Fructose: Weighing in on the Debate

Fructose has been demonised in the media recently, touted as the cause of obesity and cardiovascular disease. We believe this is misleading. Wesley Weight Management Clinic Managing Director, Neil Holt, explains why:

 

The obesity epidemic of the last 30 years is not due to a single cause and there is no magic solution: it is misleading to say otherwise. People who are overweight and have struggled to reach and maintain a healthy weight understand that very well.

The obesity epidemic in developed and developing countries is because we are consuming too much of everything: too much fat, protein and carbohydrate, calorie dense snacks, sugary drinks and alcohol. Reduced activity levels also plays a part, but the overconsumption of everything is the real world culprit.

Food has an energy content measured in calories and in our experience many overweight adults are consuming in excess of 3000 Calories per day when necessary levels for weight maintenance are in the order of 1700 - 2200 calories depending on age, gender and activity level. The overconsumption of food - including calorie dense snacks and sugary drinks - leads to increased weight, obesity and many adverse health outcomes including diabetes, heart disease and cancer. Any food - either natural or processed - when over consumed will have adverse outcomes and these are documented daily by health professionals and researchers worldwide.

A proponent of low fructose diets has accused Wesley Weight Management Clinic of advocating the use of meal replacements that are high in fructose, which he claims causes obesity and cardiovascular disease. We believe this criticism is wrong and based on a misunderstanding of how our clinical weight loss program works.

Wesley Weight Management Clinic is not a conspiracy or a product, it is well balanced clinical program designed to help people achieve and maintain a healthy weight. The Clinic is staffed by Doctors, Dietitians, Exercise Physiologists and Psychologists who work as a clinical team to help people lose weight and learn the skills to maintain a healthy weight. 

Our ownership group and our staff are committed to providing evidence based, ethical and high quality preventative health services and we continuously track and share our results with our clients, their Doctors and the community at large to demonstrate the benefits of investing in health. I believe we conduct the best weight loss service in Australia demonstrated by our outstanding weight loss results.

Meal Replacements - Optifast 800

Meal replacements, when used properly under medical supervision, are very beneficial at the commencement of weight loss. Moving people safely from 3000 Calories per day to 800 - 1000 Calories per day places them in a negative energy state and so their bodies start to process their fat stores for energy and they lose weight. In combination with moderate exercise, women can lose up to a 1kg per week and men up to 2 kg per week.

There are up to 15 meal replacements available on the market and some are nutritionally balanced and others are not. We have used Optifast 800 safely for 10 years and it is supplied by Nestlé Healthcare Nutrition.

Meal replacements are made from processed milk, similar to baby formula. They contain milk protein (14gm), fat (3gm), milk sugars (lactose 8-10gm) and added fructose (8-10 gm) for flavour and energy, vitamins and minerals. The percentage of each component is similar to a healthy balanced diet but the total portion size of the shake is 160 calories when made up with water. The energy content of 1 sachet is similar to 2 slices of bread.

Meal replacements fall into the category of low carbohydrate diets as their purpose is to switch on the oxidation of fat stores for energy, resulting in weight loss. But because our brain and nervous system require sugars that are metabolised from dietary carbohydrates for energy; meal replacements must have some carbohydrate content.

At the Wesley Weight Management Clinic people can safely consume up to five sachets of Optifast 800 per day, or 800 Calories, and that provides them with all their essential daily vitamins and minerals and keeps their hunger controlled. We monitor our clients' blood chemistry and the results of these blood tests tell us that the meal replacements used in our Clinic are safe and not causing any harm, and importantly, our clients lose weight.

Fructose

Fructose is a natural sugar found in 50 different fruits and vegetables - all of us have been consuming fructose our whole life. Fructose has been part of the food chain since man evolved.
Fructose is present in Optifast 800, but there is no more fructose than is in an apple. In five sachets per day of Optifast 800, total fructose does not exceed 50gms, a quarter of the levels of fructose that people consuming 3000 calories per day would consume (including two cans of soft drink).

It is wrong to say there is danger to health at the low levels present in Optifast 800. In fact 50gms of fructose a day is beneficial particularly to diabetics. It is only a danger to your health at artificially high levels, as seen in some published trials where already overweight and obese adults were fed artificially high levels in addition to their normal diet. These trials are conducted in a similar way to toxicological studies as opposed to food safety studies and no food would be considered safe under these conditions. Even pure water triggers adverse health at high repeat dose levels!

It is very difficult to consume high levels of fructose on its own because as a food additive it is combined with glucose in the form of sucrose (sugar) or as high fructose corn syrup (HFCS), a roughly equal mixture of glucose and fructose. The point is that in consuming sugary drinks or snacks on a daily basis, the total calorie content from their total sugar content is doing harm, not just the fructose content. Our bodies convert any excess calories in our diet to fat - it doesn't matter if the calories are from carbohydrate, fat or protein. At the Wesley Weight Management Clinic we teach our clients how to avoid processed foods and drinks with a high sugar content from whatever source, and this is a critical plank of our success.

Our Results from Using Optifast 800 in Weight Loss

At the Wesley Weight Management Clinic we have recorded the weekly visits of more than 6000 clients and their weight loss results for 10 years. We believe we have the largest database on weight loss in Australia and we publish our results on our website and in credible health journals and forums.

The main reason for recording weekly progress is to make sure that weight loss is done in a safe and sustainable way. All clients who use Optifast 800 are medically counseled by a Doctor and their blood is tested prior to commencing Optifast 800. Those who are not suited to meal replacements are prescribed a meal plan with a set calorie level.

We know that Optifast 800 used in our clinic is safe, effective and well tolerated by clients. All clients transition off Optifast 800 during their weight loss program back to normal healthy meal plans. They are taught and counseled on healthy food choices, correct portion size and good exercise - habits that will last them a lifetime. Their challenge will be to continue those good habits when they leave our environment.

Our results show that our clients lose weight, lose fat, reduce their waist lines, maintain lean tissue (muscle), lower their blood pressure, lower their total cholesterol, LDL (bad cholesterol) and blood triglycerides, lower their blood glucose and lower their cardiovascular risk (risk of heart attack) by up to 47%. We have presented these results to the International Congress of Obesity, the National Heart Foundation and the Federal Parliamentary Enquiry into Obesity and we are rightly proud of them.

In conclusion, we unashamedly stand by our Clinic, our staff, our clients and our results. The obesity epidemic, its causes and solutions, are complex and multifaceted but we know what we do is safe, effective and sustainable. While articles that implicate fructose in obesity and cardiovascular disease are right to highlight the dangers of overconsumption of sugars, the assertions in relation to our clinic, our stakeholders, our staff and our clients are factually incorrect and misleading.

Like good health, it's all about balance.

SLEEP More, WEIGH Less

Did you know that under-sleeping can lead to poor performance and impaired judgement and has also been linked to depression, obesity, diabetes and hypertension. A new study of 1,200 people showed that the average Australian adult gets less than seven hours sleep a night, below the seven to eight hours recommended by sleep experts.

A study by Columbia University, found people who slept four hours or less per night were 73% more likely to be overweight or obese. Also, people who habitually slept for five hours had 15% more ghrelin, a hormone which increases feelings of hunger, than those who slept for eight hours. Those who slept for less time were also found to have 15% less leptin, a hormone which suppresses appetite. "These differences are likely to increase appetite, and therefore contribute to obesity" Dr Taheri states. The subjects in the study also tended to eat more sweet and starchy foods when sleep was cut short.

While research continues, sleep still remains one of the body's most mysterious processes. We do know that sleep is absolutely necessary for survival and even occasional sleeping problems can make daily life feel more stressful or cause you to be less productive. Sleep loss also affects growth hormone secretion that is linked to obesity and impairs the body's ability to use insulin, which can lead to the onset of diabetes. It is paramount that we discover more about this activity where we spend a third of our lives - sleeping.

There are prescriptions and non-prescription drugs, herbs, remedies, technologies, etc that may help you get a good night's sleep. Some work for some and not for others.

Here are some tips you can try at home tonight. These tips are intended for the average adult, but not necessarily for children or persons experiencing medical problems:

• Imagining - Think of a hammock - you're up off the ground, wrapped in a cocoon of comfort, swaying gently in the open air. The sun is warm on your face and there's a cool breeze blowing you back and forth. This visualisation helps you "see" what the reward for sleeping will be, getting you more in the mood to sleep. Visualisation has proved helpful in developing the appropriate brain wave patterns for sleep.
• Magnesium - Has a calming effect on the nervous system. It is part of bones and cells, especially the smooth cells of arteries, and assists in the absorption of calcium and potassium. Over 300 enzymes in our body need magnesium to function properly. It is so important, that the brain stores a "safety supply" to have in the event of a drop in the magnesium reserves.
• Nutmeg - Grind fresh nutmeg and serve it with warm low fat milk and a touch of honey. Milk is naturally high in calcium and rich in tryptophan; together they can be a powerful tranquilizer (and very delicious).
• Hot foot baths - In the Eastern World, a hot foot bath is a traditional remedy; it draws blood from the brain to calm a racing mind. Try soaking your feet in a hot bath with a cupful of Epsom salts and a few drops of lavender essential oil, which will soothe you. Your feet absorb the magnesium from the Epsom salts and relax you further.
• Stomach rub - Soothes down the digestive system and helps bring about deeper relaxation. Lie on your back and place your hand on your belly button. Begin to make small circles in a clockwise direction as you gently glide your hand over your stomach. Let your circles gradually become bigger and bigger. When your circles reach the outside of your stomach, gradually reduce their size until you are back at your belly button again. Reverse the direction; repeat the whole series with your other hand and do this several times. Doing this with lavender oil can create an even more relaxing experience.
• Listening to an audio book - The brain works like a tape player - with one main auditory loop that processes words. If you fill that loop with an interesting book, there's no room for your own worrisome internal narrative. Especially helpful for those who have continuous thoughts running through their heads.
• Deep breathing - Take a deep breath in then slowly release out - focussing on your breathing causes your mind to get distracted from your worries and focussed on your breathing. Doing this for a few minutes can relax your mind and help you get a more peaceful sleep.
• Turn it off - Sleep experts suggest refraining from doing work, watching television, or being on the computer at least an hour before bed time. This allows your brain to start to 'wind down'.

Gangwisch. D, Malaspina. D, Boden-Albala. B, (2005) Inadequate Sleep as a Risk Factor for Obesity: Analyses of the NHANES I; COlumbia University, College of Physicians and Surgeons, New York, NY.

Taheri. S, Lin. L, Austin. D, Young. T, Mignot. E, (2004) Short Sleep Duration is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index. PLos Med 1(3): e62. doi:10.1371/journal.pmed.0010062.

Obesity in Our Youth

These days, it seems we’re constantly being bombarded with the message that Australians are bigger than ever before. It was big news when we over took the Americans to take the crown as the most overweight country in the world and now more than ever the health benefits of weight loss are being touted in the media.

Some may think that our obesity crisis is a normal result of our aging population (after all we all put on a little ‘pudge’ as we age – don’t we?) However, recent reports published by the Australian Bureau of Statistics (ABS) show that obesity is not only rampant in the older generations, but it’s increasing rapidly in those who are in their prime.

According to the report on the recent National Health Survey conducted by the ABS, 21% of Australian women aged between 18 and 24 years are overweight while a further 15% are classed as obese.  In young men aged between 18 and 24 years, there is a similar story with 28% classed as overweight and 12% classed as obese.

These results show the need for urgent action from our young people if we, as a nation, stand any chance of reducing the incidence of obesity and the co-morbidities that go with it.  And while the negative impact of obesity on health is clear, big improvements to health can be gained by small to modest losses in weight (5-10% of initial weight).

With modest changes to lifestyle, our young people are able to regain their health, vitality and make a big difference to the health of the country.  If you’re craving the opportunity to make a real difference in the world, here’s your chance.  Not only will you be contributing to a healthier society, but you’ll be reaping the benefits on a personal level as well.  This is an issue well worth some time and attention in the day to day life of every young Australian.

Before attempting to lose weight by changing your diet or tackling an exercise program, remember to consult an Accredited Practicing Dietitian.  Their expert advice will help to ensure you’re on the right track.