“The only food that contains nothing but calories is sugar" - John Yudkin
Introduction | Sugar Metabolism | Negative Effects | How Much? | Food Labels | Sugary Foods | Artificial Sweeteners | | Natural Sweeteners | Final Thoughts | Takeaway Points | References | Disclaimer
Introduction
For a long time, the debate over sugar and its effects on the human body has focused on its toxic impact. Nutrition and health experts are talking a lot about the problem of added refined sugars like fructose, glucose, and sucrose, and their derivatives, in processed foods. The biggest issues brought on by excessive sugar consumption include obesity, type 2 diabetes, metabolic diseases, systemic inflammation, and sugar addiction. Sugars that have been refined are not the same as the natural sugars that can be found in whole fruits, vegetables, and dairy products because refined sugars have very little to no nutritional value. Sugars that have been refined do not contain any of the vitamins, minerals, or fiber that are normally found in vegetables and fruits. When refined sugars are eaten, the body quickly breaks them down and absorbs them. This causes the blood sugar level to rise. A surge in blood insulin is produced as a direct result of the rise in blood sugar. This reduces the sensation of fullness, which precedes the typical "sugar high" and energy crash brought on by sugar shortly after eating.
Sugar metabolism
Sugar metabolism is the process that allows for the conversion of the food we eat into fuel for the body. There are three main types of sugar: glucose, fructose, and sucrose. All three of them provide our bodies with energy, but they differ in terms of their metabolic pathways and the effects they have on our systems.
Glucose metabolism
Glucose is a breakdown product of carbohydrates. It serves our body as a source of energy. When we consume carbohydrates, they are broken down into simple, soluble sugars [such as glucose and fructose]. Glucose is then absorbed in the intestines and transported into the circulatory system. The cells take up glucose that is circulating in the bloodstream. This process is aided by a hormone called insulin. Insulin regulates the uptake of circulating glucose into the cell and, at the same time, diminishes the amount of glucose in the blood. Once glucose enters the cells, a process called glycolysis begins, which results in ATP [adenosine triphosphate] formation in the cell mitochondria. ATP is an energy molecule that allows the cells to maintain their functioning.
Fructose metabolism
Fructose is a monosaccharide [a simple, soluble sugar] that is metabolized primarily in the liver. Fructose is absorbed in the intestine and transported via the blood stream into the liver to restore glycogen [a stored form of glucose] levels and synthesize triglycerides [fat]. The uptake of fructose into the liver is not regulated by any of the hormones [such as insulin in glucose metabolism]. Therefore, the metabolism of this monosaccharide progresses much faster and is mostly uncontrolled. A process of fructose conversion into energy [ATP molecules] is called fructolysis.
Sucrose metabolism
Sucrose is a disaccharide consisting of one glucose and one fructose molecule. Sucrose is digested in the small intestine after consumption, where it is broken down into glucose and fructose. Once they enter the bloodstream, the presence of glucose triggers insulin production by the pancreas and, at the same time, increases the absorption of fructose into the liver.
The negative effects of sugar
It is a common notion that sugar is not good for us. However, its negative effects on human health go beyond the most evident ones, namely weight gain[1] and dental health problems[10]. Excessive sugar intake is also associated with:
non-alcoholic fatty liver development[4],
mitochondrial dysfunction[5] and increased cellular aging[9],
a greater risk of heart disease and stroke[6],
type 2 diabetes and metabolic syndrome[7],
an elevated risk of dementia[8],
the development of sugar addiction[11],
a higher risk of cancer[12],
a greater incidence of chronic kidney disease[13],
elevated uric acid levels[14],
delays in the social-emotional development of children[15],
potential cognitive impairments, depressive symptoms, and impaired neurogenesis[16],
systemic inflammation[17],
weakened immune system[18][19],
increased gut permeability, and microbiota dysbiosis[19].
It is well established that drinking sugary beverages increases the risk of all-cause mortality in adults[20]. Sugar is more harmful to our bodies than most of us realize, and it contributes to a wide range of health problems. In addition to causing systemic inflammation, which is a key part of all diseases, sugar also makes cell damage worse in people who already have a health problem and keep eating sugar. It can be challenging to stop a disease from progressing under these conditions, and the results could be much more serious.
How much sugar is too much?
According to the American Heart Association, a recommended intake of added sugar [such as sucrose, dextrose, table sugar, syrups, honey, etc.] should not exceed 9 teaspoons [36 g] per day for adult men and 6 teaspoons [24 g] per day for adult women[21]. However, data from the Centers for Disease Control and Prevention's website show that the average adult male consumed 19 teaspoons [76.7 g] of added sugar per day in recent years. Women, on the other hand, consumed 15 teaspoons [60.5 g] of added sugar per day[22].
The WHO has also issued its own set of recommendations on daily added sugar consumption.
"In both adults and children, WHO recommends reducing the intake of free sugars to less than 10% of total energy intake."[23]
Such a statement has been flagged as a strong recommendation applicable to adults and children in all regions of the world.
So far, the attempts at establishing the tolerable upper intake level [UL] of added sugar have failed. The European Food Safety Authority [EFSA] was asked to conduct a review of the science and investigate how much sugar is safe for us to consume on a daily basis. The reviewing committee established multiple links between sugar consumption and a variety of health problems. However, they neither provided a science-based UL for sugar nor were they able to recommend a safe level of intake.
The reason for that was that "the risk of adverse health effects [responses] increased across the whole range of observed intake levels [doses] in a constant [linear] manner, i.e., the higher the intake, the greater the risk of adverse effects."[24]
Food labels: the many names of sugar
The majority of prepared foods, including breads, cereals, canned and frozen foods, snacks, desserts, drinks, etc., must have food labels. A policy like this ensures that consumers are well informed about the ingredients in the products they buy. Making healthier food choices can be easier if we understand what all the food products contain. However, the food industry and food manufacturers go out of their way to hide ingredients such as sugar under many different names on the labels of their products. Some of the most common names for sugar are dextrose, corn syrup, fructose, glucose, sucrose, saccharose, maltitol, and maltodextrin. The book "Sugar Has 56 Names,"[25] authored by Dr. Robert Lustig, an expert in the field of sugar and its effects on human health, lists the alternative names for sugar that the food industry uses on the labels of their products. However, as the author says himself, since the time of publication, this list has grown longer, and at this moment, there are over 260 terms that describe added sugar, as listed by the Hypoglycemia Support Foundation[34].
Because added sugar can be hidden under different names, it is also a good idea to always check the nutrition facts of the product we want to buy. It will inform us about the total and added sugar content. The total amount of sugar includes both added and naturally occurring sugars, which will help us determine how much extra sweetness was added to the product of our choice.
Which products contain sugar?
Added refined sugar is a common ingredient in many foods. It is especially prevalent in goods that have been manufactured, processed, and packaged. Therefore, everything that we do not make ourselves out of whole foods has the potential to contain added sugar. Sugar makes food more palatable, extends the shelf life of products, and makes us reach out for sugar-containing items more frequently. There is no wonder that the food industry adds refined sugar to almost anything. The products that are especially associated with high concentrations of added sugar are:
candy, cookies, and baked goods [including bread],
dairy desserts, sweet yogurts, ice cream,
cereal, granola,
alcohol, fruit juices, fruit nectars, sports drinks, energy drinks, iced teas, sweetened coffees, and premade smoothies,
low-fat products, such as low-fat yogurts,
condiments, sauces, and salad dressings,
jams, marmelades, jellies,
canned goods such as baked beans, soups, and fruit,
protein bars.
The above-mentioned products are just a few examples of where we can find refined sugars. If we look at this list and consider how many of these items we eat daily, e.g., for breakfast, we come to the realization that it is very easy to exceed any health recommendation on sugar consumption. For many of us, a typical breakfast consists of a glass of orange juice, cereal, and coffee. A glass of fiber-free orange juice [250 ml] contains on average 21 g of sugar, and 1/2 cup of cheerios [or other sweetened cereal] contains 6.5 g of sugar. If you sweeten your coffee or buy a sweetened coffee, such as Starbucks Tall Iced Coffee, you might add another 15 grams of sugar to your diet. As a result, just one meal per day contains 42,5 grams of sugar [10,5 teaspoons]. When we compare these amounts to the American Heart Association's recommendations, our breakfast alone exceeded these guidelines on sugar consumption by 1.5 teaspoons for men and 4.5 teaspoons for women.
Artificial sweeteners
Artificial sweeteners are non-nutritive substances that deliver sweetness without any caloric intake. Saccharin, acesulfame K, aspartame, neotame, and sucralose are some of the most common sweeteners found in zero-calorie advertised products. These sugar substitutes were developed to help manage the insulin resistance and obesity epidemics. However, there are studies suggesting that these substances negatively influence the gut microbiome, decrease satiety, and eventually contribute to metabolic syndrome and obesity[26]. In addition, two of the most prevalent sweeteners, namely aspartame and acesulfame K, are linked with an increased risk of cancer[27]. Furthermore, the consumption of artificially sweetened beverages was found to increase the risk of developing type 2 diabetes, metabolic syndrome, and cardiovascular problems[28].
Natural sweeteners
Natural sweeteners are substances derived or extracted from organic sources. They provide sweetness and are naturally low in fructose. Stevia, erythritol, xylitol, monk fruit sweetener, and yacon syrup are all plant-derived compounds that don't harm our health. Research has shown that stevia has the capacity to alleviate the risk factors for obesity, inflammation, and oxidative stress due to its ability to minimize blood glucose levels[29]. In addition, erythritol was found to promote a feeling of fullness after consumption because it stimulates the secretion of GI satiation hormones[30].
When we think about natural sweeteners, it is not possible to exclude such sugars as honey, molasses, maple syrup, and coconut sugar. All of these sweeteners have less fructose than regular sugar and possess nutritional value. However, their consumption should be done in moderation as well. Just like added refined sugars, they are found on the food labels of many products, and they exert the same effect on our health. Their excessive consumption in our diet can result in weight gain and metabolic issues.
Final Thoughts
Refined sugars in the form of added sugars cause great harm to human health. They are associated with obesity, type 2 diabetes, systemic inflammation, non-alcoholic fatty liver disease, chronic kidney disease, and many other health conditions. Furthermore, their regular consumption may lead to sugar addiction, which makes it even harder to break the cycle of illness. This is why it is so important to be mindful of the food we buy and eat in order to diminish the amount of sugar in our diets. Food manufacturers go to great lengths to hide sugar under different names on product labels. It also indicates the scale of how ubiquitous sugar is in processed and packaged goods. There are, however, alternatives to traditional sugar that are not harmful to our health. Natural sweeteners such as erythritol, stevia, and xylitol are safe to consume and do not cause ill health or chronic illnesses.
Takeaway Points
Refined sugar consumption is responsible for a variety of metabolic diseases.
Our body uses fructose to produce energy, synthesize triglycerides, and restore glycogen levels.
Insulin controls the blood levels of glucose, which our body uses as an energy source.
Sucrose consists of glucose and fructose.
Sugar should be consumed in great moderation. There is no safe upper intake level [UL] for sugar.
People with pre-existing health conditions should limit their sugar intake or substitute healthier alternatives.
Artificial sweeteners have been found to have negative effects on our health.
Natural sweeteners are plant-derived compounds that are low in fructose.
References
This article contains 34 citations:
Disclaimer
Read carefully: