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  #91   ^
Old Fri, Apr-03-09, 17:08
lil' annie lil' annie is offline
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Plan: quasi paleo + starch
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I'm going to check the library first, to see if any of them are any good.

Amazon has a nice feature - they list what other books are purchased at the same time - I didn't have time to click on all those links to see what else I could discover.
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  #92   ^
Old Fri, Apr-03-09, 18:07
lil' annie lil' annie is offline
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Plan: quasi paleo + starch
Stats: 153/148/118 Female 5'4"
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It's pretty easy to remember that chewing gum would probably have fruitose -- however, I read somewhere or another online that someone with DFI had a reaction to their sublingual Vitamin B-12 tablet, so if you use this, and you want to try to do '0' grams fructose, you'll have to find a B12 formula without sorbitol or fructose or dextrose or glucose.


http://www.google.com/search?hl=en&...al+b12+fructose
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  #93   ^
Old Fri, Apr-03-09, 18:20
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Valtor Valtor is offline
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Plan: VLC 4 days a week
Stats: 337/258/200 Male 6' 1"
BF:
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Location: Québec, Canada
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Good thinking !

I checked my supplements and the only form of sugar they all have is cellulose which is a polymer of glucose. So I'm ok

Thanks.
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  #94   ^
Old Fri, Apr-03-09, 18:52
lil' annie lil' annie is offline
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Plan: quasi paleo + starch
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Metabolic effects of dietary fructose in healthy subjects -- Swanson et al. 55 (4): 851 -- American Journal of Clinical Nutrition


http://www.ajcn.org/cgi/content/abs...ournalcode=ajcn
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  #95   ^
Old Sat, Apr-04-09, 00:26
Cathy B. Cathy B. is offline
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Plan: IBS Diet/Intuitive Eating
Stats: 321/194.2/199 Female 62 inches
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Hi everyone,
Thought I would jump into this discussion. Lil' Annie gave me the link to this thread when she did a "search" for "Low Fructose" and she read in my journal that I am following a low fructose diet. (Hi Annie!)

I became very interested in this subject last year when I heard about some research that indicated that fructose might be the "missing link" in the obesity epidemic. (Here is a link to the article that originally got me interested, if anyone wants to read it. http://news.medinfo.ufl.edu/article...esity-epidemic/)

As a morbidly obese woman with a long history of unsuccessful dieting attempts and a developing problem with fatty liver disease and elevated triglycerides (I don't drink alcohol, by the way.), this really caught my attention. What really made me think there was some validity to it was the fact that a few years ago, I went on a diet where we were supposed to avoid all the "white stuff", eating whole grain breads, pasta, etc., and avoid sugar. We were told to sweeten desserts with fruit juice concentrate and to use all fruit jam.

With 150 lbs. to lose, I went on that diet, expecting to see the pounds fall off. After following the diet religiously for 6 months, I had lost a grand total of 1.5 lbs! $%*~(#!!!!!

This research made so much sense. I had been eating more fruit during this time, as a substitute for sugary desserts, and when I did make a pie or something for a special occasion, I used fruit juice concentrate!

The article I read about Dr. Johnson's research led me to purchase his book, "The Sugar Fix", which I highly recommend! There is a lot of good information about his research, demonstrating the "evils" of fructose. He discusses how fructose causes rapid weight gain (all calories are NOT created equal!), it affects your appetite hormones so that you never feel full or satisfied, and it has been implicated in high blood pressure problems, Type 2 diabetes, kidney disease, fatty liver disease, and the metabolic syndrome.

Dr. Johnson recommends a low fructose diet, eating no more than 25 to 35 grams per day. HOWEVER, in order to lose weight and to enjoy the benefits of eating low fructose, it is essential to be "fructose free" for the first 2 weeks. This is Phase 1 of his low fructose diet, and he lists the various foods you can eat and the foods to avoid. It's not 100% fructose free, but you would probably be eating no more than 3 to 5 grams per day.

During this two week phase, you will reduce the levels of fructose enzymes in your cells. These enzymes are responsible for all of fructose's ill effects. Dr. Johnson says, "If you are overweight or have other conditions of metabolic syndrome, then your fructose enzymes very likely are too high and they have become overactive." According to Dr. Johnson, after this initial 2 weeks phase, you can resume eating fructose in moderation, no more than 25 - 35 grams per day, without developing the problems caused by fructose.

So what was my experience with this program? Well, I made it through the two weeks of the fructose free Phase 1, and then started eating fructose, restricting it to 35 grams or less each day. I was eating cereal, breads, pasta, along with the protein, fats, dairy, a little fruit, a tsp of jam on my bagel, etc. To my utter amazement, the weight just practically fell off, even with all those carbs! I was losing 2 or 3 lbs. each week, for about 3 weeks. Then I blew it.

I decided to "live it up" and made some cupcakes. I only put in half the sugar amount, calculated the number of sugar grams per cupcake, then dividing that number in half to get the fructose grams. I figured I could eat 2 or 3 and stay within my limit. Trouble is, I ate more like 5 or 6, and I did that 2 days in a row. Then I resumed eating 25 to 35 grams per day again and ...the scale did not BUDGE! That has gone on for a few weeks now.

Obviously Dr. Johnson is right. Given my age and morbid obesity, I am probably VERY sensitive to fructose and just those 2 days of eating over the 35 gram limit were enough to make my fructose enzymes overactive again.

I am currently trying to find the willingness to go through Phase 1 (again) so that I can again reap the benefits of the low fructose diet. At the moment, I am just treading water, not losing or gaining, while eating plenty of carbs and keeping my fructose down to 25 to 35 grams.

I am due for my physical next month. I will be interested to see what effect this way of eating has had on my fatty liver disease and triglycerides, although maybe, like the weight loss, I won't reap those benefits either until I repeat the 2 weeks on Phase 1 again.

I am glad to have found this discussion group. Personally, I think this IS the missing link to the obesity epidemic and I look forward to talking about it with other people who are "tuned in". :-)

Cathy

Last edited by Cathy B. : Sat, Apr-04-09 at 00:54. Reason: spelling error
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  #96   ^
Old Sat, Apr-04-09, 06:48
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Valtor Valtor is offline
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Plan: VLC 4 days a week
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This is very encouraging ! Thanks Cathy!

I feel very optimistic

Patrick
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  #97   ^
Old Sat, Apr-04-09, 07:10
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Valtor Valtor is offline
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Plan: VLC 4 days a week
Stats: 337/258/200 Male 6' 1"
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Location: Québec, Canada
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Interesting perspective here...

Quote:
We have just published a paper in the American Journal of Physiology in which we fed animals fructose or starch for 4 months. At the end of 4 months the animals fed fructose had lost their ability to regulate their dietary intake (that is, they had become resistant to leptin, the hormone involved in satiety). When animals on fructose were switched to a high fat diet, they ate excessive amounts and became fat quickly. In contrast, the animals fed starch could control their intake, ate less food, and gained less weight gain after switching to a high fat diet. Thus one can view fructose as the fire, and high-fat diets and starches as the firewood.

Gary makes the point that obesity is caused not by consuming excessive calories, but rather by an abnormality in fat regulation. However, when one becomes leptin and insulin resistant, one will not be able to regulate one’s dietary intake and will start to increase one’s weight. Clearly a new “set point” has to become established, or one would continue to gain weight until one would “explode” such as the “Mr. Creosote” character in the movie Monty Python’s Meaning of Life. So Gary is right that there is a resetting of the clock—but it is driven by insulin resistance and leptin resistance, which in turn is a direct consequence of fructose intake.


http://www.dietdetective.com/content/view/3540/150/

Patrick
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  #98   ^
Old Sat, Apr-04-09, 08:26
lil' annie lil' annie is offline
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Plan: quasi paleo + starch
Stats: 153/148/118 Female 5'4"
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Say, Patrick -- after you get a list of all the foods to eat during the 2 week INDUCTION to a low-fructose WOE, will you consider starting a thread in the Buddies & Chanllenges Forum?

It should contain a list of ALL foods allowable during the Frutose-FREE part of the diet, and in the second posting it should have an explanation of how & WHAT to eat after induction, in order to maintain LOW intake of fructose.

After explaining what Fructose FREE is, as opposed to Low Fructose, there should be links to this messagethread, and any other ones you consider particular good.
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  #99   ^
Old Sat, Apr-04-09, 08:38
lil' annie lil' annie is offline
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Plan: quasi paleo + starch
Stats: 153/148/118 Female 5'4"
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Patrick - it's only 36 hours for me, and I was not 0 fructose - but I'm exhibiting LOTS of the symptoms associated with low CARB, but I didn't eat low carb yesterday, as I had oatmeat, one-fourth cup blueberries and one-third cup plain yogurt, along with meats, eggs, and minute rice.

I lost FOUR pounds.

And I feel like a sponge from which ALL water has been squeezed out of, LOL

I've seen some posters recently who've complained of feeling VERY shakey in the morning, and that's precisely how I felt, before I even got out of bed.

But I can't possibly be in ketosis, as I am eating carbs.

In fact, I'm eating the cup of rolled oats I boiled up this morning, which cannot possibly be considered low CARB, right?

Also, I'm having similar sensations to what I'd used to experience on maybe the 4th day of a water fast - but I'm obviously eating more than water.....

And all my digestive discomfort has vanished.

Too bad that there's such little research available on fructose-withdrawal in humans.

HOWEVER, I am sure that there is lots of research about specific fructose-FREE foods.

Just think of how many papers have been written about the impact of OATMEAL on cholesterol levels. For instance, I've even read that there were some Scots, men who worked at an oatmeal factory who ate 5 or more bowls of oatmeal per day, whose cholesterol was LOW.

Once we have a long list of actual fructose-FREE foods, there may be a treasure trove of research already done on them, but that doesn't pay any attention to them being frutose free.
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  #100   ^
Old Sat, Apr-04-09, 10:08
lil' annie lil' annie is offline
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Posts: 1,276
 
Plan: quasi paleo + starch
Stats: 153/148/118 Female 5'4"
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Fructose- and Sorbitol-Reduced Diet Improves Mood and Gastrointestinal Disturbances in Fructose Malabsorbers

Authors: Ledochowski M, Widner B, Bair H, Probst T, Fuchs D.
Institution: Dept. of Clinical Nutrition, Institute of Medical Chemistry and Biochemistry, University of Innsbruck, Austria.


Background: Fructose malabsorption is characterized by the inability to absorb fructose efficiently. As a consequence fructose reaches the colon where it is broken down by bacteria to short fatty acids, CO2 and H2. Bloating, cramps, osmotic diarrhea and other symptoms of irritable bowel syndrome are the consequences and can be seen in about 50% of fructose malabsorbers. We have previously shown that fructose malabsorption is associated with early signs of mental depression and low serum tryptophan concentrations.

Results: Depression scores were reduced by 65.2% after 4 weeks of diet (P < 0.0001), and there was a significant reduction of meteorism (P < 0.0001) and stool frequency (P < 0.01). Improvement of signs of depression and of meteorism was more pronounced in females than in males.

Conclusion: Fructose- and sorbitol-reduced diet in subjects with fructose malabsorption does not only reduce gastrointestinal symptoms but also improves mood and early signs of depression.

Study link:

http://www.ncbi.nlm.nih.gov/entrez/...057&query_hl=58
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  #101   ^
Old Sat, Apr-04-09, 11:54
lil' annie lil' annie is offline
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Posts: 1,276
 
Plan: quasi paleo + starch
Stats: 153/148/118 Female 5'4"
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FRUCTOSE AND IBS
http://forum.lowcarber.org/showthread.php?p=7779792

Quote:


Bitter sweet

By Claire Deutsher Burke
August 03, 2008


DIGESTIVE upsets? It could be that you suffer from a condition called fructose malabsorption.
Until recently, little information has been offered in terms of possible causes or treatments for irritable bowel syndrome (IBS), the blanket term given for digestive upsets such as bloating, wind, cramping, nausea, diarrhoea and/or constipation, after more serious conditions have been ruled out.

Around one in seven Australians suffer from IBS, and many attempt to manage the condition by "eating well". But it's now known that, in many cases, the foods they turn to in order to improve their diet – fruits, vegetables and wholegrains – could actually be causing the irritation.

Fructose malabsorption – the inability to properly digest sugars in some fruits and vegetables – is believed to be a significant contributor to IBS symptoms.

Fructose is the naturally occurring sugar found in almost every fruit and vegetable and some grains, occurring either as a single sugar or a chain of sugars called fructans.

Fructose is generally absorbed by the small bowel, but in those with fructose malabsorption the small bowel is unable to break down the fructose, allowing it to travel into the large bowel.

The normal bacteria in the large bowel then act upon the undigested fructose and fructans, breaking it down by fermenting it.

Melbourne-based dietitian Sue Shepherd explains: "When fructose is fermented, it can cause the release of gas, which contributes to wind and bloating, and can change the whole bowel environment, which may lead to altered bowel habits such as diarrhoea or constipation, or a combination of both." She says symptoms of IBS are common symptoms of fructose malabsorption.

Shepherd and gastroenterologist Professor Peter Gibbons, from Monash University in Melbourne, have pioneered research into fructose malabsorption in Australia.

Diagnosis of fructose malabsorption is achieved through a simple hydrogen breath test, usually over at least two sittings (the first is a control), where patients are given a sugar drink and then asked to breathe into a breathalyser device to measure the hydrogen gas produced in
response to the drink.

"We don't have hydrogen in our breath normally, but we would have it if we have malabsorbed something," Shepherd says.
Once diagnosed, patients are advised to follow a fructose-free diet for a minimum of three months.

"If you reduce (fructose in the diet, three out of four people will have a marked improvement in their IBS symptoms," Professor Gibbons says.
Fructose malabsorption can affect people of any age, although it's more common in women than men. However, it seems that some people can spend a large part of their lives seemingly unaffected by symptoms, and then suddenly start to experience problems.

"In the majority of people, we don't know what precipitates the problem," Professor Gibbons says. "It could be something in the environment or stress, or it could be an infection, and the infection goes but the bowel is less well."


Not so fruitless

Although fructose is present in almost every fruit and many vegetables and grains, fruit and vegies don't have to be completely removed from the menu.

Foods with an even balance of naturally occurring sugars, such as fructose and glucose, are able to be absorbed normally, but if the ratio of fructose outweighs glucose, symptoms are likely.

"People with fructose malabsorption can still absorb fructose, but it has to be via a different mechanism, where glucose acts as a carrier molecule for fructose. The glucose piggybacks the fructose across the intestine and it can be absorbed that way," Shepherd explains.

Once you're aware of problematic foods (see box below), managing fructose malabsorption is relatively easy.

"It's not a case of 'I can't ever eat fruit again'," Shepherd says. "It's about teaching people about the balance between fructose and glucose, and teaching them never to have too much of a fructose load at one time; not even too many 'safe fruits' at one time. It's not a nutritionally inadequate diet – it's simply identifying what the problem foods are and avoiding them."

Unlike people with serious conditions such as coeliac disease, who must strictly steer clear of problem foods to avoid damaging their digestive system, if sufferers of fructose malabsorption are exposed to a little "bad fruit", they may experience symptoms but won't cause long-term damage.


Individual tailoring

While fructose malabsorption is a chronic condition, once diagnosis is established and symptoms have improved with the diet, it's useful to experiment with fructose foods, as individual tolerance levels vary.

"There are varying degrees of severity," Shepherd says. "Some people can handle breakouts every now and then, and others are just completely debilitated by it. That's the individual sensitivity. Our job is to teach what the general rules are and then people can incorporate it into their diet. There may be times where you will be able to eat a bread roll or an apple and be okay, but if you were to continue to do it, you'd run into strife."

Professor Gibbons says: "It's all about dose, so we initially restrict stringently and, if the patient is doing well, we start easing back to see what level of restriction they need to have. The sensitivity of the bowel differs between individuals: some people don't absorb any of the fructose they have and some people absorb some of it – it's a very variable amount that's absorbed, so there are various factors involved."

• Sue Shepherd has written two recipe books for those with fructose malabsorption, Irresistibles For The Irritable (Shepherd Works) and Two Irresistible For The Irritable (Shepherd Works). Her handbook, Fructose Malabsorption Food Product Guide (Shepherd Works), provides a useful shopping guide. For more information, visit Sue Shepherd's website at www.coeliac.com.au

A little too fruity

Problematic foods for sufferers of fructose malabsorption include:


Excess fructose

¿ Apples
¿ Pears
¿ Mangoes
¿ Watermelon
¿ Quince
¿ Fig
¿ Pawpaw
¿ Lychee
¿ Guava
¿ Persimmon
¿ Honey
¿ Fruit of any kind (even suitable fruits) in large amounts such as fruit salad, fruit juice or dried fruit.


Excess fructans

¿ Onions (all varieties, including leeks)
¿ Asparagus
¿ Green beans
¿ Artichokes
¿ Chicory
¿ Endive
¿ Radiccio
¿ Coconut cream or milk in large amounts
¿ Inulin
¿ Wheat in large amounts (bread, pasta, cakes). Note: wheat-derived ingredients used in small amounts are suitable.


Paul's story

Paul Richards, 26, a real estate agent from Montmorency, Victoria, was recently diagnosed with fructose malabsorption.

"Last year I had a stomach infection. I spent five days in hospital and after I went home I was still not feeling well. I bought litres of apple juice and other things I thought were good for me, but I kept wasting away and felt horrible every day. My gastroenterologist ordered a hydrogen breath test and it turned out fructose malabsorption was the problem.

"When I think about it, before the infection I may have been a bit sensitive to fructose, but the infection made it a million times worse. I used to go to the toilet three to four times a day, but after the infection I was going 16 to 20 times a day. I lost 24 kilograms over three months. Once I had the test I stopped eating fructose and have felt progressively better.

"As soon as I eat something I shouldn't, I get stomach cramps. At the supermarket, I check the labels on everything. I was hesitant for the first few months to go out for dinner, but now I take Lucozade with me. Because it's pure glucose, if I eat anything that contains a bit of fructose, it helps it through my system. I'm so happy to be feeling good again."



http://www.news.com.au/heraldsun/st...5006012,00.html





FROM:

http://forum.lowcarber.org/showthread.php?p=7779792
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  #102   ^
Old Sat, Apr-04-09, 16:30
lil' annie lil' annie is offline
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Posts: 1,276
 
Plan: quasi paleo + starch
Stats: 153/148/118 Female 5'4"
BF:
Progress: 14%
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They've had suspicious about the high quantity of fructose we're consuming for OVER 20 YEARS -- yet, they are SO evil, that they instructed everyone to eat NINE serving of fruit & veggies, without once telling us that they might make us SICK, due to their recommendations.

I am seriously angry, I've lost several decades of my life to battling Dietary Fructose Intolerance, and the day before yesterday is the first time I've ever heard of it.

At least ONE IN THREE Americans have FDI, but how many people have ever heard of it???


Diet and health: implications for reducing chronic disease risk
By National Research Council (U.S.). Committee on Diet and Health, National Research Council Staff
Published by National Academies Press, 1989
ISBN 0309039940, 9780309039949
749 pages



Page 58

Thus, over the century, sugar use has changed — from primarily sucrose to ^6) "g £ a mixture of sucrose, glucose (largely from corn syrup), and fructose ...

Page 59

EP CD Because of concern about possible effects of increased fructose use on certain chronic diseases or on carbohydrate metabolism, the FDA established a ...

Page 60

1 1 ~ Beverage Consumption One of the most striking changes in food consumption patterns in the past two decades is the increased consumption of co en -1-• ...

Page 274

On the average, approximately 4% of calories came from fructose, 9% from sucrose, and 5% from sugars in corn syrups (see !gi - Chapter 3, Tables 3-6 and 3-7 ...

Page 276

Rats fed the high-sucrose and high-fructose diets had high glucose peaks, relatively higher tissue insulin resistance, and increased serum cholesterol,


http://books.google.com/books?ie=IS...reased+fructose
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  #103   ^
Old Sat, Apr-04-09, 19:04
lil' annie lil' annie is offline
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Posts: 1,276
 
Plan: quasi paleo + starch
Stats: 153/148/118 Female 5'4"
BF:
Progress: 14%
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This book allegedly explains how to avoid fructose to successfully lose weight.


Sweet Poison dot Com.AU/

http://209.85.173.132/search?q=cach...e=UTF-8&strip=1


Penguin Books Australia -
Sweet Poison: Why Sugar is Making Us Fat
by David Gillespie


....Study after study seemed to be pointing to the inescapable conclusion that the fructose part of sugar was fat-inducing in animals, and probably in humans as well. Worse still, it seemed to be complicit in making us want to eat more food in general. Although I found many studies within the medical fraternity backing this line of thought, documents written for the rest of us were almost impossible to find.

Those that did exist were, more often than not, rants against sugar in general without any explanation as to why it was bad for us. I immediately changed from eliminating carbs to just eliminating foods with added sugar – at last I could eat bread again. It was impossible to remove all sugar because everything seems to contain it, so I set myself a limit of no more than 10g of sugar in a meal (about the amount of fructose in an apple). This simply meant I no longer ate sweets and biscuits or drank juice and soft drink. The weight loss continued, but the diet was a lot easier to stick to. After a few months, I was so used to not having sugar that it took no willpower at all to refuse it. In fact, on the few occasions I did try chocolates, they tasted unbearably sweet.

I've now lost the 40kg and, more importantly, no longer worry about weight gain at all. I know that I can eat when I feel hungry and stop eating when I feel full and I will not put on weight. I can eat whatever I like whenever I feel like eating, as long as it does not include sugar. I have no urge to eat when I'm not hungry....


http://209.85.173.132/search?q=cach...e=UTF-8&strip=1
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  #104   ^
Old Sun, Apr-05-09, 05:55
lil' annie lil' annie is offline
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Plan: quasi paleo + starch
Stats: 153/148/118 Female 5'4"
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Potatoes, pasta, rice may be relatively safe compared to table sugar
December 13th, 2007 - 1:10 pm ICT by admin

http://209.85.173.132/search?q=cach...e=UTF-8&strip=1

Washington, Dec 13 (ANI): If you think that going for a no-carb diet can keep you fit, then you need to think again, for a new study has found that table sugar does more harm than starchy foods such as bread, rice and potatoes.
Researchers at the University of Florida, who propose using new dietary guidelines based on fructose to gauge how healthy foods are, have called for dieters to put the new findings into practice.

Theres a fair amount of evidence that starch-based foods dont cause weight gain like sugar-based foods and dont cause the metabolic syndrome like sugar-based foods.

Potatoes, pasta, rice may be relatively safe compared to table sugar. A fructose index may be a better way to assess the risk of carbohydrates related to obesity, said Dr. Richard Johnson, the senior author of the report, which reviewed several recent studies on fructose and obesity.

Many diets, including the low-carb variety, are based on the glycemic index, which measures how foods affect blood glucose levels. Because starches convert to glucose in the body, these diets tend to limit foods such as rice and potatoes.

Researchers said while table sugar is composed of both glucose and fructose, fructose seems to be the more dangerous part of the equation.

Johnson, the division chief of nephrology and J. Robert Cade professor of nephrology in the UF College of Medicine, said that eating too much fructose causes uric acid levels to spike, which can block the ability of insulin to regulate how body cells use and store sugar and other nutrients for energy, leading to obesity, metabolic syndrome and type 2 diabetes.

Certainly we dont think fructose is the only cause of the obesity epidemic. Too many calories, too much junk food and too much high-fat food are also part of the problem. But we think that fructose may have the unique ability to induce insulin resistance and features of the metabolic syndrome that other foods dont do so easily, Johnson said.

Johnson said studies at other institutions have revealed that following a low-glycemic diet can reduce the risk for diabetes and heart disease, but the effect could occur because these dieters often are unintentionally limiting fructose as well by cutting out table sugar.

Processed foods have a lot of sugar. Probably the biggest source (of fructose) is soft drinks, Johnson said.

Johnson also noted that, in relation to obesity, the type of fructose found in .....
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  #105   ^
Old Sun, Apr-05-09, 09:45
lil' annie lil' annie is offline
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Plan: quasi paleo + starch
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Health Report - 9July2007 - The obesity epidemic

http://www.abc.net.au/rn/healthrepo...007/1969924.htm

EXCERPT......


Robert Lustig: And then the third reason that exercise is important, which is somewhat not well known, but I'm trying to evaluate this at the present time, is that it actually helps detoxify the sugar fructose. Fructose actually is a hepato-toxin; now fructose is fruit sugar but we were never designed to take in so much fructose. Our consumption of fructose has gone from less than half a pound per year in 1970 to 56 pounds per year in 2003.

Norman Swan: It's the dominant sugar in these so-called sugar free jams for example that you buy, these sort of natural fruit jams.

Robert Lustig: Right, originally it was used because since it's not regulated by insulin it was thought to be the perfect sugar for diabetics and so it got introduced as that. Then of course high fructose corn syrup came on the market after it was invented in Japan in 1966, and started finding its way into American foods in 1975. In 1980 the soft drink companies started introducing it into soft drinks and you can actually trace the prevalence of childhood obesity, and the rise, to 1980 when this change was made.

Norman Swan: What is it about this, it's got more calories than ordinary sugar weight for weight hasn't it?

Robert Lustig: No, actually it's not the calories that are different it's the fact that the only organ in your body that can take up fructose is your liver. Glucose, the standard sugar, can be taken up by every organ in the body, only 20% of glucose load ends up at your liver. So let's take 120 calories of glucose, that's two slices of white bread as an example, only 24 of those 120 calories will be metabolised by the liver, the rest of it will be metabolised by your muscles, by your brain, by your kidneys, by your heart etc. directly with no interference. Now let's take 120 calories of orange juice.

Same 120 calories but now 60 of those calories are going to be fructose because fructose is half of sucrose and sucrose is what's in orange juice. So it's going to be all the fructose, that's 60 calories, plus 20% of the glucose, so that's another 12 out of 60 -- so in other words 72 out of the 120 calories will hit the liver, three times the substrate as when it was just glucose alone.
That bolus of extra substrate to your liver does some very bad things to it.

Norman Swan: Dr Robert Lustig who's Professor of Pediatric Endocrinology at the University of California, San Francisco. And you're listening to a Health Report special here on ABC Radio National on how food manufacturers by adding fructose to our foods, either from corn syrup as in the United States or added sucrose as in Australia, may actually be making the obesity epidemic even worse, starting with damage to our liver cells, the hepatocytes.

Robert Lustig: The first thing it does is it increases the phosphate depletion of the hepatocyte which ultimately causes an increase in uric acid. Uric acid is an inhibitor of nitric oxide, nitric oxide is your naturally occurring blood pressure lowerer. And so fructose is famous for causing hypertension.

Norman Swan: High blood pressure. And what you're saying here is that the liver cell itself gets depleted of this phosphate and then you've got this downstream reaction.

Robert Lustig: That's right. And so when you have excess uric acid you're going to end up with increased blood pressure and we actually have data from the NHANES study in America, the National Health and Nutritional Examination Survey in America which actually shows that the most obese hypertensive kids are making more uric acid and have an increased percentage of their calories coming from fructose.

Norman Swan: Are they getting gout as well?

Robert Lustig: Well not yet. They will.

Norman Swan: So what you're saying in fact is that whilst we are clearly eating too much, we're passively eating too much of the wrong thing, that the food manufacturing industry is putting stuff in which is fuelling the epidemic?

Robert Lustig: Absolutely, we're being poisoned to death, that's a very strong statement but I think we can back it up with very clear scientific evidence.

Norman Swan: There's clear scientific evidence on this fructose pathway in the liver?

Robert Lustig: There's clear scientific evidence on the fructose doing three things that are particularly bad in the liver. The first is this uric acid pathway that I just mentioned, the second is that fructose initiates what's known as de novo lipogenesis.

Norman Swan: Which is fat production.

Robert Lustig: Excess fat production and so VLDL, very low density lipoproteins end up being manufactured when you consume this large bolus of fructose in a way that glucose does not, and so that leads to dyslipidaemia.

Norman Swan: And that's the bad form of cholesterol.

Robert Lustig: That's correct. And then the last thing that fructose does in the liver is it initiates an enzyme called Junk one, and Junk one has been shown by investigators at Harvard Medical School basically is the inflammation pathway and when you initiate Junk one what happens is that your insulin receptor in your liver stops working. It's phosphorylated in a way that basically inactivates it, serum phosphorylation it's called and when your insulin receptor doesn't work in your liver that means your insulin levels all over your body have to rise. And when that happens basically you're going to interfere with normal brain metabolism of the insulin signal which is part of this leptin phenomenon I mentioned before. It's also going to increase the amount of insulin at the adipocyte storing more energy.

And you put all of this together and basically you've got a feed forward system of increased insulin, increased liver fat, liver deposition of fat, increased inflammation -- you end up with non-alcoholic fatty liver disease. You end up with your inability to see your leptin and so you consume more fructose and you've now got a viscious cycle out of control.

In fact fructose, because of the way it's metabolised, is actually damaging your liver the same way alcohol is. In fact it's the exact same pathway, in fact fructose is alcohol without the buzz.

Norman Swan: So this is the obesity related fatty liver disease that people talk about?

Robert Lustig: Exactly.
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