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That Sugar Film

Tuesday, May 5
Bathurst Metro Cinema
6:45pm (meet in foyer) for a 7:10pm start

The cinema does do group discounts, so I will sort that out prior to Tuesday, May 5.

See below for some added resources to check out prior to the movie.

Official website for That Sugar Film.

So, my take on all the hyperbole is that there will be criticism of the movie for certain aspects.  No, it is not a scientific experiment, but that does not really matter.  Not all topics can be ethically researched with an elaborate clinical control trial. No human subjects research ethics committee would allow a scientist to force people to ingest such a diet!!! This is why there are other types of research designs, and this is also why science allows case studies. That is what this is, a rather flamboyant, colorful, often exaggerated case study.
Figure from Luciana et al. Proposed associations between the excessive intake of sugar sweetened beverages and chronic disease.

Weight gain. Read the Dietitian's website content from above.  There is some concern that the message of weight gain is hard to comprehend.  The body is a type of combustion engine.  Assuming all else remains stable (e.g. hydration, exercise, etc), energy in - energy out = caloric gain/loss = weight gain/loss. This can change a bit when you ingest extremely imbalanced diets, such as the high protein diet, but it is fair to say that it is hard to change the final weight gain/loss result without changes in one or both of the components to the left of the equals (=) sign. So, if the lead character of the movie gained weight, but kept calories the same, then he obviously decreased his daily exercise/activity so that he lowered his "energy out" side of the caloric equation. Pay attention to this during the movie.  From what I have seen in the trailers, he felt like crap on this high sugar diet. It would be no surprise that he was less active with such symptoms. The nutritionist in the above column should have known this!!!!

So then ,what about some resources that are based more in science? See below for the references, and see the Added Files for the pdf files of these journal articles.

Comments After The Movie
Fructose vs. Glucose
I wanted to comment on a few oversimplifications I noticed when watching the movie.  The first concerns a comparison between the metabolic differences between fructose and glucose. The initial metabolic pathways for both sugars is provided in the diagram below, which I took from the Tappy and Le review publication.

There is a risk that people walk away from the movie with the belief that fructose is a bad sugar, and that glucose is OK. If this then means that people will think it is fine to consume glucose-based candy/lollies, then that would be a disaster.  I do not want to convert you to biochemists, but all you have do is follow the arrows in the diagram to the left. When you do this, it is easy to see that except for a few initial reactions, the breakdown of fructose and glucose in the liver are almost identical. Also note that the liver can convert fructose to glucose, but not vice-versa. The take home message here is that glucose can be readily converted to fat, just like fructose. Any excessive intake of simple carbohydrate (sugars), regardless of type, is a potential risk to your health, and more so if you are sedentary.

This also means, and this is a major message from the movie, to get fat you just do not have to eat fatty foods.  Sure, excessive fat intake, and excessive protein intake can lead to an increase in body fat. However, this is harder to do than with an excessive intake of sugars, as fat and protein intake provides greater satiety. When you eat fat and protein, you feel more full. This satiety is not there to anywhere near the same degree with sugar intake.
Is A Calorie A Calorie?
In the broader context, it has to be. The medical doctor and dietitian featured in the movie were not well educated about biochemistry and the other side of the caloric balance equation - energy expenditure.  We expend energy in the body through basal metabolism (basal metabolic rate [BMR], the cellular function required to keep us alive), dietary thermogenesis (the energy required to digest and breakdown food), and movement (activities of daily living, play, exercise, other forms of physical activity). Is it possible to gain fat if you keep calories the same?  Of course it is if you do one or more of the following; 1) lower BMR, 2) lower dietary thermogenesis (if you remove some fat and protein, which the actor had to do to increase carbohydrate and maintain calories, this will happen) and 3) lower daily movement (based on symptoms and travel, I think this was inevitable).
The Main Message
Don'y lose sight of the main message of the movie. Avoid eating too much simple carbohydrate. It is as simple as that. If you do this, you should lower your caloric intake, and assuming you get enough protein and fat in your diet, you will improve the nutritional quality of your diet. Adding exercise to your daily mix of life will then allow you, over the long term, to lose fat, maintain or gain protein (muscle), feel great, and function as though you were 10 years younger!

Interesting Reading
1. Cordain L. et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr 2005; 81:341-354.
2. Avena NM. et al. Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Behav Rev 2008; 32:20-39.
3. Luciana M. et al. Cardiovascular risk and dietary sugar intake: is the risk so sweet? Int Emerg Med 2012; 7:313-322.
4. Tappy L., Le K. Metabolic effects of fructose and the world-wide increase in obesity. Physiol Rev 2010; 90:23-46.