2023-10-14 22:00:00
Why should we limit sugar?
An essential function of the liver is to transform the energy we ingest, storing it and releasing it according to the body’s needs. The liver transforms the sugars we eat into glycogen, and stores them either on site or in the muscles. Then, as needed, this glycogen will be transformed back into glucose to keep the level of sugar in the blood (blood sugar) constant. When, after a meal that is too rich, the influx of sugars is too great, the excess is stored. To do this, liver cells transform sugars into fats, which are more stable and easier to store. These will be stored directly in the liver, or kept somewhere in the adipose tissue, in the buttocks, on the stomach or elsewhere. Fat accumulation in the liver has become a major health risk and can cause diseases like NASH.
What is NASH?
Everyone has some fat in their liver, and that’s normal. This fat, which comes from the sugars and fats that we ingest, represents an energy reserve that is easily stored and mobilized. If necessary, the liver will draw on it to provide the body with the energy it constantly needs. But if the liver stores more fat than it burns, it ends up accumulating. In medical language, we then speak of steatosis and in everyday language, it is “fatty liver”. The primary cause of steatosis is that we eat more than we need. In the vast majority of cases, excess fat is well tolerated, and it is enough to return to your ideal weight for it to disappear. As long as the fat is well tolerated, the liver can continue its work without hindrance. But, in around 20% of cases, fat causes inflammation and leads to a real disease: steatohepatitis, or metabolic hepatitis, also called NASH. In June 2023, the SOS Hepatitis and Liver Diseases Federation sounded the alarm: “It is a real pandemic, which is spreading in silence. While the World Health Organization predicts that half of the world’s population will be overweight or obese in 2030, fatty liver disease already affects nearly 1.5 billion people, including 8 million in France. In the years to come, it will be at the origin of the expected explosion in the number of cirrhosis and liver cancers.”
3,000 deaths per year from liver cancer
It is in this context of public health alert that the SOS Hepatitis & Liver Diseases Federation imagined the experiment of the “month without added sugars” inspired by the success of operations such as the Month without tobacco and the January Challenge (or Dry January). For each participant, it was both about taking up a personal challenge and contributing to a collective experiment aimed at evaluating the benefits and difficulties of such an approach. At a press conference, Dr Pascal Mélin, doctor specializing in liver diseases and president of the SOS Hepatitis & Liver Diseases Federation, returned to the genesis of this operation: “SOS Hépatites was created in 1996 from people suffering from hepatitis, but we are evolving. At the beginning, there were 500,000 people with hepatitis C. Today, there are only 50,000, or even fewer. Our associative positioning is evolving, the disease is evolving, liver diseases are evolving,” explains Dr Mélin. The president of the SOS Hepatitis & Liver Diseases Federation does not hide his concerns regarding NASH: “In France, we are between 800,000 and one million people affected and between 200,000 and 220,000 are already suffering from forms severe, with cirrhotic damage. If you are not yet convinced that it is a public health problem, know that NASH is responsible for 3,000 deaths from liver cancer, this is more than the mortality due to road accidents and yet, we does not do as much as for the road,” laments the activist.
25% of respondents addicted to sugar
In spring 2023, the SOS Hepatitis & Liver Diseases Federation created a Facebook group dedicated to this operation. In total, 377 people volunteered and responded to a first questionnaire at the beginning of June. Their profile? An overwhelming majority of women (89% versus 11% of men) with an average age of 48 years and 58% of participants were overweight (compared to 48% national average), including 29% obese. , with a BMI greater than or equal to 30 (17% national average). Finally, 29% of respondents declared steatosis or NASH, a figure again higher than national data, which can be explained by recruitment channels. Nearly two out of three people indicated that they were already aware of the issue of sugar in their diet. Only 12% had never tried to limit it. Important information, 25% thought they had a sugar addiction. “This is major scientific data on which doctors are in full debate. Is there an addiction to sugar or not? This question is debated by both addictologists and diabetologists,” underlined Dr Pascal Mélin at a press conference. In the goals at the start of the experiment, 44% of people hoped to reduce their consumption of added sugars and 44% hoped that this reduction would help them lose weight.
Less cookies and chocolate
At the end of June 2023, 203 people responded to the end questionnaire. More than a third of the 377 people did not respond. “That doesn’t mean they gave up on the challenge. We can argue that our questionnaires were too long, but in any case there are still 200 people who made the effort and who gave us the gift of providing information where they were,” commented Dr. Mélin.
What do the answers to this second questionnaire tell us about this “month without added sugars”? In the end, 52% of respondents said they had done the challenge “almost every day”, 24% had done it “every day without exception”, and 24% “only on certain days”. Another important data, 88% of respondents have reduced their consumption: 47% “totally” or “a lot”, 41% “a little”, and 12% “not really”. Among the main reasons given by people who have not reduced their consumption: social pressure (parties, drinks, restaurants, etc.), lack of motivation, fatigue and stress. “If I drew a parallel with tobacco, it’s the people who say: “I know it’s bad, I’m starting to look, it’s stuck in my head.” So for me, it suits me well that 41% of people have reduced their consumption of added sugars a little, that means that we are in the question of why not, it’s possible, I can be an actor, but I’m not going any more far,” underlined the president of the SOS Hepatitis & Liver Diseases Federation. Reducing consumption of added sugars was difficult for one in three people and easy for one in three. This result must however be qualified, because many respondents were already engaged in a process of reducing sugars.
A first question was asked about the foods that the participants had stopped consuming completely, or almost, during the challenge, to see what they had focused their efforts on as a priority. 52% answered industrial biscuits and pastries, 49% chocolate and 38% sweets and confectionery (there were multiple answer choices). The example of chocolate is quite telling. On the one hand, one in two people have stopped consuming it; on the other, nearly one in five people have chosen not to reduce their consumption, even if it means opting for darker chocolate. Either because it was too difficult (chocolate is cited first among the foods that are the most difficult to stop, ahead of cakes and biscuits), or by choice (“For pleasure”, “Because it’s good”, etc.). “We weren’t in the forbidden, especially not. We are in a collective experience of risk reduction, so the word ban has never been uttered,” explained Dr Mélin.
Lack, but fewer cravings
During this experiment, 62% of participants felt feelings of lack of sugar, more or less frequent. This lack was particularly felt in cases of stress or fatigue. Specific times are also cited such as returning to work, menstruation or situations of hypoglycemia. Among the 162 people who said they were concerned by cravings (80% of respondents), 45% had fewer cravings (20% much less, 25% a little less), and 41% had the same number. However, 14% had more (10% a little more, 4% a lot more). Finally, if weight loss was not one of the main objectives of this operation, it is interesting to note that weight loss was noted by 30% of respondents (up to less than five kilos). “The goal was not to lose weight. It wasn’t the diet for the month of June before going to wear bikinis on the beach,” insists Dr. Mélin.
Furthermore, during the open questions at the end of the questionnaire, other benefits relating to the reduction of added sugars were highlighted: more energy, more desire to play sports, a refined body, a feeling of deflate, “get into your pants”, better mood, etc. Conversely, some clearly negative consequences are also noted: mood disorders, poor sleep, less energy, more fatigue.
Ultimately, 89% of respondents said they were satisfied with the experience. Many opinions (more than fifty) spontaneously pointed to the fact of having become aware that “sugar is everywhere”. Others were pleased to have seen that “it is possible to reduce sugar”. Finally, 91% of respondents thought that the collective experience would have to be repeated and in the meantime, 48% wanted to continue their momentum beyond the month of June.
Awareness ?
After presenting the data from this experiment, Dr Pascal Mélin presented the recommendations of the SOS Hepatitis & Liver Diseases Federation on this public health issue:
Better highlight the presence of added sugars; Encourage manufacturers to reduce the content of added sugars; Raise public awareness of the risks linked to excess sugar; Promote the benefits linked to the reduction in consumption; Integrate the relationship with sugar into any treatment pathway; Admit the reality of sugar addiction; Promote a month without added sugars on a large scale.
Regarding “sugar addiction”, Dr Mélin spoke, at a press conference, of “awareness” and he used strong terms to support his statement: “We would indeed like that the relationship to sugar is integrated into the collection of medical data. You will tell me, but what can we name it? Today, we cannot say that we are addicted to sugar, that we love it a little, a lot, passionately (…). We will have to invent tools and measures of this sugar consumption. And admit the reality of sugar addiction. It is fundamental to admit that some patients are real sugar addicts, sugar alcoholics. And by offering them care like the others, we are putting them in a situation of failure, we are putting them in difficulty and we are excluding them from this care,” laments Pascal Mélin. “Recognizing that there is an addiction to sugar is a strong message to tell diabetologists, your diabetic patients who have excessive sugar consumption; Be careful, aren’t they addicted? Shouldn’t we put addictologists in the loop? Provided that addictologists are of course trained in this concept of sugar addiction,” underlines the doctor.
And the president of the SOS Hepatitis & Liver Diseases Federation concludes: “Faced with the major threat represented by diseases linked to excess sugar, such as obesity, diabetes or fatty liver disease, it is It is essential that everyone becomes aware of their own consumption. Participating in a collective challenge makes it easier to achieve this: good humor and goodwill between participants is a guarantee of success. And behind it, years of healthy life are gained.”
Like Dry January (month without alcohol), it is interesting to note that this initiative came from an association of people concerned and not from public authorities. At a press conference, Remaides asked the question of a possible partnership with Public Health France. “We are going to present the initiative to them,” the representatives of SOS hepatitis & liver diseases replied. Hopefully the month without added sugars will have more support from the Ministry of Health than the month without alcohol. To be continued…
1697324450
#month #added #sugars #results