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Could fructose actually be good for us?

A new study in Diabetes Care by researchers at St. Michael’s Hospital suggests that fructose may not be as bad for us as previously thought and that it may even provide some benefit. ‘Over the last decade, there have been connections made between fructose intake and rates of obesity,’ said Dr John Sievenpiper. ‘However, this research suggests that the problem is likely one of overconsumption, not fructose.’ The study reviewed 18 trials with 209 participants who had type 1 and 2 diabetes and found fructose significantly improved their blood glucose control. The improvement was equivalent to what can be achieved with an oral antidiabetic drug. Even more promising, Dr. Sievenpiper said, is that the researchers saw benefit even without adverse effects on body weight, blood pressure, uric acid (gout) or cholesterol. In the trials reviewed, diets with fructose had the same amount of calories as the ones without and the fructose was incorporated or sprinkled on to test foods such as cereals or coffee.

Adrian Cozma
Adrian Cozma

‘Attention needs to go back where it belongs, which is on the concept of moderation,’ says Adrian Cozma, the lead author and a research assistant with Dr. Sievenpiper. ‘We’re seeing that there may be benefit if fructose wasn’t being consumed in such large amounts,’ Cozma said. ‘All negative attention on fructose-related harm draws further away from the issue of eating too many calories.’ Although the results are encouraging, longer and larger studies are still needed say the authors.

Damning fructose: what’s the evidence?

Dr John Sievenpiper
Dr Bettina Mittendorfer

‘Rather than damning fructose, efforts should be made to promote a healthy lifestyle that includes physical activity and fresh fruits and vegetables while avoiding intake of excess calories until solid evidence to support action against fructose is available,’ write Dr Luc Tappy and Dr Bettina Mittendorfer in their comprehensive review that evaluates the evidence that that fructose may be toxic and involved in obesity, diabetes and even cancer in Current Opinion in Clinical Nutrition & Metabolic Care. ‘Public health is almost certainly to benefit more from policies that are aimed at promoting what is known to be good than from policies that are prohibiting what is not (yet) known to be bad.’

Make the healthy choice the cheaper choice.

Carrot on stick

‘Taxes on “bad” foods are the dish du jour in nutrition policy,’ says Prof J.T. Winkler in an editorial in the BMJ commenting on a new study whose authors though recognising that most taxes are small, based on flawed evidence and have limited, even negative, effects propose more taxes – just a bit higher. ‘These are unlikely to be adopted and would be ineffective if they were,’ writes Winkler who makes the point that the goal should be to make the healthy choice the cheaper choice. And who can argue with this? He suggests a range of options to achieve this including agricultural policy, government catering and corporate margins.

Getting the facts to make the healthy choice …

Catherine Saxelby
Catherine Saxelby

These days, most of us head for Google for the seemingly endless amount of nutrition information just a click away. But as you trawl one site after another, it’s very easy to become confused by all the conflicting information along with a fair amount of total rubbish. Who can you trust? What’s the real deal? How can you sort fact from fiction? One of our regular contributors, Catherine Saxelby (author of the best-selling Nutrition for Life), has just published a comprehensive, 400-page A to Z guide on all the popular food and nutrition topics from acai and additives to zeaxanthin and zinc. So, if you want to have on hand a resource you can trust with all the up-to-date evidence, check out Catherine Saxelby’s Complete Food and Nutrition Companion HERE.

A plant-based diet – good for us and for the planet.

Rosemary Stanton
Rosemary Stanton

Nutritionist Dr Rosemary Stanton, who reviewed the evidence in a series of papers produced by the Medical Journal of Australia, has provided us with a summary of the findings. ‘Most people are aware of the vital roles that vegetables, fruits, wholegrains and nuts can play in a healthy diet. And yet, meat eaters get prickly and many doctors and dietitians tack warnings onto any discussion of vegetarian diets. Are fears of nutritional adequacy for plant-food based diets valid? After reviewing the papers, I wrote an accompanying editorial. I’m not a vegetarian but I acknowledge the wealth of evidence supporting the healthfulness of plant foods. In my current work, I’m also aware of their vital role in reducing our ecological footprint. And as a lover of good food, I don’t understand why we neglect so many great tasting plant foods.

So how does the evidence stand up? In a general sense, a well-planned plant-based diet turns out to be associated with a lower incidence of cardiovascular disease, bowel cancer, type 2 diabetes and obesity. For Australians, the bowel cancer aspect is particularly relevant because it’s a disease for which we score gold medal status. The World Cancer Research Fund’s band of unconflicted experts now rates the evidence as ‘convincing’ that red meat increases the risk of bowel cancer. Some plant foods, by contrast, are protective. The MJA papers show that we can also drop our warnings about deficiencies of protein, iron and zinc.

When writing textbooks in the 1970s, I spent hours poring over lists of amino acids in foods, adding up data to find combinations of plant foods that would equal the protein in meat. Modern biochemistry shows the body can take the amino acids from foods over a day or more and we can stop fussing over which seed goes with which cereal.

Warnings about iron and zinc deficiency are ubiquitous and certainly relevant in countries where people struggle to find enough to eat. In Australia and other western countries, vegetarians can relax because they are no more likely to suffer iron deficiency than meat eaters. It’s true that the haem iron in meat, poultry and seafood is absorbed better than the non-haem iron in plant foods. However, those who need more iron absorb more non-haem, iron with absorption increasing as high as almost 60% absorption during pregnancy. Old studies checked iron absorption after only a single meal taken by meat eaters. Zinc is found in abundance in grains, legumes and nuts, but many nutritionists have been concerned about competition for absorption caused by levels of compounds called phytates in the plant foods. Here the news is also good because of the way we prepare our foods, Adding yeast to breads, soaking legumes and roasting nuts decreases the effects of phytates.

The one relevant warning for plant-based diets is vitamin B12. This vitamin is found naturally only in animal products – although that does include dairy products and eggs. Those who avoid all animal foods will need a supplement or one of the soy foods with added B12.’