Last updated: June 09. 2014 11:00AM - 1062 Views

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John DiTraglia MD

Contributing Columnist

Dr. David Ludwig, yours and my old friend, is back with another editorial in this week’s Journal of the American Medical Association about his favorite subject - it’s the sugar, stupid.

He makes the good point that your body needs a continuous energy supply to do the vital things necessary to just sit there idling. This is provided by glucose, simple sugar, and free fatty acids in your blood. The total level of calories provided by either of these fuels is tightly controlled by very strong defenses - metabolic supply, energy use, and most powerful of all - hunger, because if this calorie level in your blood falls, even a little, you die very fast.

But then he goes on to say that these defenses are perverted when we eat sugar and simple carbohydrates such that the imbalance of obesity ensues, and that the studies that show that low carb diets or low simple carb diets also called low glycemic index diets, fail to fix obesity are just not careful or strict enough, and that studies that will prove this tactic are underway now. So we shall see.

But two things make me skeptical. If this was that straightforward it should have been easier to prove by now. And that terrible hunger after weight loss that makes your life so miserable is unbeatable and may also be unappeasable without sugar and carbohydrates. No beer! No bread or pasta! No fruit or milk or cookies! No beer! Just shoot me even if it would cure obesity. But it probably won’t.

1. Ludwig DS, Friedman MI. Increasing adiposity consequence or cause of overeating? JAMA 2014;311:2167-8

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