A Sugared Society

Sugar is the new black. Americans wear it with everythingwith their coffee, desserts, sodas, breads, cereals, sauces everything. Americans are obsessed with sugar. No matter what form it comes insucrose, brown rice syrup, high-fructose corn syrup, etc.sugar is sugar; and its being consumed in voracious amounts. According to the ERS food consumption data series, between 1970 and 2003, total per capita consumption of sugar and sweetener rose by 19 percent. Annual corn sweetener consumption increased to 79 pounds in 2003, up 400 percent from 1970. Instead of this black flattering the figure, which is its traditional role, this new sugared black is becoming pernicious to Americas figureinside and out. Its exposing Americans to record-high accounts of type 2 diabetes, obesity and blood glucose mania. Too much black and not enough color, i.e., fruits and vegetables, and other colorful, good-for-you dietary choices. Sugar and starch is OK in moderation; in fact, its necessary and good. But the body cannot support the rampant consumption of sugar and starches.
Want to know what happens when enough isnt enough? The National Institutes of Health (NIH) reported an estimated 92 percent of all children with type 2 diabetes are substantially overweight, and about 40 percent are clinically obese. Wait, it gets better. According to the American Diabetes Association, there are 23.6 million children and adults in the United States, or 7.8 percent of the population, with diabetes. While an estimated 17.9 million have been diagnosed with diabetes, 5.7 million people (or nearly one quarter) are unaware they have the disease. A Canadian review noted, In the United States in the next 50 years, it is projected that the percentage of adults with type 2 diabetes will exceed 30 percent, with the vast majority older than 65 years. It is therefore important to determine the best possible dietary and lifestyle modifications to prevent and control this disease and its associated complications.¹
Diabetes is a disease in which the body does not produce or properly use insulin, a hormone that is needed to convert sugar, starches and other foods into energy. What happens in type 2 diabetes is instead of the glucose (sugar) absorbing into the bloodstream and getting shuttled off to the cells by insulinsecreted from the pancreasto be converted into energy, the glucose enters the bloodstream and one of two things happens: either the pancreas doesnt produce enough insulin to transport the glucose or the cells become resistant to the insulin, stifling the normal process leaving energy levels low. Having type 2 diabetes puts the body at an increased risk for other ailments, such as heart disease, blindness, nerve damage and kidney damage.

Sugary Roots

Going back to our roots and getting grounded may be a good place to start. Fungi, herbs, seeds and bark have been shown to stump, reverse and/or prevent diabetic factors. At Georgetown University, diabetic Zucker fatty rats (ZFR), 70 to 75 weeks old, received niacin-bound chromium(NBC; as ChromeMate, from InterHealth Nutraceuticals), SX-fraction of maitake mushroom (MSX; as Maitake SX-Fraction®, from Mushroom Wisdom) and 60 percent (-)-hydroxycitric acid (HCA-SX; as Super CitriMax®, from InterHealth) from Garcinia cambogia, alone or in combination for six weeks.² Researchers found the combination of these three ingredients lowered systolic blood pressure and helped maintain body weight compared to control animals, demonstrating elderly diabetics and even aging individuals might benefit from a similar regimen. More research out of Georgetown confirmed the use of maitake mushrooms for thwarting diabetes. Spontaneously hypertensive rats (SHR) were divided randomly into a control group; a group receiving the anti-diabetic drug, pioglitazone;, and three groups consuming three different concentrations of SX-Fraction (from Mushroom Wisdom).³ SHR in the pioglitazone and SX-fraction groups showed improved glucose tolerance despite no elevation of circulating insulin concentrations and showed enhanced sensitivity to exogenous insulin.

The herbal extract Coccinia cordifolia Syn. Indica, indigenous to India, delivered promising results in a 2003 systematic review and a 2007 double blind, placebo-controlled randomized trial. After conducting an electronic literature search, Harvard researchers analyzed 108 trials examining 36 herbs (single or in combination) and nine vitamin/mineral supplements, involving 4,565 patients with diabetes or impaired glucose tolerance.⁴ They noted, There is still insufficient evidence to draw definitive conclusions about the efficacy of individual herbs and supplements for diabetes; however, they appear to be generally safe. The available data suggest several supplements may warrant further study. The best evidence for efficacy from adequately designed randomized controlled trials is available for Coccinia indica and American ginseng (Panax quinquefolius). Chromium has been the most widely studied supplement. Other supplements with positive preliminary results include Gymnema sylvestre, aloe vera, vanadium, Momordica charantia and nopal. The 2007 study, published in Diabetes Care, randomized 60 type 2 diabetic subjects (aged 35 to 60 years) into a placebo group or an experimental group, and were provided with 1 g/d of Coccinia cordifolia (as Gencinia®, from Gencor Pacific) for 90 days.⁵ Anthropometric, biochemical, dietary and physical activity assessment were carried out at baseline and were repeated at days 45 and 90 of the study. There was a significant decrease in the fasting, postprandial blood glucose and A1C of the experimental group compared with that of the placebo group. The fasting and postprandial blood glucose levels of the experimental group at day 90 significantly decreased by 16 percent and 18 percent, respectively. There were no significant changes observed in the serum lipid levels.
Fenugreek (Trigonella foenum-graecum) seeds have been studied for effects on glycemic control and insulin resistance. Indian researchers randomly divided 25 newly diagnosed patients with type 2 diabetes into two groups: Group I (n=12) received 1 gm/d hydroalcoholic extract of fenugreek seeds and Group II (n=13) received usual care (dietary control and exercise) and placebo capsules for two months.⁶ At baseline, both the groups were similar in anthropometric and clinical variables. Oral glucose tolerance test, lipid levels, fasting C-peptide, glycosylated haemoglobin (HbA1C) and HOMA-model insulin resistance were also similar at baseline. At the end of two months, in group 1, as compared to group 2, fasting blood glucose and two-hour post-glucose blood glucose were not different, but area under curve (AUC) of blood glucose as well as insulin was significantly lower (P<0.001). HOMA model-derived insulin resistance showed a decrease in percent beta-cell secretion in group 1 and an increase in percent insulin sensitivity compared to group 2. Serum triglycerides decreased and high-density lipoprotein (HDL) cholesterol increased significantly in group 1 as compared to group 2 (P<0.05). In a multi-centric unpublished clinical study of 120 subjects, fenugreek (as Trigogen, from Gencor Pacific) showed a statistically significant reduction in fasting and post-prandial glucose levels and HbA1C levels.
Chia seeds are popular for their omega-3 content, i.e., alpha-linolenic acid (ALA), but research has shown their ability to postpone post-meal glycemic response. In an unpublished study, white bread fortified with 30 g of chia seeds (as Benexia, from Proprietary Nutritionals Inc.) overall flattened post-prandial blood glucose response to the point that at 90 minutes, blood glucose was higher on chia seeds than the white bread control group. Conversely, chia seeds lowered incremental insulinemia at 30 minutes and at 45 minutes compared with the white bread control. There was no effect of chia seeds on the AUC for glycemia or insulinemia. Separately, a study published in Diabetes Care found long-term supplementation with salba (as Benexia) attenuated a major cardiovascular risk factor, systolic blood pressure and emerging factors (high-sensitivity C-reactive protein) safely beyond conventional therapy, while maintaining good glycemic and lipid control in people with well-controlled type 2 diabetes.⁷
In unpublished, preclinical trials of an alcoholic extract from the heartwood and bark of Pterocarpus marsupium (as Silbinol®, from Sabinsa) administered to diabetic albino rabbits significantly lowered blood sugar levels and improved glucose tolerance. Additionally, in an unpublished phase II open trial conducted by the Indian Council of Clinical Research, P. marsupium controlled of fasting and post-prandial blood glucose was seen in 67 of the 93 non-insulin dependent diabetes mellitus.

Another bark-related ingredient, Pycnogenol®, aka French maritime pine bark, plays several roles in the management of diabetes. In a double blind, placebo-controlled, randomized, multi-center study, 77 type 2 diabetes patients received 100 mg of Pycnogenol® (from Horphag Research Ltd.) for 12 weeks along with their standard anti-diabetic treatment.⁸ Pycnogenol significantly lowered plasma glucose levels as compared to placebo, as well as HbA1(c). However, the difference as compared to placebo was statistically significant only for the first month. In the Pycnogenol-group, endothelin-1 was significantly decreased, while 6-ketoprostaglandin F(1a) in plasma was elevated compared to placebo. Nitric oxide (NO) levels in plasma increased during treatment in both groups, but differences did not reach statistical significance. Pycnogenol has also been shown to help with diabetic retinopathy. In 2009, researchers found Pycnogenol taken at an early stage of retinopathy may enhance retinal blood circulation accompanied by regression of edema, which favorably improves vision of patients.⁹
The anti-diabetic activity of an extract from the leaves of Lagerstroemia speciosa or banaba, has also been studied. In 2003, subjects received a daily oral dose of Glucofit (previously Glucosol, from Soft Gel Technologies).¹⁰ Glucofit at daily dosages of 32 and 48 mg for two weeks showed a significant reduction in the blood glucose levels. In a soft gel capsule formulation, it showed a 30-percent decrease in blood glucose levels compared to a 20-percent drop seen with dry-powder filled hard gelatin capsule formulation (P<0.001). Another study evaluated the effects of banaba extract on blood glucose levels in 12 subjects, including seven males and five females.¹¹ Blood glucose was measured at the time of fasting and 30, 60 and 120 minutes after ingesting a starch meal (540 kcal). Then, a soft capsule of banaba extract (as Glucofit) with 10 mg of corosolic acid was orally administered every morning for two weeks. A significant inhibitory effect was observed at the each point of fasting and 30, 60 and 120 minutes within one week after administrating the soft capsule. Both weight loss and improved body mass index (BMI) were observed after two weeks.

Sugar Shields

Although diabetics should limit their carbohydrate intake, starch blockers work advantageously to avoid the peaks and valleys starches can cause on glucose levels. Just like paper covers rock, starch blockers can trump the negative effects of high-glycemic carbohydrates. Brown seaweed has been shown to reduce the rate starches and sugars are converted into glucose. One study at Laval University, Quebec, found polyphenols from brown seaweeds (InSea2 , from innoVactiv) may alter the acute glycemic and insulin response to carbohydrate ingestion. Specifically, compared with placebo, subjects experienced a 3.6-reduction in plasma glucose concentration, a 5.9-percent reduction in insulin and a 6.9-percent increase in the Cederholm index of insulin sensitivity.¹² In an unpublished animal study, InSea2 significantly reduced blood glucose in both lean and obese Zucker rats when it was administered orally together with table sugar during a four-week period. Additionally, a separate unpublished, pilot clinical study supported InSea2s use in blood glucose management, as 500 mg of InSea2 decreased AUC and incremental AUC, and lowered blood glucose levels at 60 and 90 minutes.

White kidney bean (Phaseolus Vulgaris) can also serve as a carb blocker, helping to reduce sugar spikes. In an open-label, six-arm crossover study conducted by Medicus Research including 13 randomized subjects, the glycemic index of Wonder Brand White Bread was significantly reduced by the addition of 3,000 mg of a proprietary, standardized extract of white kidney bean (Phase 2 Carb Controller®, from Pharmachem Laboratories) in powder form.¹³ Additionally, in participants receiving 1,500 mg of Phase 2 for eight weeks versus those receiving an identical placebo twice daily, an average of 3.79 lbs was lost compared to 1.65 lbs., respectively. Triglyceride levels in the Phase 2 group were reduced to an average of 26.3 mg/dL, more than three times greater a reduction than observed in the placebo group. A 2009 study reported a northern kidney bean extract (as Phase 2) had in vivo efficacy for inhibition of starch absorption and may prove beneficial in weight reduction in individuals consuming large amounts of starch. It also may inhibit starch-induced hyperglycemia in normal and diabetic subjects.¹⁴
Although not a starch blocker, Hi-maize® (from National Starch) is a resistant starch, i.e., starch that resists digestion in the small intestine and reaches the large intestine. It has been shown to improve insulin sensitivity in healthy and diabetic subjects, as well as subjects with metabolic syndrome.¹⁵ In a 2010 study, researchers concluded Consumption of resistant starch improves insulin sensitivity in subjects with the metabolic syndrome. Unlike in animal models, diabetes prevention does not appear to be directly related to changes in body adiposity, blood lipids or inflammatory markers. A second study published in the American Journal for Clinical Nutrition found dietary supplementation with a resistant starch (as Hi-maize) has the potential to improve insulin sensitivity.¹⁶ In the study, 10 healthy subjects supplemented 30 g/d of resistant starch for four weeks. Insulin sensitivity was higher after resistant starch supplementation than after placebo, and insulin sensitivity during the meal tolerance test (MTT) was 33-percent higher (P=0.05). Forearm muscle glucose clearance during the MTT was also higher after resistant starch supplementation (P=0.03) despite lower insulin concentrations (P=0.02); glucose clearance adjusted for insulin was 44 percent higher. Subcutaneous abdominal adipose tissue nonesterified fatty acid (NEFA; P=0.02) and glycerol (P=0.05) release were lower with resistant starch supplementation, although systemic NEFA concentrations were not significantly altered. Short-chain fatty acid concentrations (acetate and propionate) were higher during the MTT (P=0.05 and 0.01, respectively), as was acetate uptake by adipose tissue (P=0.03). Fasting plasma ghrelin concentrations were higher with resistant starch supplementation (2,769 compared with 2062 pg/mL; P=0.03), although postprandial suppression (40 to 44 percent) did not differ significantly. Measurements of gene expression in adipose tissue and muscle were uninformative, which suggests effects at a metabolic level.

The Sugar Magic in Minerals

Minerals play many physiological roles, one of them being on glucose metabolism. A randomized, double blind, placebo-controlled study out of Corpus Christi, TX, enrolled 476 subjects with poorly controlled type 2 diabetes. They received either 600 mcg of chromium picolinate (as Chromax®, from Nutrition 21)  and 2 mg of biotin, or a matching placebo for 90 days in combination with stable oral anti-diabetic agents.¹⁷ HbA(1c) in the chromium picolinate/biotin group decreased 0.54 percent, mainly pronounced in subjects whose baseline HbA(1c) was greater than or equal to 10 percent, and highly significant when compared with placebo. Fasting glucose levels were reduced in the entire chromium picolinate/biotin group versus placebo, and reductions in fasting glucose were also most marked in those subjects whose baseline HbA(1c) was greater than or equal to 10 percent, and significant when compared to placebo.

Separately, data from a review of 15 clinical studies involving 1,690 supported the safety and therapeutic value of chromium picolinate (as Chromax) for the management of cholesterolemia and hyperglycemia in subjects with diabetes.¹⁸ In Washington, a niacin-bound chromium (as Chromate) given to modestly dieting and exercising African-American women caused a significant loss of fat and sparing of muscle compared to placebo.¹⁹ Once chromium was given at these dose levels, there was a 'carry-over' effect. Blood chemistries revealed no significant adverse effects from the ingestion of 600 mcg of niacin-bound chromium daily over two months. And it also showed an effect on young obese women, as high levels of chromium picolinate (as Chromate) supplementation fared better than just exercise training alone for modification of certain coronary artery disease (CAD) risk factors.²⁰
Manganese, another beneficial mineral, and Chirositol (from Cyvex Nutrition), derived from carob juice and containing D-Chiro-Inositol, significantly reduced blood glucose levels in diabetic mellitus-induced rats after three weeks.²¹ After 12 days of oral administration, Chirositol decreased blood glucose levels by a combined 23-percent when compared to the control group, while administration of both Chirositol and manganese sulfate resulted in a combined 40-percent decrease during the same time period. Also of note was the decrease in overall body weight of both male and female rats receiving Chirositol and manganese sulfate, with females exhibiting a 25-percent body weight decrease over the control group, and males 21 percent as measured during the 21-day study period.

The Fruit of Sugar

Nature and her fruitful bouquet of offerings gives the natural products industry plenty of fruit-derived natural options to help regulate glucose levels, one of them being pterostilbenea natural analog of resveratrol found in berries such as blueberries, cranberries, sparkleberries, lingonberries and grapes. Pterostilbene isolated from Pterocarpus marsupium lowered the blood glucose levels by 42 percent, as compared to 49 percent in the metformin-treated group in diabetic rats.²² Pterostilbene also helps to increase insulin levels, which helps to reduce blood glucose levels.²³ And, in a 21-day study in hypercholesterolemic Chinese Golden Hamsters using synthesized pterostilbene, researchers found the addition of pterostilbene dropped the blood glucose levels 14 percent.²⁴

Its clear, the natural products industry is working hard to make black sexy and flattering again by helping Americans get back on track, leaving their over-sugary, Candyland ways behind and practicing moderation as well as a little supplementation.

References are on the next page...

References for "A Sugared Society"

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2.       Talpur N et al. Effects of niacin-bound chromium, Maitake mushroom fraction SX and (-)-hydroxycitric acid on the metabolic syndrome in aged diabetic Zucker fatty rats Mol Cell Biochem. 2003;252(1-2):369-77

3.       Preuss HG et al. Enhanced insulin-hypoglycemic activity in rats consuming a specific glycoprotein extracted from maitake mushroom Mol Cell Biochem. 2007;306(1-2):105-13. Epub 2007 Aug 1

4.       Yeh GY et al. Systematic review of herbs and dietary supplements for glycemic control in diabetes Diabetes Care. 2003 Apr;26(4):1277-94

5.       Kuriyan R et al. Effect of supplementation of Coccinia cordifolia extract on newly detected diabetic patients Diabetes Care. 2008 Feb;31(2):216-20

6.       Gupta A, Gupta R, Lal B. Effect of Trigonella foenum-graecum (fenugreek) seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: a double blind placebo controlled study J Assoc Physicians India. 2001 Nov;49:1057-61

7.       Vladimir Vuksan, PHD et al. Supplementation of Conventional Therapy With the Novel Grain Salba (Salvia hispanica L.) Improves Major and Emerging Cardiovascular Risk Factors in Type 2 Diabetes  Results of a randomized controlled trial Diabetes Care November 2007 vol. 30 no. 11 2804-2810

8.       Lui X et al. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II Life Sci. 2004;75(21):2505-13.

9.       Robert Steigerwalt et al. Pycnogenol® Improves Microcirculation, Retinal Edema, and Visual Acuity in Early Diabetic Retinopathy Journal Of Ocular Pharmacology And Therapeutics 2009;2(6):537-40

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11.   Tsuchibe Satomi et al. An inhibitory effect on the increase in the postprandial blood glucose by Banaba extract capsule enriched corosolic acid J Integrated Study of Dietary Habits 2006;17(3):255-59

12.   Benoit Lamarche et al. Study of the acute impact of polyphenols from brown seaweeds on glucose control in healthy men and women FASEB. April 2010; 209.4

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14.   Joe A.Vinson et al. Investigation of an Amylase Inhibitor on Human Glucose Absorption after Starch Consumption The Open Nutraceuticals Journal 2009;88-91; http://www.bentham.org/open/tonutraj/openaccess2.htm

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16.   Kendall CWC, Esfahani A, Sanders LM, Potter SM, Vidgen E.  The effect of a pre-load meal containing resistant starch on spontaneous food intake and glucose and insulin responses.  J Food Tech. 2010; 8(2):67-73

17.   Albarracin CA, et al. Chromium picolinate and biotin combination improves glucose metabolism in treated, uncontrolled overweight to obese patients with type 2 diabetes Diabetes Metab Res Rev. 2008 Jan-Feb;24(1):41-51

18.   Broadhurst CL, Domenico P Clinical studies on chromium picolinate supplementation in diabetes mellitus--a review Diabetes Technol Ther. 2006 Dec;8(6):677-87

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21.   Gilbert Gluck et al. Synergistic Effects of d-Chiro-Inositol and Manganese on Blood Glucose and Body Weight of Streptozotocin-Induced Diabetic Rats Current Bioactive Compounds 2010;6: 90-96

22.   M. Manickam et al. Antihyperglycemic Activity of Phenolics from Pterocarpus marsupium J. Nat. Prod. 1997, 60, 609-610

23.   Pari et al. Effect of pterostilbene on hepatic key enzymes of glucose metabolism in streptozotocin- and nicotinamide-induced diabetic rats Life Sciences 79 (2006) 641645

24.   Agnes M. Rimando et al. Pterostilbene, a New Agonist for the Peroxisome Proliferator-Activated Receptor r-Isoform, Lowers Plasma Lipoproteins and Cholesterol in Hypercholesterolemic Hamsters J. Agric. Food Chem. 2005, 53, 3403-3407