I recently listened to The Catalyst, a program on Australian National TV (ABC). They were talking about the obesity crisis in countries like the US and also now in Australia. As I am struggling to control my weight and to eat a healthy diet, I was interested to listen to the experts. Professor Michael Cowley (Physiologist, Monash University, Melbourne) and Professor Robert Lustig (Paediatric Endocrinologist, University of California, San Francisco) gave valuable information which I have summarised and compared with other literature on the topic. I work with children with various learning issues, including ADHD and we are always looking for new research to help these children how to improve concentration. ADHD has a negative impact on cognitive learning.
The named professors claim that in only a few decades we now have more obese people than undernourished people on the planet. This brought along an increase in diabetes as well. We often discuss the increase in ADHD and behavioural problems in children – we try to determine if this is a real increase, or only our perception of what is actually “normal” behaviour, that has changed. We also try to determine if the increase in these problems are related to parenting skills or to the perception that children are less active than in previous generations. Many people love to blame the TV and the use of computers. My belief is that it is a combination of many different factors and that we should educate ourselves to find the best solution for any specific child. These may be different for different children and families. In the end we want to improve concentration, encourage cognitive learning and reduce the need for ADHD medication.
To get back to the program on ABC, Professor Lustig claims that sugar is driving all of the chronic metabolic diseases that we know about today. Metabolic diseases occur when the process your body uses to get or make energy from the food you eat, is disrupted. Food is made up of proteins, carbohydrates and fats. These are broken down by chemicals in your digestive system into sugars and acids, providing energy for your body. Your body uses this energy immediately or store it in the body as fat in organs such as your liver and muscles, or as body fat. A metabolic disorder develops when some organs such as your liver or pancreas do not function normally and abnormal chemical reactions take place in your body. Diabetes is an example.
During the 70’s there were media campaigns to reduce fat in the diet as to reduce heart disease. Some even claimed that if there is no fat in food, it cannot make you fat. However, the reduction in fat in processed food drove the increase in sugar in these foods – check the sugar levels in low fat muesli bars! When they took fat out of a product it was made tasteless. So they had to replace it with something – that was sugar. Low fat yoghurt is another example. The sugar content in some of these yoghurts is so high that you might as well eat candy. This is a win-win for the food industry – the food tastes so good that we can’t stop eating! The food industry is making money out of this and we are losing our health. The American Heart Foundation recommended that fatty snacks be replaced with high-sugar products like juice, hard candy, and spreads like syrup and honey. And I can add that anybody travelling in the US is surprised by the amount of sweet foods they consume – from pancakes drizzled with maple syrup for breakfast to sweet tasting bread and meat dishes.
In the States they have seen a significant increase in sugar consumption in the last several decades. The chances are that you are eating more sugar and starch than you realise. It is not only in the obvious things like soft drinks and candy. One half of the sugar we are consuming today is in items such as tomato sauce, barbecue sauce, hamburger buns, all sorts of processed foods. Almost every item in the supermarket with a food label has some form of sugar in it.
It’s this increase in dietary carbohydrate that’s messing with our metabolism. If you constantly provide carbohydrates to the body, you’ll have constantly high insulin levels, and that will lead to increased fat deposition in tissues. The higher your insulin, the more likely you are to store fat, because insulin is the main hormone that puts fat into fat cells.
Now, if it’s subcutaneous fat, the type that collects under the skin, then that’s not so bad for your health. But if it’s visceral fat, the type that collects around your belly and your organs – well, that’s when problems arise. Visceral fat releases a different set of hormones, and, in particular, it releases what we call pro-inflammatory hormones that cause inflammation elsewhere in the body.
So it’s possible to be lean, but still have a lot of visceral fat around your organs. And it’s possible to be lean and metabolically unhealthy. So being slim doesn’t necessarily mean you’re healthy. Up to 40% of normal-weight people show signs of metabolic disease. And 20% of obese people are actually metabolically healthy.
When you burn protein for energy, it takes twice as much energy to metabolise that protein into energy as for carbohydrate. It’s known as the ‘thermic effect of food’. Those calories are not recoupable. So you actually burn more energy metabolising protein than you do carbohydrate. The net effect of eating a calorie from carbs versus a calorie from protein is actually quite different. That’s why our experts say not all calories are equal.
That aside, exercise does have other health benefits that extend beyond weight loss. Dr Lustig says minimising carbs from processed foods – the foods we’ve been told to eat most of for the last 30 years – weight loss should follow.
Professor Robert Lustig says that when he gets people off sugar, and he gets their insulin down, they all of a sudden feel more energetic. They all of a sudden want to engage in physical activity. And that’s part of why they lose weight. So the question is – which is driving the obesity epidemic, the behaviours or the biochemistry? Professor Lustig says that the biochemistry always comes first. It’s easy to fall into the trappings of sugary food, because the more you eat, the more you want.
MRI scans show that sugar triggers the same reward centres in the brain as nicotine, alcohol or cocaine.
He says sugar should be regulated like tobacco and alcohol.
Both of those are toxic and addictive. And we regulate them and we keep them out of the hands of children. Well, sugar meets the same criteria of ubiquity, toxicity, abuse and negative impact on society that tobacco and alcohol also achieve. Some nutritionists warn against demonising sugar in the same way we demonised fat in the ’70s. They say the focus on sugar will result in unbalanced dietary advice. However, it seems Australia’s peak health authorities are slowly catching onto Professor Lustig’s warnings. They’ve launched new campaigns to encourage people to rethink sugary drinks, and they’ve recently updated our dietary guidelines to include warnings about sugar consumption.
On August 17, 2013 WebMD writes that soft drinks are actually liquid candy.
Recently soft drinks have also been associated with behavioural problems in young children, according to an Aug. 16, 2013 article published by Elsevier.
Previous studies associated soft drink consumption with aggression, depression, and suicidal thoughts in adolescents, however, the relationship had not been evaluated in younger children. A new study by Shakira Suglia, ScD, and colleagues from Columbia University’s Mailman School of Public Health, University of Vermont, and Harvard School of Public Health assessed approximately 3,000 5-year-old children and found that aggression, attention problems and withdrawal behaviour are all associated with soft drink consumption in young children. They found that children who drank 4 or more soft drinks per day were more than twice as likely to destroy things which belonged to others, get into fights, and physically attack other people.
These kids also had increased attention problems and withdrawal behaviour in comparison to other children not consuming soft drinks.
The child’s aggressive behaviour score increased with every increase in soft drinks servings per day.
Now, soft drinks usually also contain levels of preservatives and colourants. The article did not mention these levels but according to a dietician, intolerances to preservatives and colourants can also affect behaviour and attention.
I am sure that few people reading this article will allow their children to consume 4 or more soft drinks week, not to speak of per day! However, studies such as these indicate that there is a correlation between sugar and health, between sugar and energy levels and metabolic disease. Even if your child does not develop poor health or metabolic disease, it will affect energy levels and attention.
To improve concentration, to encourage cognitive learning and to possibly reduce the need of ADHD medication, let us at least try the avenue proved to be healthier for our children. This means to reduce the intake of sugar and to control sugar consumption.
Poor diet and eating habits do not cause ADHD. And when it comes to controlling impulsivity, inattention, and other symptoms, there is no substitute for medication and behavioural therapy, which are clearly the most effective approaches.
But recent research suggests a possible relationship between ADHD and the foods one consumes. http://www.additudemag.com/adhd/article/859.html
You can have a look at the Australian Government New Dietary Guidelines 2013: http://www.nhmrc.gov.au/guidelines/publications/n55
Let us all look out for hidden sugar in products; especially low fat products sold as “healthy” alternatives. Let us prepare food from fresh products and reduce sugar, preservatives, artificial food colours, flavourings and sweeteners. We should aim for a healthy and balanced diet. Our bodies might just react thankfully by being healthy and energetic!