The (Real) Foe in the Food


Feature Story

For quite sometime, medical science might have gotten its lines crossed concerning the real culprit in metabolic syndrome. Obesity is a feature but not the main culprit. Neither is fat in the diet. Fructose is!

By Gelyka Ruth R. Dumaraos | Photos by Ramir G. Cambiado


Obesity is not the culprit. Neither is fat.

The myth on obesity being the number one culprit in having metabolic syndrome, such as diabetes, is what top endocrinologists would like to debunk.

Dr. Augusto Litonjua talks about the dangers of fructose to one’s health at the Scientific Symposium held at EDSA Shangri-La
Dr. Augusto Litonjua talks about the dangers of fructose to one’s health at the Scientific Symposium held at EDSA Shangri-La

Fats do not make you fat. Fructose does.

Dr. Augusto Litonjua, acknowledged as the Father of the Philippine Endocrinology and founder of the Philippine Center for Diabetes Education Foundation (PDCEF) Inc., said that many are not aware that fructose means danger to one’s health.

Dr. Robert H. Lustig tackles how fructose and not fat, triggers diabetes
Dr. Robert H. Lustig tackles how fructose and not fat, triggers diabetes

Fructose, or a type of sugar found in fruits and sweetened food products and beverages—could be the root cause of metabolic syndromes such as heart diseases, stroke, and diabetes. There are a cluster of conditions that may lead to these diseases—obesity, high blood pressure, high blood triglycerides, low levels of high-density lipoprotein (HDL) cholesterol, and insulin resistance.

But even before one tries to deal with these conditions, it is better to look on the food one eats and analyze its sugar content, even the fruits we think are healthy.

According to a study made by United States Department of Agriculture (USDA), people thought that table sugar is bad for the health and shifted to eating fruits which was a healthy option.

Dr. Litonjua explained that fructose is not easily broken down by the body, resulting in formation of harmful chemical compounds including the “bad fat.”

“After which, the prevalence of diabetes and obesity went up along with the increased consumption of fruit sugar – the (diabetes and obesity) rate was higher than when Americans were consuming table sugar or glucose,” explains Dr. Litonjua during his talk during the “Fats and Sugars: Friends or Foe?” conference organized by PCDEF and Unilab.

The (Real) Foe in the Food 2He adds that fructose is not metabolized by insulin, unlike glucose. “Fructose goes to the liver where it is being deposited and the liver turns it into triglyceride, a form of fat storage making the liver fatty with intake of too much fructose.”

Fix the food

Dr. Litonjua links the lack of knowledge of many about fructose, and that many believed eating fruits is good.

“There’s this notion that fruits are good. But fruit sugar is fructose and these are abundant in fruits,” he says.

Adding to this is the growing number of consumers who patronize chemically-produced form of fructose found in convenient stores and supermarket. Many of these consumer products have as high-fructose corn syrup (HCFS), an alternative sweetener to raw sugar. These are commonly found in sugar-sweetened beverages (SSBs), such as soft drinks and fruit juices.

“If you would ask me if Filipinos are aware of the effects of high-fructose corn syrup, I would say no,” Dr. Litonjua says.

For PCDEF, a leading diabetes awareness association in the country, there is a need for Filipinos to be aware on the negative effects of fructose, especially the HFCS.

Sugar is the bad guy

Moreover, PCDEF also wants to debunk the myth that fat is the foe.

The (Real) Foe in the Food 3Dr. Robert H. Lustig, a professor at the Division of Endocrinology, Department of Pediatrics at the University of California, stresses that people do not die of obesity. He wants to debunk the thinking that fat makes one sick and that fat makes one fat. However, it has not worked for years. He stresses the global prevalence rate of diabetes which rises four percent each year. However, obesity only increases one percent each year.

Dr. Lustig also highlights that fact that there are countries with a high number of obese people but without diabetes—Mongolia, Iceland, and Micronesia. Meanwhile, there are diabetics—such as those in Pakistan, China, and India, who are not obese.

“Turns out that sugar was really the bad guy,” Dr. Lustig adds.

The advocate against sugar consumption notes that there are people who are thin on the outside, fat on the inside (TOFI) who can get the disease. On the other hand, some metabolically healthy obese persons don’t develop diabetes.

Dr. Joy Fontanilla, head of Center for Weight Intervention and Nutrition Services (WINS) at St. Luke’s, Medical City, serves as moderator
Dr. Joy Fontanilla, head of Center for Weight Intervention and Nutrition Services (WINS) at St. Luke’s, Medical City, serves as moderator

“It’s not about obesity, it never was. It’s about diabetes,” Dr.Lustig says, again stressing that sugar, specifically fructose, is the bad guy.

“Without enough houIt’s not about obesity, it never was. It’s about (sugar and) diabetes”

August 2017 Health and Lifestyle

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