To alcohol! The cause of and solution to all of life’s
problems. We’re all familiar with the dangers of alcohol
and the fact that frequent alcohol consumption can fry your liver. Anyone who has had alcohol before will not
doubt that it is a toxin, even if they are not familiar with what it specifically does
inside your body. This is because you can experience the immediate
or “acute” effects of alcohol exposure in a single night after just a few drinks. You might not notice your heart rate becoming
irregular, your blood vessels dilating, or your loss of fine motor control, but you will
notice something is different as you become “drunk” or “intoxicated”. Then if the pleasant feeling of being drunk
had you doubting whether or not alcohol is a toxin, the hangover that comes the next
day will surely confirm that it is. So you don’t really need much education
or convincing about whether or not frequent consumption of alcohol has some potentially
serious effects on your health. The reason you can feel the effects of alcohol
right away and get “drunk” is because a little bit of the alcohol is metabolized
by the brain. Actually what goes to the brain is less than
10% of the alcohol. The majority of it- about 80% gets metabolized
by the liver. This is why you can develop all sorts of serious
liver issues quite quickly if you’re drinking on a daily basis. However, your liver is a very powerful organ
that can handle various toxins relatively well, so one night of celebrating your birthday
at the bar isn’t going to have you trying to get on the liver transplant list. But what if we could make an alcoholic drink
with a special type of alcohol that didn’t get metabolized in the brain, so you wouldn’t
experience the acute effects of alcohol toxicity? You could have several beers at lunch and
still be sharp as a tack during the company meeting at 2PM. Maybe you’d even be allowed to drink and
drive because it wouldn’t impair your motor skills. Companies might even get away with marketing
this special alcohol to kids. “I present to you… kid beer” Hey I mean if the kid isn’t slurring
his words and falling down, it should be OK right? …Of course not, no parent in their right
mind would give their kid alcohol simply because they don’t appear drunk. So here are the immediate health effects,
and the long term health effects that come with alcohol consumption. How would you feel about a substance that
doesn’t get metabolized in the brain, so you get none of these and you only have to
worry about 8 of these 12 problems from frequent consumption? …Still not OK that, I’m guessing. Well we already have a substance like this
that is consumed on a daily basis. Like alcohol, it’s not necessary for any
biochemical reaction in the body, you don’t need it to survive. It’s not metabolized in the brain so it
doesn’t get you drunk, but like alcohol and other toxins, it’s processed primarily
in the liver. And frequent consumption of it leads to all
sorts of health problems. This substance is fructose. Table sugar, sucrose, is made up of one molecule
of glucose and one molecule of fructose. Fructose is in honey, it’s in fruit juice,
it’s in high fructose corn syrup – it’s what makes the really sweet stuff sweet. “Okay, now you wouldn’t think twice about
not giving your kid a budweiser. But you don’t think twice about giving your
kid a can of coke. But they’re the same.” This is Robert Lustig, he is one of the biggest
factor in bringing the detrimental effects of sugar to light. At first, he can sound a bit over the top
when talking about sugar- “Sugar is a poison, it is a chronic, dose dependent hepato- liver
toxin.” However, he can back all his statements up
with more than 16 years of medical research, academic discourse, policy analysis, data
analysis, a whole lot of patient care and maybe most important: the biochemistry of
how sugar is processed in the body. There’s all sorts of compelling statistics
we could talk about, but the actual mechanisms that cause sugar to have such bad effects
on the body paint a much clearer picture. Once you understand how it is processed in
the body, it leaves very little debate as to whether or not sugar could be considered
a toxin, and you start to see how a lot of modern health issues are caused by sugar. Let’s look at how sugar is metabolised,But
first we’ll look at glucose or “starch” to see how a non-toxic carbohydrate is metabolized. By the way, it’s not necessary to remember
all these specific terms that come up. Just pay attention to how glucose flows through
the cell so we can see how it’s different from alcohol and sugar. So here is what’s happening in your liver
when you eat something like a slice of white bread. First off, only 20% of the glucose you ate
will actually hit the liver because the other 80% is metabolised by all the other cells
in your body. Before glucose can get into the liver cell,
it needs to stimulate the pancreas to make insulin. The insulin will stimulate this insulin receptor
IRS-1, which causes a series of reactions to then stimulate SREBP1 and activate this
enzyme called glucokinase. Glucokinase takes glucose to Glucose 6-Phosphate
which mostly gets stored in the liver as Glycogen. Glycogen is a good thing because it acts as
a reserve tank of energy that your body can access when necessary. This is why runners will “carb load” before
a race- to completely fill up their glycogen stores and have more energy during the race
than what is just sitting in their gut. What doesn’t go to glycogen gets metabolized
down to pyruvate. Pyruvate enters the mitochondria, Mitochondria
is like the coal furnace of your cell because it converts the Pyruvate to Acetyl-CoA then
burns that in the TCA cycle to produce a bunch of energy in the form of ATP. Not all of this is gonna get burned off so
a little bit may be left over as citrate. The SREBP1 from before activates these three
enzymes start a process called de novo lipogenesis. De novo “new” lipo “fat” genesis “making”. So the cell is taking this leftover citrate
and converting it into fat. The liver really doesn’t want the fat sitting
around inside it, so it gets converted down to something called VLDL which is stored in
your fat tissue. Not only can this make you fat, but VLDL is
actually a big contributor to heart disease. While this might sound bad, it’s actually
not that big of a deal because remember: only 20% of the glucose made it to the liver, then
half of that went to glycogen, then alot of that is burned off for energy, so maybe 1/50th
of what you ate will actually turn into VLDL. So could a farmer whose eating rice and vegetables
at every meal die of a heart attack? Maybe. But it’s gonna happen when they’re about
age 90, so that’s not too bad. So now let’s look at ethanol, which is “drinking
alcohol” to see what makes it so different from glucose. Here’s what happens in the liver when you
have an alcoholic drink. As you can guess, ethanol is not necessary
for any biological process, so a majority of is processed like a toxin in the liver. 10% will get processed in the stomach and
intestines and another 10% gets processed by the kidneys, muscle and the brain. This is the first big difference between glucose
and ethanol, the liver has to work 4 times as hard because it processes 80% of the ethanol
that comes in. Ethanol doesn’t need insulin to get into
the cell, it just diffuses in there and is converted to acetaldehyde. Acetaldehyde generates something called reactive
oxygen species. Reactive oxygen species damage proteins in
the body, can cause cancer and are thought to be the key factor in aging. This is how anti oxidants are supposed to
combat aging, because they deal with these ROS’s. The acetaldehyde then gets converted to acetate
and goes into the mitochondria like last time. With glucose, only 20% of the substrate went
to the liver and then maybe half of that went to the liver mitochondria because the rest
went to glycogen. So what alcohol is doing is overloading your
mitochondria. So A bunch of acetate comes in, goes through
the TCA cycle and you’re left with a ton of citrate. The same three enzymes start “new fat making”
are stimulated and you end up with a lot of bad fat. This will go to your fat stores, primarily
your visceral fat. This is the stuff that causes a lot of health
issues and surrounds your organs, giving you a big gut. This is why people get “beer bellies”
because that’s the area that gets filled with the fat produced by alcohol. So the liver has all this fat being produced
that it doesn’t want sitting around inside it so it will also export some of the fat
out in the form of free fatty acids. These can get into the muscle, causing muscle
insulin resistance which is very problematic. Some of it won’t even be able to get out,
so you have a fat droplet sitting around in the liver and now you have your alcoholic
fatty liver disease. So the excess of Acyl-CoA, the ethanol and
the ROS species activate an enzyme called JNK1 which is the bridge between metabolism
and inflammation. This ends up further damaging the liver and
it promotes insulin resistance within the liver by inactivating IRS-1, that insulin
receptor from before. This means your pancreas has to work a lot
harder and pump more insulin out to do its job. Now let’s look at sugar. Sugar is made up of equal parts glucose and
fructose. Fructose is what causes the problems so let’s
see how it’s metabolized very similarly to ethanol. Here’s what’s going on in the liver when
you have a glass of something sweet like orange juice. So first off – like Ethanol, Fructose is not
necessary to the body so it’s treated like a foreign substance and almost 100% of it
is processed in the liver. It comes in, gets metabolized down to pyruvate
and enters the mitochondria. Now we have the same situation where everything
goes straight to the liver, does not get stored in glycogen and overloads your liver cell’s
mitochondria. The pyruvate goes through TCA cycle, produces
a bunch of citrate and that gets converted down to VLDL. This leads to increased risk of heart disease
and visceral fat accumulation. Now you’ve got a “soda belly”. Like before, it exits the cell as free fatty
acids leading to muscle insulin resistance. Not all of the fat can get out of the cell
so fat accumulates in the liver and you get non alcoholic fatty liver disease. The same JNK1 gets stimulated which promotes
inflammation and JNK1 acts on the same IRS-1 insulin receptor causing insulin resistance
in the liver. All of this is actually illustrated really
well in the movie “That Sugar Film.” Damon Gameau goes on a diet with plenty of
low fat and so called “healthy” foods like yogurt, whole grain cereals, fruit juice
and fruit smoothies. The aim is to eat foods marketed as “healthy”
while reaching the average sugar intake of a typical Australian which is about 40 teaspoons. His results demonstrate all of these biochemical
processes we just talked about. He gained 8.5kg and an extra 7% total body
fat mainly in the form of visceral fat, his heart disease risk went up, he’s developed
insulin resistance and after only 18 days he developed non alcoholic fatty liver disease. What I thought was interesting was that he
didn’t change the amount of calories he was consuming yet he packed on such a significant
amount of fat. Actually there’s another element to fructose
metabolism that makes it generate so much fat. Fructose forms something called Xylulose 5-Phosphate,
and this further stimulates the de novo lipogenesis enzymes, leading to even more fat making. That explains the obesity epidemic. Also, when it’s getting converted to Fructose
1-Phosphate it produces Uric Acid. Uric Acid raises your blood pressure and now
you get hypertension too. Oh and Coca Cola still wants to pretend that
obesity is all about calories and a calorie is just a calorie no matter where it comes
from. One thing I should mention is that fiber helps
prevent the sugar in fruit from becoming a problem. Fiber reduces the rate of intestinal absorption
meaning your liver can easily handle the steady stream of sugar from a piece of fruit. The fiber will also fill you up. So 4 apples might be actually a lot of food
to take in in one sitting, but you can get 4 whole apple’s worth of sugar delivered
to your liver in a few seconds from one glass of apple juice. One night of tequila shots isn’t going to
cause your liver to explode, but having a shot of whiskey with every meal and for a
snack would do some serious damage. By the same token, having a big piece of cake
with ice cream at a birthday party isn’t that big of a deal, but most of us are loading
up on sugar all throughout the day without noticing it. We’ll have a breakfast of cereal and juice,
then a starbucks pseudo-milkshake thing on the way to work, have a sandwich with low
fat yogurt for lunch, a granola bar for a snack, then some pasta with a salad for dinner. But we’re not realizing that that the yogurt
has as much sugar as candy, the granola bar has as much sugar as a package of oreos, and
even your pasta sauce and salad dressing has sugar pumped into it. 80% of the 600,000 packaged food items on
the market have added sugar in them. By the way, they’re not gonna have any of
that protective fiber you find in whole fruits or vegetables. The fiber has been removed to improve shelf
life of the products. The average American child sees 30,000 TV
commercials a year advertising fast food or candy. While something like kid beer sounds joke-ish-ly
evil, maybe it’s not all that different from these fun, colorful sugar packed items
kids have access to wherever they go. “Alright, I’m hanging up.” “You know what’s the most destructive force
in the universe?” “Sugar?”