Do Runners Have a Sugar Addiction?: Is the White Stuff Running You Down and Wearing You Out? “Probably,” says Dr. Phil Maffetone

“Sugar,Sugar”

Sugar, ahh,
Honey, honey.
You are my candy girl,
And you got me wanting you.
Honey, ahh,
Sugar, sugar.
You are my candy girl,
And you got me wanting you.
–The Archies (1969)

Sugar is my vice. My Big Bad. It’s the arch-nemesis of my life’s ambition to remain physically active and healthy. This unrepentant sweet tooth comes with a very heavy price. That feel-good sugar high, whether it comes from fruit juice or cookies, is merely temporary. I might as well call myself a sugar junkie.  I know I’m doing my body a serious injustice.

Could this addiction be a result of my 30-year embrace of vegetarianism? Or this is what happens when your father just happened to be a candy salesman who was always bringing home samples of Kit Kats, Milk Duds, licorice whips, Butterfingers, Baby Ruths, Jolly Ranchers, and so on. It was like having Halloween year round.

Dr. Phil Maffetone has always– and I mean, always– encouraged me to give up sugar. “You will be an entirely new person,”he counseled.”You will be amazed at the transformation.”  Since I am not all that overweight– perhaps five or ten pounds of middle-age spread curdling around the gut– Phil was actually referring to the fact that I’d have much greater energy, feel healthier, cope better with stress, and be less prone to emotional ups and downs.

Sugar got me through my  20s and 30s in flying colors. In 1978, I biked solo across the country– 2,800 miles– primarily on Snickers and Mountain Dew. When I took up triathlon in the early 80s and did the Hawaii Ironman, I was still a fiend for sweets.

On the eve of one 24-hour mountain bike race in the mid- 90s, I remarked to friends who asked why I wanted to subject my body to such a tough physical ordeal: “I’m a glutton for punishment because my gluttony needs punishing.”

Now that I am in my AARP 50s, and running is my main form of exercise, I’m more aware than ever how important good nutrition is. Yet I’m still a sucker for sugar, dosing my daily morning 16-oz cup of Gevalia coffee with at least 6 or 8 small cubes of brown cane sugar. Late afternoon snacks are usually a soft drink or cookie (often both).

If I have TWO resolutions for 2013, it will be these: start running barefoot and finally give up this vexing dependency on sugar. As Phil expertly shows in the following essay (scroll down), “Do Runners Have a Sugar Addiction,”  there really is no reason for an endurance athlete to be dependent on sugary treats for energy needs. As for the general public, sugar is a leading cause of obesity, and contributes to many types of life-shortening diseases such as diabetes. Sugar probably kills as many Americans as tobacco.

A recent excellent piece in Mother Jones magazine by Gary Taubes and Cristin Kearns Couzens provides shocking evidence that Big Sugar is as notorious, shameless, and profiteering as Big Tobacco. Sugar’s real story only began in the late 1970s. The authors explain:

Industry ads claiming that eating sugar helped you lose weight had been called out by the Federal Trade Commission, and the Food and Drug Administration had launched a review of whether sugar was even safe to eat. Consumption had declined 12 percent in just two years, and producers could see where that trend might lead.

So a new marketing advertising campaign was launched whose main goal was to counteract public opinion that eating sugar was bad.

Consumers had come to see sugar as fattening, and that most doctors suspected it might exacerbate, if not cause, heart disease and diabetes. With an initial annual budget of nearly $800,000 ($3.4 million today) collected from the makers of Dixie Crystals, Domino, C&H, Great Western, and other sugar brands, the {Sugar } association recruited a stable of medical and nutritional professionals to allay the public’s fears, brought snack and beverage companies into the fold, and bankrolled scientific papers that contributed to a “highly supportive” FDA ruling… and  made it “unlikely that sugar will be subject to legislative restriction in coming years.”

Over the subsequent decades, sugar would be transformed from what the New York Times in 1977 had deemed “a villain in disguise” into a nutrient so seemingly innocuous that even the American Heart Association and the American Diabetes Association approved it as part of a healthy diet. Research on the suspected links between sugar and chronic disease largely ground to a halt by the late 1980s, and scientists came to view such pursuits as a career dead end. So effective were the Sugar Association’s efforts that, to this day, no consensus exists about sugar’s potential dangers. The industry’s PR campaign corresponded roughly with a significant rise in Americans’ consumption of “caloric sweeteners,” including table sugar (sucrose) and high-fructose corn syrup (HFCS). This increase was accompanied, in turn, by a surge in the chronic diseases increasingly linked to sugar. Since 1970, obesity rates in the United States have more than doubled, while the incidence of diabetes has more than tripled.

Their article ends with this rather bleak scenario that leaves a bitter taste in one’s mouth. Despite the attempts to ban soft drinks in schools or trying to pass a tax on junk food, sugar in all its manifestations,is here to stay:

During the battle over the 2005 USDA guidelines, an internal Sugar Association newsletter described its strategy toward anyone who had the temerity to link sugar consumption with chronic disease and premature death: “Any disparagement of sugar,” it read, “will be met with forceful, strategic public comments and the supporting science.”

Like the tobacco industry before it, the sugar industry may be facing the inexorable exposure of its product as a killer—science will ultimately settle the matter one way or the other—but as Big Tobacco learned a long time ago, even the inexorable can be held up for a very long time.

–Bill Katovsky

***

Do Runners Have a Sugar Addiction?: Is the White Stuff Running You down and Wearing You Out? Probably. 

by Dr. Phil Maffetone

Since the 1960s I’ve known how harmful sugar could be. Growing up on sugar, I first had to get off the stuff. Along the way, I’ve written about it, helped others deal with its miseries, researched it and witnessed the deception by industries, governments and others who, for greed, chose to promote it as healthy. And, in the course of only one generation, millions of third-world people have gone from starvation to obesity through the consumption of sugar (the World Health Organization calls this the “nutrition transition”).

Clearly there are many health and fitness problems that result from the consumption of sugar in more than very small amounts. These go beyond the obvious issue of obesity and diabetes, and include cancer and heart disease. In addition, sugar can increase chronic inflammation, whose associated injuries and physical disabilities range from arthritis and bursitis to muscle, ligament and tendon disorders—if the word ends in “itis” it’s inflammatory (as in tendonitis).

Even marathoners  are getting more fat than ever, despite expending a lot of calories in training. Unfortunately, too many of these calories burned during a workout are in the form of sugar and not fat. This occurs because the consumption of sugar affects one’s  metabolism, forcing the body to use much more glucose for energy and too little fat. The result is less energy available for working out and virtually all other activities, and, because less fat is used for energy, it’s stored throughout the body.

Normally, we burn both glucose and fat for energy all day and night. Those who have trained the body to use more fat have higher energy levels and less stored fat.

The reasons for all this are clear.  The hormone insulin, produced by the pancreas, increases when one  consume sugar, and this results in less fat burning, increased fat storage, and more reliance on glucose for energy.

How much sugar and fat do you burn? This can be tested via a gas analyzer to determine respiratory quotient, providing the percentage of sugar and fat burned. Not many people are aware of this evaluation. But the same type of test, typically performed on a treadmill, measures VO2max or maximal oxygen uptake. Despite its popularity, VO2max is a relatively worthless number to know, whereas the amount of sugar and fat one burns for energy is very valuable.

The over-consumption of sugar and the immediate increase in insulin to high/abnormal levels can be a devastating problem, even for endurance athletes. The question is how much sugar does it take to wreck your metabolism. That answer is individual Many also don’t realize just how much sugar they’re really eating.

Sugar in Disguise

Sugar comes in many forms. One of the world’s most commonly consumed foods quickly converts to it after eating—refined flour. In addition, agriculture scientists have made changes to some of our natural foods, causing them to convert to sugar quickly after eating them too, including potatoes, corn, watermelon and pineapple. In all these examples, the result is an increased intake of sugar, just as if you scooped up the white stuff with a spoon and ate it raw for dinner. These factors are associated with what researchers call the glycemic index of a food, which is related to how much insulin is produced in response to eating sugar or foods that quickly convert to it.

Let’s take a closer look at these important issues.

The processing of flour involves removing the fiber (along with a variety of other nutrients), which increases the food’s glycemic index. It’s not just flour that quickly converts to sugar, as many food items can do the same, including various types of starches commonly used in packaged, canned and other processed foods.

In addition to wheat flour, other foods that don’t contain sugar can also have a high glycemic index. Corn flakes, for example, can produce too much insulin just like eating pure sugar—likewise for some baby food cereals.

So even if you think you’re not eating much sugar, think again: bread, cereal, rolls, bagels, rice cakes, pancakes and foods made with refined flour can convert to sugar and raise insulin fast.

In addition to table sugar, called sucrose, many other names for different versions of the same harmful food are found throughout our foods. These include beet sugar, corn sugar, high-fructose corn syrup, rice syrup, and maltose (and other malt sugars such as maltoxdextrin). If you read ingredient lists on food packages you’ll find sugars listed everywhere; from ketchup and mayonnaise to cold cuts and fish products, not to mention the obvious colas, Gatorade and so-called energy bars. There is even a separate listing for “sugar” under the “carbohydrate” heading on nutrition labels. Most, although not all, of these sugars are the added variety.

Sugar is also hidden in many packaged, canned and otherwise processed food, sometimes not listed on the label. The ongoing name game with labeling is meant to deceive consumers, with food lobbyists petitioning governmental regulation so that the companies that make these products, don’t look bad. It was not long ago, for example, that the only ingredient in peanut butter was listed as peanuts. But sugar was there too. That loophole has been closed, but we usually only hear about others after the fact, so beware of any packaged  prepared foods. The same is true in restaurants, fast foods are full of it, but most food services use sugar as a cooking ingredient. Stick with real food—fresh fish without sauce, a salad with only olive oil and vinegar, fresh fruit for dessert.

Through increased insulin, sugar affects your metabolism in several ways. As noted above, it reduces fat burning in favor of glucose for energy. It literally turns the body into a fat-storing machine. This reduces your endurance—whether you’re training for a marathon or just getting through a busy workday.

Insulin also converts sugar to fat. In fact, about 40 percent of the carbohydrate consumed—from white sugar to products made from refined flour, and other carbohydrates too—turns to fat and is immediately stored in the body. In the majority of people, especially those with too much body fat and burn more sugar than fat for energy, even higher amounts of carbohydrates consumed are converted to fat—perhaps 50 percent or more.

That plain breakfast bagel—which half will turn to fat? Likewise for many low- and no-fat foods—these terms usually mean “more sugar.” That’s because fat is an important source of flavor, and removing it makes a food bland. Manufacturers add more sugar to make these low-fat foods tastier.

Reduced Performance

Among the problems caused by sugar and high-glycemic foods is reduced human performance. Whether you’re a runner trying for a better race time, an executive or student wanting more brain power, a pilot, machine operator or commuter who can’t afford to make an error, poor function is associated with sugar consumption. (Perhaps more accidents come from this than alcohol.)

The most common symptoms of excess sugar intake include sleepiness or loss of concentration after meals. That’s because blood sugar is reduced by insulin, and the brain relies on a constant supply of this form of sugar. Abnormal sugar regulation can occur in those without diabetes or other diseases, and, in addition to increased body fat, one of the more common symptoms is reduced brain function. (Another complaint in those eating too much sugar is intestinal gas, often due to the inability of the body to effectively digest many kinds of sugar.)

Sugar Addiction

If this information is so well known, and it is, why can’t millions just stop eating sugar, and other high-glycemic foods? There’s a war on sugar in some local governments who want to keep sugar out of schools or reduce the amount of sugar in single-serving items. But the sugar industry, whose deception and harmful products are not unlike the tobacco industry, has a secret weapon—addiction.

Many people encounter great difficulty giving up sugar and items containing it. Foods don’t taste the same without sugar, they say. And because sugar is such a widely used ingredient found in many processed products, from so-called “healthy breads” to cereals and energy bars to even tomato sauce, finding out which foods don’t contain sugar or high-fructose corn syrup can be a nutritional challenge. This problem alone is a reason to make as much of the food you eat as possible, from real food ingredients.

The dependency on sugar consumption is an addiction; weaning oneself off sugar is not easy.

For many years, studies have demonstrated that sugar triggers the brain’s pleasure and reward centers. Found in the emotional areas of the brain, these are responsible for the release of “feel good” neurotransmitters called dopamine. These are the same brain areas stimulated by cocaine, nicotine, opiates (such as heroin and morphine), and alcohol. This addiction is not an imaginary thing in the minds of millions of sugar junkies—it’s associated with real physiological changes in the brain. And, perhaps because the brain’s pleasure areas are also very close to the pain centers, withdrawal from sugar has been described by many as painful—not unlike romantic pain or eliminating nicotine or caffeine

.

After a big meal of pasta, bread, a sugary drink, and dessert, does your behavior change? (Do you observe this in others?) Do you react to eating sugary foods by getting sleepy, moody, or losing concentration? When you avoid sugar or don’t eat it, do you experience cravings or uneasiness with strong desires to eat more? Do you tend to eat sugary foods even though you know you shouldn’t, and feel you should better control yourself?

These questions about addiction are similar to indications of drug addiction, and the reason researchers and clinicians see an overlap between sweets and drugs. 

The cycle is perpetuated with the feeling of withdrawal when the drug, or sugar, is not available, followed by the urge to abuse the drug (sugar) again. 

There’s another aspect of sugar addiction to be aware of. Do any of these statements apply to you when it comes to eating sugar-containing foods and other refined carbohydrates?

1. Eating until feeling uncomfortably full.

2. Eating large amounts when not physically hungry

3. Eating much more rapidly than normal.

4. Often eat alone because you’re embarrassed by how much you’re consuming

5. Feeling guilty, depressed, or disgusted after overeating.

6. Marked distress or anxiety regarding binge eating. 

Binge-eating episodes are associated with 3 or more of these questions, and could provide criteria for a clinical diagnosis of binge eating with sugar.

The 4th edition of Diagnostic and Statistical Manual of Mental Disorders (an American Psychiatric Association publication that provides descriptions and characteristic symptoms of different mental illnesses) defines binge eating as a series of recurrent binge episodes in which each is defined as eating a larger amount of food than normal typically during any two-hour period. Without exaggeration, I’ve been given similar histories by thousands of patients throughout my career—people who were not, in my opinion, mentally ill, but had sugar addiction that caused binge eating of it.

There are far more sugar-binge eaters who may not be diagnosed as having a clinical disorder, but the reality is that sugar addiction for these individuals may be very real. In fact, Nicole Avena and colleagues at Princeton University’s Department of Psychology, state that, “the physiological consequences of binge eating may be similar, whether engaged in naturally because of hunger, casually for social or hedonic reasons, or regularly enough to warrant a diagnosis.” In their study on addiction, published in the Journal of Nutrition (2009), they state that, “Individuals with a preference for bingeing on sweet foods tend to binge more frequently.”

Still, many people have trouble accepting the notion that sugar is addicting.

“More scientific studies are needed” is the mantra often voiced by the media, the sugar industry, and its lobbyists, and the sugar addicts themselves.  This denial is a convenient cop-out—of those addicted and especially by those who reap monetary benefits from sugar and sugar-containing products. (To this day, the tobacco industry also claims that, “more studies are needed,” to determine whether cigarette smoking or second-hand smoke is harmful.) 

At the same time, many clinicians have struggled with trying to help patients who could not reduce or eliminate sugar because of its tenacious, unhealthy hold on them. Millions of people have experienced the “pain” of sugar withdrawal—they can’t just stop eating it without being uncomfortable. They’ve enjoyed the brain’s pleasure effects while eating it, now the effects of withdrawal include a type of pain associated with intense craving and desire, and the inability to stop.

Yet the fact that sugar is strongly addictive is knowledge put to use by the very companies who put the sweet stuff in our food and drinks. They carefully place sugar-laden foods in easy-to-access locations, such as at the checkout counter; many are also placed at eye level for children to see while sitting in the shopping cart; holidays are now based more on giving, buying and eating sugar than anything else, it seems.

The Bottom Line

Of all the health conditions I’ve treated in people, all the fitness problems encountered in a wide variety of athletes, coach potatoes and everyone in between, the single recommendation that helped more people the most is the elimination of sugar and high-glycemic foods. In fact, this seemingly simple, single recommendation can dramatically improve your health, reduce body fat, and increase performance. Eliminate these harmful foods today and you can be significantly better tomorrow.

Does this mean no more desserts or enjoyable food? Certainly not! While I avoid all high glycemic foods and meals, I eat healthy, homemade dessert daily—lower glycemic treats, sweetened with small amounts of honey or fruit. Honey is a lower glycemic food, tolerated well by healthy people and most of those transitioning from sugar addiction to a healthier lifestyle.

Ultimately, it’s our personal choice to be healthy or not, to perform well or poorly, to reach our athletic potential or continue to struggle, or be injured or in pain, or live life to the fullest—or, to finally shed the unwanted fat from our body.