Medical Myths About Sugar

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From Medical News Today

1. Sugar is addictive

Some experts believe sugar is an addictive substance. For instance, the authors of a controversial narrative review in 2017 write:

“Animal data has shown significant overlap between the consumption of added sugars and drug-like effects, including bingeing, craving, tolerance, withdrawal, cross-sensitization, cross-tolerance, cross-dependence, and reward and opioid effects.”

However, this review focuses on animal studies. As the authors of another review explain, “there is a methodological challenge in translating this work because humans rarely consume sugar in isolation.”

Dr. Dominic M. Dwyer from Cardiff University’s School of Psychology explains, “Although certainly present in some people, addiction-like behaviors toward sugar and other foods are present only in a minority of obese individuals. However, we should remember that sugar can drive the overconsumption of foods alongside its addiction-like potential.”

Along similar lines, Prof. David Nutt, Chair of the Independent Scientific Committee on Drugs and head of the Department of Neuropsychopharmacology and Molecular Imaging at Imperial College London, writes:

“There is not currently scientific evidence that sugar is addictive, although we know that sugar has psychological effects, including producing pleasure, and these are almost certainly mediated via brain reward systems.”

It is worth noting that even though health experts do not class sugar as an addictive substance, that does not make it healthful.

2. Sugar makes kids hyperactive

This is perhaps the most common myth associated with sugar: eating candy causes children to run wild. In fact, there is no scientific evidence that sugar increases hyperactivity in the vast majority of children.

For instance, a 1995 meta-analysis in JAMA combined data from 23 experiments across 16 scientific papers. They concluded:

“This meta-analysis of the reported studies to date found that sugar (mainly sucrose) does not affect the behavior or cognitive performance of children.”

However, people with children may doubt the truth of this conclusion. For those interested in reading more, we address this myth extensively in an earlier edition of Medical Myths.

3. Sugar causes diabetes

Another relatively common myth is that sugar directly causes diabetes. However, there is no direct link between the two. The confusion perhaps arises because there is an intrinsic association between blood sugar levels and diabetes.

The story is a little more complicated, though. Overweight and obesity are risk factors for type 2 diabetes, and consuming high levels of sugar does increase the likelihood of developing overweight or obesity. However, sugar is not the direct cause of type 2 diabetes.

As for type 1 diabetes, dietary and lifestyle factors do not play a part.

4. Avoid fruit when dieting

Fruits are delicious, partly because they are sweet, thanks to naturally occurring sugars. Because of their sugar content, some people believe that we should avoid eating fruit when maintaining a moderate weight.

This is a myth. Fruits contain a range of healthful compounds, including a variety of vitamins and minerals, and fiber.

Fruit consumption is associated with health benefits, including a reduced mortality rate.

One study concluded that freeze-dried mango “does not negatively impact body weight but provides a positive effect on fasting blood glucose.” Another study found that consuming blueberries enhanced insulin sensitivity.

However, it is worth noting that the two studies mentioned above received grants from the National Mango Board and the United States Highbush Blueberry Council, respectively.

Make of that what you will, but there is no doubt that consuming fruit benefits health. Removing it from our diet to reduce sugar intake would be a mistake.

5. We must eliminate sugar from our diet

Because we know consuming excess sugar is bad for health, it makes sense to reduce our intake. However, it is not necessary to remove it from our diet entirely.

As we noted above, fruits contain sugar, and they benefit health, so cutting it from our diet would be counter-productive.

As with everything in life, moderation is key. With that said, sweetened beverages, such as soda, have associations with several negative health consequences, including kidney damage, cellular aging, hip fractures, obesity, type 2 diabetes, and more.

Cutting soda from our diets would certainly not be a terrible idea.

6. Sugar causes cancer

Despite the rumors, most experts do not believe sugar directly causes cancer or fuels its spread.

Cancer cells divide rapidly, meaning they require a great deal of energy, which sugar can provide. This, perhaps, is the root of this myth.

However, all cells need sugar, and cancer cells also require other nutrients to survive, such as amino acids and fats, so it’s not all about sugar. According to Cancer Research UK:

“There’s no evidence that following a sugar-free diet lowers the risk of getting cancer, or boosts the chances of surviving if you are diagnosed.”

As with diabetes, there is a twist — increased sugar intake has links with weight gain, while overweight and obesity are linked with increased cancer risk.

So, although sugar does not directly cause cancer and does not help it thrive, if someone consumes high levels of sugar and develops obesity, their risk increases.

Scientists are continuing to investigate the relationship between cancer and sugar intake. If there are links between the two, they are likely to be convoluted. For instance, the American Cancer Society write:

“There is […] evidence that a dietary pattern high in added sugars affects levels of insulin and related hormones in ways that may increase the risk of certain cancers.”

One study, which included data from 101,279 participants, concluded that “[t]otal sugar intake was associated with higher overall cancer risk,” even after controlling for multiple factors, including weight.

Other researchers have found links between sugar intake and specific cancers, such as endometrial cancer and colon cancer. However, for now, the link is not as solid as the rumor mill claims.

The Take Home Message

Sugar is a much-researched topic. Typing “sugar health” into Google Scholar brings up more than 78,000 results from 2020 alone. Navigating this amount of content is unwieldy, and, as with any scientific topic, there are disagreements.

Something to bear in mind is that many studies investigating the health impacts of sugar receive funding from the food industry. One review of research into soft drink consumption, nutrition, and health examined the results of 88 relevant studies.

They found “clear associations” between soft drink intake, body weight, and medical issues.” Tellingly, they also report that “studies funded by the food industry reported significantly smaller effects than did non-industry-funded studies.”

Although there are a number of misunderstandings surrounding sugar, some things are certain: although it might not directly cause diabetes or cancer, eating high levels of sugar is not healthful. Moderation, is the solution.

Weight Loss Medical Myths

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From Medical News Today

1. Skipping breakfast aids weigh loss

The common adage that breakfast is the most important meal of the day may or may not be true, but it seems unlikely that skipping the morning meal aids weight loss.

The rationale behind this strategy is that missing one meal a day leads to a lower overall intake of calories. However, the story is not so straightforward.

One study, published in 2010, analyzed food intake information from 2,184 people aged 9–15 years. Twenty years later, the researchers asked for the same information again.

They compared data from people who had skipped breakfast during childhood and adulthood with data from those who had never skipped breakfast or had done so only in adulthood.

Compared with the other groups, the participants who skipped breakfast during both childhood and adulthood tended to have larger waist circumferences, higher fasting insulin levels, and higher total cholesterol levels.

Sometimes, people who skip breakfast eat more during the rest of the day to counteract the deficit. But one 2013 study found that missing breakfast does not lead to eating more at lunch. The authors conclude that “Skipping breakfast may be an effective means to reduce daily energy intake in some adults.”

However, these researchers only monitored the participants’ food intake at lunch, not dinner. And the study only included 24 participants, so we should be wary of drawing solid conclusions from the findings.

A much larger 2007 study, which involved more than 25,000 adolescents, looked for links between skipping breakfast and having overweight. The researchers also assessed the roles of alcohol intake and levels of inactivity.

The scientists found that skipping breakfast had a stronger association with overweight than either alcohol consumption or levels of inactivity.

A 2020 systematic review and meta-analysis that appears in the journal Obesity Research & Clinical Practice concurs. After analyzing the results of 45 previous studies, the authors concluded:

“Skipping breakfast is associated with overweight/obesity, and skipping breakfast increases the risk of overweight/obesity.”

2. “Fat-burning” foods can aid weight loss

Certain foods are referred to as “fat-burning.” This sounds too good to be true, and it probably is.

Some people claim that foods such pineapple, ginger, onions, avocados, asparagus, celery, chilies, broccoli, green tea, and garlic speed up the body’s metabolism, thereby helping the body burn fat.

There is little scientific evidence, however, that these foods can help reduce weight.

3. Weight loss supplements can help

Proponents of certain supplements claim that they, too, help the body burn fat. In reality, these are generally ineffective, dangerous, or both.

The Food and Drug Administration (FDA) report that they have “found hundreds of products that are marketed as dietary supplements but actually contain hidden active ingredients […] contained in prescription drugs, unsafe ingredients in drugs that have been removed from the market, or compounds that have not been adequately studied in humans.”

Jason Humbert, a senior regulatory manager at the FDA, adds:

“We’ve also found weight loss products marketed as supplements that contain dangerous concoctions of hidden ingredients, including active ingredients contained in approved seizure medications, blood pressure medications, and antidepressants.”

Only FDA approved “weight loss” prescription can help with weight loss along with proper diet and regular exercise.

4. Low fat foods aid weight loss

Of course, reduced fat or low fat foods are likely to contain less fat. However, these products sometimes compensate with added sugar or salt. Checking labeling is key.

Also, it is worth noting that “reduced fat” does not necessarily mean “low fat,” but simply that the fat content of a product is lower than the full-fat version.

5. Thou shalt not snack

People may believe that snacking is a cardinal sin of dieting. In some cases, though, snacking can help people manage their caloric intake more effectively. It is not so much snacking itself, but what one snacks upon that that counts.

Snacking may be more complex than it first appears. While some snack on celery and others on cookies, some people might snack because they are hungry and others because they are bored.

Having a piece of fruit or some low fat yogurt between meals, for instance, might reduce food cravings, keeping a person from overeating at mealtimes or resorting to more energy-dense snacks.

Some research has shown that people with obesity are more likely to snack than people without the condition. In this case, switching from unhealthful to healthful snacks may aid in weight loss, if this is a goal.

In general, snacking is multifaceted — it may support or hinder weight loss efforts, and in some cases it may have little effect.

Older research, from 2007, investigated the role of snacking in weight loss. In the yearlong study, the researchers asked one group of participants to have three meals a day, without snacking. A second group was asked to have three meals and three snacks daily. Individuals in both groups consumed equivalent amounts of energy each day.

At the end of the study, the authors found no difference in weight loss between the two groups; snacking, it seems, neither helped nor hindered.

Another study, from 2011, investigated the “relationship between eating frequency and weight loss maintenance.” The researchers recruited participants who had previously had overweight or obesity but who had since maintained healthy weights.

They compared these individuals’ eating patterns with those of people with obesity and people with healthy weights who had never had overweight.

The team found that participants with healthy weights ate more snacks than those who had lost weight — and that people with overweight ate the fewest snacks.

Overall, the authors concluded that “Eating frequency, particularly in regard to a pattern of three meals and two snacks per day, may be important in weight loss maintenance.”

6. No treats allowed

This follows on from the myth above. Of course, limiting sugary, high fat treats is important, but cutting them out entirely is unnecessary and could be counterproductive.

As the British Heart Foundation explain:

“Depriving yourself of all the foods you enjoy won’t work. You’ll eventually give into temptation and abandon your efforts. There’s no harm in allowing yourself a treat now and again.”

7. Some sugars are worse than others

There is a rumor that minimally processed sugars, such as those in maple syrup or honey, are more healthful than white sugar. In reality, our bodies process sugar in the same way — regardless of its source. The gut reduces all sugars into monosaccharides.

Rather than looking at sugar processing, it is more important to note the amount of sugar in any food. All types of sugar provide around 4 calories per gram.

8. Cut out all sugar

Following on from the myth above, we know that all sugar is high in calories. However, a person looking to lose weight does not need to mercilessly cut sugar from their diet.

As with all things, moderation is key. It may instead be a good idea to avoid products with added sugar.

9. Artificial sweeteners are healthful

To lower their sugar intakes, many people opt for low- or no-calorie sweeteners, such as aspartame. This may reduce the number of calories consumed, but some studies have linked artificial, or nonnutritive, sweeteners to weight gain.

A systematic review and meta-analysis published in 2017 analyzed 37 existing studies involving a total of 406,910 participants to investigate the impact of sweeteners on cardiometabolic health.

According to the researchers, “Observational data suggest that routine intake of nonnutritive sweeteners may be associated with increased BMI [body mass index] and cardiometabolic risk.”

However, not all studies have reached this conclusion. Researchers and health experts continue to discuss the effects of nonnutritive sweeteners on weight loss and metabolic health.

10. You can target fat in specific areas

Some people are particularly keen to lose fat from certain areas, such as the thighs or abdomen. In reality, this targeting is not possible. All bodies respond differently to weight loss, and we cannot choose which bits of fat will go first.

However, if weight loss is paired with exercises to tone a particular area, it can give the impression of more region-specific weight loss.

Both Coolsculpting and Emsculpt can help with targeting certain areas of the body along with diet and exercise

11. This fad diet is excellent

Vast legions of diets have become fashionable only to fade into obscurity, making room for more. As the Centers for Disease Control and Prevention (CDC) explain in a nutshell:

“[Fad] diets limit your nutritional intake, can be unhealthy, and tend to fail in the long run.”

The take-home

Overall, losing weight can be challenging. Our bodies evolved during leaner times, so they are primed to take on energy and store it. However, many of us live in a world where calories are readily available, and our bodies still store this energy as if it’s going out of fashion.

In general, reducing the caloric intake and exercising is the most reliable approach to weight loss. With that said, people with chronic diseases, including diabetes and obesity, should speak with their doctors before beginning a new weight loss regime.

It is also worth remembering that if anything seems too good to be true, it probably is — any “weight loss miracle” is unlikely to be miraculous. Most foods are not inherently unhealthful, but it is a good idea to consume high-sugar and high-fat foods sparingly.

MEDICAL MYTHS ABOUT DIABETES

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1. Eating sugar causes diabetes

Eating sugar does not directly cause diabetes. However, consuming a sugary diet can lead to overweight and obesity, which are risk factors for type 2 diabetes.

This is a common myth, perhaps understandably — blood sugar levels play an essential role in diabetes. Sugar itself, though, is not a causal factor.

As ever, the story is complex: there does appear to be a link between regularly drinking soda and risk for type 2 diabetes.

One large study published in 2013 found that, even after controlling for energy intake and body mass index (BMI), drinking soda has links with an increased risk of developing the disease. The study did not find this association in relation to other drinks, such as artificially-sweetened beverages and fruit juices.

Scientists still do not understand why some people develop type 1 diabetes, and others do not. However, nutrition is not a risk factor.

2. Diabetes is not serious

Perhaps because diabetes is so common, some people believe that it is not a serious disease. This is incorrect. There is no cure for diabetes, and there are a host of complications that can occur if a person does not manage the condition well.

Complications include cardiovascular disease, nerve damage, kidney damage, blindness, skin conditions, and hearing impairment.

In 2018, diabetes was the underlying cause of 84,946 deaths in the U.S. The World Health Organization estimate that diabetes caused the death of 1.6 million people in 2016.

3. Diabetes only affects people with obesity

Overweight and obesity are risk factors for type 2 diabetes and gestational diabetes, but the condition can occur in people of any weight. According to data from the Centers for Disease Control and Prevention (CDC) National Diabetes Statistic Report, 2020, 11% of people with type 2 diabetes in the U.S. are neither overweight nor obese.

Type 1 diabetes has no associations with body weight.

4. Obesity always leads to diabetes

Although obesity increases the risk of diabetes, it does not inevitably lead to the disease. According to the CDC, an estimated 39.8% of adults in the U.S. have obesity, but 13% have diabetes.

5. People with diabetes cannot eat sugar

People with diabetes certainly do need to manage their diets carefully: monitoring carbohydrate intake is important. However, they can still incorporate treats.

The American Diabetes Association explain:

“The key to sweets is to have a very small portion and save them for special occasions, so you focus your meals on healthier foods.”

Individuals with diabetes need to carefully plan what and when they will eat to ensure that their blood sugar levels remain balanced.

A related myth is that people with diabetes need to eat special “diabetes-friendly” foods. These products are often more expensive, and some can still raise glucose levels.

6. Diabetes always leads to blindness and amputation

Thankfully, this is a myth. While it is true that diabetes can lead to blindness and amputations in some cases, it is not inevitable. And for individuals who manage their condition carefully, these outcomes are rare.

The CDC estimate that 11.7% of adults with diabetes have some level of vision impairment. Lower-extremity amputation occurs in around 0.56% of people with diabetes in the U.S.

Experts have identified several risk factors that increase the likelihood of experiencing diabetes-related complications. These include obesity and overweight, smoking, physical inactivity, high blood pressure, and high cholesterol.

7. People with diabetes should not drive

A diabetes diagnosis does not automatically mean that someone needs to stop driving. In a position statement on diabetes and driving, the American Diabetes Association explain:

“[M]ost people with diabetes safely operate motor vehicles without creating any meaningful risk of injury to themselves or others.”

However, they also explain that, if concerns arise, people should undergo assessment on an individual basis. According to the U.S. Department of Transportation:

“[P]eople with diabetes are able to drive unless they are limited by certain complications of diabetes. These include severely low blood glucose levels or vision problems. If you are experiencing diabetes-related complications, you should work closely with your diabetes healthcare team to find out if diabetes affects your ability to drive.”

8. Prediabetes always leads to diabetes

In the U.S., an estimated 88 million, or 1 in 3, adults have prediabetes. Prediabetes is a condition where blood sugar levels are higher than normal but not quite high enough to classify as diabetes. If left unchecked, prediabetes can develop into type 2 diabetes.

However, it is not a given. Lifestyle changes can turn the tide. Regular physical activity and a more healthful diet can stop diabetes in its tracks.

9. People with diabetes cannot be active

Once again, this is untrue. In fact, exercise is an important component in the management of diabetes. Among other things, exercise helps drive weight loss and reduces blood pressure, both of which are risk factors for complications. It can also help the body use insulin better.

However, exercise can impact blood sugar levels in various ways, sometimes increasing it and, at other times, decreasing it.

According to Diabetes U.K., “Some days, you’ll do exactly the same type of activity and eat the same foods, but your blood sugar levels may act differently to what you’d expect.”

They also offer tips for managing blood sugar during activity:

Check your blood sugar while exercising and keep a record of how it behaves to show your doctor. This can help guide any necessary changes in insulin.

For people who are at risk of hypos, keep fast-acting carbohydrates close to hand.

Wear diabetes identification so that people can help if needed.

10. You can ‘catch’ diabetes

This is a myth. Pathogens do not cause diabetes, so a person cannot pass it to someone else. Doctors classify it as a noncommunicable disease.

11. Some natural products cure diabetes

Currently, there is no cure for diabetes. Any claims that a product can cure diabetes are false. Many herbal or natural products will do little or nothing and, in some cases, they can potentially cause harm; diabetes.co.uk explain:

“[B]ecause certain herbs, vitamins, and supplements may interact with diabetes medications (including insulin) and increase their hypoglycemic effects, it is often argued that [using] natural therapies could reduce blood sugars to dangerously low levels and raise the risk of other diabetes complications.”

Diabetes is a complex but common disease. As its prevalence increases, it is essential to overturn myths as we find them.

COVID VACCINATION INFORMATION

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From Medical News Today:
Some vaccines use a whole virus or bacterium to teach our bodies how to build up immunity to the pathogen. These pathogens are inactivated or attenuated, which means weakened. Other vaccines use parts of viruses or bacteria.

Recombinant vaccine technology employs yeast or bacterial cells to made many copies of a particular viral or bacterial protein or sometimes a small part of the protein.

mRNA vaccines bypass this step. They are chemically synthesized without the need for cells or pathogens, making the production process simpler. mRNA vaccines carry the information that allows our own cells to make the pathogen’s proteins or protein fragments themselves.

Importantly, mRNA vaccines only carry the information to make a small part of a pathogen. From this information, it is not possible for our cells to make the whole pathogen.

Both mRNA COVID-19 vaccines that Pfizer/BioNTech and Moderna have developed cannot cause COVID-19. They do not carry the full information for our cells to make the SARS-CoV-2 virus, and therefore, cannot cause an infection.

RNA is a notoriously fragile molecule. Delivering mRNA successfully to cells inside our bodies and ensuring that enzymes within our cells do not degrade it are key challenges in vaccine development.

Chemical modifications during the manufacturing process can significantly improve the stability of mRNA vaccines.

Encapsulating mRNA in lipid nanoparticles is one way to ensure that a vaccine can successfully enter cells and deliver the mRNA into the cytoplasm.

mRNA does not linger in our cells for long. Once it has passed its instructions to the protein-making machinery in our cells, enzymes called ribonucleases (RNases) degrade the mRNA.

It is not possible for mRNA to move into the nucleus of a cell as it lacks the signals that would allow it to enter this compartment. This means that RNA cannot integrate into the DNA of the vaccinated cell.

There is no risk of long-term genetic changes with mRNA vaccines.

The mRNA COVID-19 vaccines by Pfizer and Moderna have undergone safety testing in human clinical trials.

The United States Food and Drug Administration (FDA) have granted Emergency Use Authorization (EUA) for the Pfizer mRNA vaccine after reviewing the safety data from over 37,000 trial participants.

“The most commonly reported side effects, which typically lasted several days, were pain at the injection site, tiredness, headache, muscle pain, chills, joint pain, and fever,” the FDA wrote in their statement. “Of note, more people experienced these side effects after the second dose than after the first dose, so it is important for vaccination providers and recipients to expect that there may be some side effects after either dose, but even more so after the second dose.”