As sugar is added to lots of foods and beverages, many people probably eat and drink more sugar than they may realise. Reducing sugar intake is a healthy idea, although it is quite a challenge to reduce the intake of sugar, as it acts like a drug in the brain. Less intense than cocaine and heroin, but nonetheless addictive for some people, sugar activates the very same region in the brain that makes you experience a high and feelings of pleasure. Like using hard drugs, bingeing on sugar blunts the “pleasure” response over time, making you want the sugar fix more frequently and in higher doses to experience the same feelings of pleasure.
What is sugar and what does it do in the body?
Sugar refers to all sweet carbohydrates and is a type of carbohydrate that does not contain any essential nutrients, as it only provides energy. Naturally occurring sugars are found in lactose in milk, glucose in fruits and vegetables, fructose in fruit and honey, and maltose in wheat and barley. Added sugars refers to refined sugars that are added to foods and drinks by the manufacturers for many reasons, such as making the food taste sweeter, improve its appearance, or helping to preserve foods.
As a form of carbohydrate, sugar provides the same amount of energy, expressed as kilojoules (kJ) per gram, as other forms of carbohydrates found in breads, pasta, and rice, for example. One gram of carbohydrate provides 16 kJ of energy while one gram of fat provides virtually double the energy at 37 kJ. It is however easier to overindulge in foods and drinks with a high sugar content, all contributing to the number of kilojoules, while not providing the satiety that the intake of fat gives.
Sugar is sugar and naturally occurring sugars are not necessarily healthier in terms of sugar content than added sugars, although naturally occurring sugars are likely to be in combination with fiber, vitamins, and minerals, which makes it the healthier option.
A single molecule of sugar consists of equal amounts of glucose and fructose, which gets separated early during the digestive process in the small intestine. About 80% of glucose circulates in the blood stream and around 20% goes to the liver, while 100% of fructose goes straight to the liver.
When glucose enters the bloodstream, it signals the pancreas to release the hormone insulin, which allows cells to absorb the glucose for processing inside the cells, and in this way restoring blood sugar concentration to its normal range. The mitochondria in cells process glucose to form energy. Too much sugar, too often repeated, results in the body being flooded regularly with glucose, which causes repeated spikes in insulin levels. Eventually the cells revolt and become desensitized to insulin, a condition called insulin resistance, which is a precursor to diabetes.
While glucose is the currency of energy in the body, fructose is the currency of energy storage, in the form of fat, in the body. Liver cells, if flooded by excess amounts of fructose, converts most of this excess to fat, called triglycerides, which are reflected as rising triglyceride levels in the bloodstream. The byproduct of fructose metabolism in the liver is uric acid. High levels of uric acid have in the past few years come to the fore as the instigator of harmful effects on most metabolic processes in the body, including impaired brain functioning and high levels of inflammation.
How to reduce the intake of sugar:
The World Health Organization strongly recommends the intake of sugar to be less than 10% of total energy intake and suggests a further reduction to below 5% of total energy intake to reduce disease risk in adults and children.
Replacing foods that are high in sugar with healthy options will provide all the essential vitamins and minerals without the added calories and the most effective way to do it is to change your diet gradually. Remember sugar acts like a drug to the brain’s reward center and cutting out sugar suddenly can lead to strong cravings and giving in again to the temptation of sweet foods and drinks. Building up to a low-sugar diet over time would help to retrain the palate and one would be less likely to crave the missing sugar.
A good starting point is to slowly eliminate the most obvious sources of sugar, such as sugary beverages, candy, baked goods such as cakes and muffins, and reducing the amount of sugar in coffee and tea, working up over time to use none.
Once the most obvious sources of sugar have been reduced or cut from the diet, it is time to identify other products that contain sugar. Reading product labels carefully could open a viper’s nest of hidden sugars. Sugar is hidden under at least 70 different names, many ending in “-ose” such as sucrose, glucose, dextrose, lactose, and fructose. A myriad of names that could hardly be associated with sugar, or are innocent sounding, are used on the label. Keep in mind, sugar by any other name is still sugar.
In his book “Drop Acid” Dr. David Perlmutter lists seventy different commonly used names for sugar, listed here in alphabetical order.
- A: agave syrup, anhydrous dextrose.
- B: barley malt, beet sugar, birch syrup, blackstrap molasses, brown rice syrup, brown sugar, buttered sugar/buttercream.
- C: cane juice (crystals), cane sugar, caramel, carob syrup, coconut palm sugar, coconut sugar, confectioners’/powdered sugar, corn sweetener, crystal dextrose, crystalline fructose.
- D: date sugar, demerara sugar, dextrin, dextrose, diastatic malt.
- E: ethyl maltol, evaporated cane juice, evaporated corn sweetener.
- F: florida crystals, fructose, fruit juice, fruit juice concentrate.
- G: galactose, glucomalt, glucose, glucose syrup solids, Golden sugar/syrup, grape juice concentrate, grape sugar.
- H: high-fructose corn syrup.
- I: icing sugar, invert sugar.
- L: lactose, liquid fructose.
- M: malt syrup, maltodextrin, maltose, maple syrup, molasses, muscovado sugar.
- N: nectar (including all fruit nectars, such as peach-, pear-, agave-, palm- and coconut nectar).
- P: palm sugar, panela sugar.
- R: raw sugar, refiners’ syrup, ribose, rice syrup.
- S: saccharose, simple syrup, sorghum syrup, sucanat, sucrose, sugar beet syrup, sugar cane juice.
- T: tapioca syrup, treacle, turbinado sugar.
- X: xylose.
- Y: yacon syrup, yellow sugar.
Sugar also hides in condiments (tomato sauce, salad dressing, for example), pasta sauce and other sauces, breakfast cereals, and energy bars.
Simple carbohydrates, found for example in white flour, white rice, and white pasta, in which starch is quickly broken down in the body into glucose, resulting in a spike in blood sugar levels. Simple carbohydrates can usually be replaced with whole grain options.
Artificial sugars may boast to have little or no calories, but beware, they are much sweeter than sugar and can trick the body into thinking that they are actual sugar, which can intensify sugar cravings. Research has indicated that a high intake of artificial sweeteners over the longer term may confuse your body into storing fat and inducing diabetes. Adding together the various mechanisms of potential harm from artificial sweeteners – from confusing the body with the sweet taste without calories, to altering gut bacteria – artificial sweeteners have likely played a role in worsening the widespread obesity and diabetes epidemic.
Sugar sweetened drinks contribute significantly to added sugars in the diet, such as fruit juices, sweetened teas, specialty coffees, cold drinks, energy drinks, and other beverages. Calories from sweetened drinks are absorbed quickly and result in a rapid increase in blood glucose levels. In addition, drinks don’t make you feel as full as solid food does and as a result people who consume lots of calories from drinks don’t eat less food to compensate for it. To stay hydrated, these drinks can be replaced with water, sparkling water, unsweetened herbal tea, and coffee without sugar.
Processed foods probably contain added sugars or refined ingredients (such as white flour) and can be replaced with whole foods, such as vegetables, fruits, nuts, seeds, lean meats, fish, whole grains, and legumes. Whole foods have not been processed or refined and do not contain additives or other artificial substances. Ultra-processed foods such as fast foods may contain sugar, salt, saturated (unhealthy) fat, and additives that are engineered to improve the taste, but are inherently unhealthy.
Canned foods, especially those packed in syrup, can also contain high levels of sugar.
As most desserts are loaded with sugar and/or refined carbohydrates and do not contribute much nutritional value, they can be replaced with fresh or baked fruit.
Alse be careful of low-fat options, as they could possibly be loaded with added sugar to make them more palatable.
As the palate may miss the taste of sugar, tasty herbs and spices can be used to replace sugar to make food and drinks tasty, such as cinnamon and vanilla.
It helps to plan nutritious meals and healthy snacks for days in advance, to have healthy food and snacks – such as fresh fruit – at hand to refrain from reaching for a sugary snack.
Conclusion:
A diet rich in whole foods and with a reduction in sugar intake have many health benefits, such as reducing inflammation in the body, reducing the risk of obesity and type 2 diabetes, and weight loss – which relies on lifestyle changes that also involve regular exercise.
Keep in mind, if you keep high sugar foods in the house, you are likely to eat them!
References:
Added sugars: Don’t get sabotaged by sweeteners. Published 3 April 2021. Mayo Clinic. USA. (www.mayoclinic.org)
Sugar. Published online and reviewed 12 September 2022. Better Health Channel, Department of Health, Victoria State Government. Australia. (www.betterhealth.vic.gov.au)
13 Simple ways to stop eating lots of sugar. Published online and updated 22 July 2021. Healthline. (www.healthline.com)
Tips for cutting down on sugar. Published online and reviewed 17 April 2018. American Heart Foundation. (www.heart.org)
How to cut down on sugar in your diet. Published online and reviewed 3 October 2022. National Health Service. UK. (www.nhs.uk)
What to know about no-sugar diets. Published online and reviewed 13 December 2019. Medical News Today. (www.medicalnestoday.com)
Sugar. Published online and reviewed July 2021. Healthdirect. A government funded service. Department of Health and Aged Care. Australian Government. (www.healthdirect.gov.au)
Drop Acid. Book by Dr. David Perlmutter. Published 2022 by Little, Brown Spark, USA. P.324.
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