Are We Drinking Our Way to Diabetes?

New Research: Sugary Drinks May Lead to Diabetes Especially For Women

By Melanie Hundley

First, the word is out.  Seems everywhere we look, even in the mirror, someone we know and care about has Type 2 diabetes or is dangerously close.  And until someone has the very personal experience of walking out of a clinic clutching a new prescription for diabetes drugs, they possibly will ignore most anything researchers write about preventing diabetes, healthy diet, and exercise, me included.  And for some living with Type 2 diabetes, the information still does not seem to register.

Now, let me encourage us.

Make diabetes real whether you have it or are on the fast track to it. Spend an afternoon at the library reading about diabetes in the scientific and medical research journals.  Pick up a medical book about diabetes complications.

Or if you really want a dose of reality, consider volunteering at a dialysis clinic or a hospital or a nursing home requesting to help with diabetics specifically.  Volunteer to read to a blind diabetic. Offer a ride to the grocery store or pharmacy for an amputee.  Got ice? Remember your diabetic neighbors may need ice for their insulin during a power outage.  See for yourself what some complications from diabetes can really mean.  For some of us, that is what it may take to realize how important it is to make any changes we can to improve our health, especially where diabetes is concerned. 

Today, rather than ask if we are eating our way to diabetes, let us focus on what we may commonly be drinking.  How often do we sip on liquids sweetened with common sugars?  I was raised on "sweet tea," so I can testify this is quite possibly the case for those raised in the southern U.S.

In the spirit of knowing more and taking better care of ourselves worldwide, here is my review of a new report published in the August 2011 Journal of Nutritional Biochemistry.  The topic was whether men or women were at more risk for Type 2 diabetes associated with liquid fructose consumption.  The researchers hailed from the University of Barcelona and other organizations.

After reporting potential health problems associated with drinking fructose sugar in 2007, they vowed to dig deeper to see if there was prevalence between women or men for the associated issues.  I will refer to the entire team here as Vilà et al for brevity.  Please see the cited sources for more information.

What Is Already Known?

The researchers set the stage for their report by reminding readers of several tidbits, all cited fully in their article:

• Worldwide, "obesity, metabolic syndrome, insulin resistance, and diabetes" occurrences are at epidemic levels and join the ranks of smoking, high blood cholesterol, high triglycerides, and high blood pressure at attacking the arteries
• Some of these artery-related diseases seem to be "more prevalent in females"
• Consumption of beverages laced with sugars containing fructose has increased, and
• Even one or more daily servings of those beverages may double "the risk of developing diabetes."

The Study

Beverages containing fructose seem to be common, whether man made or natural.  An animal test model was designed and conducted to explore the effects of drinking fructose dissolved in drinking water for two weeks.  The quantities consumed were not noted; however, I assume it was whatever the animals required to quench their thirst. The animals were also provided food. This short duration of sugar water supplementation appears to have been sufficient to develop the symptoms reported.  According to Vilà et al, the control group of animals was not supplemented with sugar.

After reading the researchers' test information, I wondered how that sweetened water might taste or compare to more common choices of beverages.  They advised that the animals were given a 10% weight to volume (w/v) mixture.  The test mixture used would require taking ten grams of fructose and dissolving it in 100 milliliters (ml) of water.  That would produce a 10% w/v mixture.

For U.S. quantities, I took out my pencil and paper.  I located a container of fructose crystals weighing 16 ounces as advertised online.  The displayed label listed one serving of the crystalline fructose as one teaspoon or 4 grams of "sugars" or 4 grams of "carbohydrates."  An online metric weight converter tool reported that 100 ml of water was about 0.4 cups. So, the research test mixture was very roughly a little over 2 teaspoons of fructose in just under a half cup of water if my math is accurate. That mixture provides about 8 grams of sugar carbohydrates in the serving.

I then compared the label ingredients of a major cola product obtained from a link off their website for nutritional information.  They report that one half cup of that particular mixture of their cola contains 27 grams of "sugars" or 27 grams of carbohydrates.  The ingredient list also advises the sweetener in the cola is "derived from corn" and is a "mixture of two simple sugars, glucose and fructose."

Based on that information, I roughly estimated that the cola is about three times "sweeter" than the drinking water given to the animals.  I decided that the amount of sweetener in the animal's water was not excessive in my opinion if cola was much sweeter, even if cola may contain a mixture of glucose and fructose. I stopped there in the rudimentary comparisons as I believe these sources gave me a sufficient frame of reference and satisfied my curiosity about my own selection of sweetened beverages.

Females vs. Males

While observing the animals in the study, Vilà et al paid close attention to how the ingestion of the "sugar" water affected the animals' health.  While some results reportedly showed impact to both the males and females, the researchers were especially interested in noting if any changes were more prevalent in the females.

The Results

Vilà et al report several observations that may help explain some of the molecular mechanisms involved with drinking fructose sweetened products, especially those associated with the increased incidence of Type 2 for women.  The recorded effects apparently induced by the ingestion of a 10% w/v fructose solution included:

• Elevated triglycerides (in males and females)
• Fatty liver (hepatic steatosis) (in males and females)
• Elevated insulin levels (hyperinsulinemia) (only in females)
• Glucose intolerance (only in females).

Readers may not be familiar with some of these metabolic processes identified by the team. However, by identifying these processes, Vilà et al proposes a linkage between fructose-sweetened beverages and increased risk of Type 2 diabetes, and even more so in women than men.

Fructose

If someone decides to reduce their fructose consumption, what should they consider? Beverage labels may indicate the product contains sugar, fructose, sucrose, high fructose corn sweetener, natural sweeteners, etc.

Is it true that where there's "sugar," there is fructose? According to an article on Exploratorium.edu, table sugar, or sucrose, used for sweetening many beverage products is composed of two sugars, fructose and glucose. And in the presence of some acidity, the sucrose will separate into these two simpler sugars and provide a source of fructose.  Reading the ingredients on a beverage product, the acid may be present from other natural juices or added as is the case with a major cola (phosphoric acid).

Other articles containing information about fructose:

• An online article on Consumer Reports.org from 2009 shared some interesting information about sweeteners in a major cola product.
• Reuters recently ran a story about cancer and fructose.
• About.com offers a tidy article about fructose in our diets.
• North Dakota State University Extension Service shares information on how much sugar is in some fruit juices.

I realize this research does not provide a list of "bad" beverages, nor indications of how much fructose is too much.  Readers may considering consulting with a registered dietician to assess how much fructose they are consuming per day.  There are books available with sugar load information. As for drinking our way to diabetes, Vilà and the team may have provided the first clue for those interested in preventing or improving Type 2 diabetes, especially women. 

A special thanks to Dr. Juan Carlos Laguna Egea, Pharmacology Professor, University of Barcelona, for providing additional insight on their research efforts.

Disclaimer: This is an editorial review only, written by a non-medical author, and is subject to change or update.  The information and links contained in this article are for educational purposes only to support further inquiry and should not be used for diagnosis or to guide treatment. Any reader who is concerned about his or her health should contact a licensed medical doctor for advice.  While every effort is made to ensure accuracy, readers should always refer to the original cited sources for verification and/or any interpretation of source material. Author assumes no liability for content, errors, and/or omissions.  

 

Sources

• Consumer Reports.org. (2009, June). Coke vs. Coke: a Tale of Two Sweeteners. Retrieved August 4, 2011, from organization website.
• Dolson, L. (2008, October 9). Fructose: sweet but dangerous. About.com. Retrieved August 4, 2011, from corporate website.
• Exploratorium.  (2011). Science of Cooking: What is Sugar? Retrieved August 4, 2011, from education website.
• Farlex. (2011). Glucose intolerance. The Free Dictionary. Retrieved August 4, 2011, from corporate website.
• Farlex. (2011). Hepatic steatosis. The Free Dictionary. Retrieved August 4, 2011, from corporate website.
• Farlex. (2011). Hyperinsulinemia. The Free Dictionary. Retrieved August 4, 2011, from corporate website.
• Fox, M. (2010, August 2). Cancer cells slurp up fructose US study finds. Thomson Reuters. Retrieved August 2, 2011, from corporate website.
• Mathern,J., Garden-Robinson, J. Fresh squeeze facts: a parents guide to juice. North Dakota State University Extension Service.  Retrieved August 4, 2011, from education website. 
  
• Mayo Clinic. (2011, June 1). High Cholesterol. Retrieved August 4, 2011, from corporate website. 
• The Coca-Cola Company. (2009). Nutrition:Connection.   Retrieved August 4, 2011, from corporate website.
• The Science Company. Preparing Chemical Solutions. Retrieved August, 4, 2011, from corporate website. 
• Vilà, L., Roglans, N., Perna, V., Sánchez, R. M., Vázquez-Carrera, M., Alegret, M., & Laguna, J. C. (2011). Liver AMP/ATP ratio and fructokinase expression are related to gender differences in AMPK activity and glucose intolerance in rats ingesting liquid fructose. Journal of Nutritional Biochemistry, 22(8), 741-751. Retrieved July 29, 2011, from EBSCOhost online database.  DOI:10.1016/j.jnutbio.2010.06.005.

Article Copyright 2011 by Melanie Hundley, U.S.A.  All Rights Reserved. No claim is made to other copyright materials cited.
Photo credit: nuttakit.

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