5 Nutrients You’re Deficient In… If You Eat Too Much Sugar

December 5, 2015 in Categories: by

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sugar-poisonWhen we talk about eating too much sugar, the conversation usually revolves around excessive energy intake, empty calories, blood glucose and insulin spikes, or increased risk of chronic diseases (like diabetes, cancer, and heart disease). But, there’s actually another huge problem that gets less airtime in the sugar discussion: micronutrient deficiencies!

It turns out, a high intake of sugar can contribute to nutrient deficiencies in ways other than by displacing more nutritious foods. We’ve discovered a number of mechanisms by which sugar can actually deplete (or reduce the absorption) of certain vitamins and minerals. As a result, eating too much sugar can induce deficiencies, even when our overall micronutrient intake appears to be adequate.

So, which nutrients suffer on a high-sugar diet? Let’s take a look!

5-nutrient-deficiencies-caused-by-sugar

1. Vitamin D

It’s no secret that vitamin D deficiency is a big problem these days (especially for those living far from the equator), but lack of sun exposure isn’t the only cause. Excessive sugar intake (especially in the form of fructose) may actually exacerbate vitamin D deficiency!

Synthesis of Vitamin D

How does it work? Researchers have discovered that a high intake of fructose can increase the expression of an enzyme responsible for degrading vitamin D (24-hydroxylase), while also decreasing the expression of an enzyme that helps synthesize vitamin D (1α-hydroxylase). As a result, fructose can enhance the breakdown of vitamin D in the kidneys while also impairing the body’s ability to synthesize it. The result is a reduction in vitamin D levels, and the potential for the harmful effects of deficiency to manifest (such as greater susceptibility to infection, higher risk of autoimmunity, increased rates of certain cancers, and overall lower immune function). No wonder 75% of people in Western countries are deficient in vitamin D!

And, it gets worse! Vitamin D deficiency and a high fructose intake can enter a vicious cycle, because low levels of vitamin D can actually exacerbate the inflammatory properties of fructose. Multiple studies have shown that vitamin D depletion increases non-alcoholic fatty liver disease (NAFLD) induced by fructose, and that vitamin D plays a crucial role in quelling the inflammation caused by high-fructose, Western-style diets. Historically, vitamin D levels would naturally be higher during sunny months when higher-fructose foods (like fruit) were in season. But, now that we have year-round access to nearly any food (and year-round roofs over our heads preventing sun exposure!), the potential for vitamin D and fructose to antagonize each other is greater than it’s ever been.

2. Calcium

Calcium is famous for supporting skeletal health (including bones and teeth), as well as assisting in blood coagulation and acting as an electrolyte (helping nerves send signals and muscles contract). But, calcium is another nutrient negatively impacted by a high sugar intake!

calcium_regulationHere’s how it works. Normally, vitamin D helps facilitate calcium absorption by regulating active calcium transport in the small intestine (a process that becomes even more important when calcium intake is on the low side, or when calcium requirements increase—such as during growth or lactation). Because the process is greatly dependent on blood levels of vitamin D3, the vitamin-D-lowering effects of fructose can have a ripple effect on calcium, causing our bodies to be unable to absorb as much as we need from dietary sources. That spells trouble during times when we need calcium the most, like during pregnancy or when we’re trying to heal broken bones.

And, along with fructose, a high intake of another form of sugar (glucose) has been shown to increase calcium excretion by the kidneys, through several proposed mechanisms (inhibiting tubular reabsorption of calcium, and possibly suppressing parathyroid hormone from the spiked blood sugar and insulin that comes after a high-sugar meal). Yikes!

3. Magnesium

Magnesium is a serious rock-star mineral that’s only started receiving the attention it deserves in recent years. Along with regulating muscle and nerve function, making protein, building bone, synthesizing DNA, and regulating blood sugar levels, magnesium is required by literally every organ in our bodies. In other words, it’s pretty important!

Both a high sugar intake and elevated insulin levels (which can result from a high intake of refined carbohydrates, including sugar) have been shown to increase the excretion of magnesium by the kidneys, by inhibiting tubular reabsorption (the same process that leads to calcium excretion) and by guzzling through the body’s magnesium reserves during sugar metabolism. That’s partly why people with diabetes or chronically high insulin tend to have higher magnesium requirements and more rapid magnesium depletion.

In fact, the interaction between sugar and magnesium is a two-way street: along with sugar depleting magnesium, magnesium plays a role in stabilizing blood sugar (by influencing cellular uptake of glucose and insulin secretion). So, when magnesium levels are too low, blood sugar regulation can also be impaired—setting the stage for even greater magnesium depletion due to the higher levels of glucose in the blood!

4. Chromium

Chromium is a trace mineral involved in macronutrient metabolism and blood sugar control, and although we only need small amounts of it to be healthy, a high sugar intake can increase the likelihood of deficiency. Consuming excessive amounts of simple sugars causes more chromium to be excreted in the urine (in one study, eating a diet of 35% simple sugars increased chromium excretion from 10% at baseline to 300%). The effect has been pinpointed to the insulinogenic properties of refined sugars, and the impact of elevated insulin on chromium loss.

Like with magnesium, chromium and sugar have an interactive effect due to chromium’s role in blood sugar regulation. Just as a high sugar intake can contribute to chromium deficiency, chromium deficiency can contribute to poor glucose tolerance and higher blood sugar levels (since adequate chromium is needed for insulin binding, increasing the insulin receptor number, and insulin receptor phosphorylation).

5. Vitamin C

It shouldn’t come as a surprise that humans are pretty weird (hey, its true!), and one of our quirks involves vitamin C. Out of all the mammals in the world, only a handful (including humans) are unable to synthesize their own vitamin C. (The reason is due to a mutation in the GULO (gulonolactone oxidase) gene, which codes a protein needed for converting glucose into vitamin C.)

vitamin_c_glucose_similar_structureSo, what does this have to do with high-sugar diets? Both glucose and vitamin C use the same transporters to enter cells, and research has shown that high levels of glucose (whether in the intestines or in the blood) can slow down or limit the absorption of vitamin C by our bodies. The Glucose Ascorbate Antagonism theory, proposed by Dr. John Ely in the 1970s, describes the competition between vitamin C and glucose—where elevated glucose restricts vitamin C from entering cells (ultimately leading to reduced immune function).

oranges_high_vitamin_c_and_sugarFortunately, many higher-sugar whole foods (like fruit) are naturally high in vitamin C, helping offset these effects. But, the same protection isn’t there when it comes to excessive intakes of refined sweeteners like white sugar and high-fructose corn syrup!

So, Should We Avoid All Sugar?

As I’ve discussed previously, smaller and occasional intakes of sugar are unlikely to be harmful. It’s the chronically high intakes typical of the Standard American Diet—not the occasional sweet treat or sugar-containing recipe—that we start to damage our health and raise our risk of a variety of modern diseases.

But, the fsugar-640act that sugar (glucose and fructose) can deplete our bodies of essential nutrients is a good one to keep in the back of our heads as we go about our days making decisions on what to eat! If you’re someone who find themselves reaching for a sweetened treat frequently, that could be doing your body some harm even if that treat falls under the Paleo umbrella.

Yet, the takeaway isn’t to avoid anything containing sugar, but to focus on whole foods whenever possible, and emphasize nutrient-dense sources of sugar like berries and blackstrap molasses when we do want something sweet!

Citations

Anderson RA. “Chromium, glucose intolerance and diabetes.” J Am Coll Nutr. 1998 Dec;17(6):548-55.

Anderson RA, et al. “Urinary chromium excretion and insulinogenic properties of carbohydrates.” Am J Clin Nutr. 51:864–868.

Christakos S, et al. ” Vitamin D and intestinal calcium absorption.” Mol Cell Endocrinol. 2011 Dec 5;347(1-2):25-9.

D’Erasmo E, et al. “Calcium homeostasis during oral glucose load in healthy women.” Horm Metab Res. 1999 Apr;31(4):271-3.

Djurhuus MS, et al. “Insulin increases renal magnesium excretion: a possible cause of magnesium depletion in hyperinsulinaemic states.” Diabet Med. 1995 Aug;12(8):664-9.

Douard V, et al. “Chronic high fructose intake reduces serum 1,25 (OH)2D3 levels in calcium-sufficient rodents.” PLoS One. 2014 Apr 9;9(4):e93611.

Douard V, et al. “Dietary fructose inhibits lactation-induced adaptations in rat 1,25-(OH)₂D₃ synthesis and calcium transport.FASEB J. 2012 Feb;26(2):707-21.

Douard V, et al. “Excessive fructose intake causes 1,25-(OH)(2)D(3)-dependent inhibition of intestinal and renal calcium transport in growing rats.” Am J Physiol Endocrinol Metab. 2013 Jun 15;304(12):E1303-13.

Kozlovsky AS, et al. “Effects of diets high in simple sugars on urinary chromium losses.” Metabolism. 1986 Jun;35(6):515-8.

Lemann J, et al. “Evidence that glucose ingestion inhibits net renal tubular reabsorption of calcium and magnesium in man.” J. Clin Invest. 1970 Apr;75(4):578-85.

Lennon EJ & Piering WF. “A comparison of the effects of glucose ingestion and NH4Cl acidosis on urinary calcium and magnesium excretion in man.” J Clin Invest. 1970 Jul;49(7):1458-65.

Lennon EJ, et al. “The effect of glucose on urinary cation excretion during chronic extracellular volume expansion in normal man.” J Clin Invest. 1974 May;53(5):1424-33.

Paolisso G, et al. “Magnesium and glucose homeostasis.” Diabetologia. 1990 Sep;33(9):511-4.

Roth CL, et al. “Vitamin D deficiency in obese rats exacerbates nonalcoholic fatty liver disease and increases hepatic resistin and Toll-like receptor activation.” Hepatology. 2012 Apr;55(4):1103-11.

Swaminathan R. “Magnesium metabolism and its disorders.” Clin Biochem Rev. 2003 May;24(2):47-66.

Wilson JX. “Regulation of vitamin C transport.” Annu Rev Nutr. 2005;25:105-25.

Comments

Look, I’m all for cutting down on sugar, it’s clearly a problem that so many people have so much in their diets but if what you said was actually true (rather than a convenient way of self-publicising) we would be seeing epidemics of rickets, scurvy, hypomagnaemia and whatever chromium deficiency causes. I work as a doctor in a city with huge sugar intakes and i never see these diseases and i do look for them. So many of the LCHF people fall into the trap of putting a good story ahead of the evidence, please don’t be one of them.

Wow! You’re a doctor? Sugar and grains were slowly killing me. The SAD made me sick!! I have rheumatoid arthritis, thyroid disease and gluten intolerance. I’m DQ2 and DQ8 positive. Lost heaps of weight giving up sugar and grains. I feel so alive today instead of just existing. Unless you have tried LCHF, DON’T criticise!

You can be short on a nutrient long before you get to the classical deficiency stage, and it does produce other symptoms. I am not sure what’s up with me but for a long period of time I seemed to be a vitamin-A burner. If I didn’t keep up daily with supplementation, and I mean the real stuff, not beta carotene, I’d have these massively heavy periods. Supplementing made the flow ramp down a lot. I’ve talked about it several times over the years and a friend of mine tried the same tactic and got the same result. Yeah, maybe it was placebo effect, but I doubt it. My daughter was born with some issues that also pointed to me not getting enough vitamin A at key points during her fetal development. (I was very broke that year.)

They’re also seeing correlations between suboptimal levels of vitamin D in the blood and increased instances of type 2 diabetes and other chronic health problems, and this is long before the subject gets anywhere near rickets.

The standard recommendations for nutrient intake are for preventing the classical deficiency diseases. They aren’t the amounts typically seen in the diets of people with very good health.

Also don’t forget that a lot of processed foods on the SAD are enriched, and particularly with vitamin D if the person’s consuming dairy. They’re still getting SOME vitamin D. It just isn’t what you’d call the ideal situation, and especially if they’re also not getting enough sun.

Stop knee-jerking and pay attention. I bet you’ve heard this stuff before. If you MDs had all the answers we wouldn’t be in this mess now.

Hi there

Where do you get calcium from seeing paleo doesn’t include dairy? I’ve kept my son off it but am concerned as he is not getting enough calcium but I can’t figure out where to get the calcium from.

Thanks :-)

Sarah, I am diabetic so I have used Stevia for several years. I understand that there are a lot of people who make it out to be as harmful as sugar. When I ask them what I should substitute for Stevia in my green tea I am told not to use anything. I love green tea and there is no way I can drink it sweet free. So, what do you suggest? I do not use sugar or any of the natural sugars like honey because they send my sugar readings sky high. So, what is the alternative?

While reading this article, I remember my old self. I have such a huge sweet tooth before and if I see sweets, I couldn’t resist my cravings. Back then, I didn’t know the cons of it. I just have sweet intake every day without knowing its consequences. But now, I’m already living a healthy lifestyle.

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