Tag Archives: glucose

Obesity | The Paleo Diet

Unfortunately, 70% of the United States is now overweight.1 And nearly half of that 70% is obese – a truly scary prospect for the future of our nation’s health.2 But despite this alarming obesity epidemic (technically it is a pandemic, because the entire world is suffering from this problem) there has never been more debate about what exactly is causing the issue.3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 While this article will cover specific transcription factors and antioxidant pathways, the big bullet points for preventing obesity are simple.26 27 28 29 30 31 32 33 34 35

For starters, we are eating too many calories.36 37 38 39 Secondly, we are eating too much sugar and not enough nutrients.40 41 42 43 44 45 46 47 48 49 50 Third, we are not getting enough exercise.51 52 53 And lastly, we are stressed like never before, and sleeping less than ever.54 55 56 57 58 59 In a way, the rest of the debate is just minutia, because until we fix these four problems, we are not going to be able to stop this boat from capsizing.

Booth FW, Laye MJ. Lack of adequate appreciation of physical exercise’s complexities can pre-empt appropriate design and interpretation in scientific discovery. J Physiol. 2009;587:5527–5539.

But if we are to delve into the details of obesity, there are two dichotomous factors, which are at play. As I mentioned, too much sugar is a cornerstone of our nation’s various health problems. The fructose transporter GLUT5 plays a specific role in this problem, since we are taking in far too much fructose in our collective diet.60 61 62 63 64 By contrast, if we were to eat more vegetables and other healthful foods, we would see better results via the Nrf2 pathway.65 66 67 68 69 70 Most of us are aware that free radicals are categorized as ‘bad’ and antioxidants as ‘good’.71 But the details behind these scientific terms remain elusive, for most of the population.

Evolution of the consumption of high-fructose corn syrup (HFCS) and sucrose in the United States between 1970 and present. HFCS has increased rapidly to replace 50% of the sucrose consumption. Over this period, not only total sugar consumption but also total calorie intake and total fat intake have increased significantly. (USDA)


Fructose metabolism in liver cells. Fructose metabolism (grey arrows) differs from glucose (black arrows) due to 1) a nearly complete hepatic extraction and 2) different enzyme and reactions for its initial metabolic steps. Fructose taken up by the liver can be oxidized to CO2 and then converted into lactate and glucose; glucose and lactate are subsequently either released into the circulation for extrahepatic metabolism or converted into hepatic glycogen or fat. The massive uptake and phosphorylation of fructose in the liver can lead to a large degradation of ATP to AMP and uric acid.60

Summary of the potential mechanisms for fructose-induced insulin resistance.60

The research on fructose has been steamrolling the scientific community since the viral popularity of pediatric endocrinologist Robert Lustig’s lecture, a few years ago.72 73 74 75 Not surprisingly, the food and beverage industry is trying like mad to stop any bad publicity from arising from the scientific community, around their sugary cash cow.76 But the actual, unbiased data has been very damning.77 78 79 80 Take the following chart, which shows that fructose in beverages, which do not list it on the label, often contain quantities of fructose that surpass the amount of the substance in beverages which do list it on the label.

Fructose concentration and fructose-to-glucose (F:G) ratio: juices. Concentration of fructose (g/L) in juices is displayed on the left y axis (open bars) and the F:GAdjusted is shown on the right y axis (solid bars). * Products with high-fructose corn syrup listed as an ingredient on the label. F:GAdjusted, the F:G ratio adjusted for other detected disaccharides.

Walker, R.W.; Dumke, K.A.; Goran, M.I. Fructose content in popular beverages made with and without high-fructose corn syrup. Nutrition 2014, 30, 928–935.

In an evolutionary sense, this level of fructose consumption is out of control and unprecedented.81 82 83 We’ve known for thousands of years, humans consumed about 20g of fructose each day.84 85 Their intake came from fruit and honey,86  vastly different than more concentrated sources of fructose, like soda. For one thing – there is no fiber in soda, which might slow down hepatic absorption of fructose. Oh, and for those curious, we are now consuming about 80g of fructose per day, on average.87 88

Proposed pathways and mechanisms underlying the differential effects of fructose compared with glucose consumption on adipose deposition, postprandial lipid metabolism glucose tolerance/insulin sensitivity.

Stanhope, K. L., & Havel, P. J. (2010). Fructose consumption: Recent results and their potential implications. Annals of the New York Academy of Sciences, 1190, 15–24. doi:10.1111/j.1749-6632.2009.05266.x

But why is fructose so harmful, and how does the GLUT5 transporter factor into this issue? GLUT5 was successfully cloned around 20 years ago and was initially described as a glucose transporter, until it became clear that it was specifically related to fructose.89 The brain and kidneys have both shown levels of GLUT5 mRNA and/or protein.90 This (indirectly) means that by eating too much fructose, your brain processes might be impaired.91 92 93 Since we now know that high levels of HA1c correlate with dementia, this shouldn’t be shocking news.94

Your small intestine has the greatest amount of GLUT5, and it also controls the availability of fructose to other areas.95 Interestingly, intestinal GLUT5 mRNA levels and fructose transport rates are very low until fructose is introduced, or after a few weeks of development (this appears to be genomic).96 97 98 99 The problems start to arise when too much fructose is introduced (via processed foods, usually) too early, creating a baseline of consumption, which seems to need to be satisfied.100 101 102 103 Though the science is still out, this ‘created need’ may force children to overeat, and as a result, become overweight and/or obese.

The GLUT5 transporter has been linked to hypertension, and also to diabetes.104 105 Since the United States spends over $240 billion on diabetes annually, scientific research into the area of GLUT5 should be pushed to the forefront, with the hope being that by better understanding the transport and processing of fructose, we can help improve the rates of disease – if not prevent them entirely.106

For example, diabetes profoundly affects GLUT5 expression in the small intestine.107 By down-regulating GLUT5 protein levels in those with high blood sugar, we may have a mechanism to help diabetics. Of course, there are many potential areas of research, which could be interesting for the GLUT5 transporter. But for the brevity of this article, I will stop here.  I invite those further interested to research the GLUT5 transporter, via easily using a search engine to locate articles on PubMed relating to the topic.

Lustig RH. Fructose: metabolic, hedonic, and societal parallels with ethanol. J Am Diet Assoc. 2010;110(9):1307-21.

One of the many issues with fructose is that it helps to cause non-enzymatic glycation – in layman’s terms; fructose helps to age your liver.108 This shouldn’t be surprising. Remember – increased dietary intake of sugar was linked to dementia – premature aging/degradation of brain tissue usually due to excessive buildup of the beta amyloid protein.109

By contrast, activation of the Nrf2 pathway may help to stop aging – not just in your liver, but also throughout the body.110 The Nrf2 pathway helps in regulating over 500 cytoprotective genes, which give your cells multiple layers of protection.111 112 Interestingly, research has found that dietary flavonoids help to activate this pathway, and thus, your diet can truly determine whether you age quickly or slowly.113 It really is this simple. Sort of.

NRF2, p53 and FOXOs support complementary antioxidant pathways.

Gorrini, C., Harris, I. S. & Mak, T. W. Modulation of oxidative stress as an anticancer strategy. Nature Rev. Drug Discov. 12, 931–947 (2013).

You see, in science, one must resist the urge to oversimplify, and in this case we must remember to not forget all the other stressors to our cells. This means sleep quantity and quality, exercise, stress from work, genetics, epigenetics, pollution – it is truly a never ending list. However, we very much have control over what we put in our mouths.

Differential responses to rising oxidative stress.

Stefanson, A. L., & Bakovic, M. (2014). Dietary Regulation of Keap1/Nrf2/ARE Pathway: Focus on Plant-Derived Compounds and Trace Minerals. Nutrients, 6(9), 3777–3801. doi:10.3390/nu6093777

The Nrf2 pathway has been recently found to react to apigenin and luteolin (dietary phytochemical flavones) in a favorable way.114 The antioxidant pathway is activated upon ingestion of apigenin and luteolin, and the flavones may be responsible for vital anti-inflammatory effects.

Schematic representation depicting some of the various cytoprotective proteins that are upregulated by Nrf2. Flavonoid-mediated protection from ischemic/hemorrhagic stroke, traumatic brain injury, and/or other neuropathies may result in large part from Nrf2 regulation of these pathways.113

In fact, activation of the Nrf2 pathway is being studied fairly extensively, in regards to cancer prevention and treatment.115 Since dietary activation is very cheap (especially when compared to pharmaceutical drugs) this research could pave the way for widespread effective change in our world’s health. Mandatory spinach and kale consumption might be a potential guideline – if one was to hypothesize about potential ways this research could be implemented on a widespread basis.

Schematic representation depicting the potential mechanisms by which flavanol-mediated Nrf2 induction leads to activation of cytoprotective pathways after stroke, traumatic brain injury, and/or other neurodegenerative diseases. Flavanols may induce Nrf2 through binding to receptors seated on the plasma membrane and subsequent initiation of intracellular signaling cascades. Alternatively, passive diffusion or active transport through the plasma membrane may permit direct cytosolic dissociation of the Keap1/Nrf2 complex or activation of second messengers that regulate Nrf2 translocation into the nucleus. Upon nuclear translocation, Nrf2 binds to AREs on the promoter regions of cytoprotective genes to regulate heme/biliverdin, glutathione, NAD(P)H, and/or other protective pathways.113

So, if your diet is making you fat, old and sick, you now have some great motivation to affect change. What can be more powerful than that? By loading up on neuro-protective vegetables and healthy fats, as well as quality proteins (which contain essential amino acids) you will be helping to fight back against cellular aging, obesity and illness.

And good news – a Paleo Diet – by its very nature – eliminates all the bad choices for you, and emphasizes all the best foods. The work has already been done. It couldn’t get any easier. You have a path towards obesity, dementia and medication. You also have a path towards health, wellness and vitality. The choice is yours – so choose wisely.


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113 Leonardo CC, Doré S. Dietary flavonoids are neuroprotective through Nrf2-coordinated induction of endogenous cytoprotective proteins. Nutr Neurosci. 2011;14(5):226-36.

114 Paredes-gonzalez X, Fuentes F, Jeffery S, et al. Induction of NRF2-mediated gene expression by dietary phytochemical flavones apigenin and luteolin. Biopharm Drug Dispos. 2015;

115 Jaramillo MC, Zhang DD. The emerging role of the Nrf2-Keap1 signaling pathway in cancer. Genes Dev. 2013;27(20):2179-91.

Does Fructose Promote Overeating? | The Paleo Diet

In the early 1980s, public health authorities began warning that saturated fat was driving obesity and various degenerative diseases. During this same period, high-fructose corn syrup (HFCS) rose to prominence, sneaking itself into processed foods, especially sodas, cookies, and cakes.

Saturated fat consumption fell. Sugar consumption and overall caloric intake rose. Obesity, metabolic syndrome, type-2 diabetes, and other diet-related diseases got worse. These disturbing facts have prompted nutrition scientists to begin investigate fructose (a primary type of sugar) as a possible driver of the obesity crisis.

Does fructose uniquely promote overeating? Does fructose affect satiety differently than other sugars, particularly glucose?

Before looking into these questions, we should note that fructose is almost always accompanied by glucose in natural foods. The following chart, for example, shows the sugar content of common foods.

Does Fructose Promote Overeating? | The Paleo Diet

Almost all foods containing sugars, including vegetables, include both glucose and fructose (as well as sucrose, which is 50% fructose and 50% glucose). The ratio of fructose to glucose for most foods hovers around 50:50 and generally never exceeds 70:30.

It’s been suggested that high-fructose corn syrup is more dangerous than table sugar because it contains proportionally more fructose, a modest 55% compared to 50% for ordinary table sugar. According to the numbers in the chart, if fructose were inherently more dangerous than glucose, we would have to conclude that apples and pears are worse than bananas and blueberries.

So is there any evidence that fructose promotes overeating? Is snacking on apples rather than bananas a bad idea? In 2013, a study published in the Journal of the American Medical Association sparked headlines like, “Fructose changes brain to cause overeating, scientists say,” and “Revealed: fructose ‘may spur overeating.’”1, 2

From the actual study, we read, “Glucose but not fructose ingestion reduced the activation of the hypothalamus, insula, and striatum—brain regions that regulate appetite, motivation, and reward processing; glucose ingestion also increased functional connections between the hypothalamic-striatal network and increased satiety.”3

It seems convincing. But was this study representative of real-world scenarios? Let’s see how the study was organized. The scientists worked with 20 normal-weight subjects (10 men, 10 women) without diabetes and a mean age of 31. The study was a blinded, random-order crossover design (so far so good).

Following an overnight fast, subjects drank 300ml of cherry-flavored water with either 75g of fructose or 75g of glucose. 60 minutes later, blood samples were drawn and the subjects completed a series of surveys rating “feelings of hunger, satiety, and fullness on a scale of 1 to 10.”

First of all, 75g of sugar, whether fructose or glucose, is an inordinately large amount to consume at one time. Roughly equivalent to 2.5 cans of soda, this might not be reflective of real-world consumption patterns. More importantly, however, we never consume foods or beverages sweetened entirely by fructose or by glucose. Invariably, both sugars are present, typically in 50:50 ratios.

This study made headlines because it contradicted previous studies. A 2007 study, for example, tested energy balance and satiety of high-fructose corn syrup (55% fructose, 45% glucose) compared to sucrose (50% fructose, 50% glucose). The scientists found that glucose and fructose contribute to satiety through different biochemical mechanisms, but overall there are no significant differences between sucrose- and HFCS-sweetened drinks with respect to satiety and energy balance.4

Ultimately, the fructose/overeating issue comes down to quantity and form (whole foods versus liquids). Fructose appears to have bidirectional effects. In other words, effects on certain biomarkers (fasting triglycerides, insulin sensitivity, etc.) at moderate doses may be absent or even opposite those observed at very high/excessive doses.5

Very high/excessive doses are almost certainly detrimental, but moderate doses, especially when consumed as whole foods, can be very beneficial. Researchers from the Harvard School of Public Health, for example, determined that consumption of whole fruits, particularly blueberries, grapes, and apples, is associated with decreased type-2 diabetes risk, whereas consumption of fruit juice is associated with increased risk.6


Foods containing fructose, especially fruits and vegetables, are healthy when consumed as part of a balanced Paleo diet. Eating a couple pieces of fruit each day doesn’t promote overeating, but drinking 4 cans of soda or fruit juice might. More research must be done to better understand fructose, but when you read that fructose is dangerous, ask about the quantity, source, and form (liquid/whole food) of fructose. Also keep in mind that glucose almost always accompanies fructose in real foods, so studies on pure fructose consumption may not be relevant to real-world eating.

Christopher James Clark, B.B.A.
Nutritional Grail

Christopher James Clark | The Paleo Diet TeamChristopher James Clark, B.B.A. is an award-winning writer, consultant, and chef with specialized knowledge in nutritional science and healing cuisine. He has a Business Administration degree from the University of Michigan and formerly worked as a revenue management analyst for a Fortune 100 company. For the past decade-plus, he has been designing menus, recipes, and food concepts for restaurants and spas, coaching private clients, teaching cooking workshops worldwide, and managing the kitchen for a renowned Greek yoga resort. Clark is the author of the critically acclaimed, award-winning book, Nutritional Grail.



[1] CBS/Associated Press. (January 2, 2013). Fructose changes brain to cause overeating, scientists say. CBS News. Retrieved from //www.cbsnews.com/news/fructose-changes-brain-to-cause-overeating-scientists-say/

[2] Associated Press. (January 2, 2013). Revealed: fructose ‘may spur overeating.’ The Independent. Retrieved from //www.independent.co.uk/life-style/health-and-families/health-news/revealed-fructose-may-spur-overeating-8434959.html

[3] Page, KA., et al. (January 2, 2013). Effects of Fructose vs Glucose on Regional Cerebral Blood Flow in Brain Regions Involved With Appetite and Reward Pathways. Journal of the American Medical Association, 309(1). Retrieved from //jama.jamanetwork.com/article.aspx?articleid=1555133

[4] Soenen, S., et al. (December 2007). No differences in satiety or energy intake after high-fructose corn syrup, sucrose, or milk preloads. American Journal of Clinical Nutrition, 86(6). Retrieved from //ajcn.nutrition.org/content/86/6/1586.full

[5] Livesey, G. (April 22, 2009). Fructose Ingestion: Dose-Dependent Responses in Health Research. The Journal of Nutrition, 139(6). Retrieved from //jn.nutrition.org/content/139/6/1246S

[6] Muraki, I., et al. (August 29, 2013). Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. British Medical Journal, 347. Retrieved from //www.bmj.com/content/347/bmj.f5001


Earlier this month, researchers from the University of Warwick published a study in Nutrition & Diabetes regarding the interaction of methylglyoxal (MG), a reactive glucose metabolite, and HDL cholesterol. HDL is universally known as “good cholesterol” and low HDL is an independent risk factor for cardiovascular disease.1 The study’s lead author, Dr. Naila Rabbani, claims “MG damage to HDL is a new and likely important cause of low and dysfunctional HDL, and could count for up to a 10% risk of heart disease.”2

Blood MG levels increase with short-term and persistent increases in blood glucose levels.3, 4 MG is particularly reactive, up to 40,000 times the reactivity of glucose, but is kept in check by an enzyme called glyoxalase 1 (Glo1).5 To address the problems of decreased HDL by way of decreased Glo1 and elevated MG, Rabbani suggests the creation of new food supplements and drugs: “By understanding how MG damages HDL we can now focus on developing drugs that reduce the concentration of MG in the blood.”6

While this recent study is an important contribution to scientific literature on “good” and “bad” cholesterol, it begs the question, can’t proper nutrition negate, or at least diminish, the need for proposed new supplements and drugs? According to a 2003 USDA publication, the average American eats an estimated 32 teaspoons of sugar daily.7

Sugar sweetened beverages may be uniquely dangerous with respect to decreased HDL levels. A 2012 study found that each additional teaspoon of added sugar per day consumed in beverage form results in a 0.12 mg/dL decrease in HDL.8 Since elevated blood glucose levels are associated with elevated MG levels, cutting drastically back on sugar is a logical first step toward establishing healthier MG levels.

The Paleo Diet, of course, eschews sugar, delivering only small amounts of glucose (and fructose) via fruits and vegetables, thereby promoting optimal MG and HDL levels. Other aspects of the Paleo Diet also promote increased HDL. For example, phenolic compounds in olive oil have been shown to increase HDL.9 DHA, a particular variety of omega-3 abundant in seafood, increases HDL.10 Saturated fat, which is embraced by the Paleo Diet, increases HDL.11

An unfortunate trajectory of medical research is the emphasis on developing products designed to address disease symptoms rather than addressing their underlying causes. If we are serious about getting healthy, we must make meaningful lifestyle changes. The diseases of modernity, including cancer, heart disease, and diabetes, are often referred to as lifestyle diseases because they are primarily caused by improper diet, smoking, and sedentary lifestyles.

Supplements and drugs are of little worth absent meaningful lifestyle changes. With respect to cholesterol, this means forgoing added sugar while eating a diet rich in animal foods and vegetables, with modest amounts of fruits, seeds, and nuts. In other words, the Paleo Diet promotes balanced cholesterol levels, making cholesterol-modifying supplements and drugs largely unnecessary.

Christopher James Clark, B.B.A.
Nutritional Grail

Christopher James Clark | The Paleo Diet TeamChristopher James Clark, B.B.A. is an award-winning writer, consultant, and chef with specialized knowledge in nutritional science and healing cuisine. He has a Business Administration degree from the University of Michigan and formerly worked as a revenue management analyst for a Fortune 100 company. For the past decade-plus, he has been designing menus, recipes, and food concepts for restaurants and spas, coaching private clients, teaching cooking workshops worldwide, and managing the kitchen for a renowned Greek yoga resort. Clark is the author of the critically acclaimed, award-winning book, Nutritional Grail.



1. Mahdy, AK, et al. (November 2012). Cardiovascular disease risk reduction by raising HDL cholesterol–current therapies and future opportunities. British Journal of Pharmacology, 167(6). Retrieved September 18, 2014.

2. University of Warwick. (September 1, 2014). Sugar substance ‘kills’ good HDL cholesterol. Retrieved September 18, 2014.

3. Beisswenger, PJ, et al. (April 2001). α-Dicarbonyls Increase in the Postprandial Period and Reflect the Degree of Hyperglycemia. Diabetes Care, 24(4). Retreived September 18, 2014.

4. McLellan, AC, et al. (July 1994). Glyoxalase system in clinical diabetes mellitus and correlation with diabetic .omplications. Clinical Science (London), 87(1). Retrieved September 18, 2014.

5. Thornalley, PJ. (December 2003). Glyoxalase I–structure, function and a critical role in the enzymatic defence against glycation. Biochemical Society Transactions, 31(6). Retrieved September 18, 2014.

6. Ibid, University of Warwick.

7. United States Department of Agriculture, Agriculture Fact Book 2001–2002, March 2003, Office of Communications. Retrieved September 18, 2014.

8. Welsh, JA, et al., (April 2012). The association between sugar intake and HDL levels varies by sugar type and source. The FASEB Journal, 26(Supplement). Retrieved September 18, 2014.

9. Covas, MI, et al., (September 2006). The Effect of Polyphenols in Olive Oil on Heart Disease Risk Factors. Annals of Internal Medicine, 145(5). Retrieved September 18, 2014.

10. Bernstein, AM, et al. (January 2012). A meta-analysis shows that docosahexaenoic acid from algal oil reduces serum triglycerides and increases HDL-cholesterol and LDL-cholesterol in persons without coronary heart disease. Journal of Nutrition, 142(1). Retrieved September 18, 2014.

11. Hayek, T, et al., (April 1993). Dietary fat increases high density lipoprotein (HDL) levels both by increasing the transport rates and decreasing the fractional catabolic rates of HDL cholesterol ester and apolipoprotein (Apo) A-I. Presentation of a new animal model and mechanistic studies in human Apo A-I transgenic and control mice. Journal of Clinical Investigation, 91(4). Retrieved September 18, 2014.

Honey: The Sticky Truth

It’s still mostly fructose.

As I mentioned in my lecture on the realities of food addiction, I am often asked whether honey, a common staple in contemporary Paleo Diets, is beneficial. Typically I recommend a diet low in sugar to most clients, because of the addictive and rewarding properties of the substance.1 This means honey, which is mostly sugar,2 typically gets the “thumbs down” as well. In fact, honey is about 40% fructose, 200% sweeter than glucose, which is found in less sweet carbohydrate sources, and can be used by every cell in your body for energy.3

This is in contrast to fructose, which largely gets handled by the GLUT5 transporter, and is almost entirely cleared in the liver.4
Metabolism and Honey

Fructose does not raise insulin levels,5 reduces leptin (your satiety hormone)6 and has many parallels with ethanol (alcohol).7 With honey being the food single-handedly highest in fructose, only behind soda and applesauce,8 it is generally a good idea to limit intake in today’s modern obesogenic environment.9

Metabolic Effects of Fructose: Honey

However, hunter-gatherers have traditionally sought out honey,10 often enduring great risks to procure the substance.11 While researchers state honey is the most energy dense food in nature,12, carbohydrate and protein contain 4.1 kcal/gm, Fats (acylglycerols) ~ 8.8 kcal/gm depending upon the acyl group, and ethanol 6.9 kcal/gm. Accordingly, honey contains almost carbohydrate entirely and, therefore, has a caloric density roughly half that of fats. Hence, honey is not the most energy dense food in nature, but rather fat. Hunter gatherers acquired fat (triacylglycerols) from both plant and animal food sources. Concentrated animal triacylglycerol sources include marrow, subcutaneous fat, perinephral fat, mesenteric fat, and retro-orbital fat. Brain, a highly favored food does not contain triacylglycerols but rather is a rich source of fatty acids contained in the phospholipid fraction and, therefore, remains more energetically dense than carbohydrate. Certain plant foods including nuts, some seeds, olives and avocadoes are rich sources of monounsaturated fatty acids. But, honey was a favored food of hunter-gatherers. The Hadza of Tanzania rank honey as their favorite food.13

Also of note, is a study barely a week and half old, which describes diet-dependent gene expression in honey bees.14 This study details the gene expression, which vastly differs between bees fed honey, and those fed either sucrose or high fructose corn syrup (HFCS). This study points out key differences in the gene expression effects of a natural food like honey, compared to man-made creations.

Since it was traditionally thought that bees would respond equally to table sugar and HFCS, as they would to honey, this study is of vast importance, showing the differential responses, genetically, that bees exhibit. This has potential translational implications for humans,15 which is vital in the obesity pandemic,16 and the metabolically diseased state,17 in which we currently live.
Differences in Honey Gene Expressions

Could a simple replacement of natural sweeteners, like honey, with man-made creations, like HFCS, be a potential cause of genetic changes?18 It seems possible. However, we must proceed with caution, and never base any substantial conclusions on one study, especially when it was not performed on human beings. This study is also supported by another recent finding that HFCS-rich diets may be partially to blame for collapsing bee colonies.19

Interestingly, some studies have shown honey may instead have potentially “obesity protective” effects.20 This is based on observations in responses to the hormone ghrelin and peptide YY (3-36).21 In another study, researchers showed that honey has a gentler effect on blood sugar levels on a per gram basis, at least when compared with sucrose.22

Honey: Chart 4

However, to me, this doesn’t change the biochemistry of fructose, of which honey is largely comprised. It makes more sense to eat whole fruit, starchy sources of carbohydrate and vegetables. It is true that the metabolism and neurochemical responses of pure fructose, such as those used in many studies, may be slightly different than the fructose found in honey. But, in practice, humans consume sweet foods with complete abandon,23 whether it’s man-made or natural.24 Keep honey as a rare treat, as our hunter-gatherer ancestors (seasonally) did.25 This will limit reward to your brain, which will help to limit more reward-seeking behaviors.26


1. Lustig RH. Fructose: it’s “alcohol without the buzz”. Adv Nutr. 2013;4(2):226-35.

2. Available at: //nutritiondata.self.com/facts/sweets/5568/2. Accessed July 23, 2014.

3. Petelinc T, Polak T, Jamnik P. Insight into the molecular mechanisms of propolis activity using a subcellular proteomic approach. J Agric Food Chem. 2013;61(47):11502-10.

4. Tappy L, Lê KA. Metabolic effects of fructose and the worldwide increase in obesity. Physiol Rev. 2010;90(1):23-46.

5. Schaefer EJ, Gleason JA, Dansinger ML. Dietary fructose and glucose differentially affect lipid and glucose homeostasis. J Nutr. 2009;139(6):1257S-1262S.

6. Shapiro A, Mu W, Roncal C, Cheng KY, Johnson RJ, Scarpace PJ. Fructose-induced leptin resistance exacerbates weight gain in response to subsequent high-fat feeding. Am J Physiol Regul Integr Comp Physiol. 2008;295(5):R1370-5.

7. Lustig RH. Fructose: metabolic, hedonic, and societal parallels with ethanol. J Am Diet Assoc. 2010;110(9):1307-21.

8. Available at: //nutritiondata.self.com/foods-000011000000000000000.html. Accessed April 12, 2014.

9. Bray GA. How bad is fructose?. Am J Clin Nutr. 2007;86(4):895-6.

10. Douard V, Ferraris RP. Regulation of the fructose transporter GLUT5 in health and disease. Am J Physiol Endocrinol Metab. 2008;295(2):E227-37.

11. Marlowe FW, Berbesque JC, Wood B, Crittenden A, Porter C, Mabulla A. Honey, Hadza, hunter-gatherers, and human evolution. J Hum Evol. 2014;71:119-28.

12. Eteraf-oskouei T, Najafi M. Traditional and modern uses of natural honey in human diseases: a review. Iran J Basic Med Sci. 2013;16(6):731-42.

13. Available at: //www.epjournal.net/articles/sex-differences-in-food-preferences-of-hadza-hunter-gatherers/. Accessed July 23, 2014.

14. Diet-dependent gene expression in honey bees: honey vs. sucrose or high fructose corn syrup. Scientific Reports. 2014;4

15. Purnell JQ, Klopfenstein BA, Stevens AA, et al. Brain functional magnetic resonance imaging response to glucose and fructose infusions in humans. Diabetes Obes Metab. 2011;13(3):229-34.

16. Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804-14.

17. Owens S, Galloway R. Childhood obesity and the metabolic syndrome. Curr Atheroscler Rep. 2014;16(9):436.

18. Brown RJ, De banate MA, Rother KI. Artificial sweeteners: a systematic review of metabolic effects in youth. Int J Pediatr Obes. 2010;5(4):305-12.

19. Mao W, Schuler MA, Berenbaum MR. Honey constituents up-regulate detoxification and immunity genes in the western honey bee Apis mellifera. Proc Natl Acad Sci USA. 2013;110(22):8842-6.

20. Erejuwa OO, Sulaiman SA, Wahab MS. Honey–a novel antidiabetic agent. Int J Biol Sci. 2012;8(6):913-34.

21. Larson-meyer DE, Willis KS, Willis LM, et al. Effect of honey versus sucrose on appetite, appetite-regulating hormones, and postmeal thermogenesis. J Am Coll Nutr. 2010;29(5):482-93.

22. Shambaugh P, Worthington V, Herbert JH. Differential effects of honey, sucrose, and fructose on blood sugar levels. J Manipulative Physiol Ther. 1990;13(6):322-5.

23. Bray GA. Fructose: should we worry?. Int J Obes (Lond). 2008;32 Suppl 7:S127-31.

24. Avena NM, Rada P, Hoebel BG. Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Biobehav Rev. 2008;32(1):20-39.

25. Pontzer H, Raichlen DA, Wood BM, Mabulla AZ, Racette SB, Marlowe FW. Hunter-gatherer energetics and human obesity. PLoS ONE. 2012;7(7):e40503.

26. Volkow ND, Wang GJ, Fowler JS, Tomasi D, Baler R. Food and drug reward: overlapping circuits in human obesity and addiction. Curr Top Behav Neurosci. 2012;11:1-24.

Curb Your Hunger | The Paleo Diet

It can be challenging at first to curb the carbohydrate cravings and hunger that arises when you are adjusting to a Paleo lifestyle, especially during the holiday season. By following the tips below, you can successfully ward off hunger that some people experience when transitioning to The Paleo Diet.


As the old saying goes, “breakfast is the most important meal of day.” This statement is especially true for people leading a Paleo lifestyle. The high-paced life of the average American frequently leaves little time for preparing a hearty breakfast first thing in the morning. Allocate an extra 30 minutes of your morning to cook a breakfast that will boost your energy levels for the entire day.

Scrambling vegetables, cage-free omega-3 eggs, and uncured pasture raised bacon or sausage is a quick and hearty meal that will provide adequate nutrients to keep you fueled throughout the day. If you’re getting tired of bacon and eggs for breakfast consider having salmon with avocado and fresh berries to get your day started on the right foot!

Order The Paleo Diet Cookbook for a collection of breakfast alternatives.

Up Your Protein and Fat Intake

Carbohydrates are digested quickly in our bodies. Excessive carbohydrate consumption often results in a surge of glucose levels throughout the blood stream and an eventual post-carb “crash.” Fat and protein are digested at much slower rates.

Protein consumption also promotes the formation of the peptide PYY, which is known to reduce hunger and aid in weight loss. If you come down with hunger pangs around lunch time, consider adding extra grilled chicken to your garden salad, or a couple of hard boiled eggs to up your your protein and fat intake.

Snacking on nuts in moderation throughout the day will also help to up your consumption of healthy fats.

Carbohydrates for Athletes

If you regularly engage in aerobic and or anaerobic activities you may feel fatigue from inadequate carbohydrate intake. Grains, sugar, and white potatoes are not recommended on The Paleo Diet, but there are plenty of other fruit and vegetable carbohydrate sources that can boost your athletic performance by restoring your muscle glycogen levels.

Sweet potatoes are commonly recommended by many experts within the Paleo community because they slowly release carbohydrates into your body, thus preventing any significant alterations in blood glucose levels. Recent studies show that fruit smoothies also are rich carbohydrate sources that have little adverse effects upon our blood sugar levels. Turnips, parsnips, squash and zucchini also are great options to include in post workout meals. Bananas are inexpensive and high in potassium and carbohydrate. For a quick and easy pre-workout or post-workout snack consider bringing a couple ripe bananas to the gym.

Learn more about the best approach for athletes to adopt the Paleo lifestyle in The Paleo Diet for Athletes.

Kyle Cordain
The Paleo Diet Team

Diabetic | The Paleo DietNovember is National Diabetes Month, so now is a great time to reflect upon the 26 million people who already have diabetes, as well as the nearly 80 million with pre-diabetes (those on high alert for developing the condition). If you fall into any of these groups, or know someone who does, take the time to consider what kinds of food choices may lead to better health.

Sometimes, better health means that weight loss is necessary. Obesity increases the risk for diabetes, and losing weight can help keep your blood glucose level on target.

Luckily, it may not be necessary to lose all those excess pounds to improve diabetes outcomes. Losing just 5-10% of your body weight can help lower your blood glucose, total cholesterol, and blood pressure levels. Here, we will outline one eating plan that can help people with diabetes lose weight, among many other possible benefits.

The Paleo Diet

Often, people do not make time to prepare their own meals or even monitor their food intake. This can lead to regular intake of packaged, processed foods. Many experts believe that this trend away from carefully prepared whole foods has contributed to the rise in obesity, diabetes, and other chronic diseases.

A growing number of nutrition researchers and doctors now suggest that we try a return to simpler diets, based on grass-fed and free-range animal products, fresh seafood, and whole fruit, vegetables, seeds, and nuts.

The Paleo (Paleolithic) Diet, also known the Hunter-Gatherer Diet, is a healthy-eating plan based on fresh, unprocessed plants and animals. Even though it is modeled after human diets from thousands of years ago, the Paleo Diet consists of easy-to-find foods, such as fish, eggs, fruit, vegetables, nuts, and grass-fed meats. Most versions of the diet do not include grains (like wheat, rye, and barley) or legumes (like beans). Only a few versions include dairy, if it is from grass-fed cows or raw (“unpasteurized”).

Supporters of the Paleo Diet also think that you should avoid all processed fats, such as vegetable oil, soybean oil and margarine. This is because they are not whole foods and have been shown to contribute to heart disease. However, they do approve of several types of oil, including flaxseed, walnut, macadamia, avocado, olive and coconut. Most sugar is also limited.

The Paleo Diet can be adjusted for your specific tastes, weight loss goals and blood glucose needs. The Paleo Diet is very strict about the types of foods you can consume, however those foods that abide by the Paleo premise can be consumed in unlimited quantities. On this diet, you and your healthcare team can choose how much carbohydrate, protein and fat is best for you.

Why Switch to The Paleo Diet?

The Paleo Diet is high in vitamins and minerals, unprocessed, and low in foods that trigger allergic reactions. People with diabetes may benefit from improved blood glucose control, weight loss, and higher energy on this eating plan.

Here are other possible benefits of the Paleo Diet:

  • Lower blood pressure and cholesterol
  • Better blood glucose control
  • Better brain health
  • Stronger muscles
  • Better digestion
  • Increased absorption of vitamins and minerals
  • Increased immunity
  • Relief from allergies and skin diseases
  • Improved energy levels
  • Increased insulin sensitivity
  • Reduced depression and anxiety
  • Improved sleep

If you have poor digestion, allergies, high blood glucose, or any other symptoms of nutritional deficiency, think about speaking with your healthcare team about the Paleo Diet. With good planning, this healthy eating plan can be very nutrient-dense, low in allergens, and made specifically to suit your individual needs and tastes. It is a good idea to read more about this subject if you do decide to talk about it with your doctor or healthcare team. Have a look at some of the many books and articles written about the Paleo Diet, the Primal Diet, and “ancestral diets.” These are all slightly different eating plans based on the same basic idea: whole, unprocessed, and low-allergen foods are best.

Jonathan Jarashow, Publisher
Diabetes Digest Family of Magazines

Learn how adopting The Paleo Diet can help diabetics:

Paleolithic Diet is Best Bet for Diabetes and Other Diseases

Cow’s Milk and Type 1 Diabetes

Tequila | The Paleo Diet

Hi Dr. Cordain,

I came to you via my research on The Paleo Diet. I’ve found some articles that say tequila and wine are the only two forms of alcohol allowed on The Paleo Diet. Can you speak to this in greater detail?

I work for a very small tequila brand and we’re hoping to offer our ultra-premium products to your diet followers as an improvement to what they may be consuming.

Cheers and thanks for your help!


Dr. Cordain’s Response:

Hi Serena,

From a purely factual perspective, no alcohol is “Paleo,” as our Stone Age ancestors lacked the technology to produce either fermented or distilled drinks containing ethyl alcohol. Nevertheless, we live in the 21st century and cannot possibly eat only wild plant and animal foods as our ancestors did. Hence, the idea behind contemporary “Paleo” diets is not to replicate their diets exactly but only to mimic the food groups they ate with commonly available modern foods like fresh veggies, fruits, grass produced meats, seafood, and nuts and to avoid the food groups they generally didn’t eat like dairy, cereal grains, legumes, refined sugars, vegetable oils, salt and processed foods.

In all of my books I have included the 85:15 rule which allows people to occasionally “cheat.” Most people can achieve significant improvements in health and well-being by maintaining 85% compliance with The Paleo Diet. Others who are overweight or obese or have other health-related issues need to be even more compliant 90 to 100% of the time.

Accordingly, alcohol consumption is allowed occasionally, and in moderation. A glass of wine with dinner a few times a week will not derail the therapeutic effects of The Paleo Diet. Similarly, alcoholic beverages from distilled spirits also are allowed, but they should be made with non-sugary mixers. Tequilas often contain substantial amounts of refined sugars including sucrose, glucose, and high fructose corn syrup, unless they are distilled from 100% agave plants with no added sugars. Purge the sugars from the shakers. When life hands you limes and you reach for Jose, understand the merits or lack thereof of alcohol and tequila consumption in Paleo diets.


Loren Cordain, Ph.D., Professeor Emeritus

Affiliates and Credentials