Added Sugar and You

A growing body of research is pointing to added sugar as amongst the leading causes of some of the world’s biggest killers, for instance cancer, obesity, heart disease and diabetes. Consumption in the modern western processed diet is staggering with added sugars found in most processed foods.

What is added sugar?
While there are several definitions available, added sugar may be understood as any sugar carbohydrate which has been added to a food or beverage; essentially a sugar carbohydrate that is not a whole food.
For instance, an apple naturally contains sugars, these are found naturally within the whole apple and therefore are not added sugars, however should you take those whole apples and process them in some way (like juicing them), then you are left with added sugars (apple juice). Consuming an apple is not consuming an added sugar, consuming apple juice is consuming added sugars.

3 Main Types of Added Sugars

Natural	Artificial	Sugar Alcohols
Honey Rice Malt Syrup Straight Glucose Corn Syrup Agave Nectar Coconut Sugar Brown Sugar White Sugar Molasses/ and Blackstrap Fruit Juice and Concentrates (not whole fruit smoothies) Maple Syrup Stevia	Saccharin Sucralose Aspartame Neotame Aspartame	Xylitol Mannitol Maltitol Isomalt Lactitol Erythritol

I Really Feel like I Crave Sugar, Why is This?

There are several reasons...

1. Consuming added sugar causes dopamine and opioid release. Dopamine and opioids are neurotransmitters associated with experiencing feelings of pleasure and pain relief, raising levels of these chemicals in our bodies help us to feel good, and we naturally want more of that. Research has also identified neurochemical changes in the brains of 'sugar addicted' individuals which reflects changes seen in 'drug addicted' individuals, for instance changes in dopamine and opioid receptor binding. These effects of added sugar exposure and resulting behaviours is one reason why added sugar can be so addictive in susceptible individuals.
2. Stress. As a society, we tend to live in such a way that places us in a 'fight or flight' dominant state. Physiologically your mind/body naturally seeks balance, and one method of reducing the 'stress load' is via sugary carbohydrate consumption. Consuming added sugars as you now know releases 'feel good' chemicals which support a relaxed parasympathetic state - an antedote to stress so to speak. Feeling stressed? You are more likely to crave carbs/ sugars. 
3. Desensitisation. Did you know your taste buds become accustomed (desensitised) to the taste of added sugar. Feed your taste buds added sugar constantly and they will adjust to the taste, hardly noticing it anymore. Once this occurs, you need more intense flavours to get the same response. When I feed people my low added sugar food, they find it bland, lacking sweetness. To me it might be very sweet, but their taste buds are desensitised and they need much more added sugar to register the same 'sweet hit' that I get. Thankfully, you can ‘retrain’ or ‘recalibrate’ your taste buds so they pick up the subtle flavours in food once again in as little as 6wks. 
4. Dysbiosis. Your large intestine (colon) contains rougly one kilogram of bacteria comprised of thousands of different strains, some are health promoting some are not. Dysbiosis is a state of bacterial imbalance in the large intestine where non-health promoting bacteria dominate. These bacteria thrive on added sugars and as studies show, gut bacteria influence cravings and food choices, demanding to be fed the foods that make them thrive. 

Did you know?

The majority of people can actually obtain all their energy and nutritional needs from wholefoods free from added sugars. The majority of us could actually never consume an added sugar again, and still manage to live a happy, healthy, active life. Interesting isn’t it…

I know I don't need added sugar but I still want to enjoy some. What is the healthiest way to do this?

• Natural added sugars are generally made up of a ratio of glucose and fructose and one of the main reasons added sugar can be harmful is due to the fructose content. Glucose can  be metabolised (broken down) by every cell in the body, but fructose can only be metabolised by the liver. Small intakes of fructose (such as found in whole fruit consumption) is converted into glucose by the liver to be used as fuel by all cells of the body. If glucose intake exceeds your bodies requirements (through consuming added sugars and especially high fructose added sugars), the excess glucose is put away in a storage form called glycogen; this occurs in the liver and skeletal muscles. Whenhen these storage sites are full, the excess glucose is then stored as triglycerides (a storage form of fat). Roughly 20minutes of high intensity exercise will deplete your glucose reserves after which stored fat (triglycerides) will be converted back to glycogen and used for fuel. One way to lose fat weight is to engage in high intensity exercise for more than 30minutes.
• Knowing this, it is good to understand that fat free products full of added sugars may contribute to body fat stores if all that glucose coming in exceeds your bodies demands. 
• Remember I said it is the liver which metabolises (breaks down) fructose, and it is the liver that converts the excess fructose into triglycerides (fat). When fructose is converted to fat in the liver, it is shipped out as VLDL very low density lipoproteins) cholesterol particles. Some of this lodges in the liver and can over time lead to non-alcoholic fatty liver disease. High VHDL levels are also linked to cardiovascular disease.
• Fructose also inhibits ghrelin secretion, which is a hormone involved in feel satiated, or full/ satisfied. Lowering ghrelin secretion blocks satiety and leads to increased food consumption, which in turn contributes to weight gain and insulin resistance.
• High fructose consumption leads to excess glucose on the blood, in time insulin receptors can become  overwhelmed leading to insulin resistance and eventually type 2 diabetes.
• Chronic high levels of glucose in the blood is also highly inflammatory, which contributes to the onset and progression of disease formation in the body.

Having said all this, if you are going to use natural added sugars, choose ones which:

1. Are made with minimal processing
2. Have low fructose levels
3. Contribute some health value/ benefit (such as vitamin, mineral, fibre content)  

I have put together a table which outlines the most common natural added sugars, their fructose levels, health value (nutrient levels) and level of processing. I have also rated each one based on these three factors. This is not a scientific rating and in my personal opinion it would be best to choose those which are rated ‘better’ or ‘best’.

Not Rated = probably best to avoid

Good = some health value but not great

Better = moderate health value

Best = best choice

Fructose content greater than 50% = High

Fructose content of around 35-50% = Medium

Fructose content below 35% = Low

Natural Sweetener	Fructose Level	Health Value	How Processed?	Good Better Best
Blackstrap Molasses	Low	A natural Multi-Mineral Supplement (Iron, potassium, Calcium, Manganese, Magnesium, copper, selenium). Glycaemic Index of 55 which is borderline low. Natural stool softener. Low overall sugar content	Moderate           – third boil	Best
Unsulphured Molasses	Low	Some Mineral Content	Moderate           – second boil	Better
Coconut Palm Sugar Made from the sap of the Coconut palm.	Medium	Good source of potassium,   appreciable levels of Magnesium and phosphorous. Low Gl of 35. Good source of inulin; a probiotic fibre which feeds healthy bowel bacteria and supports gastrointestinal health.	Minor	Better
Green Stevia Powder or Leaves	Zero	Contains Steviosides and Rebaudioside A which have anti-hyperglycaemic, anti-hypertensive, anti-inflammatory, anti-tumour, anti-diarrheal, diuretic and immune-modulating actions. However you would need to consume large quantities to receive these benefits. Only small quantities needed for sweetness	Minor or None	Best

White Stevia Powder or fluid Extract	Zero	Steviosides and Rebaudioside A Only small quantities needed for sweetness	High	Better
Brown Rice Syrup	Zero	Able to be metabolised by all cells in the body.	Moderate	Better
Agave Syrup	High	Low GI of 30 Contains Fructans which act as prebiotics feeding healthy gut bacteria and supporting nutrient absorption.	Minor to None	Good
Xylitol Indigestible Sugar alcohol	Zero	GI of 13 which is very low Prebiotic action Actively protects against dental cavities with 15mg ingestion/ day Biofilm busting activity	Highly	Better
White Cane Sugar, Raw Sugar, Brown Sugar	Medium	Calories	Highly	Not Rated
High Fructose Corn Syrup	Medium	Calories	Highly	Not Rated
Rapadura Sugar	Medium	Small qty’s of several minerals Natural high antioxidant levels of flavonoids and phenols (these may be destroyed during heat evaporation)	Low	Good
Maple Syrup	Medium	Antioxidants. Calcium, magnesium, manganese, zinc, potassium and iron. GI of 54 which is borderline low	Low	Better
Honey	Medium	Varies depending on floral source Anti-bacterial and anti-inflammatory properties	Low to Moderate depending on product	Better

What If I Don’t Want To Consume Added Sugars Anymore?

Now you can always sweeten foods naturally without added sugar by using whole foods. Of course there are the obvious ones like medjool dates, or whole fruits in general; but don’t forget your vegetables too. Once your taste buds, bacteria and body become accustomed to naturally sweet flavours, you will be able to accommodate that sweet taste with things like corn, beetroot, sweet potato, pumpkin and parsnips which all have a natural sweetness to them.

Hey, what about the sugar alcohols and artificial sweeteners?

Given all these natural options on offer, there really is no need to even consider using/consuming sugar alcohols or artificial sweeteners. Indeed research on the benefits of artificial sweeteners is fairly inconclusive, with as many against as those in favour. According to the Harvard School of Public Health, some research is finding that artificial sweeteners may actually interfere with the body’s ability to self-regulate calorie-intake, and may lead to an overall overconsumption of calories. Then there is the whole false sense of safety that often comes with consuming processed foods sweetened artificially. You know what I am talking about, ‘hey this can of ……. Has zero sugar, which means I can have 2 or 3’. Of course this does not take into account the colours, flavours, preservatives and acids present, not to mention the effect on overall fluid balance.

Please remember that your body is a dynamic natural organic being which functions best when you fuel it with dynamic natural organic foods. 

References

• DiNicolantonio J., Lucan S., (2014). The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart 1:e000167. doi: 10.1136/openhrt-2014-000167
• Yang Q., Zhang Z., Gregg E., Flanders W., Merritt R, Hu F. (2014) Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. JAMA Intern Med. 174(4):516–524. doi:10.1001/jamainternmed.2013.13563
• Wagner, K., Brath, H. (2012) A global view on the development of non-communicable diseases. Preventative Medicine (54). ppS38-S41. doi.org/10.1016/j.ypmed.2011.11.012
• Barquera, S., Pedroza-Tobias, A., Medina, C., Hernandez-Barrera, L., Bibbins-domingo, K., Lozano, R., Moran, A., (2015). Global Overview of the Epidemiology of atherosclerotic Cardiovascular Disease. doi.org/10.1016/j.ypmed.2011.11.012
• Avena N., Rada, P., Hoebel, B (2008). Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroschience and behavioural Reviews
   32(1). doi.org/10.1016/j.neubiorev.2007.04.019

• Avena, N., Rada, P., Moise, N., Hoebel, B, (2006). Sucrose sham feeding on a binge schedule releases accumbens dopamine repeatedly and eliminates the acetylcholine satiety response. Neuroscience 139(3). doi.org/10.1016/j.neuroscience.2005.12.037

• Alcock, J., Maley, C., Aktipis, C, (2014). Is eating behavior manipulated by the gastrointestinal microbiota? Evolutionary pressures and potential mechanisms. BioEssays, 36: 940-949. doi:10.1002/bies.201400071