A fruitless call to arms

I feel so badly for anyone who is trying to raise a healthy kid or grow a healthy fetus or just live a healthy life.

There you are, bopping along, doing the best you can. When whaddayaknow, out pops a headline about Dr. Somebody who stands up at a conference and announces that we’re doing everything wrong, wrong, WRONG!

A case in point: A couple of days ago over on MD Consult, the headline read, “Fructose is metabolized like fat; leads to obesity, expert says.”

Fructose? Fructose as in fruit? Healthy, wholesome, natural fruit?

Reporter Christine Kilgore reports the gist of Dr. Robert H. Lustig’s presentation as, “Fructose is a ‘dose-dependent chronic hepatotoxin’ that is metabolized like fat and leads to all the manifestations of the metabolic syndrome….”

Let’s pause for a moment and make sure everyone understands just what metabolic syndrome is. In establishing the diagnosis, doctors look for three of the following:

  1. Increased waist circumference (>40″ in men, >35″ in women)
  2. Elevated triglycerides (>150 mg/dL)
  3. Low HDL [“good”] cholesterol (<40 mg/dL for men, <50 mg/dL for women)
  4. Hypertension (systolic BP>130 and/or diastolic>85, or hypertensive medication use)
  5. Impaired fasting glucose (>110 mg/dL)

If you’re unlucky enough to have all five, you have twice the risk of heart attack or stroke as compared to the general population.

Okay, so when we left off, Dr. Lustig was telling us that all that fructose is going to rot out our livers and make us fat, diabetic, stroke or heart attack victims. He makes it sound like you’d be better off having a can of lard for lunch than an apple or an orange. Scary stuff.

If that isn’t enough Kilgore quotes him as saying, “Fructose is like alcohol without the buzz, and we are feeding it to our kids nonstop….” Say what? I guess you’d be better off sending Junior to school with a fifth of vodka in his lunch box than that darned apple or orange. Even scarier stuff.

And finally, Lustig ends on an inspirational note, “We as pediatricians are on the front lines. It’s our job to fix this.” Did I mention that this was the plenary address at the annual meeting of the American Academy of Pediatrics? Also, Kilgore reports that he got a standing ovation after this pep talk.

Now, I am not a doctor, not a pediatrician, not a nutritionist or dietician. All I have going for me is too much education and a sprinkling of common sense. So playing the role of Jane Q. Public, let me ask this rhetorical question: Is it the case that fructose is fructose is fructose?

In his talk, Dr. Lustig seemed to be decrying the growing tendency to give kids fruit drinks. Now a fruit drink can be pure fruit juice, or it can be a mixture of a modest portion of juice along with a heckuva lot of water, some artificial flavor and coloring, and a huge hit of high fructose corn syrup, which is known in various circles as HFCS. Does it make a difference which one little Susie or Edward is guzzling down?

How about when that fruit juice is contained inside a whole fruit (an apple, rather than apple juice, an orange or tangerine rather than OJ)?

Personally, HFCS scares me. It’s not a natural substance. Wikipedia tells me that it:

…Comprises any of a group of corn syrups that has undergone enzymatic processing to convert its glucose into fructose and has then been mixed with pure corn syrup (100% glucose) to produce a desired sweetness. In the United States, HFCS is typically used as a sugar substitute and is ubiquitous in processed foods and beverages, including soft drinks, yogurt, industrial bread, cookies, salad dressing, and tomato soup.

The Mayo Clinic says that the jury’s out on whether or not HFCS is just fattening, empty calories or something more sinister, but personally, I avoid it, which is very difficult to do. Nowadays, they put it into everything. For example, I found only one rarely stocked brand of relish that did not contain HFCS. Like you need that much sweetener in dill relish? They put it in fiber bars and protein bars and just about every processed food you can find at the supermarket.

And I think I’d agree with Dr. Lustig that kids swilling even pure fruit juice all day is not the best plan. The sugar content makes it a kid-favorite, but it’s hard on the teeth and kids may use it to forego eating more nutritious solid food — at least that’s what my niece does.

But does Dr. Lustig really believe that whole fruit, complete with all its natural fiber, vitamins, minerals, juice, and phytochemicals is equivalent to a cup o’ HFCS? Nah. My common sense rebels.

My Aunt Joan made it to her 91st birthday, and she absolutely loved eating fruit, whole fruit. You name it, she loved it. There was always a basket brimming with different kinds of fruit in the middle of her dining room table. And the fruit wasn’t wax, nor was it for display. And the only reason Joan passed on was that after burying husband #4, she’d had enough. Too old and too tired to go for #5, she died a few months later.

But up until the last year of her life, she could go out and walk for four or five hours without stopping. She was no wizened up “little old lady.” She was amazingly hale and healthy.

So while these pediatricians whip up anti-fruit hysteria, I think I’ll go out in the kitchen and eat a clementine and a big ol’ juicy apple, in honor of Aunt Joan. Sometimes, you just gotta live dangerously.

Reference: Kilgore C. Fructose is metabolized like fat; leads to obesity, expert says. MD Consult. Philadelphia, PA: Elsevier Global Medical News. 16 Nov 2009.

Copyright © 2009 by Candace L. Van Auken. All rights reserved.

I am a writer and an activist for people who are disabled by chronic illness. I am also interested in issues related to the LGBTQIA community and to women making music.

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Posted in Nutrition, Pediatrics, Public health

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