Aug
07
2015

Sugar As White Death

By | heart attack, Heart Disease, Inflammation, Nutrition, Prevention

We can think of sugar as white death, as sugar is responsible for heart attacks, strokes and even some cancers. Sugar is causing disability and mortality to a much higher degree than most people are aware of: a recent study pointed out that worldwide 184,000 deaths per year are attributable to sugar-sweetened beverage consumption; among those there are 133,000 deaths from diabetes, 45,000 deaths from cardiovascular disease and 6,450 deaths from cancers. Those people who developed disabilities from strokes, heart attacks, osteoporosis and severe arthritis measured 8.5 million disability-adjusted life years throughout the world and were related to sugar-sweetened beverages. 4.5% of these were from diabetes that was related to sugar-sweetened beverages.

These statistics are only regarding sugar-sweetened beverages! This does not take into account mortality from sugar in processed foods, in cookies, cakes and candies. It also does not take into account starchy foods like pasta, bread, bagels, white rice etc. that are all digested by amylase in the mouth and in the gut to turn into sugar within half an hour of ingesting them.

In the following I like to give an overview of what sugar does to our system.

History of sugar production

The initial production of refined sugar was developed in India as this review of the history of sugar shows.

In Great Britain the consumption of sugar was 4 pounds per person per year in 1700; it rose to 18 pounds per year in 1800, to 36 pounds per year by 1850 and over 100 pounds per year by the twentieth century. Similar figures are true for the US and in all developed countries. In 1747 the German chemist Andreas Marggraf identified sucrose in beet root. Since then technology was developed to extract sugar from the beet root, which was cheaper to do than extracting it from sugar cane. Both methods are in use today. In addition high-fructose corn syrup has been developed in 1970 and it replaces sugar in many uses, for instance in soft drinks and in processed foods.

Overall we are exposed to sugar in all disguises, such as sugar-sweetened beverages, candies, sweetened yogurt that is sold as “healthy”, power bars that are sugar laden and many more.

Effect of sugar on our bodies

1. Diabetes

As already pointed out above the average sugar consumption has increased from 4 pounds per person in 1700 to above 100 pounds per person in our time. Our poor pancreas has to cope with this additional burden of sugar and if it can’t, we get diabetes. The CDC says that in 2008 there were 8 cases of new type 2 diabetes cases per 1000 people in the US. The CDC projects that in 2050 this number will likely increase to 15 new cases of type 2 diabetes per 1000 people.

This shows you that the capacity of the human pancreas is limited. There is a breaking point regarding our insulin production. The insulin production has a limit, because the insulin producing cells in the pancreas can only produce a limited amount of this sugar-clearing hormone. When this point is reached the person is said to have developed diabetes. Diabetes causes heart attacks, strokes, kidney failure, blindness and circulation problems in the legs leading to amputations.

2. Cardiovascular disease

Diabetes is not the only problem that sugar causes. Our cardiovascular system is suffering because sugar makes the liver produce more LDL cholesterol that gets oxidized by sugar; the triglycerides are rising as well with continued sugar intake and with too much sugar intake there is excessive weight accumulation causing type 2 diabetes. This leads to more lipids in the arterial walls, called arteriosclerosis. The end results are heart attacks and strokes.

3. Cancer

It may not be obvious how sugar intake can lead to cancer. But sugar has been found to oxidize tissues and in the process produce dangerous free radicals. This causes chronic inflammation leading to mutations in the DNA of cells and weakening of the immune system. This will in time lead to cancer. Many cancer researchers have investigated this in detail in the last decades. I reviewed this in this blog, if you would like more information about it.

4. Brain atrophy and Alzheimer’s disease

Sugar overconsumption has been found to be one important factor in the development of Alzheimer’s disease, which is associated with the development of brain atrophy. Brain atrophy is just the mirror lesion in the brain that comes from hardening of the arteries. Brain atrophy develops when not enough nutrients and oxygen reach your brain cells. Part of the brain surface dies off and memory cells are lost. The end result is dementia or Alzheimer’s. Read more about this here.

5. Arthritis can come from sugar overconsumption

As I have summarized in this blog arthritis often is due to over consumption of processed foods including sugar products.

As I am explaining in this blog Dr. Hoffer has developed a simple supplementation for arthritis that will reverse the metabolic changes that are associated with arthritis. But you must switch to a Mediterranean diet without sugar and starchy foods, if you want to experience relief from your arthritis symptoms.

6. Low fat diet not helpful to reduce heart attack rates

As I pointed out before the low fat diet that was popular in the 1980’s until the early 2000’s did not help reducing heart attacks.

The low fat diet was laden with sugar, meaning that it was a low fat, high carb diet, and all of the problems I described above with weight gain, high LDL, high triglycerides and the development of diabetes caused more heart attacks and strokes. The real solution to preventing obesity and lowering heart attacks and strokes is to use a low carb/low to medium fat diet like the Mediterranean diet.

7. We need our muscles in older age

When we eat too many carbs from chocolate, candy, donuts and pasta there is not enough quality protein in our food to feed our muscles. If this is combined with a lack of exercise we are in double trouble of having flaccid muscles. This leads to falls and fractures, but is entirely preventable by eating a proper diet and exercising regularly.

8. ADHD can be fuelled by sugar

I have reviewed ADHD (attention deficit hyperactivity disorder) and mentioned that sugar and gluten sensitivity may be part of the problem. It is important to sort out nutritional factors by going through an elimination diet. Often our Western style diet (sugar and fat rich) is making things worse for the child with ADHD.

Apart from other measures avoiding sugar is very important for the ADHD patient.

9. Chronic inflammation

What causes chronic inflammation in the body and is responsible for both hardening of the arteries as well as arthritis? If you guessed sugar intake, you guessed right. I explained this in detail in this blog.

This concept is one of the biggest new things in the 21st century. The research goes back to the mid-nineties and culminated in the detection of an inflammatory marker, the C-reactive protein (CRP). The CRP level can now be used as a readily available blood test to detect inflammation in the body. Often this test will be positive in patients with arthritis, autoimmune diseases and cancer.

10. Obesity

Processed food contains wheat and sugar. The problem is that the high gliadin concentration in the Clearfield variety of wheat makes people addicted to food and sugar makes them gain weight. This is the cause of the obesity and diabetes wave. The remedy is to cut out all wheat and sugar as well as starchy foods. Switch to a Mediterranean diet without sugar and starchy foods.

11. Pimples and acne

Who would have thought that acne could come from a combination of sugar and milk products? Careful epidemiological studies have shown that in some regions of Africa, Brazil and Japan teenagers who eat the local food do not get acne, but when they switch to a Western style diet they come down with acne.

12. Tooth decay from too much sugar

Gum infections and severe tooth decay were found in the 1990’s to cause inflammation in the blood, which can be measured by using the C-reactive protein (CRP). Streptococcus viridans, a bacterium that populates gums and teeth can cause subacute endocarditis, a dangerous infectious disease of the heart valves, which can be responsible for sudden death in younger persons. There are other bacteria in the mouth that feed on sugar that we eat, particularly if we do not brush and floss our teeth regularly. This means there is double trouble: Sugar causes cavities and gum disease, but also causes heart attacks and heart valve infections.

Sugar As White Death

Sugar As White Death

Conclusion

Sugar and starchy food consumption affect so many organ systems that it is no wonder that people say that they feel better when they switch from the standard American diet to a Mediterranean type diet. We do not really want to buy a heart attack, a stroke, diabetes and Alzheimer’s disease when we go to the grocery store. But this is what you get in time when you buy the starchy foods and sugar containing processed foods that are in the center part of the grocery store.

The neighbor’s shopping cart

When I go shopping I always eye the groceries of my neighbor before or after me. Sometimes it is scary to look at the content of some of the shopping wagons. There is bread, potato chips, pretzels, chocolate bars, cookies, and the whole line-up that is really rich in sugar. Manufacturers mix sugar into healthy yoghurt, so it becomes unhealthy. Honey or maple syrup makes granola unhealthy. Jams contain 50% sugar, and on and on it goes. It is sobering to see how illness and disability is for sale, one shopping at a time. The reassuring truth is that you have choices!

Jul
27
2013

Flossing and Brushing Saves Your Heart

By | Dentistry, Health, heart attack, Heart Disease, Infectious Disease, Nutrition, Prevention

It was not until about the mid 1990’s when it became apparent that gum infections and severe tooth decay could cause inflammation in the blood measurable by using the CRP marker (C-reactive protein). As this link shows Dr. Joseph Muhlestein at the University of Utah demonstrated in 1996 that chronic gum infection could cause a heart attack. He isolated the bacterium Chlamydia pneumoniae in 79% of patients undergoing coronary bypass surgery, while samples from heart transplant patients isolated this bacterium in only about 5%. The new thinking was that bugs that multiply in diseased gums could migrate into the blood and cause platelets from the blood to clump together and block coronary arteries causing heart attacks. Harvard University researchers have confirmed this. In the past it was known that a bad tonsillitis with an aggressive bacterium, Streptococcus viridans, could cause subacute endocarditis, a dangerous infectious disease of the heart valves, which can be responsible for sudden death in younger persons. Neglected cavities in teeth can also harbor this bacterium. Another study in 2009 showed that two particular strains of bacteria in infected gums, Tannerella forsynthesis and Preventella intermedia, were associated with an increased risk for heart attacks; but it was more the overall burden of bacteria in the infected gums than the specific bacteria strains that mattered most.

Flossing and Brushing Saves Your Heart

Flossing and Brushing Saves Your Heart

 

Preventing heart disease by brushing and flossing

With this background it is easier to understand that we need to take good care of our teeth and gums, if we want to maintain good health. As a start most people should see their dental hygienist (who usually works in a dentist’s office) twice a year. The dental hygienist will probe the depth of gingival pockets with a periodontal probe. A normal depth measures up to and including 3 mm. Deeper pockets than that usually indicate that the patient did not floss regularly. One needs to floss at least once per day, better twice per day and it should not bleed after flossing (initially when a person flosses for the first time the gums tend to bleed a bit).

The hygienist will do scaling of plaques on the tooth enamel. Any cavity that is detected will be brought to the attention of the dentist. At the end of the scaling procedure fluoride is applied, which puts a coating on the tooth surfaces to prevent tooth decay.

When deeper pockets (6 mm or more) are detected a trial of subgingival root brushings has shown to have a very beneficial result within only 14 days.

Periodontal pockets were improved and bacterial counts of periodontal infections were shown to have improved as well.

Oral care and cavity prevention in the population

It has been accepted for quite some time that a combination of brushing and flossing are the best methods to control dental plaque, which is the precursor for cavities.

In order to test the knowledge of adults in families with small children these authors from the School of Public Health of the Maryland University investigated Maryland’s adult population knowledge regarding caries prevention. It turns out that there were deficiencies in knowledge about the prevention of dental caries and the importance of fluoride to create strong, decay resistant enamel.

A randomized, prospective study is planned in Hong Kong which will start teaching oral hygiene to kindergarten children aged 3 and will be reinforced several times later to instill good dental hygiene behaviors into these children’s health routine as outlined in this link. Not only is it important to teach brushing and flossing, but also food habits with cutting down on sugary and starchy snacks as these foods make the saliva acidy promoting caries producing bacteria in the plaque.

This English study shows that a primary school based caries prevention program reduced caries by 35% when sugar intake was limited in the interventional group and brushing of teeth was done twice per day along with flossing.

An addition to flossing for those with narrow tooth intervals or those with braces is a waterpik system. This can be used to clean food residues from the spaces between your teeth and from gum pockets. Flossing once or twice per day is still needed to remove plaque to avoid tartar build-up. Before bedtime it is advisable to floss first, then use a waterpik, then use your electric toothbrush with a fluoridated toothpaste. During the day use the waterpik after meals followed by brushing with an electric toothbrush with non-fluoridated toothpaste.  Water Picks are also called “water flossers”; they are easier on your gums.

Other measures helpful in preventing tooth decay

Xylitol is a natural sweetener originally derived from birch. Sugarless gum often is sweetened with Xylitol. This study has shown that chewing Xylitol containing gum can effectively reduce caries. This paper describes that the increased saliva production from chewing gum provides a slightly alkaline environment for teeth. This helps to clear out sugar faster from the oral cavity after a meal, inhibits bacterial growth, neutralizes the pH in plaque that is on the acidy side after sugar consumption. The authors concluded that chewing Xylitol gum is a useful addition to the other known preventative measures of dental decay prevention, such as brushing and flossing teeth.

The techniques the dentist is using to treat plaque and dental decay have been refined by a new technique describe in this Australian publication as a minimum intervention caries prevention program.

The four methods used in minimum intervention dentistry are described here.

1. Recognition: to recognize potential caries factors early through lifestyle factor analysis and saliva testing.

2. Reduction: alter the diet and lifestyles to increase the pH of the saliva, which will reduce the risk factors for caries.

3. Regeneration: to arrest and reverse minimum lesions at the earliest stage. Use agents such as fluorides and casein phosphopeptides-amorphous calcium phosphates to achieve this.

4. Repair: when a cavity is present, a technique of “conservative caries removal” involves using bioactive materials to allow healing of the dentine layer of the tooth.

Reduction of cariogenic bacteria

I already mentioned above that alkalization of saliva by chewing Xylitol gum could significantly help prevent tooth decay. It does so by raising the pH, while chewing on sugary foods or starchy foods lowers the pH (making it more acidy). Growth of caries producing bacteria, which are called “cariogenic bacteria” is stimulated by acidy saliva and inhibited by alkaline saliva. For this reason people whose diet consists of a lot of vegetables and greens will have more alkaline saliva and are less prone to develop cavities. The worst foods to get cavities are sugar in its many disguises and starchy products (candies, bread, rice, potatoes, pasta, bagels, cookies, cakes).

What can cause bacteria from the mouth to appear in the blood? One common condition is periodontitis, which is a chronic inflammatory condition of pockets of the gums around the teeth. This originates from neglecting your teeth and not flossing. Smokers are more afflicted by this as well. Dental procedures called scaling and root planing are often done for chronic periodontitis. This study from January 2013 shows that there is about the same amount of bacteria that leak into the blood following these procedures when compared to flossing.

Sometimes a dentist will recommend using a short-term antibiotic to reduce the leakage of bacteria into the blood, particularly with people who have heart valve problems or had porcine heart valve replacement in the past. This publication from 2009 also describes that dental flossing causes bacteria to be shed into the blood (bacteremia).

Conclusion

Dental self-care should be taught to children at an early age to educate them to brush their teeth twice a day and floss them at least once per day. At the same time they need education what causes cavities in terms of food intake and that fluoride can help make teeth more cavity resistant. They should avoid sugar in pop, candies and cookies etc. Parents best teach by example! Regular visits to the dentist’s office will safe money on the long term. Regular scaling by a dental hygienist every 6-month will remove plaque from which cavities develop when bacteria thrive in them and produce acids that affects the enamel. Minimum intervention dentistry discussed above (4 methods used) can prevent your teeth from decaying. Regular flossing will keep your gums healthy and reduce the colonization of the mouth with bad, cariogenic bacteria. With all this in place you likely will keep your teeth for a long time and not need dentures or tooth implants because of lost teeth. At the same time you will prevent your immune system being overwhelmed by mouth bacteria, which could have lead to a heart attack had you neglected your teeth. As mentioned in the beginning, a CRP blood test is a useful tool to rule out chronic infection.

More information on:

1. Tooth decay: http://www.nethealthbook.com/articles/dentistry.php#Tooth_Decay

2. Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

Reference: http://www.webmd.com/heart-disease/features/your-guide-gum-disease

Last edited Nov. 7, 2014

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