Oct. 31, 2011 -- It's no surprise that many sodas have a lot of sugar. What may be more surprising is that many fruit drinks, often billed as healthier alternatives, are often loaded with close to the same amount of sugar and calories.
That is one of the findings of a new report from Yale University.
The report, being presented today at the American Public Health association annual meeting in Washington, D.C., also finds that many beverage companies are marketing their drinks to kids and teens despite a promise to stop.
The American Beverage Association, an industry trade group, takes issue with the new findings. It says the beverage companies have taken many positive steps to protect children's health, including advertising only certain types of drinks on programming to children 12 and under.
Researchers from Yale University's Rudd Center for Food Policy and Obesity looked at the contents of close to 600 drinks made by 14 companies. They included sugary sodas, energy and sports drinks, fruit drinks, flavored waters, and iced teas as well as diet energy drinks and diet children's fruit drinks.
They found that an 8-ounce serving of a full-calorie, non-diet fruit drink has on average 110 calories and 7 teaspoons of sugar. This is?equal to the amount that is found in an 8-ounce serving of sugary soda or energy drink.
"The companies have pledged not to advertise to children or if they do, it will just be for certain better-for-you products," says study researcher Jennifer Harris, PhD. She is director of marketing initiatives at the Yale Rudd Center for Food Policy and Obesity.
Unfortunately, their idea of "better-for-you" drinks is water, sugar, and a tiny amount of juice, she says.
"Many fruit and energy drinks have as much added sugar and calories as sugary sodas," Harris says. Some of these drinks have as much sugar as an 8-year-old should consume in a day, she says.
Full-calorie iced teas, sports drinks, and flavored waters typically contain 3 to 5 teaspoons of sugar per 8-ounce serving, the report states.
The stakes are high, Harris says.
Drinking just one 8-ounce sugar-sweetened drink everyday increases a child's odds for becoming obese by 60%. Sugary drinks are the No. 1 source of added sugar in our diets and the No. 1 source of calories for teens, the report states.
"Parents believe that drinks like Capri Sun, Sunny D, Gatorade, and Vitamin Water are healthy choices for their kids, but they are not," Harris says.
"We were surprised by how little juice there was in children's fruit drinks. And a lot of diet drinks have artificial sweeteners. But unless you know the chemical name, you wouldn't realize it," she says.
Harris says that the only appropriate drinks for children are water, low-fat milk, and 100% fruit juices.
Nutritionist Dana Greene, RD, agrees. "Don't be fooled by healthy-looking labels," she says. "Read the fine print and if you can't pronounce it, you probably don't need or want it in your child's body."
March 28, 2011 (Anaheim, Calif.) -- Nicotine appears to be the main culprit responsible for high blood sugar levels in smokers with diabetes, according to new research presented here at the annual meeting of the American Chemical Society.
Those constantly high blood sugar levels, in turn, increase the risk of serious diabetes complications such as heart attack, stroke, kidney failure, and nerve damage.
''If you have diabetes and if you are a smoker, you should be concerned about this," says Xiao-Chuan Liu, PhD, a researcher at California State Polytechnic University in Pomona, who spoke about his findings at a news conference Sunday.
In his laboratory study, he exposed human blood samples to nicotine. The nicotine raised the level of hemoglobin A1c, a measure of blood sugar control. The higher the nicotine dose, the more the A1c level rose.
For years, doctors have known that smokers who have diabetes tend to have poorer blood sugar control than nonsmokers with diabetes.
However, until Liu's study, he says, no one could say for sure which of the more than 4,000 chemicals in cigarette smoke was responsible.
About 26 million people in the U.S. have diabetes, according to the American Diabetes Association, although 7 million of those are undiagnosed.
Liu took red blood cells from people and treated them in the laboratory with glucose and nicotine at various concentrations.
To measure the effects of the nicotine on the levels of blood sugar, he used the hemoglobin A1c blood test. This test measures the average blood sugar control for the previous three months or so.
The higher the test results, the more uncontrolled the blood sugar is.
Liu used doses of nicotine comparable to what would be found in the blood of smokers. The levels of nicotine he used in the lab would correspond roughly to the exposure a smoker would get by smoking one or two packs a day, he says.
He found that the nicotine raised the HbA1c level by nearly 9% to up to 34.5%, depending on nicotine exposure.
The study was funded internally, Liu says.
The study results about nicotine and blood sugar make sense, says Peter Galier, MD, attending physician and former chief of staff at Santa Monica--UCLA Medical Center & Orthopaedic Hospital. "I was always under the impression that nicotine was the culprit," Galier says. He reviewed the study findings for WebMD.
''What the study is telling us is that nicotine is most likely the reason smokers have elevated HbA1c levels," says Galier, an associate professor of medicine at the University of California Los Angeles David Geffen School of Medicine.
Ideally, Liu says, doctors will use the new study results to encourage patients with diabetes to stop smoking cigarettes. But he warns that smokers shouldn't use the smoking cessation products that contain nicotine, such as the nicotine patches, long-term because of their effects on blood sugar.
He couldn't pinpoint an ideal maximum time for using such products.
Makers of nicotine patches suggest that smokers use patches of progressively declining strengths as they wean themselves from cigarettes.
Galier encourages short-term use of the nicotine replacement products. "I usually recommend using each strength for two to four weeks," he tells WebMD. With a three-step program, people ideally stay on the product only for 6 to 12 weeks, he says.
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
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March 24, 2011 -- Researchers taking nutritional snapshots of the population around a major metropolitan area for more than 30 years say they’ve noticed something interesting: as consumption of added sugars has increased, so too, have body weights.
Researchers parsing the myriad reasons for America’s collective growing girth have looked at the contributions of total calories and fat, experts say, but less is known about what role added sugars might play.
Added sugars are sugars in foods that aren’t naturally occurring. They’re mixed in as sugar or syrups during processing or preparation.
The sugar in fruit, fructose, for example, wouldn’t count as an added sugar. But the high-fructose corn syrup that’s added to some kinds of fruit cocktail would fall into that category. So would sugars added to sweeten yogurt, soft drinks, and processed snacks and desserts like cookies, cakes, and pies.
“We’re looking at trends,” says study researcher Lyn M. Steffen, PhD, MPH, an epidemiologist at the University of Minnesota School of Public Health. “We looked at them in women and men, and in both men and women, added sugar intake increased since 1980.”
“At the same time, BMI [body mass index] has also increased,” Steffen tells WebMD. Though the study isn’t designed to prove that one is causing the other, the closely parallel trends over 27 years of data collection may point to the need for closer investigation. “It looks suspicious,” she says.
The study was presented at the American Heart Association's Nutrition, Physical Activity and Metabolism/Cardiovascular Disease Epidemiology and Prevention 2011 Scientific Sessions.
An industry group that represents sugar producers says the evidence of a connection is lacking.
“A single study, performed by AHA [American Heart Association] or any other group, is inconclusive and needs further investigation,” says Andrew Briscoe, president and CEO of the Sugar Association. “When a major review occurs, the results always come back the same -- there is no scientific evidence to support a need to set an intake level for sugar.”
“It is necessary for consumers to understand the importance of practicing moderate consumption of all foods and beverages while maintaining a healthy lifestyle” Briscoe says. “Focusing on any one food takes away from the most important and more tangible goal of caloric balance.”
Every five years since 1980, researchers have surveyed about 5,000 people around the Minneapolis-St. Paul, Minn. area, asking questions about what they ate within the last 24 hours. They also collected information about body weight, age, socioeconomic status, and lifestyle.
Researchers ran the answers through a software program that has compiled nutritional analysis information on hundreds of thousands of food products. By doing that, they were able to tell how much sugar people ate was added or naturally occurring.
Jan. 10, 2011 -- All that added sugar in the diets of typical teens could increase their risk for heart disease, a new study suggests.
After analyzing data from a national health survey, researchers concluded that the average teenager eats the equivalent of 28 teaspoons -- or close to 500 calories' worth -- of added sugar each day.
Added sugars are calorie-containing sweeteners present in processed foods or beverages, and spotting them on food labels is not always easy.
Sugar, corn syrup, and high-fructose corn syrup are among the most commonly used and widely recognized added sugars. Less well known are sweeteners containing fructose, sucrose, and maltose.
In a study published last April, researchers from the CDC and Atlanta’s Emory University found that adults whose diets contained the most added sugar also had the lowest HDL, or good, cholesterol and the highest LDL, or bad, cholesterol.
Their new study, published today in the American Heart Association (AHA) journal Circulation, finds the same pattern among teens.
The study merged a 24-hour dietary recall by teens participating in the National Health and Nutrition Survey (NHANES)? between 1999 and 2004 with data from the U.S. Department of Agriculture on added sugar content in foods.
The teens’ average daily consumption of added sugar was three to five times higher that the limit deemed acceptable by the American Heart Association (AHA), which considers a “prudent upper limit” to be about 100 calories, or 6 teaspoons, for most women and 150 calories, or 9 teaspoons, for most men.
When the researchers examined data on cholesterol levels and other heart disease risk factors among the teens in relation to their added sugar consumption, they found that:
Although the findings raise questions about whether the added sugar in processed foods contributes to poor cholesterol profiles and other heart disease risk factors, more direct research is needed to prove a link.
“We need controlled studies to really understand the role of added sugars in cardiovascular disease,” researcher Jean A. Welsh, MPH, RN, tells WebMD.? “But it is important to be aware of the added sugar in the foods we all eat.”
Sugary sodas, sports drinks, and fruit- or fruit-flavored drinks containing added sugars are among the largest sources of added sugars in the diets of children and teens, Welsh says.
Teaching children and teens about healthy eating and giving them the tools they need to do so could make a big difference in childhood obesity and, potentially, heart disease rates in the future, preventive cardiologist Suzanne Steinbaum, MD, of New York’s Lenox Hill Hospital tells WebMD.
She points to public health initiatives like Michelle Obama’s Let’s Move campaign as a step in the right direction.
“Nearly a third of kids in this country are overweight or obese,” she says. “We don’t yet know what this will mean for cardiovascular risk, but it is probably a safe bet that we are going to see younger and younger people with heart disease.”
She says the public needs to send a strong message to the food industry.
“The message is to get the added sugars out of processed foods,” she says. “That isn’t likely to happen unless consumers demand it.”
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Oct. 11, 2010 (San Diego) -- High-fructose corn syrup, a sweetener used in soft drinks and many other products, isn't more likely than sucrose, commonly called table sugar, to promote weight gain, according to a study presented at the annual meeting of the Obesity Society.
The study was supported by the Corn Refiners Association, a trade organization representing corn refiners who make high-fructose corn syrup and other products.
When overweight and obese people were given each type of sweetener, ''we saw no differences between the two treatments," says researcher Joshua Lowndes of the Rippe Lifestyle Research Institute at Florida in Celebration.
While high-fructose corn syrup has gotten a reputation as a "bad" sugar, the new study found that neither sweetener, when consumed as part of a sensible diet, promoted weight gain or fat accumulation.
To compare the two, Lowndes assigned 105 overweight or obese people, average age 38, to one of four groups. All were instructed to eat a diet that would maintain their current weight over the 10-week study.
They were assigned to drink milk sweetened with either high-fructose corn syrup or sucrose.
One group drank 10% of their calories from a high-fructose corn syrup-sweetened milk, and another group got 20% of their calories from the beverage.
A third group drank 10% of their calories from a sucrose-sweetened milk, and a fourth group drank 20% of their calories from the beverage.
The levels of sweetener consumed are typical levels, according to Lowndes.
They compared body weight before and after the study, as well as body fat percentage, fat mass, and abdominal fat. The participants visited the clinic weekly and reported their dietary intake.
''There were no differences in the amount of calories they decided to eat," Lowndes says of the sucrose and high-fructose corn syrup groups. "If there were differences, they are very small."
''Energy intake was up about 350 or 400 calories a day," he says.
At the end of 10 weeks, the difference in body weight for all groups averaged 2 pounds, he found. There were no substantial changes in body fat percent, fat mass, or belly fat.
The study is small, cautions Connie Diekman, RD, director of university nutrition at Washington University in St. Louis, who attended the presentation.
Even so, she says, ongoing research seems to suggest the study results make sense. "Evidence so far suggests it's the sugar intake, not the type" that leads to weight gain and other problems.
In 2008, the American Medical Association concluded that high-fructose corn syrup does not appear to contribute more to obesity than any other caloric sweetener, but said that further research is needed on the health effects of all sweeteners.
When Diekman counsels university students, she doesn't tell them to avoid high-fructose corn syrup. She does advise them to limit their sugar intake.
"My recommendation is, all added sugars must be less than 10% of total calories daily," she tells WebMD. In practical terms, what does that mean?
If you can eat 2,000 calories a day to maintain your weight, she says, ''a 250-calorie cookie may be more than you should eat."
Diekman is immediate past president of the American Dietetic Association and serves on the 2010 advisory panel for the National Dairy Council.
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
May 27, 2010 -- We know that a spoonful of sugar helps the medicine go down, and now new research shows it may also take some of the ouch out of your infant's routine shots.
The findings, which appear in the Archives of Disease in Childhood, show that infants up to 1 year of age shed fewer tears and may feel less pain when they drink a sweet-tasting sugary solution (sucrose or glucose water) before their routine immunization, when compared with infants who tasted water or received no treatment.
"Sucrose or glucose along with other recommended physical or psychological pain reduction strategies such as non-nutritive sucking (NNS), breastfeeding or effective means of distraction should be consistently utilized for immunization," conclude the researchers, who were led by Denise Harrison of the Hospital for Sick Children in Toronto.
NNS typically refers to the use of pacifiers or sucking on thumbs or other fingers. The researchers can't recommend precise doses or concentrations of sugar water at this time, but they definitely feel this practice is worth a shot. "Health care professionals should consider using sucrose or glucose before and during immunization," they conclude.
For children getting multiple shots, they suggest giving the sugar water before the first shot and throughout the procedure so the pain-relieving effects last.
Researchers analyzed 14 studies of infants up to 1 year of age who received sugar water (sucrose or glucose), plain water, or nothing before getting their routine immunizations. The studies comprised data on 1,674 shots. The study found that infants given sugar water cried less than infants who received water or nothing in 13 of the 14 studies reviewed.? The effects tended to wane as infants aged.
"This is something we do all the time before a circumcision in a newborn," says Laura Wilwerding, MD, a clinical associate professor of pediatrics at the University of Nebraska Medical Center in Omaha.
"We dip a gloved finger in sucrose water because it is pretty well-accepted that sucrose or glucose water work as anesthesia," she says. "It is good news that this helps with shots as infants grow older."
Sugary solutions can be used in other situations as well. "It can also be a useful strategy to get kids to settle down for stitches, especially if they are at an age where they are still sucking on a pacifier," she suggests. Parents can dip the pacifier in the sweet solution, she explains.
April 17, 2009 -- New research that suggests a link between dangerously low blood sugar and dementia in older patients with type 2 diabetes raises more questions about the strategy of aggressively treating diabetes patients to achieve tight glycemic control.
Older patients in the study whose blood sugar fell so low that they ended up in the hospital were found to have a higher risk for dementia than patients with no history of treatment for low blood sugar, known medically as hypoglycemia.
Having uncontrolled diabetes is associated with an increased risk for Alzheimer's disease and other age-related dementias in elderly patients.
The thinking has been that aggressive treatment to achieve tight glycemic control would lower this risk.
But the new study suggests such treatment may do more harm than good in older patients if blood sugar levels drop to very low levels.
Several other recent high-profile studies have raised similar concerns.
Researcher Rachel Whitmer, PhD, of Kaiser Permanente Division of Research in Oakland, Calif., says understanding the impact of blood sugar on cognitive function is older patients is critical.
"We are in the midst of an epidemic of type 2 diabetes and we are going to see more dementia than we have ever seen before as these patients age," she tells WebMD. "We really have to get a handle on the role of glycemic control in this."
The study included 16,667 patients with type 2 diabetes enrolled in a northern California diabetes registry. The average age of the patients at study entry was 65.
Whitmer and colleagues examined more than two decades of medical records to determine whether the participants had ever been hospitalized or treated in a hospital emergency department for hypoglycemia.
Symptoms of hypoglycemia can include dizziness, disorientation, fainting, and even seizures. Mild to moderate episodes often don't require treatment, but severe episodes can lead to hospitalization.
None of the study participants had a diagnosis of dementia when they were enrolled in the study in 2003. Four years later, however, 1,822 of the more than 16,600 patients (11%) had been diagnosed with dementia.
Compared to patients with no history of low blood sugar requiring treatment, patients with a single episode of hospital-treated hypoglycemia were found to have a 26% increase in dementia risk.
Patients treated three or more times for hypoglycemia had nearly double the dementia risk of patients who had never been treated.
The study appears in this week's issue of Journal of the American Medical Association.
Alan M. Jacobson, MD, is the director of psychiatric and behavioral research at Harvard Medical School's Joslin Diabetes Center.
He calls the study "compelling" but adds that more research is needed to prove that severe hypoglycemia is a cause of dementia.
Dec. 30, 2008 -- Maintaining normal blood sugar levels as we age may protect against more than diabetes. It may also help prevent age-related memory loss, a new study shows.
Using high-resolution brain imaging, researchers showed that rising blood sugar levels selectively target a key area of the brain linked to memory decline.
The finding suggests that interventions to improve blood sugar, such as getting regular exercise and eating a healthy diet, may help both the body and the brain as it ages.
"We have known that exercise improves blood sugar and that it helps prevent age-related memory loss," says lead researcher Scott Small, MD, of Columbia University Medical Center. "In this study, we were able to show the specific area of the brain that is impacted by rising blood sugar."
Focusing on the hippocampus -- the area of the brain associated with memory and learning -- Small and colleagues previously identified a section that was most associated with age-related memory decline.
In their newly published study, the researchers looked at how this area, known as the dentate gyrus, is affected by changes typically seen with aging, such as rising cholesterol, body weight, and blood sugar.
Human and animal imaging studies confirmed that rising blood sugar was the only change directly associated with decreased activity in the dentate gyrus.
Because blood sugar levels tend to rise with age, the finding suggests that monitoring and taking steps to lower blood sugar as we grow older may be an important strategy for preventing age-related cognitive decline for everyone, not just people with diabetes, Small tells WebMD.
The study was funded by the National Institute on Aging, the American Diabetes Association, and the McKnight Brain Research Foundation. It appears in the December issue of the journal Annals of Neurology.
"Beyond the obvious conclusion that preventing late-life disease would benefit the aging hippocampus, our findings suggest that maintaining blood sugar levels, even in the absence of diabetes, could help maintain aspects of cognitive health," Small says in a news release.
Because exercise improves the ability of the muscles to process glucose, it makes sense that it helps protect cognitive function as we age, Small says.
Linda Nichol, PhD, of the National Institute on Aging, tells WebMD that the research may help explain why diabetic people are at increased risk of developing Alzheimer's disease.
She says studies are under way to determine if drugs that regulate blood sugar can help slow cognitive declines in people with early evidence of the disease.
It is far too soon to say if people who don't have diabetes might benefit from taking the drugs as they get older, she says.
"We already know that physical exercise can help people stay cognitively sharp as they age," she adds. "This study may help explain why."