying and characterizing this kind of unique metabolic changes associated with specific types of cancer will lead to the development of new cancer therapies, which may exploit a particular cancer’s unique sugar needs.”

He adds that there is no effective therapy that specifically targets lung squamous cancers. “So a very interesting further study would be to test if reduction of sugar consumption, which will restrict sugar to cancer cells, can reduce the tumor growth of this highly sugar-addicted lung cancer,” says Kim.

In fact, an upcoming study by Kim’s group will examine the effect of a sugar-restricted diet on the progression of lung cancer in an animal model of the disease. The U.S. Department of Agriculture estimates that in 2015, on average, each American consumed more than 75 pounds of refined sugar, high-fructose corn syrup, and other sweeteners combined.

Drinking Too Much Soda May Be Linked to Alzheimer’s

Two new scientific studies raise questions about whether both regular and diet drinks cause brain disease.
by Deena Shanker

https://www.bloomberg.com/news/articles/2017-04-20/drinking-too-much-soda-may-be-linked-to-alzheimer-s

When it comes to the dangers of regularly drinking soda and other sugar-sweetened beverages, the science is clear. It rots your teeth, makes you fat, and puts you at a higher risk of diabetes, heart attack, and stroke. The list goes on and on—just ask your doctor.

When it comes to diet soda, the science has been less solid. It will lower your overall sugar consumption to switch from Coke to Diet Coke, but it might cause other problems. Artificial sweeteners have been associated with—but not shown to necessarily cause—weight gaindiabetes, and heart disease

On Thursday, two studies by the same group of researchers gave soda drinkers—both diet and regular—a whole new reason to drop the habit entirely.

The first, published in the medical journal Stroke, found that consumption of artificially sweetened beverages was associated with a higher risk of stroke and dementia, including Alzheimer’s disease. The second, published in Alzheimer’s & Dementia, found that higher consumption of sugary beverages was associated with markers for pre-clinical Alzheimer’s disease. 

Led by researchers at Boston University School of Medicine, the authors of the Stroke study conducted a review of data collected through the Framingham Heart Study, a multi-decade observational review that began with more than 5,000 volunteer participants in 1948 and has included their offspring since 1971 and their grandchildren since 2002. The FHS entailed nine examination cycles held approximately every four years; participants logged beverage intake through questionnaires that surveyed their diets over the previous 12 months. In these studies, the researchers looked at the seventh cycle for the offspring, from 1998 to 2001, and the second cycle for the grandchildren, from 2008 to 2011. 

In the study cited in Alzheimer’s & Dementia, the researchers found that higher consumption of sugary beverages was associated with a pattern consistent with preclinical Alzheimer’s, including smaller total brain volume and poorer episodic memory. The authors called the findings “striking” because they were found in a middle-aged sample and withstood statistical adjustment for such factors as physical activity and total caloric intake. The results align with earlier research done with smaller samples, including one with 737 middle-aged participants in the Boston Puerto Rican Health Study, which found that higher sugar intake was cross-sectionally associated with Alzheimer’s-like behavioral patterns.

The Alzheimer’s & Dementia study notes its limitations, including that it doesn’t establish causality, the homogenous population sample didn’t include minorities, and questionnaire-based consumption data are inherently unreliable. 

Responded William Dermody Jr., vice president of policy at the American Beverage Association, the chief lobby for soda makers: “The Alzheimer’s Association points out that the greatest risk factors for Alzheimer’s are increasing age, family history of Alzheimer’s, and genetics—not sugar intake, from any source.”

The Stroke study, meanwhile, found an association with artificially sweetened beverages and stroke and dementia, while not finding a similar association for consumption of sugar-sweetened beverages, an observation the authors characterized as “intriguing.” An editorial accompanying the study noted this finding—and that it contradicted other studies that found the opposite. This study, the authors noted, has the same limitations as the Alzheimer’s & Dementia analysis, as well as another important one: The association could be a case of reverse causality, “whereby sicker individuals consume diet beverages as a means of negating a further deterioration of health.”

That concern is based on the way diabetes status partially mediated the association between artificially sweetened beverage consumption and dementia. In other words, having diabetes may be more of a risk factor for dementia than consuming artificially sweetened beverages is. The relationships among beverage consumption, diabetes, and dementia remain unclear.

All this, said Dean M. Hartley, director of Science Initiatives at the Alzheimer’s Association, points to an important reminder: Correlation doesn’t necessarily mean causation. Dermody of the American Beverage Association emphasized this point: “The authors of this study acknowledge that their conclusions do not—and cannot—prove cause and effect.” 

Still, Hartley said, this study provides an important starting point for further studies. “Many of our first understandings of a disease come from associations,” he said. “It’s why it’s critical to get more funding at a national level.” The Alzheimer’s Association has been advocating increased research funding, including a $400 million boost for 2017 through the National Institutes of Health, currently pending before Congress, and at least another $414 million for 2018. (The Trump administration budget proposal calls for a $5.8 billion cut (PDF) to the NIH for 2018, which is about 20 percent.)

Hartley also recommends the association’s 10 Ways to Love Your Brain for proactive steps towards brain health, including exercise, a healthy diet, and keeping up education, and he advises everyone to speak with physicians about their specific health conditions. Still, when it comes to soda—diet or regular—the safest course is to skip it. “I think they’re both bad,” he said. “Pure water is always a very good thing.”

By Jeffrey Eisenber, MD

Natural and Artificial Sweeteners

So if sugar and high fructose corn syrup are toxic when over consumed, where can we turn to satisfy our addiction for sweetness?

How about natural sugar substitutes? They must be a healthy alternative to that Darth Vader sugar… They have the word “natural” attached to it which just exudes safety right? Hmmm...not so fast.

This category of contestants include Agave, Maple syrup, Molasses, coconut palm sugar, and Honey.

Let's discard with Agave first as it is highly processed, and mostly fructose (evil). It wins the prize for the unhealthiest natural sugar substitute. Coconut palm sugar is less processed and may have some nutrients, but it is high in calories and fructose. Maple syrup and Molasses can boast some trace minerals, vitamins, and antioxidants…but they are still sugars which clearly outweigh any of the above benefits.

Honey from the typical grocery store is refined…stripped of any of its natural gifts. If unrefined (usually from health stores or farmer’s markets) it does have antimicrobial, antioxidant, anti inflammatory, and immune benefits along with trace vitamins and minerals. Unfortunately, the catch is the same…it is loaded with calories and fructose.

Ok…the natural sugar substitutes strike out. How about artificial sweeteners? They aren't sugars and they have virtually no calories. Surely they are the preferred alternative…the teachers pet!

Ah, not so fast. Artificial sweeteners are hundreds of times sweeter than glucose. The result: our taste buds are tricked and become dulled…normally sweet foods and drinks become irreparably bland causing us to crave higher and higher amounts of the sweet stuff to satisfy us.

The artificial sweeteners also stimulate the same dopamine brain reward pathway as sugar, cocaine, marijuana, barbiturates, and gambling. But the brain never sees the sugar! And this reward center does not like to be tricked. It responds by directing us to fulfill its anticipated sugar load by loading up on anything sweet it can find. (think “diet drink anomaly” where people who consumed diet drinks on a daily basis gained significant weight)

The artificial sweeteners also lead to an insulin release which lowers our blood sugar levels and increases our cravings for food.

They also alter our gut Microbiome and diminish the signals from our gut that tell us we are full.

Who are these not so fab-five artificial sweeteners? Aspartame, Sucralose, saccharin, xylitol, and ACE K.

Bottom line: natural and artificial sweeteners are not the teacher’s pets with regards to sugar substitutes and improved health…they are imposters. We have to retrain our taste buds to accept healthier food choices that may seem bland at first but are packed with the nutrients and vitamins our cells crave. With our taste buds retrained, we won't have to douse our palate with processed food. The real food, the stuff that Mother Earth produces, will be appreciated in a whole new and healthier light.

 

By Dr. Jeffrey Eisenberg, MD

Telomeres

A telomere is a sequence of DNA at the end of our chromosomes. These end caps are protective as they preserve genetic information. However, telomeres shorten with each cell division. They burn down like a candlewick, leaving the chromosomes vulnerable to damage. Eventually the telomere length “runs out” and the cell can no longer rejuvenate. The result is cellular death!

It is hypothesized that humans can live to be 122 years old based on the study of telomere length. So why do the overwhelming majority of us fall so short of these expectations? Well, it turns out that inflammation, stress, and sugar accelerate the rate at which telomeres shorten. This speeds up the rate of biological aging, and is linked to heart disease, obesity, Diabetes,, cancer, and neurodegenerative disease.

The American Journal of Public Health (10/16/14) was the first study to show that soda consumption is associated with telomere shortening and cellular aging. It is based on the work of Elizabeth Blackburn, a USCF researcher who received the Nobel Prize in 2009, who calculated that the daily consumption of a 20oz sweetened sugary beverage (SSB) was associated with 4.6 years of accelerated biological aging. (Comparable to the effect of smoking)

So telomere length is epigenetically influenced by nutrition! If we can eat more healthily,  (avoiding excess sugar and processed carbohydrates while maximizing our exposure to antioxidants and anti-inflammatories) we may be able to slow down the rate of telomere shortening, repair damaged telomeres, and even lengthen these same telomeres. Be like a Vulcan: “ Live long and prosper! “

By Dr. Jeffrey Eisenberg, MD

Sugar and Mood

Dopamine is an example of a “feel good” hormone. When this neurotransmitter is released and binds with the dopamine receptors in a particular part of our brain, we experience euphoria and a desire to pursue and repeat a specific pleasurable pathway.

Sugar happens to be one of the most powerful triggers of Dopamine release. It lights up that part of the brain like a pinball machine…similar to the effect one feels when addicted to alcohol, cocaine, amphetamines, marijuana, and gambling. That feeling of well being that sugar facilitates is called the “sugar high”.

With repetitive stimulation however, the Dopamine receptor sites down regulate themselves so that larger amounts of Dopamine are needed to achieve the same “high”. This is what we call “tolerance”, the first step to full blown addiction.

So how does excess sugar consumption contribute to mood fluctuations? Well, it turns out that sugar and processed carbohydrates influence the blood levels of the very amino acids (tryptophan and tyrosine) that form our feel good hormones: dopamine and serotonin.

When we consume sugar, our blood glucose levels rise, resulting in an increased release of insulin. This allows the passage of those amino acids into the brain that form our feel good hormones. We then experience that all to familiar sugar rush and feeling of euphoria. However, as our blood sugar level continues to rise with excess consumption of sugar, the resulting hyper-secretion of insulin leads to a precipitous decline in that blood sugar level resulting in a rapid drop in our neurotransmitters (dopamine and serotonin). What follows is a feeling of depression, anxiety, or other mood fluctuations.

 Unstable blood sugar levels lead to unstable neurotransmitters and subsequently to significant fluctuations of mood! This is a particularly precarious situation for patients who are already anxious, depressed or bipolar. So cut out the excess sugar and feel better both physically and mentally!