Written Assignment
Unit 6
Introduction to Nutrition
HS 2611 - AY2021-T3
Susan Sampson (Instructor)
Added sugars, refined grains and Obesity
1. What evidence supports the role of added sugars and refined grains in the
development of obesity?
Carbohydrates may either be considered as perfect substances due to their nutritional
content (brain, nervous system and fueling the cells) specially if these are slow-releasing
(polysaccharides), or terrible if eaten in excess as in fast-releasing sugars. These last ones
contain no fiber and are easily absorbed and metabolized whereas slow-releasing carbs
are slowly digested and aid digestion and gut microbiome. Simple sugars if eaten in
excess may alter blood glucose levels, via negative feedback and cause a spike in insulin
levels, which make consumers to feel hungry faster. (Zimmerman & Snow. 2012) These
rapidly digested carbohydrates have also a high glycemic index and glycemic load. By
making consumers to feel hungry faster after eating fast-releasing carbs, can lead to
overeating and therefore increase the risk of weight gain, diabetes and heart disease.
According to a recent systematic review and meta-analysis on ‘food groups and risk of
overweight, obesity and weight gain’, the study concluded that an “increased risk of
adiposity was observed for refined grains (for overweight/obesity and weight gain), red
meat (for abdominal obesity) and sugary sweetened beverages (for overweight/obesity
and abdominal obesity)” (Schlesinger et al. 2019).
According to a diet and lifestyle change study “people who increased their consumption
of French fries, potatoes and potato chips, sugary drinks and refined grains, gained more
weight over time - an extra 3.4, 1.3, 1.0, and 0.6 pounds for every four years, respectively.”
(Mozaffarian et al. 2019)
In terms of added sugars, such as high-fructose corn syrup (HFCS) negatively affects
how we metabolize and store body fat, since its sweeter than fructose (glucose).
Consuming higher amounts of added sugars is a factor in weight-gain for many people
since they don’t compensate for the increased calories with increasing energy expenditure
through exercise or by reducing energy intake from other foods. Also the increase
consumption of HFCS in the USA mirrors the rapid increase in obesity (The consumption
of HFCS increased > 1000% between 1970 and 1990). “The digestion, absorption, and
metabolism of fructose differ from those of glucose…. Unlike glucose, fructose does not
stimulate insulin secretion or enhance leptin production.” (Bray GA et al. 2004)
According to systematic review of randomized controlled trials and observational studies
found that reducing intake of sugars in adults result in weight loss and increasing intake
of sugars results in weight gain. (Te Morenga et al. 2011)
2. What evidence refutes or shows no association between these foods with obesity?
Strong evidence of direct causality is still difficult to manage, due to the complexity of
the issue. For example, in terms of added sugars, the authors of the systematic review and
meta-analyses of randomized controlled trials on dietary sugars and body weight, have
stated that the increased weight verified in the participants (of the study) is due to the
excess calorie intake and not due to the sugar consumption. (Te Morenga et al. 2011).
According to the scientific article, published in 2019 of the Advances in Nutrition journal,
“No meta-analyses on the association between refined grain intake and measures of body
weight or body fat have been performed.” (Glenn A Gaesser. 2019)
3. Do you think that the obesity epidemic in North America and worldwide is solely
due to nutrition?
Definitely not. According to Obesity (silver spring journal) in an investigation
following adolescents, state that physical activity (PA) begins to decline with a gradual
increase in weight. Moreover, the author’s point that physical inactivity “in adolescence
strongly and independently predicts total abdominal obesity in young adulthood, favoring
the development of a self-perpetuating vicious circle of obesity and physical inactivity.”
(Pietiläinen KH et al. 2008)
In addition, the WHO, the U.S. Dept. of Health and Human Services (and other
authorities) recommend that for good health, adults should get the equivalent of two and
two and a half hours of moderate to vigorous physical activity a week. In the US, people
work more in low-activity jobs, drive more cars to work and walk less and children ride
less bikes to school.
3. To what extent do you think physical activity, or the lack thereof, contributes to
the obesity epidemic?
Obesity “results from energy imbalance: too many calories in, too few calories burned.”
(Harvard. TH Chan. 2020) How many calories burned depends on various factors,
however an easier to quantify variable are the amount of calories consumed per day.
According to the WHO, worldwide about one in three people gets little, if any, physical
activity. Since sedentary activities, such as watching TV, playing videogames, using a
computer or phone, are on the rise vs physical activity, therefore obesity and weight gain
is also increasing. (Harvard. TH Chan. 2020)
There is much debate about how much exercise people need in order to avoid gaining
weight. According to one study involving 175 overweight adults, divided into 3 groups
assigned 3 regimens of exercise (low, medium and intensive) without change in diet,
demonstrated that only those who adhered to the high intensity training (equivalent to
jogging 20miles a week) lost abdominal fat. (Slentz et al. 2005)
5. If you could only choose one factor, which has a stronger influence on obesity:
added sugars and refined grains; or physical activity?
I would choose physical inactivity as pulling more influence over causing obesity than
the bad dietary choices, since there’s no direct evidence of causality for added sugars and
refined grains consumption causing obesity. Conversely, the evidence for physical
inactivity is clearer and more reproducible in comparison. Studies demonstrate, that
preventing obesity with physical activity is easier and a way to maintain a steady weight.
(Harvard. T.H. Chan. 2020).
References:
Bray GA, Nielsen SJ, Popkin BM. (2004). Consumption of high-fructose corn syrup in
beverages may play a role in the epidemic of obesity. Am J Clin Nutr. Apr;79(4):537-43.
doi: 10.1093/ajcn/79.4.537. Erratum in: Am J Clin Nutr. 2004 Oct;80(4):1090. PMID:
15051594.
Glenn A Gaesser. (2019). Perspective: Refined Grains and Health: Genuine Risk, or
Guilt by Association? doi: 10.1093/advances/nmy104
Harvard. T.H. Chan. (2020). Physical activity. School of Public Health. Retrieved from:
https://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/physical-
activity-and-obesity/#references
Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. (2011). Changes in diet and
lifestyle and long-term weight gain in women and men. N Engl J Med. 2011 Jun
23;364(25):2392-404. doi: 10.1056/NEJMoa1014296. PMID: 21696306; PMCID:
PMC3151731.
Pietiläinen KH, Kaprio J, Borg P, Plasqui G, Yki-Järvinen H, Kujala UM, Rose RJ,
Westerterp KR, Rissanen A. (2008). Physical inactivity and obesity: a vicious circle.
Obesity (Silver Spring). Feb;16(2):409-14. doi: 10.1038/oby.2007.72. PMID: 18239652;
PMCID: PMC2249563.
Sabrina Schlesinger et al. Food Groups and Risk of Overweight, Obesity, and Weight
Gain: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.
Adv Nutr. 2019 Mar; 10(2): 205–218. Published online 2019 Feb 25.
doi: 10.1093/advances/nmy092
Slentz CA, Aiken LB, Houmard JA, et al. (2005). Inactivity, exercise, and visceral fat.
STRRIDE: a randomized, controlled study of exercise intensity and amount. J Appl
Physiol. 2005; 99:1613-8.
Te Morenga L, Mallard S, Mann J. (2012). Dietary sugars and body weight: systematic
review and meta-analyses of randomised controlled trials and cohort studies. BMJ. Jan
15;346:e7492. doi: 10.1136/bmj.e7492. PMID: 23321486.
Zimmerman, M., & Snow, B. (2012). An introduction to nutrition, V1.0. Lardbucket
Book Project. http://2012books.lardbucket.org/books/an-introduction-to-
nutrition/index.html
