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Unformatted text preview: Editorial See corresponding article on page 774. Too much sugar, too much carbohydrate, or just too much? 1,2 David JA Jenkins, Cyril WC Kendall, Augustine Marchie, and Livia SA Augustin In this issue of the Journal, Gross et al (1) show that since 1963 carbohydrate intakes have increased by 126 g/d, with high- fructose corn syrup constituting 10% of total energy intakes. At the same time, the incidence of diabetes has increased by 47%. This important study highlights many key issues related to diet and lifestyle for the 21st century and beyond. Is the increased incidence of diabetes the result of an increased consumption of high-fructose corn syrup alone or of the consumption of the wrong type of carbohydrate in general? Or, does it reflect a total carbohydrate intake that is too high? Does this question belie the fact that we are now simply eating too much and exercising too little? CARBOHYDRATE COMPARED WITH SUGAR The panel that developed the dietary reference intakes estab- lished a low recommended dietary allowance for carbohydrate, 130 g (26% of a 2000-kcal diet), which is based on brain utili- zation and is in keeping with the trend established by the new dietary focus on carbohydrate restriction. Weight-loss diets in this category include the Atkins diet, which recommends carbo- hydrate intakes of 20 g/d during its induction phase. However, in view of the constraints imposed by other macronutrients, in terms of both health and the nature of the current food supply, another term was coinedthe acceptable macronutrient distri- bution range (2). According to the acceptable macronutrient distribution range, 45 65% of total energy as carbohydrate is advocated. At this range, no upper level of sugar intake was established, but a maximum intake of 25% of energy was sug- gested. The article by Gross et al would have been useful as part of this debate. Concerns about sugar being linked to concerns about refined carbohydrates in general are not new. These concerns have been expressed in the writings of Cleave (3), Yudkin (4), and Burkitt and Trowell (5). As the antithesis of fiber-rich foods, refined carbohydrates are linked to a wide array of chronic diseases, including colon cancer, diabetes, and cardiovascular disease. However, clear data on sugar consumption and specific diseases are not readily available. Fructose has been shown to raise serum triacylglycerol concentrations and possibly LDL-cholesterol concentrations (6), and refined carbohydrates may reduce circu- lating HDL-cholesterol concentrations. However, strong associ- ations between sucrose and fructose intakes and heart disease or diabetes have not been shown, nor is there a clear indication that...
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This note was uploaded on 08/24/2010 for the course PSYC 123 taught by Professor Kellybrownell during the Spring '08 term at Yale.
- Spring '08