Sugar causes more problems than just rotten teeth

Dietary sugars are the major cause of tooth decay, as research such as this article in the Journal of Dental Research suggests (October 2015, Vol. 94:10, pp. 1341-1347). This isn't news to you as a dentist.

However, sugar causes more than rotten teeth. It is also a major cause of metabolic syndrome, which is the precursor to many chronic diseases such as diabetes, cardiovascular disease, and nonalcoholic fatty liver disease.

Alvin Danenberg, DDS.

Metabolic syndrome, as a precursor to many diseases, is the name for a group of risk factors. To be diagnosed with metabolic syndrome, a patient must have at least three of the following risk factors:

• Large waistline
• High triglyceride level
• Low level of high-density lipoprotein (HDL) cholesterol
• High blood pressure
• High fasting blood sugar

Unique research

Robert Lustig, MD, and his co-researchers wrote two interesting papers, which were published in 2016. In the first study, the researchers studied 43 children with obesity and metabolic syndrome (Obesity, February 2016, Vol. 24:2, pp. 453-460). The study lasted 10 days. At the start of the study, researchers recorded the children's specific parameters for metabolic syndrome while on their normal diet. Over the course of the remaining nine days, the children were given meals to eat, which had all added sugars removed. Basically, the children ate the same calories, including the same protein and fat percentages, as their normal diet. However, starchy foods replaced all added-sugar foods. The diet even included unhealthy processed foods, which did not include added sugars. If the participants' weight declined during the trial, the researchers increased the amount of food to sustain their weight without adding any sugars. At the end of 10 days, the researchers again recorded the measureable markers of metabolic syndrome.

The results showed that every aspect of the children's metabolic health improved, with no change in weight since weight was controlled. Blood pressure, triglycerides, low-density lipoprotein (LDL) cholesterol, insulin sensitivity, and glucose tolerance all improved. All this happened in only nine days by removing added sugars.

In a further analysis and later publication of this study, researchers found an improvement in triglyceride levels and lipoprotein profiles, which indicated a reduction of risk factors for cardiovascular disease (Atherosclerosis, October 2016, Vol. 253, pp. 171-177).

In addition, LDL size increased, small-sized HDL decreased, and the triglycerides/HDL ratio lowered. Once again, these improvements occurred after removing all added sugars for only nine days.

This study showed that sugar is a major causative factor for metabolic syndrome and cardiovascular risk. The authors stated that this was the first human research project in obese children exhibiting metabolic syndrome that demonstrated that health detriments of sugar and specifically fructose were independent of sugar's caloric value or effects on weight. The takeaway is that all of us can improve our overall health by just removing added sugars from what we eat.

My patients

I am concerned with oral health and overall health. Many of my patients want to change their nutrition and lifestyle to improve their overall health and dental health. For those patients, I first suggest they fill out a three-day food journal. Their journal will show them and me the foods they are eating that may be harmful to their bodies.

Then, I isolate the most offending foods and suggest substitutions that may be healthier. Processed grains, all added and concentrated sugars, and unhealthy fats and oils are the most offending foods. That's how I start my education program for all who want to be proactive with their health.

A version of this column first ran on Dr. Danenberg's blog. DrBicuspid.com appreciates the opportunity to reprint it. His book Crazy-Good Living from Elektra Press is available here.

Alvin Danenberg, DDS, practices at the Bluffton Center for Dentistry in Bluffton, SC. He is also on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is drdanenberg.com.

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