Many of my column topics are inspired by clients and by media. Sugar has been blamed for the explosion of obesity around the world. Celebrity dieters proclaim, “sugar is bad, fructose is good.”
There’s some truth to these statements but what do you think?
First, a short quiz to see how much you know about sugars.
Question: What country consumes the most sugar yearly?
The United Kingdom
United States of America
Answer: Of the countries listed, USA holds the dubious honor of first place.
The USDA reports that the average American consumes between 150-170 pounds of refined sugars yearly, translating to about 126 grams per day, or more than 24 added teaspoons daily. The UK averages 93 grams; Canada, 89 grams. China averages only about 16 grams. As for Ecuador, reports show that as poorer countries become increasingly urbanized, there’s a corresponding increase in consumption of animal fat and protein, refined grains, and added sugar, contributing to increased rates of obesity, diabetes, and heart disease.
Question: Which of the following sugars is found naturally in milk?
Answer: Lactose. Milk contains different carbohydrates including lactose, glucose, galactose, and others. Lactose is a disaccharide composed of two simple sugars, glucose and galactose, which gives milk it’s sweet taste.
Question: Drink one can (12-oz) of sugary soda or sports drink daily for a year and increase your risk of gaining:
2 lbs./ 0.9 kg
5 lbs./2.27 kg
10 lbs./4.54 kg
15 lbs./6.8 kg
Answer: 15 lbs/6.8 kg. Research shows that liquid calories don’t put a dent in your appetite. And most don’t limit to one small can – if you drink soda, you’re likely drinking more than 12-oz. daily. Calculate: One 12-oz can of Coke contains 140 calories. Multiply 140 calories times 365 days/year = 51,100 calories, divide by 3,500 calories (in one pound) = just shy of 15 lbs. or 6.8 kilos yearly.
Question: A Fruit Smoothie is a better choice than a sugary soft drink. True or False?
Answer: True and False. The ‘smoothie’ is ‘better’ in that it contains a little protein (3 g), some fiber (3 g), and a smidgen of calcium and vitamin C. But they contain lots of calories, mostly from naturally-occurring and added sugars. For example, a small Banana Berry™ Smoothie from Jamba Juice contains 280 calories and 59 grams of sugar – 14.75 teaspoons of sugar (including the carbohydrate from the fruit, frozen yogurt, and sherbet). The advertisement says “no high fructose corn syrup,” but the very first ingredient is “apple-strawberry juice blend” which tells you that this is a highly processed ingredient and a concentrated source of sugar. See the Jamba Juice info here.
A sugar by any other name…
All caloric sweeteners contain about 20 calories per teaspoon or about 4 calories per gram.
“Sugar” includes ingredients such as sucrose (table sugar), corn syrup, high fructose corn syrup, honey, agave, maple syrup, panela, and molasses.
Some sugars labeled “natural” contain minute amounts of minerals and vitamins, including honey, maple syrup, and especially molasses. But in the amounts recommended, they can’t be considered adjuncts to health.
“Natural” sweeteners from juice such as evaporated cane juice, fruit juice concentrates, and nectars are perceived as more healthful than refined sugars, but all have an identical effect on blood sugar.
What about fructose and agave?
Agave syrup is a refined, processed sweetener made from agave nectar. In its natural form, agave nectar contains healthful antioxidants, but once processed, it becomes high in fructose, higher than high glucose corn syrup. Fructose is a monosaccharide found in many plants including fruit. As a food ingredient, it is derived from sugar cane, sugar beets, and maize. A high intake of agave and added refined fructose is linked to increased triglycerides, fatty liver disease, and increased risk for heart disease.
Health author and physician Andrew Weil writes that he no longer uses or recommends agave syrup, and says that excessive added fructose may increase the risk of cancer.
A small amount of agave nectar occasionally won’t kill you, but it’s no better than regular sugar or corn syrup. Weil suggests cutting sweeteners in general to a minimum. For a sweetener, he prefers authentic maple syrup for its taste and much lower fructose content compared to agave. In Cuenca, real maple syrup is hard to find: readers, if you have a suggested source, please post in the comments below.
What About Sugar Alternatives?
The U.S. Food and Drug Administration (FDA) regulates non-nutritive sweeteners (NNS) and the approval process includes determination of probable intake, the cumulative effect from all uses, and toxicology studies in animals. Non-nutritive sweeteners (NNS) are many times sweeter than sugar, and may be either ‘natural’, such as stevia, or ‘artificial’, such as sucralose (Splenda). All provide little or no calories (energy).
Artificial sweeteners approved for use in the USA and seen throughout Latin America include acesulfame potassium (ace-K or Sweet One), aspartame (Equal and NutraSweet), neotame, saccharine (Sugar Twin, Sweet ‘N Low), and sucralose (Splenda).
However, in a recent study published in the Journal of Toxicology and Environmental Health, researchers take issue with the FDA’s testing methods for sucralose. They found that sucralose is stored in fatty tissue for longer than previously thought, and creates “metabolites whose potential health effects we know little or nothing about.” They conclude, “It’s time to revisit the safety and regulatory status of sucralose.” An October 2018 Israeli study concludes that artificial sweeteners “can adversely affect gut microbial activity” with researchers cautioning a link to a wide range of health issues from cancers to type 2 diabetes.
Polyols (sugar alcohols) are also sweeteners and include sorbitol, xylitol, and mannitol. Typically found in candies, chewing gum and desserts, they’re not calorie-free, but typically contain less than half the calories of sugar, and don’t cause tooth decay. However, excessive polyols can cause gastric effects like bloating and gas.
Plant-sourced sweeteners include monk fruit extract and the herb stevia. Manufacturers extract and process monk fruit and stevia leaves into powder — of course, now this substance is not totally “natural” since to get them into those little packets that stay shelf-stable, these sweeteners are highly processed and many have additives. The real thing — the stevia plant — is readily available here in Cuenca — you can grow it on your patio or garden. Check out my column on stevia here.
Want more sweet?
Dates and raisins and all dried fruits are naturally sweet. Chop them up and add to your cereals, smoothies, and desserts to add sweetness, fiber, and nutrients like iron too.
Does more sugar = more obesity?
The epidemic of obesity continues unabated, and countries that formerly had to deal more with malnutrition and under-nutrition like China and India are now faced with the health consequences of overweight and obesity. In Ecuador, children are noted to be consuming inadequate amounts of fresh fruits and vegetables, although there’s no shortage of either. The BMC Journal cites the “large abundance of competitive foods (junk food) and lack of fresh fruit offered in schools. A diet consistently high in added sugars is linked to obesity, increased risk for diabetes, and high blood lipids including triglycerides and low-density lipoproteins (LDL). Besides sodas, fruit juices, energy drinks, and sweetened coffees are full of added sugars.
However, it’s not just added “sugar” per se that is the worry. It’s the number of hidden sugars in foods, some hidden in plain sight. For example, children’s breakfast cereals can contain as much as 30 percent of their calories from added sugars. Yogurts, perceived to be healthy food, are often sweetened with a huge amount of sugar. For example, an 8-oz cup of fruit-flavored, nonfat yogurt contains 46.5 grams of added sugar. That is 11.6 teaspoons of sugar. Imagine buying a cup of plain, unsweetened yogurt, opening it up, and spooning 11.6 teaspoons of sugar into it. Or giving it to your kid like that.
Have you shopped the cereal aisle lately? There ain’t no fruit in Froot Loops™, but there’s plenty of sugar in this brand and many others. The marketing to kids makes me furious. All those “kids” cereals whose first ingredient is sugar are positioned right at munchkin-eye-level. By design. Kids can’t help but be mesmerized by the bright colors and promises of dessert for breakfast.
But they can’t make us eat it! Buy unsweetened yogurts and cereals. You control the sugar and teach your kid that he or she can control the sugar. Add naturally sweet fruit (mango is my favorite), and for a little more sweetness, drizzle on a bit of organic honey. Always read the ingredient label first. If sugar is one of the first three ingredients, leave it on the shelf.
Finally, does sugar cause obesity?
We’re always looking for a villain, but sugar is a distraction. Yes, too much sugar can contribute to obesity, but the excessive sugars compounded by too much fat and fried foods/junk foods, too few fruits and vegetables, and too little activity that creates this recipe for disaster.
And sweet is both an acquired and inherent taste. When every beverage you drink is sweetened, you begin to expect all beverages to be sweet, and when they are not, it’s a letdown.
Similarly to salt — when you’re used to food being highly seasoned with salt, unsalted foods taste flat.
So, break away from that sugar habit, and discover the taste of food. Real sugar isn’t out of my diet absolutely, just not regularly. Desserts are a treat, and I’m not going to eat it if it’s not worth it.
Sugar does more than just sweeten foods; it bulks, browns, and texturizes baked goods. There’s no substitute for sugar in my chocolate biscotti, but I reduce the amount in the recipe and still get a great cookie.
Here’s a link to my very favorite Biscotti Cioccolato recipe by Linda Wells, published online by the New York Times. I’ve been making this treat for more than 20 years. I always cut the sugar back from one cup to a half-cup, without any complaints. I especially love that I can get some great dark chocolate here in Cuenca.
Andrew Weil, MD. What’s wrong with agave nectar?
Brandongaille.com. 29 Awesome Sugar Consumption Statistics.
BioMed Central. Dietary intake practices associated with cardiovascular risk in urban and rural Ecuadorian adolescents: a cross-sectional study.
FamilyDoctor.org. Added sugar: What you need to know.
Journal of Toxicology and Environmental Health, Part A. Intestinal metabilism and bioaccumulation of sucralose in adipose tissue in the rat.
Neuroscience News. Artificial sweeteners have toxic effects on gut bacteria.
NY Times Cooking: Biscotti Cioccolato.
Stevia.com. Growing Your Own
Time.com. More people are now obese than underweight, study finds.