Doug Cook RD
Nutrition Demystified. Health Exemplified
Nutrition advice that makes sense. Separating hype from reality.

Sugar

sugar-cubes

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A recent article in the journal Nature, from the University of California, caused shock waves in the blogosphere when when a handful of researchers stated that sugar is so toxic to the human body and human health that governments around the world should regulate it like a toxin, not unlike alcohol, tobacco or trans fat. The researchers propose regulations such as taxing all foods and drinks that include added sugar, banning sales in or near schools and placing age limits on purchases. For decades, the saturated fat bad rap centred on increased risk for chronic diseases like cardiovascular disease, stroke and coronary heart disease, but recent studies continue to build on a lesser known hypothesis that sugar is the real culprit.

Where does the concern come from?

Evolutionary biologists and health experts claim that from an evolutionary perceptive, sugar in the form of fruit was available only a few months of the year, at harvest time. Similarly, honey was guarded by bees and therefore was a treat, not a dietary staple. Added sugar was not a significant component of the human diet until the advent of modern food-processing methods. Since then, the intake of sugar has risen steadily. Sugar and foods high in sugar like cookies, pies, cakes, candies used to be a rare treat and not consumed everyday.

How bad is sugar for your health?

Higher intakes of added sugar have been shown to increase blood pressure, triglycerides [a type of blood fat] and cholesterol, along with your risk for liver failure [by causing a fatty liver], obesity, coronary heart disease and diabetes type 2. Many researchers are seeing sugar as not just “empty calories,” but rather a chemical that becomes toxic in excess. At issue is the fact that glucose from complex carbohydrates, such as whole grains, is safely metabolized by cells throughout the body, but the fructose element of sugar is metabolized primarily by the liver. This is where the trouble can begin — taxing the liver, causing fatty liver disease, and ultimately leading to insulin resistance, the underlying causes of obesity and diabetes.

As far back as the 1960s and 1970s, a researcher, [a smart guy who wisely questioned the data that implicated saturated fat in cardiovascular], by the name of Yudkin found a positive association between sugar consumption and coronary heart disease and diabetes type 2 and more recently the Nurses’ Health Study found that a diet with a high glycemic load [or high in total carbohydrate with an emphasis on sweets, added sugar and highly processed starches] had an increased risk for coronary heart disease and insulin resistance.

Many studies have linked dietary sugar with adverse changes in lipoproteins: high sugar intake is associated with lower HDL and diets high in sugar [sucrose or table sugar, greater than 20% of one's energy/calorie intake] has been associated with, and shown to increase triglycerides.

At first the evidence had been less clear with diabetes type 2, but a couple of recent prospective studies have shown diets with a high glycemic load predicts its development.

A lesser discussed idea is the role that higher intakes of sugar have on nutritional adequacy or the likelihood that one’s getting enough of the essential nutrients needed for health and chronic disease prevention. Diets that include a lot of foods high in added sugars like soft drinks, processed foods, fruit drinks, sweetened cereals, yogurt, candies etc [or greater than 25% of total calories] may displace lower sugar, higher nutrient-dense foods like fruits, vegetables, meats, egg, fish, pulses [chickpeas, lentils, beans and dried peas], nuts and seeds.

How much sugar are we eating anyway?

For the purposes of nutrition education communication around the word ‘sugar’ and health, ‘sugars’ really refers to added sugars, those that are refine from food and then added back to food production leading to a possible excess of sugar and calorie consumption. For the most part, added sugars referred to honey, syrups, and sugars like brown, white, turbinado, raw, palm or other forms derived from plant saps.

As of 2010, Canadian intake of sugar is estimated to be 51 g or about 13 teaspoons per day for an extra 208 calories per day, an amount I suspect to be very conservative. This works out to 18.61 kg or 40.95 pounds per year. This is based on total available sugar in the marketplace with an estimated adjustment for losses due to waste, storage issues or spoilage of foods and not measured intake – an extraordinarily difficult task to conduct.

In the USA, things are a little different. Americans consume on average more than 600 calories per day from added sugar, equivalent to a whopping 40 teaspoons or 160 g, that’s 128 pounds or 58 kg per year. It’s true that Americas drink more fully sweetened soft drinks and other beverages like iced tea which explains much of the difference between the two countries.

Contrast this to the estimated amount North Americans consumed 100 years ago: 11 kg per year, or 30 g, which equals about 7.5 teaspoons per day.

It is for this reason that the American Heart Association recommends a daily maximum of 10 teaspoons of added sugar. Its because of sugar’s potential negative impact on health and its pervasive use and presence in the food supply than many health professionals and researchers feel that government should consider stepping in to regulate its use in food manufacturing not unlike they did with trans fat, a suggestion that has experienced its first wave of backlash from both industry and many consumers alike.

The debate as just started.