Sugar Breakdown
By Catherine Guthrie
When it comes to evaluating sugar's negative health impacts, the threat of extra pudge is just the beginning. Even great health threats — including inflammation-based diseases — may lurk at the bottom of the sugar bowl.
Americans are on a bona fide sugar binge.
During the past 25 years, the average person’s
intake of sugar and other natural sweeteners
ballooned from 123 to as many as 160 pounds
a year. That breaks down to more than 20 teaspoons
of the added white stuff per person per day. And our
collective sweet tooth is growing. For the past decade,
Americans’ sugar consumption has edged upward at the
average rate of nearly 2 percent a year.
Why the sugar obsession? The vilification of fat may
be partly to blame. During the low-fat frenzy of the past couple
of decades, oils were squeezed out of processed foods —
and sugar was pumped in to make reduced-fat
foods tastier. It seems clear now that we
effectively traded one dietary evil for another.
New research is revealing disturbing links
not just between sugar and obesity, but
also between sugar and inflammation.
Inflammation, of course, has been implicated
as a major factor in a number of vitalityzapping
diseases, from cancer and diabetes to
atherosclerosis and digestive disorders.
Whether you’re concerned with managing your weight,
your health, or both, it makes sense to evaluate the
impact your sugar habit could be having on your body.
The Refined-Carb Connection
On the spectrum of dietary dangers, processed sugars are
on a par with unhealthy fats. “High-fructose corn syrup is
the primary cause of obesity in our culture,” says Elson
Haas, MD, author of
Staying Healthy with Nutrition
(Celestial Arts, 2006, New Edition). “Our bodies simply
aren’t built to process all that sugar.”
Still, to date, sugar doesn’t have nearly as bad a
reputation as it probably deserves. One of the reasons it
slips under the radar is that connecting the dots between
sugar and disease requires widening the nutritional net
to include
all refined carbohydrates (like processed flours, cereals and sugars of all sorts). This may seem like a fine
point, but it’s an important distinction.
Most dietary sugars are simple carbohydrates, meaning
that they’re made up of one or two sugar molecules stuck
together, making them easy to pull apart and digest.
Complex carbohydrates, like those found in whole grains,
legumes and many vegetables, are long chains of sugar
molecules that must be broken apart during digestion,
therefore offering a longer-lasting surge of energy. The
presence of naturally occurring fiber, protein and fat in
many whole foods further slows the sugar-release process.
The more processed and refined the carbohydrate, as
a rule, the faster it breaks down in the digestive system,
and the bigger the sugar rush it delivers. That’s why refined
flours, sugars and sugar syrups pose such a problem for
our systems.
The body is exquisitely designed to handle small
amounts of sugar. But refined carbs deliver a larger rush
than our bodies were designed to accommodate, or even
cope with. In ancient times, hunter-gatherers coveted
the occasional piece of fruit or slab of honeycomb as a
rare treat and source of rapid-fire energy for, well —
hunting and gathering.
Today, sugar lurks behind most cellophane wrappers,
and the energy it provides is more likely to get socked
away on our hips than burned while stalking dinner.
Being active goes a long way toward vanquishing excesssugar in the bloodstream, but it doesn’t negate the need
to watch your intake. To make matters worse, unlike the
fruit sugar (fructose) our ancestors savored, today’s sugary
treats are made with refined sugars (usually some derivative
of table sugar or high-fructose corn syrup), which
can overwhelm the body’s ability to balance blood sugar.
“Refined sugar is a genetically unfamiliar ingredient,”
says Jack Challem, a nutrition researcher and author of
The Inflammation Syndrome (John Wiley & Sons, 2003). “A lot of health problems today are the result of ancient
genes bumping up against modern foods.”
To wrap your head around sugar’s destructive powers,
it helps to understand how the body reacts when it meets
the sweet stuff. With each gulp of a sports drink or soda,
for instance, simple carbohydrates are quickly dismantled
into simple sugar molecules (glucose) that pass directly
into the bloodstream. As a result, blood sugar rises
markedly. To bring levels back to normal, the pancreas
releases insulin, which lowers blood-sugar levels by
escorting glucose out of the bloodstream and into cells.
If energy needs are high at the time sugar hits the
bloodstream, that sugar is put to good use. But a too
frequent or too heavy supply of sugar pushes the
pancreas into overdrive, causing it to release too much
insulin — a spew instead of a squirt. And an excessive
release of insulin spells inflammatory trouble.
Sugar and Inflammation
A newly understood phenomenon, inflammation underlies
modern health scourges, from heart disease to obesity to
diabetes. “Sugar can play a role in inflammatory diseases,”
says Dave Grotto, RD, a spokesperson for the American
Dietetic Association. “Poor regulation of glucose and
insulin is a breeding ground for inflammation.”
Under normal conditions, inflammation helps the
body rebound from injury. For instance, if you cut yourself
shaving, white blood cells race to the scene to mop
up the wound, destroy bacteria and mend tissue. But
when the injury is deep inside the body, such as inside
the blood vessels of the heart, hidden inflammation can
trigger chronic disease, and experts are only beginning
to understand how sugar fans the flames.
In the development of heart disease, the type of
carbohydrate in your diet may be as important as the
type of fat, says Walter Willett, MD, professor of epidemiology
and nutrition at the Harvard School of Public
Health (HSPH) and author of
Eat, Drink and Be Healthy (Free Press, 2005). The more refined carbs you eat, the
more likely you are to be supplying your body with more
sugar than it can handle with healthy results.
That point hit home when Willett and a team of
HSPH nutrition researchers looked at diet and health
history data from more than 75,500 women who took
part in the Nurses’ Health Study. At the start of the study
in 1984, all the nurses were given a clean bill of health.
Ten years later, 761 had either been diagnosed with or died from heart disease. When
researchers distilled the numbers,
they found a telling parallel between
women eating a high-glycemic diet
of refined carbohydrates and those
with heart disease. An even more
disturbing trend was within the
group of women at risk for heart disease: Those who
ate the most carbohydrates — including sugars —
doubled their risk of heart attack compared
to those with diets only moderately high
in carbohydrates.
Nutrition experts stress that
there’s no point avoiding the carbs
that come from eating a balanced,
healthy, whole-foods diet. But there
is plenty of good reason to avoid
the refined carbs that quickly
turn to sugar in the body.
Such sugars deliver
more excess (and mostly
empty) calories, which
the body then con-
verts to triglycerides,
a key indicator of
heart disease.
Sugar-rich diets
stress the heart in
other ways, too. When
blood sugar is high,
the body generates
more free radicals.
Rogue molecules that
pinball through the
body damaging cells,
free radicals stimulate
the immune response,
which can inflame the
lining of the blood
vessels leading to the
heart. And the damage
doesn’t stop there.
From Sugar Comes Fat
Until recently, the connection between sugar and obesity
was murky. Dietitians assumed that in the battle of the
bulge, sugar was a lesser foe than dietary fat. But new
studies reveal sugar may play a bigger role in weight
gain than suspected. And carrying excess body fat
further reduces your body’s ability to manage its
sugars effectively.
When scientists want to measure the effects of
sugar on health and weight, they turn to the biggest
source of sugar in American diets:soft drinks. A pilot
study published in the March 2006 issue of
Pediatrics
showed for the first time that simply cutting back on
sugary drinks can reduce excess body fat. Researchers at
Children’s Hospital Boston enrolled 103 sugar-guzzling
teenagers, divided them into two groups (an intervention
and a control), and measured the effects of the drinks on
their weight. For almost six months the intervention
group got weekly home deliveries of their choice of
noncaloric drinks, including bottled water, iced tea and
diet sodas. The scientists called the teens monthly to
check in and cheer them along. The control group went
about their normal drinking habits. In the end, the teens
in the intervention group cut their intake of sugary
drinks by 82 percent and lost weight.
Although the average weight loss was “modest,”
the teens who weighed the most at the beginning saw
the biggest losses, roughly a pound a month. This study
goes to show that reducing sugar intake, particularly
sugar-sweetened beverages, is one of the best ways to
improve one’s diet, Harvard’s Willett says. “Sugar is an
important source of excess calories in the American
diet — a serious problem given the obesity epidemic.”
Cutting Back
The best way to reduce unhealthy sugars in the diet is to
consume fewer processed foods and drinks in general,
and refined carbs and sugars in particular. Fuel your
energy demands with a slower-burning balance of
proteins, healthy fats and whole-food carbs.
For a healthier alternative to sugars that you add at
the table or kitchen counter, dietitian Grotto suggests
switching to sweeteners that are higher in naturally
occurring fructose, such as agave syrup or malted barley,
which have a less dramatic effect on blood sugar and
insulin. Still, you should limit your intake to no more
than 3 teaspoons a day. “These sweeteners won’t elicit
the glycemic responseof table sugar,” he says, “but you
shouldn’t eat them by the gallon.”
'
For sweetening tea or cereal, you might also try
stevia, a natural calorie-free herb made from a South
American shrub. It’s sold at health-food stores as a
dietary supplement and is widely available in both
powder and liquid forms.
Take heart: Enjoying a limited amount of refined
sugar isn’t going to devastate an otherwise consistent
healthy-living regimen — but that doesn’t mean you
should keep swallowing it indiscriminately. “The sugar
highs and lows brought on by high-carbohydrate foods
create a dangerous addiction,” researcher Challem notes.
And the sooner we break our addiction to sugar, the
better off our bodies will be.
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