In the second of three articles about the real foods that raise your cholesterol (animal products are not among them!), we are going to look at sugar and review a form of sugar known as fructose. (If you missed the first article on trans fats, you can read it here.)

Studies have shown that it matters what form the sugar takes, what the sugar’s source is, and that not all sugars react the same way inside our bodies.

Glucose and Fructose
To help you understand the difference between glucose and fructose and more importantly, why it matters, I have to cover a little science. Bear with me and I’ll try to keep it simple and brief.

Glucose and fructose are two of the most common forms of sugar. They are both simple sugars and they have the same molecular form. But they have a different structure and as a result, they are metabolized very differently in the body.

One recent study followed participants for only 10 weeks. During the study, 25% of the participants’ energy requirements came from consuming either glucose or fructose sweetened beverages. The weight gain of both groups was comparable. But the group that consumed the fructose drinks gained measurably more intra abdominal fat, or the fat that forms around the organs in the abdomen. This fat has been shown to be a risk factor for many chronic illnesses including heart disease.

The fructose group also developed insulin resistance. In other words, they became less sensitive to insulin, the hormone whose job it is to control blood sugar levels through the release of glucose into the blood. Insulin resistance can lead to metabolic syndrome, which has been shown to increase the risk of heart attack among other things. And metabolic syndrome is the precursor to type II diabetes.

A number of studies have now revealed significant health differences between the consumption of glucose and fructose so let’s look at the differences.

Glucose is the basis for all cellular energy. Since every cell in your body uses glucose, when you consume any glucose, your body utilizes it almost immediately. If you consume 120 calories of glucose, less than one calorie will be stored as fat because the rest essentially gets ‘burned up.’ Because it’s typically broken down in the cells, only a small amount of glucose will need to be broken down by the liver, the organ that performs carbohydrate metabolism and detoxification (among other roles.)

As mentioned above, despite having the same molecular formula, fructose has a very different structure. As a result, they are metabolized very differently. Unlike glucose, which is metabolized in the body’s cells, fructose is metabolized completely by the liver just like ethanol — a known toxin — according to Dr. Robert Lustig, Professor at the University of California at San Francisco Medical School.

Metabolism in the liver also creates by products that pose health challenges, especially if the liver is working hard all day. Some of the by products include toxic waste and uric acid (which raises blood pressure and can lead to gout.)

Because our liver has so many important jobs, it can get overloaded and burn out; since  we cannot live without it, the less burden we place on our livers, the better. Given the choice between glucose and fructose, it’s definitely better for our bodies to consume glucose, which can be processed predominantly in the cells of the body, over fructose since fructose taxes our livers.

In addition, there are several connections between fructose and fat. Remember that when we consume 120 calories of glucose only one is stored as fat. But when we consume 120 calories of fructose, 40 of those calories will be stored as fat! When it is metabolized, fructose is turned into free fatty acids, VLDL (the bad cholesterol), and triglycerides, which are stored in the body as fat.

The fatty acids also form fat droplets, which can accumulate in your liver and skeletal muscle tissues. These fat deposits can lead to non-alcoholic fatty liver disease and result in insulin resistance. Fructose is a carbohydrate that is metabolized in the body like a fat so no wonder it impacts our weight and our health so dramatically.

Fructose is not inherently bad. It is commonly found in the fruits and vegetables we’ve eaten for thousands of years. If we consume small amounts from fruits and vegetables throughout the day as our ancestors did, we might derive about 15 grams of fructose from our daily diets. (I did read an interesting report recently that stated the way we grow fruit today has increased the amount of fructose it contains, which would add to the burden.)  But this fructose would also be consumed along with the vitamins, minerals, antioxidants and fiber contained in the fruits and vegetables, which would also help to balance out the sugar intake.

If we increase our fructose consumption exponentially, as we have in recent years, with current estimates that a typical teenager takes in 73 grams a day just in sweetened drinks alone, (and for you non-soda drinkers you’re not off the hook: sugar comes plentifully in sports drinks, processed fruit juices and flavored milks), it’s not hard to see how this could pose metabolic challenges to our bodies and impact cholesterol and heart health.

Too much sugar or processed foods will start us on a road toward diabetes or insulin resistance. While that can occur with all sugars, as we just saw, fructose has an even more damaging effect due to its impact on very small LDL and Triglycerides. While there are many reasons to avoid diabetes as it poses numerous health risks, one of its greatest impacts is on heart health.

According to Dr. Frederic Vagnini, “It is apparent to me in my practice, and it is becoming more and more documented in the scientific literature that individuals with any type of heart ailment, be it a heart attack, stroke, peripheral vascular disease, angioplasty or bypass surgery experience, hypertension, or hyperlipidemia, will be found upon examination to have elevated glucose levels—that is, diabetes or pre-diabetes.

Dr. Vagnini makes it clear that it’s not just the diagnosis of diabetes, but the simple effect of elevated glucose levels. When we have elevated glucose over time we experience what is known as pre-diabetes, and the damage begins to occur, Often it can take years to go from pre-diabetes to full diabetes diagnosis, but during that time, significant damage to our heart health is steadily occuring.

For people with diagnosed diabetes, heart attack and stroke are the leading cause of death; heart attacks in people with diabetes are more serious and more likely to result in death. But even without a diagnosis of diabetes, as Dr. Vagnini has observed, elevated glucose is present in people experiencing any type of heart ailment, which makes it important to take action long before your blood sugar reaches the 125 level that constitutes a diabetes diagnosis. (Many doctors say healthy blood sugar should be below 80. If you want to learn more, you can read my article “The Diabetes Myth” here.)

Dr. Vagnini concludes, “Years ago, cholesterol became a household word because of the hundreds of millions of dollars spent on health education through the National Cholesterol Education Program of the Institutes of Medicine. Today glucose levels are just as important as cholesterol (hyperlipidemia) as a risk factor for heart disease; yet they are not given sufficient attention by medical practitioners.”

Maybe it’s time we start paying attention to the connection.

To your wellness and health: your true wealth!


Author: Inger Pols is the Editor of the New England Health Advisory and Author/Creator, Finally Make It Happen, the proven process to get what you want. Get a free special report on The Truth About Sugar: It’s Not All Equal. Learn more about Inger and receive her free bestselling ebook What Your Doctor Isn’t Telling You.

Article Photo: courtesy of Stuart Miles |


I often hear diabetes described as a consequence of obesity or eating fast food and drinking too much soda. While it is true that bring overweight and drinking soda or eating junk food definitely increases the likelihood of blood sugar concerns, (just one can of soda a day has been shown to increase the risk of diabetes by 22%), it’s a myth that this condition affects only overweight fast-food eaters.

Many of the people I know who have been diagnosed with type 2 diabetes or its precursor, insulin resistance, are healthy and are not overweight. I see diabetes diagnoses more and more among active men and women who don’t fit the stereotypical profile at all. (For two famous examples, think Halle Berry and Tom Hanks.) That’s because many of us are making some basic dietary mistakes in our quest to be healthy. The good news is that these mistakes can be corrected and type 2 diabetes can be reversed or avoided with some simple dietary changes.

What is diabetes?

Diabetes, officially known as diabetes mellitus, is actually a group of metabolic disorders that results from high blood glucose (blood sugar). There are three types of diabetes: type 1 diabetes occurs when an individual is born without the ability to produce insulin and so they must take insulin injections; type 2 diabetes affects 90% of those diagnosed with diabetes and will be the focus of this article; and gestational diabetes, which affects some women during pregnancy.

A metabolic disorder is one in which the way our body uses digested food for growth and for energy is impaired. We break down all of our food into smaller components that can be more readily utilized by the body. Carbohydrates are broken down into glucose, which our cells need for energy and growth: it’s our principal source of fuel.

Our cells, however, cannot use glucose without the presence of the hormone insulin, which is produced by the pancreas. After we eat, the pancreas releases enough insulin to allow for the glucose in our blood to move into our waiting cells. Type 2 diabetes occurs when there is not enough insulin produced or when the cells do not respond to the insulin, also known as insulin resistance.

Too much glucose floating around the blood can cause damage to the vessels that supply blood to our organs. That’s why diabetes can result in heart disease, stroke, kidney disease, and nerve and vision problems.  While eventually the excess glucose is passed out of the body through our urine, the cells that require it for their growth and energy never took it in.

Many people have high blood glucose and have not been diagnosed. They may be in a state known as pre-diabetes. Pre-diabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Pre-diabetes is also called impaired fasting glucose or impaired glucose tolerance. Many people with pre-diabetes develop type 2 diabetes within 10 years. In addition, they are at greater risk for heart disease and stroke as damage to the heart begins to occur even in the very early stages of blood glucose elevation.

Blood glucose measurements fall on a range that runs from insulin sensitivity to insulin resistance to an official diagnosis of diabetes. Often these numbers creep up slowly over time so that before diabetes is officially confirmed, many years of blood sugar increases have been observed. That’s why many doctors say that when your blood sugar numbers are increasing, even by very small amounts over the years, it’s a cause for concern.

Traditionally, normal glucose was said to fall in the range of 70-99 mg/dL. Glucose between 100-125 mg/dL was considered to be impaired and glucose levels of 126 mg/dL and above were diagnosed as diabetes.  However, more physicians are now suggesting that normal glucose is actually under 80, that levels between 80 and 100 indicate pre-diabetes or insulin sensitivity, and levels between 100 and 125 indicate insulin resistance.

If you are overeating sugary foods, your body may not be able to handle all of the glucose you take in at a meal. (When I say sugary, I mean foods that are readily broken down into sugars, such as simple carbohydrates. This is what is measured on the glycemic index, or GI scale). If that’s the case, you know your first line of attack is portion size and food quality to ensure that you are eating healthy fats, protein and complex carbohydrates (fiber-rich foods) at every meal to prevent a huge overload of sugar in your blood all at once after you eat.

Even if your meal portions are not excessive, what you are eating — and when you are eating it — can also lead to glucose overloads that over time can impair your blood sugar levels. So let’s examine a few of the reasons diabetes is creeping into the “seemingly” healthy eater’s world.

Food Combining

The first clue to healthy eating lies in the food combinations I just mentioned. The reason foods like rice and potatoes (and yes, even pasta which surprisingly is not the bad guy it’s been made out to be because it is actually high in protein so its slows the sugar absorption) have been a part of a healthy diet for a long time is that they were eaten in small quantities along with protein, healthy fat and fiber.

If you go to Italy, you don’t typically get pasta for a main dish: it’s a prima or first dish served in a small portion and the second dish or segunda is usually meat or fish. Both would be served with lots of vegetables, on the side or in the sauce. Because pasta has high protein levels, reasonable portions, especially with vegetable sauces are actually a good food choice, especially for meat-free dining.

In Ireland, Shepard’s Pie combined potatoes with a little inexpensive meat and vegetables. In Asia, rice and noodle bowls had lot of vegetables with some fish or chicken or tofu (more on tofu coming soon: it’s not a healthy protein option the way we get it here in the unfermented form. But in the fermented form, it’s a nutritional powerhouse.)

Traditional meals in every culture were created combining proteins (fish, game, insects, or whatever was available) with whatever they had for vegetables (fresh grown in summer, dried or preserved in winter) along with healthy fats like avocados, olive oil, coconut oil, butter or ghee, lard, or nuts and seeds.

Fiber rich foods like vegetables, legumes and true whole grains help prevent overeating because they require more chewing and they slow the eating process down so that your brain has time to signal you that you’re full.  Fiber also been shown to help prevent blood sugar spiking by slowing down its absorption.

Protein helps you feel fuller by slowing the time it takes food to move from your stomach to your intestines. Protein helps build muscle mass, which burns more calories. Your body also burns more calories digesting and metabolizing protein than most other foods and best of all, it has been shown to stabilize blood sugar levels when it’s eaten with sugary foods or simple carbohydrates.

Healthy fats not only make you feel full but they are required to metabolize our fat-soluble vitamins such as A, D and E. In addition, studies have shown that inclusion of healthy fats like olive oil, avocados and coconut oil lowered blood glucose levels significantly.

It’s clear why combining these foods, especially when eating simple carbohydrates as well, works on two levels: first by slowing down the eating process, enabling your body to feel fuller and to receive the signal of satiety so you’ll eat less and then by working directly on the blood glucose levels to minimizing spiking overloads and regulate your blood sugar absorption.

Why Breakfast Matters

The right combination of foods goes a long way toward eliminating blood sugar concerns and can be even more important at key times of the day such as any time your stomach is empty, especially first thing in the morning.  The typical breakfast of donuts, pancakes, muffins, French toast, bread, and yes, even seemingly healthy grain cereal, converts to sugar very quickly. Protein and fiber such as a veggie omelet, or eggs of any kind with whatever veggies and/or lean meat/fish you might have on the side, makes for a better choice. Other good options are steel cut oats or quinoa as a breakfast cereal.

When I ask people about their eating habits, I’m always surprised by the number of “healthy” eaters who tell me they have a bowl of fruit for breakfast. While many of us do need to eat more fruit, (though most of need to increase our vegetables more than fruits), and while whole fruit does have fiber, waking up to a big bowl of fruit/sugar first thing in the morning can start the day down a challenging path and lead to blood sugar spikes and glucose concerns over time.

I’m not saying don’t eat fruit: obviously it adds a lot more nutritional value than a candy bar! But if you have heard about the dangers of donuts or sugary cereal in the am, a bowl of fruit can have a similar impact. If you love your fruit, make sure you are eating plenty of fiber, protein and healthy fat along with it. (Think quinoa or Greek yogurt, and nuts or butter along with it). Also consider spacing it out throughout the day rather than eating it on an empty stomach first thing in the morning.

That leads to a specific call out to those who drink smoothies or shakes or big glasses of juice for breakfast. The same concerns about sugar and fruit are present when they are consumed in liquid form. Because liquids don’t require chewing (and obviously don’t contain solids), they move through the body quickly and don’t stay with you as long.

If you must drink juice, try carrot juice or tomato juice (in a glass bottle, not canned juice or bloody mary mix) and definitely no more than 6 ounces; that’s the size of those little juice glasses your mom or grandma used to have. If you can’t live without your liquid breakfast smoothie or shake, again, make sure there is adequate protein such as a raw milk protein powder as well as fiber and healthy fat included and even then, consider eating something solid first.

A recent study in the journal Appetite revealed that those who drank sugary drinks (including juices, shakes and smoothies) in the morning were hungrier later than those who didn’t. Not a surprise since we just talked about how liquid sugar moves through you quickly. But the study showed that the morning sugar drinkers were still hungrier than the non-drinkers several hours AFTER lunch! They ended up eating more calories throughout the rest of the day than those who did not eat or drink something sugary in the morning.

One Sugar To Avoid

The last hidden glucose threat is one we’ve heard a lot about recently: high fructose corn syrup. If you’ve read the special report available on my website, you know why fructose is more concerning than glucose. (If you haven’t read it yet, it’s free and you can get it at

We all need to limit our fructose consumption for many reasons. The most important for the purpose of this article is that fructose interferes with the hormone leptin’s signaling, which tells our brains that we are full. Over time, consuming high fructose corn syrup can lead to the leptin signaling becoming disrupted so we begin to eat more and more; we do not get the message to stop because we are full. High fructose corn syrup has been directly connected to type 2 diabetes. It is also metabolized in the liver, like a toxin, so eating too much also places a burden on our immune system that can have other health impacts.

Many people tell me that they don’t eat high fructose corn syrup, but when I look in their kitchens, I see it in so many products. It’s in salad dressings, crackers, cookies, bread, ketchup, tomato sauce, cocktail sauce, barbeque sauce, yogurt, and even jars of pickles! It’s everywhere in the processed food world, so if you’re not eating wholly organic and you consume packaged foods, you really have to read the label and look for it.

I know what you’re thinking: do I really need to do that and is a little bit really that bad? It takes about 10 seconds to look at the label before you buy and scan for high fructose corn syrup and it can save your life, as high fructose corn syrup is not only tied to diabetes, but it’s connected to cancer and heart disease as well.

If you eat out, you can bet it is in many of the dishes you are served or the food items you purchase because it is much cheaper to make and serve them and they last longer using high fructose corn syrup, which is why it came into our food supply to begin with.

Avoiding these common mistakes can help to keep your blood sugar levels under control and keep diabetes and insulin resistance at bay.

To your wellness and health: your true wealth!


Author: Inger Pols is the Editor of the New England Health Advisory and Author/Creator, Finally Make It Happen, the proven process to get what you want. Get a free special report on The Truth About Sugar: It’s Not All Equal at

Photo Source: Microsoft Clip Art


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