THE BALLARD OF SUGAR (PART 1)

BY: DR. BAYNE FRENCH MD DC

The Ballard of Sugar Part 2

"Tell Me Something I Care About"

This article presents, in simplified terms, a range of negative effects the author attributes to sugar.

The article’s position is that metabolic health (described here as “metabolic wellness”) may be improved or worsened depending on an individual’s sugar intake. It also states that recommendations to consume very high amounts of sugar per hour during exercise are harmful.

The article states: Optimal human performance is a direct result of optimal metabolic wellness. It argues that athletes with longer careers and fewer injuries are more likely to be those with strong metabolic health.

The article further argues that high hourly sugar intake recommendations in endurance sport contribute to poorer metabolic health. It also claims that some practitioners teach athletes to “train the gut” to tolerate and absorb very high amounts of sugar, and that this increased absorption may be linked to intestinal lining damage and “leaky gut syndrome”. The article says leaky gut will be discussed later and describes it as a contributor to wider disease processes.

The article’s position is that evidence supporting a causal link between sugar intake and various metabolic diseases is strong, and that optimal athletic performance requires metabolic health, which the article describes as incompatible with regular sugar consumption.

Sugar refresher

The article uses “sugar” as a broad term and then defines key forms:

• Sucrose (table sugar) is described as a disaccharide made of one glucose molecule and one fructose molecule bonded together. The enzyme sucrase in the intestine breaks sucrose into glucose and fructose, which are then absorbed through the intestinal wall into the bloodstream and go directly to the liver.
• High-fructose corn syrup (HFCS) is described as not naturally occurring and as being produced by converting some glucose from corn syrup into fructose. The article states that fructose is very sweet and that HFCS products contain different fructose percentages (for example HFCS 55 is 55% fructose and is common in soft drinks). It also states that Coca-Cola and Pepsi changed from sucrose to HFCS in 1984.

The article states that studies in the 1950s reported health harms associated with sugar. It references British physician Dr John Yudkin, stating he argued sugar contributed to cardiovascular disease and wrote Pure, White, and Deadly in 1972.

The article also states that Tufts University compiled data on sugar-sweetened beverage (SSB) consumption and concluded sugar caused heart disease, type 2 diabetes, cancer, and obesity, published in Circulation in 2015, and that the findings supported “an urgent need for strong global prevention programs” to reduce SSB consumption. It then contrasts this with claims that some athletes, endurance fuel companies, and PhDs recommend high sugar intake for performance.

The article references Dr Robert Lustig, stating he considers sugar “toxic” and describing a study of adolescents in which sugar was replaced with complex carbohydrates calorie-for-calorie. It states the subjects lost weight, improved insulin resistance, and reduced fatty liver disease, despite consuming the same number of carbohydrate calories. The article attributes this difference to fructose: it states all cells can metabolise glucose, but only the liver metabolises fructose, and that fructose is highly potent in promoting lipogenesis (fat formation).

Metabolism refresher

The article uses “metabolism” to refer broadly to chemical processes that occur after digestion and result in energy storage or energy use. It states that many diseases reflect long-term metabolic abnormalities.

It gives examples, stating that heart attacks are often the end result of atherosclerosis, which the article describes as slow and consistent and influenced by metabolic abnormalities. It lists heart attack, stroke, fatty liver disease, type 2 diabetes, obesity, dementia, cancers, and other diseases as “metabolic in nature”, and states that metabolically efficient patients develop disease later.

The article references a book, Your Inner Engine by Dr Vanderkooi, describing metabolism as conversion of food to energy, and then expands this to include the total set of reactions after digestion leading to energy storage or energy burning.

Reasons the article gives for why sugar is harmful and not suitable as exercise fuel

1) Altered immune function

• The article explains phagocytosis as the process in which white blood cells engulf germs (viruses, bacteria, fungi).
• It cites a 1973 paper in The American Journal of Clinical Nutrition measuring a “phagocytic index” (the number of bacteria inside white blood cells) after consumption of sugary substances.
• It states that immune function was impaired rapidly, with the largest reduction 1–2 hours after consumption, and that the effect lasted more than 5 hours.
• It states two additional observations:
• Complex carbohydrates did not reduce the phagocytic index.
• Intermittent fasting increased the phagocytic index.
• It notes that white blood cells also engulf abnormal/cancerous cells and suggests post-sugar immune changes may relate to cancer risk.
• It also references a 2025 paper (Staltner et al., Redox Biology 2025), stating that short-term high-fructose exposure in healthy people altered immune cell receptors (on monocytes) and produced abnormal inflammatory responses when exposed to bacteria.

2) Cardiovascular disease (CVD)

• The article describes CVD as involving arterial disease, with heart disease and stroke as common outcomes.
• It cites a JAMA Internal Medicine study of over 30,000 people followed for decades, stating that higher sugar intake was associated with higher cardiovascular mortality.
• It states that people consuming more than 25% of daily calories from sugar had nearly a threefold increased risk of dying.
• It argues that this association was consistent across age, sex, race, education, body weight, and physical activity level.

3) and 4) Visceral adipose tissue (VAT) and cortisol

• VAT is described as fat inside the abdominal cavity, around organs, with fatty liver disease given as an example.
• The article states VAT is biologically active and releases substances that contribute to cardiovascular disease and cancer.
• Cortisol is described as a major stress hormone, with chronically elevated levels linked to disease.
• It cites Gyllenhammer et al. (2014, Obesity), stating that adolescents with the highest sugar intake had the highest cortisol levels and the greatest VAT accumulation.
• It states waist circumference is a stronger predictor of heart attack risk than weight or BMI, and cites NHLBI thresholds: women >35 inches and men >40 inches as higher risk for type 2 diabetes and heart disease.
• It states that sugar promotes liver fat formation (lipogenesis), increasing fat storage in and around abdominal organs, and that cortisol effects worsen abdominal fat accumulation.

5) Uric acid (UA) formation

• Uric acid is described as a cause of gout and also as contributing to other metabolic problems.
• The article references Dr Haig (over 100 years ago) describing elevated uric acid as contributing to many diseases, and references Dr Perlmutter’s 2022 book Drop Acid as a comprehensive resource.
• It states elevated uric acid contributes to elevated blood sugar, insulin resistance, high blood pressure, type 2 diabetes, abnormal cholesterol, systemic inflammation, and weight gain.
• It cites Chen et al. (Arthritis & Rheumatology, 2009), stating uric acid is implicated in all-cause mortality, especially cardiovascular disease.
• It identifies fructose as a major driver of uric acid formation. It distinguishes between refined sources (such as HFCS) and unprocessed fructose-containing foods (fruit, honey, some vegetables), stating these contain lower fructose amounts and that fibre and phytonutrients slow absorption and reduce xanthine oxidase activity (an enzyme that forms uric acid).
• It cites a 2019 BMJ Open study of over 150,000 people finding a strong relationship between sugar-sweetened beverage intake and elevated uric acid, but not the same association with whole fruit intake.

6) Nitric oxide (NO)

• NO is described as supporting insulin function and vasodilation (widening of blood vessels), which the article links to performance.
• It cites Wang et al. (Diabetes, 2013), describing NO as improving insulin function in muscle cells, aiding glucose entry and glycogen formation.
• It states uric acid hampers NO’s effect and links this to impaired performance and increased risk of heart disease, diabetes, and erectile dysfunction.

7) Fluid retention

• The article states fructose increases vasopressin (antidiuretic hormone), which causes the kidneys to retain fluid.
• It states excess body fluid is unhealthy and, for athletes, affects power-to-weight ratio, metabolism, and cardiovascular strain.
• It notes that people often lose weight quickly after reducing sugar intake and states this reflects fluid loss due to lower vasopressin levels.
• It also states vasopressin causes vasoconstriction (narrowing of blood vessels), reducing blood flow to muscles.

8) ATP

• ATP is described as the primary energy molecule and necessary for muscle contraction.
• The article states exercise increases ATP formation but argues sugar—especially fructose—is unfavourable for ATP production.
• It states fructose is processed by fructokinase, which requires ATP, and cites Douard et al. (Journal of Physiology, 2013) reporting that cellular ATP fell by 40–50% after consumption of sugar-sweetened beverages.
• It adds that ATP use produces AMP, which is discussed next.

9) AMP and AMPD2

• The article states that sugar, particularly fructose, increases AMP levels, and that AMP stimulates uric acid formation.
• It states uric acid increases AMPD2 (adenosine monophosphate deaminase 2), which increases fat storage.
• It states that animals have surging AMPD2 prior to hibernation to gain fat.