The Science Behind Sugar - What Doctors Want You To Know
Artin Entezarjou, M.D. from EBT – Evidence Based Training.
Sugar - We hear so much about it. Are all sugars bad for us? Or should I only avoid white/processed sugar? What about added sugars?! The doctors from the Evidence Based Training team break down the actual science on sugars below!
Understand the various terms used to describe sugar.
Understanding Sugar Molecules
The first step to understanding sugars is to understand the various terms used to describe them, as they don’t all mean the same thing. The best way to go about this is to acknowledge that carbohydrates are all made up sugar molecules. Sugar molecules are the building blocks of carbs. The smallest sugar molecules that you need to be aware of are “glucose” “fructose” and “galactose”. These make up most of the carbs we eat on a daily basis. For example:
- Paring glucose to fructose gives us sucrose: classic white table- sugar, also found in honey and corn syrup
- Paring glucose to galactose gives us lactose, the carb found in milk- products.
- Lining up long chains webs of glucose gives us starch, the carb found in grains, wheats, legumes, potatoes and vegetables.
How Does Your Body Process Sugar?
Carbohydrates are broken down by the gut into the smaller sugar molecules “glucose”, “fructose” and “galactose”, so that they can be absorbed into our bloodstream. The pancreas then releases the hormone insulin into your bloodstream to get sugar into our cells to use as energy. If you eat more calories than your body is burning, the sugar will be stored in your liver, muscles and even as fat tissue. If you burn more calories than you eat, the pancreas releases another hormone, glucagon, which helps release the stored sugar and fat to the blood so that it can then be used by our cells for energy. So it is excess calories, and not sugar, that ultimately decides if you gain or lose fat!
Calorie deficits are still an important part of losing weight.
What Happens if You Over-Eat?
Assuming you eat more calories than you burn, you will gain weight. If your diet is also high in sugars, more fat may be stored between your inner organs (called “visceral fat”). Combined with low levels of exercise, the fat between your organs can make your pancreas stop working properly, leading to insulin levels not adjusting accordingly (called lowered insulin sensitivity). Your pancreas may eventually even produce less insulin! Lower insulin sensitivity means your body cannot get sugar from the blood into your cells where it is needed, leading to higher blood sugar levels. This is what we call Diabetes.
High blood sugar can lead to a slew of long term health issues.
Over time, high blood sugar levels will make your arteries, liver and metabolism dysfunctional and lead to heart disease, vision impairment, kidney dysfunction, nerve dysfunction and much more. As doctors we see these patients every day, and lifestyle change is the first line of treatment! You can therefore see why you have more reasons than looking good on the beach to keep your weight balanced.
Which Sugars Are Dangerous?
What you may also have noticed from the list above is that the same sugar molecule that you get in white sugar is found naturally in fruits and vegetables. Thus, on a molecular level, there is no real difference between “added sugars” and “natural sugars”. So what makes added sugars dangerous? The truth is that the DOSE makes the poison. Too much sugar is linked to heart disease, even when considering calories consumed! But did you know that limiting sugar intake too much also links to high risk of heart disease? Our bodies need carbs for energy, and finding the sweet spot is what it’s all about!
Cut out added sugars from your diet before you get rid of fruits. Fruits are full of other nutrients and fiber!
How to Hit the Sugar Sweet Spot
Studies show that safe sugar consumption is below 10% of calories, but at the same time data shows that we are getting 15 - 21% of our calories from sugar! That’s up to 11% more than we need! In some cases, many American's consume 3x the daily recommended amount of sugar.
Track your sugar consumption - most Americans consume an excess of sugar.
So why are we overconsuming sugar? Because it is being ADDED to many foods in the form of added sugars! Out of those 15- 21% sugar in our diet, HALF (7-11%) are from added sugars (X). Moreover, about 75% of items in the average American grocery store contains added sugar. So, even though there is nothing inherently dangerous in added sugars, we still recommend cutting them out of your diet to hit the sugar sweet spot, minimizing your risk of heart disease!
“Cutting out added sugars is thus a good principle to follow to reach the sugar sweet spot.”
Sugar itself isn’t poisonous, but getting too much of it may not be optimal to your health.
Think Bigger Than Just Sugar
But what if you manage to stay around the 10% mark, and choose to get these 10% from added sugars instead of natural sugars – are they the same thing? Well, yes and no. Even though doing this might make you stay “safe” when it comes to sugar itself, you are compromising other micronutrients that are essential for you health. Getting 10% of your sugars from ice cream and candy will most likely mean that you are missing out on other micronutrients that you need at the end of the day. This is especially true if you are trying to lose weight, since you are eating so little food already. (X)
Naturally occurring sugars are a package deal, so when you get sugar from a whole fruit or vegetable, you almost always get vitamins, minerals, fibers, complex carbohydrates and possibly fat that make sure you get your daily dose to help you stay healthy. This is why its healthier to have fruit than just added sugar, even if the sugar amounts are equal between the two. Also, the “package deal” makes whole food sugar sources hard to overconsume and allow you to stay within healthy doses of sugar.
The word “sugar” can refer to many things, and while there really isn’t any difference in the sugar molecules found naturally in food and the ones added to our foods, natural sugars tend to come with many other nutrients making these food sources a healthier choice! Most of us are eating too much sugar, and the easiest way to hit the sweet spot is to cut foods with added sugars: This will bring you one step closer to looking better, feeling better and living longer!
4. World Health Organization (2015) Guideline: Sugar Intake for Adults and Children.
5. Nordic Council of Ministers (2014) Nordic Nutrition Recommendations 2012, 5th ed.
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