Fructose: An Argument Against It
by Dr. Mitchell Rasmussen, DC, CFMP, FRC-ms
In his widely-sold book, “Brain Maker”¹ Dr. David Perlmutter, M.D. goes on at length about fructose. He acknowledges that fruit contains fructose, but that it isn’t the main source of fructose in the Standard American Diet (SAD- The perfect acronym!).
When fruit is eaten in its whole-food form, we are getting:
fiber (which not only adds bulk to the stools, but bulk to the stomach),
beneficial vitamins in their natural form,
naturally occurring colors which are generally full of antioxidants²,
as well as the fructose.
I have patients who tell me they drink a glass of store-bought fruit juice every morning because, “I need my vitamin C.”
If you consider how we evolved, I’d bet that no humans gained better health by eschewing an all-inclusive food like an orange in favor of only its sweet liquid. Evolutionarily speaking, it just doesn’t make sense.
Back to Science
Fructose is the sweetest naturally occurring sugar that we know of.¹
Everybody talks about the “glycemic index”, and interestingly enough, fructose doesn’t actually have a high glycemic index. This was originally hailed as a god-send for diabetics, but the reason for the lack of a direct blood-sugar response is terrifying....
Whereas most cells in the body are able to utilize glucose, and thus glucose freely circulates in the blood until insulin brings it into the tissues, the liver is pretty much the only place for fructose to go. Unfortunately for us, this hepatic metabolism of fructose generally provides, as its product, FAT.⁴
Because the liver is such a beast of an organ, much of the fructose we consume never even ends up in the blood-stream. The liver is a massive detoxifier, and it is able to do a lot as far as making all substances we consume more water-soluble (and able to be urinated out through the renal system) as well as less toxic. I picture the liver as a funnel. It can send a lot of stuff through the funnel, but it needs to prioritize.
Since fructose is a powerful reducing sugar⁵, it promotes the creation of compounds known as “advanced glycation end products” (AGEs) which have been implicated in the pathogenesis of many diseases, including those of the cardiovascular system as well as complications with diabetes, and certain cancers.⁶
Fructose metabolism is a major liver burden and it forces the liver to expend enormous amounts of energy (ATP) just trying to deal with it, that other liver functions get “pushed to the back burner.”
There are possible implications as a result of fructose abuse pretty much everywhere we look. Dr. Perlmutter goes on ad nauseam about the metabolic ramifications of fructose, and a lot of this has to do with the fact that fructose (specifically in high fructose corn syrup preparations) isn’t triggering the important hormones for metabolism regulation, so this is where the obesity and metabolic syndrome issues stem from.
However, if we consume fructose in the form of whole-foods and at a TOTAL level below 25 grams per day, this doesn’t seem to be as deleterious.⁹ It is when humans mettle with nature and make it un-natural where the human metabolism gets out of whack.
There was a study (on monkeys) in the American Journal of Clinical Nutrition which showed that, fructose can quickly, regardless of whether or not you get fat, hurt your liver¹⁰ . It looks like a main reason for this is because fructose may function like a toxin in the blood with the capability to cause serious bleeding, kidney cell death, and other issues.
It is when humans mettle with nature and make it un-natural where the human metabolism gets out of whack.
What I want you to take away is this:
1) Fructose is innocuous in our lives, especially in processed foods. Read labels on things, and make a conscious effort to get back to eating foods in the form they grew, so then you don’t even need to worry about reading labels.
2) Use moderation in things. The body is remarkable, and the body can deal with a lot of insult, until it can’t anymore. That is when dis-ease sets in. I don’t mean to make you think you can’t enjoy your life, to eat fun things, or to let loose every now and then. But it is all about balance!
3) An informed public is a formidable public. I hope to give you some information, a little bit of education. Now go ahead make decisions for your health. This information isn’t always easily accessible for the general public, and high fructose corn syrup is shoved into processed food at an alarming rate. I just want you guys to be aware, to get a little bit more knowledgeable, and then to do what you want with it.
You are all unique, incredible creatures. Creatures of habit, creatures of conscience, creatures with the ability to change. Remind yourself that. You can change. You have this amazing brain in your head, and it is capable of much more than you ever thought possible. If you put your mind and heart in the direction of living a little bit healthier and well-informed life, there is no doubt you can!
Curious about what fruit to eat when limiting FRUCTOSE?
CLICK HERE to access a PDF Handout of Low-Fructose Fruit!
Want to work with a functional medicine doctor to run labs and assess nutrient status? Struggling with hormone imbalance, IBS, weight gain, mood changes? Let's look at BIOCHEMISTRY. Read more about Functional Medicine at The Facility here.
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¹¹Anand, P., Kunnumakara, A., Sundaram, C., & al., e. (2008, September). Cancer is a Preventable Disease the Requires Major Lifestyle Changes. (E. Review, Ed.) Pharmaceutical Research, 25(9), 2097-2116. doi:10.1007/s11095-008-9661-9
⁴Bray, G. A. (2007, October). How bad is fructose? (A. S. Nutrition, Ed.) The American Journal of Clinical Nutrition, 86(4), 895-896. Retrieved October 2016, from http://ajcn.nutrition.org/content/86/4/895.full
²Fajardo-Lira, C. (.-S. (n.d.). Institute of Food Technologists- Feeding the minds that feed the world. Retrieved from http://www.ift.org/knowledge-center/learn-about-food-science/food-facts/what-are-antioxidants.aspx
¹⁶Ford, E. S., Giles, W. H., & Mokdad, A. H. (2004, October). Increasing Prevalence of the Metabolic Syndrome Among U.S. Adults. Diabetes Care, 27(10), 2444-2449. doi:10.2337/diacare.27.10.2444
⁵Gaby, A. R. (2011). Sucrose and High-Fructose Corn Syrup. In A. R. Gaby, Nutritional Medicine (pp. 8-10). Concord, NH: Fritz Perlberg Publishing.
¹³Gout- Topic Overview. (n.d.). Retrieved 2016, from WebMD: http://www.webmd.com/arthritis/tc/gout-topic-overview#1
⁶Jiao, L., & al., e. (2015, January). Dietary consumption of advanced glycation end products and pancreatic cancer in the prospective NIH-AARP Diet and Health Study. The American Journal of Clinical Nutrition, 101(1), 126-134. doi:10.3945/ajcn.114.098061
⁷Kathleen McCormick, M. C. (2011, December). Women's Health Connections- The Educational Resource Center of Women's International Pharmacy. (R. C. Michelle Davenport and Carol Petersen, & W. I. Pharmacy, Eds.) Retrieved 2016, from Women's International Pharmacy: http://www.womensinternational.com/pdf/liver.pdf
¹⁰Kavanagh, K., & al, e. (2013, August). Dietary fructose induces endotoxemia and hepatic injury in calorically controlled primates. The American Journal of Clinical Nutrition, 98(2), 349-357. doi:10.3945/ajcn.112.057331
⁹Mercola, J. (2013, January 14). Confirmed- Fructose Can Increase Your Hunger and Lead to Overeating. (D. Joseph Mercola, Producer) Retrieved October 2, 2016, from Mercola.com-Take Control of Your Health: http://articles.mercola.com/sites/articles/archive/2013/01/14/fructose-spurs-overeating.aspx
¹⁴Nakagawa, T., & al., e. (2006, February 3). A causal role for uric acid in fructose-induced metabolic syndrome. American Journal of Physiology- Renal Physiology, 290(3), F625-F631. doi:10.1152/ajprenal.00140.2005
¹²Nguyen, S., Choi, H., Lustig, R., & Hsu, C. (2009, June). Sugar-sweetened beverages, serum uric acid, and blood pressure in adolescents. Journal of Pediatrics, 154(6), 807-813. doi:10.1016/j.jpeds.2009.01.015
³Pectin. (2009). Retrieved from WebMD: http://www.webmd.com/vitamins-supplements/ingredientmono-500-pectin.aspx?activeingredientid=500&activeingredientname=pectin
¹Perlmutter, D. (., & Loberg, K. (2015). Brain Maker. New York: Little, Brown and Company.
⁸Raftogianis, R., Creveling, C., Weinshilboum, R., & Weisz, J. (2000). Chapter 6: Estrogen Metabolism by Conjugation. Journal of the National Cancer Institute Monographs, 2000(27), 113-124.
¹⁵Rudic, R., Shesely, E., Maeda, N., Smithies, O., Segal, S., & Sessa, W. (1998, February 15). Direct evidence for the importance of endothelium-derived nitric oxide in vascular remodeling. The Journal of Clinical Investigation, 101(4), 731-736. doi: 10.1172/JCI1699
¹⁷What is Metabolic Syndrome? (2016, June 22). Retrieved October 2, 2016, from National Institutes of Health- National Heart, Lung, and Blood Institute: http://www.nhlbi.nih.gov/health/health-topics/topics/ms
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