Eating sugar damages and eventually destroys your nerves. That’s the main message from the book Sugar Crush by Dr. Richard Jacoby and Raquel Baldelomar. This is a book that mixes some fairly detailed medicine and cell biology discussions with very practical tools for evaluating your state of health.
Dr. Jacoby is a Doctor of Podiatric Medicine, specializing in foot surgery. In the book, he explains that he was trained to help diabetic patients as their health and feet deteriorated. One of his first experiences in surgical training involved holding a gangrenous leg while it was cut off a diabetes sufferer. When he realized that high sugar diets caused the systemic inflammation that led to peripheral neuropathy (nerves dying in people’s feet), and that the inflammation could be treated with diet, he started researching this book, working with Raquel Baldelomar, founder of the Quantise health care marketing agency.
There are several aspects of this book I found unique. First was the extensive discussions of the causes and effects of neuropathy–deterioration and death of nerves. The claim is that the inflammatory effects of high levels in sugars in the body cause inflammation of both the nerves and the tissues that the nerves run through. This results in both pressure on the nerves and some direct damage due to inflammation of the nerves. That causes decreased function, leading eventually to the loss of those fine and large nerve networks in parts of the body, most notably Dr. Jacoby’s speciality, the feet. The biggest gap is this otherwise excellent discussion is that the authors make no mention of the work of Dr. Richard Johnson at the University of Colorado, Denver. The work of Dr. Johnson’s lab on the metabolism of the sugar fructose to uric acid would fill several gaps in the explanations in Sugar Crush. Elevated uric acid is a very potent systemic inflammatory agent. As in Fat Switch, Sugar Crush strongly makes the point that over time, some of the inflammatory damage is permanent.
Another unique aspect was the detailed, plain English discussion of symptoms and the implications. The book goes through the stages of neuropathy in depth. It discusses efficacy of conventional drug treatments for neuropathy symptoms in the feet (not great…). It describes surgical release techniques for neuropathies throughout the body, including migraine headaches. However, the book keeps coming back to the idea that the best treatment is to cut sugar out of one’s diet. Even if some permanent damage has occurred, almost everyone will see improvements.
At the end of the book is very practical information on diets. The authors encourage two types of diet. One is the low carb, ketogenic diet that Dr. Jacoby himself follows, which he describes as having gone “cold turkey.” The alternative then described is the more gradual shift using techniques nutritionist Judy Nicassio has developed. Nicassio consults with patients in Dr. Jacoby’s podiatric practice. As you can tell from the rest of the website, I prefer the ketogenic diet. But that’s because for mental and physical health reasons, I want to stay in nutritional ketosis, i.e. keto-adaptation. I didn’t see a clear indication in the Sugar Crush that the authors understood that keto-adaptation is a fundamentally different metabolic state than carb adaptation. The primary focus of the book is sugar toxicity, not optimal metabolic state.
This is an excellent introduction to the effects of high sugar diets with special emphasis on neuropathies. It improved my understanding of that aspect of sugar-induce pathology.