Sugars hurt Asians more, says health expert

• Sugar consumption, not obesity is link to diabetes

• In US high fructose syrup is the culprit

• People eat too much and exercise too little

SAN FRANCISCO, California — Asians are 60 percent more likely than Caucasians to develop diabetes even at the same body mass index (BMI).

This is according to Robert H. Lustig, M.D.S.L., Division of Endocrinology-Department of Pediatrics and member, Institute for Health Policy Studies, University of California San Francisco (UCSF).

In a lecture sponsored by the Asian Health Institute Thursday night at the UCSF Hospital in San Francisco, Lustig compared Asians to the famous idiom – “the canary in the coal mine” in that “watching the Asians about what has happening told us about what to do.”

Also president of the Institute for Responsible Nutrition, Lustig said the number of people in China with diabetes is at 98.4 percent greater than the United States with 24.4 percent. He noted, however, that diabetes gets worse when people get older.

Normally, Lustig said, diabetes is associated with obesity. “But that’s not actually, true because the level of obesity in China is not high and diabetes is higher, same findings proved true in India (with 65.1 percent of diabetes, second to China) where the incidence of diabetes is lower than obesity.”

Causation or correlation

“Eighty-percent related but not the same,” said Lustig, “it doesn’t mean that if you are obese, you have diabetes. Asians can afford to gain weight much less than African Americans and Latinos — and this is why, Asians are the canary in the coal mine.”

Genetics only contributes 3.3 kg (of BMI) from all the factors and Lustig said, “the rest can be explained by environment and that genetics contributes five to 10 percent of trait variance of Metabolic Syndrome.”

“Obesity is not the issue in China. At issue are metabolic syndromes such as diabetes, dementia, alzheimer, cancer, and so on,” he added.

Further study revealed that Metabolic Syndrome (MS) could be seen in children but could not be defined. “The reason is because each definition seek to define cut-offs (90 percent), meaning  “it misclassifies points all the time because you’re drawing the line in many places. “

Mechanically, MS is insulin resistance, Lustig said. The cause of MS is till unknown and is difficult to define in adults.

Medical facts

Insulin has two effects on the liver. “When your liver is working right, your glucose is safe and healthy,” Lustig said. “One could be diabetic but not have MS. Metabolic Syndrome is characterized by high blood sugar and high triglyceride (fat) levels.”

Kids have high fatty levels but they don’t drink alcohol, Lustig said. “(It) turns out, sugar does it, too — fermentation of sugar — non-alcoholic fatty liver disease is an epidemic (45 percent – Latinos; 33 percent – Caucasians, 24 percent – African Americans).”

It was learned that the fat in the liver drives insulin resistance, “it’s coming right inside the liver,” Lustig said. Some of the promoting factors include obesity and hypertension.

On the other hand, Type 2 Diabetes has selective insulin resistance.

The western diet has been transported to China for “ease and coolness,” Lustig said. “This  (type of) diet makes people more sick because it’s not about obesity, it’s about what we’re eating more.”

The total caloric intake is not the fat. In 1977, Lustig recalled that America was told to go low fat, from 40 percent to 10 percent. “ It didn’t work as obesity became prevalent.”

In the U.S., the culprit is high fructose corn syrup — current US annual consumption of HFCS is 63 pounds per person. In the rest of the world, it’s sugar. The world sugar consumption has tripled in the past 50 years, according to Lustig.

“All calories count, no matter where they came from including Coca-Cola and everything else with calories,” the Coca-Cola Company said in a campaign.

While we eat too much and we exercise too little, Lustig said, “some calories cause disease more than others, different calories metabolize differently and a calorie is not a calorie.”

Foods that cause weight gain are: number one – potato chips; two – potatoes or fries; and three – processed meats. Between 1822 to 2005, Lustig said there was a 100 percent increase in HFCS and sugar for fat.

Added sugar also promotes weight gain while fructose possesses unique metabolic characteristic, which promote cellular damage and also meets the definition of toxin.

Obese and overweight

Diabetes is “what’s bankrupting Medicare, and Chinese get it more,” Lustic reiterated.

Sponsored by the Asian Health Consortium, the Asian Healthcare Institute, Inc. and the Advisory Cabinet of the UCSF Asian Health Institute, the study also revealed that America is 30 percent obese and 70 percent overweight.

“The 57 million sick people are at fault for poor diet and exercise,” Lustig stated.

The irony is, he said, 40 percent (67 million sick people) out of 70 percent have normal weight with metabolic dysfunction. “These cost a lot of money, bringing the total to 124 million sick people. “

Soda per capita

In San Francisco alone, the highest rates of diabetes hospitalization directly correspond with the highest rates of expenditures on sweet soda drinks.

As of 2010, nearly a third (31.7 percent) of children and adolescents in San Francisco were either obese or overweight. New research shows that the health impacts of liquid sugar are more severe and more immediate than sugar added to foods, including increased risk for liver damage and pancreatic and endometrial cancers. (ncbi.gov)

San Franciscans are spending as much as $62 million a year in health care costs that are directly attributable to sugar-sweetened beverages (San Francisco Budget and Legislative Analyst).

Lustig pointed to several studies about the effects of soda or carbonated drinks.

“China is consuming a lot of sugar,” he said, “ In Europe, every can of soda every day increases the risk by 29 percent (of having diabetes) — and this is causation, it’s correlated as per the International Diabetes Federation and World Bank World Development Indicators Database.”

The same study on US Sugar Consumption revealed that every extra 150 grams of calories increase per day diabetes prevalence is 0.1 percent. “But if this 150 calories were a can of soda, diabetes prevalence increases 11-fold by 1.1 percent,” according to the study.

As the GDP (gross domestic product) increases, soft drink consumption increases in China. “Between 2002-2007, China’s increase in softdrink has been enormous and you can afford it least,” noted Lustig.

Lustig said that the American Heart Association recommends a decrease in  (soda) intake from 22 tsp. per day to 9 tsp. per day for males and 6 tsp. per day for females.

“WHO (World Health Organization) says on its March 5 policy — to cut (soft drink) to 5 percent. Now, here in U.S., we’ve 17 percent consumption,” Lustig warned.

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