‘Tis the season for sweets. It begins with “tricks” or “treats” in the form of Halloween candy and then it turns into decadent desserts after Thanksgiving meals and culminates in the generous baked good and chocolate offerings that come with Christmas and New Year. If you are among the health or weight conscious, you probably plan to avoid or minimize sugar this holiday season but that can be a genuinely difficult feat. Many avoid carbohydrates (carbs) all together but is this the healthiest choice and if so, for whom? I don’t believe in “one size fits all” recommendations and personally, I think carbs have gotten a bad wrap. Knowing more about sugar can help you make better choices for your individual health and that of your family.
WHAT IS SUGAR?
Carbohydrates, proteins and fats are the three basic macronutrients required in a balanced diet. Carbohydrates are found in a wide range of foods that contain vitamins and minerals, phytochemicals, antioxidants, and dietary fiber. Fruits, vegetables, grain foods, and many dairy products naturally contain carbohydrates in varying amounts, including sugars.
When you think of sugar, you probably think of the sweetener in the sugar bowl but there are many different types of sugar. Table sugar, or sucrose, is made up of equal amounts of the simple sugars glucose and fructose. It is naturally found in fruits and vegetables. Fructose is a simple sugar found in fruits, honey, and root vegetables. Glucose is the main source of energy for the body and the only fuel used by brain cells. It may also be referred to as dextrose. Galactose is the simple sugar found in milk and dairy foods. Galactose and glucose together form lactose. Corn syrup is made from corn and is 100% glucose. High Fructose Corn Syrup is a mixture of glucose and fructose produced from corn. It is usually comprised of 55 percent fructose and 45 percent glucose.
GOOD CARBS VS BAD CARBS
Upon ingestion, most carbohydrates and complex sugars are broken down into glucose. Sucrose is broken down into both glucose and fructose. (*More on this below) Dietary glucose can be stored in the liver and muscle cells in the form of glycogen. When the level of glucose in the blood drops, glycogen is converted to glucose to maintain blood glucose levels. Several hormones, including insulin, work rapidly to regulate this process. In the process of carbohydrate metabolism, the body is unable to distinguish between sugars that are added to foods and sugars that occur naturally in foods, since they are all broken down into the same chemical form (glucose).
You may wonder then what classifies a carbohydrate as either “good” or “bad”. The answer to that seems to lie in determining the food’s glycemic index or glycemic load. The glycemic index indicates how quickly a particular carbohydrate raises blood sugar (and therefore insulin) levels while the glycemic load takes food portion sizes into account. The idea is that low glycemic or, complex carbohydrates, are better for health because the carbs they contain are digested at a slower rate. Clinical evidence to support this claim has, however been mixed. It appears that for otherwise healthy individuals with generally healthy diets, when the overall amount of carbohydrate intake is low, cardiovascular health risks like blood pressure, cholesterol and triglycerides are better managed. The low glycemic index approach does not necessarily translate into improved insulin sensitivity/effectiveness or lower cardiovascular risk. For diabetics, however, studies have shown that choosing lower glycemic foods especially as snacks, can prevent spikes in blood sugar and insulin. The most important reason to choose complex carbs like whole grains, fresh fruits and vegetables and high fiber foods, over high glycemic/simple carbs is their high nutrient content. Over time, they significantly contribute to overall health.
ADDED SUGAR A WHOLE DIFFERENT STORY
The real reason to avoid sugar is not because carbs are bad or good but because excess sugar is detrimental to health. Here are 7 ways sugar can adversely affect one’s health:
Nutritional deficiencies: Added sugars, like sucrose and high fructose corn syrup, contain calories but no nutritional benefit. Liver disease: *When sugar is broken down into glucose and fructose, the glucose is essential and used by the brain or stored in the liver as glycogen for later use. Any excess fructose, however, is metabolized in the liver which converts it into fat if there are adequate glycogen stores. Over time, this can cause nonalcoholic fatty liver disease (NAFLD) or, fatty build up in the liver, and nonalcoholic steatohepatitis characterized by fatty liver, inflammation and liver scarring. According to Sugarscience.org, the incidence of NAFLD and NASH has doubled, along with the rise of fructose consumption in the past 35 years. Estimates vary, but conservatively, 31% of American adults and 13% of kids suffer from NAFLD. Eating a lot of transfats, being overweight and not exercising also can contribute to NASH. Most people with NASH also have Type II diabetes. Abdominal weight gain: Just like one can acquire a “beerbelly” from excess alcohol consumption, “sugarbelly” can develop with excess fructose intake. The liver exports the excess fats stored within it and deposits it throughout the abdominal region and around the internal organs. These fats cells are metabolically active so they can send out signals that disrupt normal hormone functioning throughout the body. These hormonal imbalances may contribute to heart disease, stroke, diabetes, cancer and Alzheimer's disease. Insulin resistance and metabolic disease: Insulin is a hormone produced by the pancreas to allow glucose in the bloodstream to enter the cells for metabolism. Insulin resistance develops when blood sugar levels are chronically excessively high and cells of the body are no longer responsive to insulin activity. It is associated with metabolic disease, obesity, cardiovascular disease and particularly Type 2 diabetes. Diabetes: In response to insulin resistance, the pancreas produces more insulin until it can no longer meet the demands. People who drink sugarsweetened beverages can have up to an 83% higher risk of Type II diabetes. Dental disease: Sugar can increase the risk of dental cavities as well as periodontal (gum) disease which is linked to diabetes and cardiovascular disease. Dysbiosis and inflammation: Excess sugar contributes to imbalances in normal gut microflora, digestive disturbances and systemic inflammation.
WHAT ABOUT SUGAR SUBSTITUTES?
Sugar substitutes offer an option for sweetening foods without the added calories contained in sugar. This was initially seen as a viable alternative to natural sugar to prevent weight gain and obesity. Animal studies have, however, convincingly proven that artificial sweeteners cause body weight gain. “A sweet taste induces an insulin response, which causes blood sugar to be stored in tissues, but because blood sugar does not increase with artificial sweeteners, there is hypoglycemia (a drop in blood sugar) and increased food intake.” Increased caloric intake causes weight and fat gain. In the Multiethnic Study of Atherosclerosis, daily consumption of diet drinks was associated with up to a 36% greater risk for metabolic syndrome and a 67% increased risk for type 2 diabetes.
These sweeteners are also more potent than table sugar and highfructose corn syrup. “People who routinely use them may start to find less intensely sweet foods, such as fruit, less appealing and unsweet foods, such as vegetables, downright unpalatable.” Animal studies even suggest that artificial sweeteners may be addictive, even more so than cocaine!
HOW TO STRIKE A SUGAR BALANCE
Carbohydrates are a necessary part of a healthy diet. Here are ways to keep your sugar intake in check:
1. Focus on a whole foods diet as much as possible and minimize processed foods. Added sugar is hiding in up to 74 percent of packaged foods!
2. Read labels and watch out for “lowfat” foods as these are often high in sugar. 3. Eat balanced meals, especially breakfast, frequently throughout the day. This will maintain adequate blood sugar levels and prevent cravings for sweets. 4. When you do eat sweets, brush your teeth soon after to prevent cavities periodontal disease. 5. During the holidays, consider focusing on savory treats instead of sweets. Here is a great resource for crossover cookie ideas.
If you have been eating high amounts of sugar for a long time and have strong cravings, you may benefit from speaking to your doctor about possible assessments and treatments for gut flora imbalances, inflammation and metabolic diseases.
Enjoy healthy holidays!
FoodInsight.org NY Times Authority Nutrition Harvard Health Publications
Dr. Adeola Mead, ND is the Natural Choice Network's Healthy Living Content Coordinator. She is a naturopathic physician with a clinical focus on women's health and stress-related illness. Dr. Mead is passionate about using natural medicine education as a powerful healing tool for both individuals and communities.