Oh, How Sweet It Is!

Sugar

We all know that beyond a quick energy boost and taste gratification, there are very few positive health benefits to consuming sugar. Harmful health problems including obesity, Type 2 Diabetes, heart disease, non-alcoholic fatty liver disease, chronic inflammation, cognitive decline (Alzheimer’s) and some cancers are a few of the most common diseases associated with sugar intake.^[1]

We know desserts such as pastries and cookies, candy, and dairy products like flavored yoghurt and ice cream contain sugar. Many people aren’t aware that numerous processed foods have hidden or added sugars in their ingredients such as corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey and so on. Common products that people don’t think to be full of added sugars are ketchup, soups, cured meats and even bread.

Let’s talk a bit more about sugar sweetened beverages. The most overt sources of extra sugar in our diets comes in the form of sugar-sweetened beverages like coffees, soft drinks, and fruit drinks. Research reveals that people don’t decrease their calories to offset the extra calories they drink in sugar sweetened beverages.^[4] This results in excess caloric intake, resulting in weight gain, and increased risk for Type 2 diabetes and cardiovascular disease.^[5]

Many of our sugar sweetened beverages are made from high-fructose corn syrup (HFCS). Refined sugar (table sugar) breaks down into two simple sugars in our body, glucose and fructose. Fructose is fruit sugar – and fruit is good for you – however the unhealthy sources of fructose are refined sugar and HFCS. HFCS is derived from corn and is utilized in many processed foods instead of sugar as it is much sweeter and cheaper.  There are different concentrations of HFCS, the most commonly used being HCFS-55, which contains 55% fructose and is about 25% sweeter than sugar.^[6] While almost all of the cells of our body use glucose, only liver cells can metabolize fructose. The liver makes fat from the fructose, and this can lead to non-alcoholic fatty liver disease and cardiovascular disease over time.^[7] Studies also show fructose elevates our stress hormone cortisol, which in turn increases belly fat, the unhealthiest and disease-promoting fat.^{[8] [9]}

Many people are unaware that there is a correlation between ingesting sugar and depression of our immune system. A research study fed different forms of sugar to the participants and found that the efficiency of neutrophil phagocytosis decreased up to 50% after 1-2 hours of eating sugar, and lasted up to five hours!^[10] That was consuming the equivalent of about 2 tall cans of soda. Remember that the gut is a large part of our immune system?  Our gut microbiota thrives on both processed and complex carbohydrates. Complex carbohydrates (starchy plants) feed the beneficial gut bacteria, which keeps the opportunistic and pathogenic bacteria under check.^[11] Consuming a lot of processed carbs and refined sugar, however, triggers the growth of harmful gut bacteria which promotes gut inflammation, setting off an impaired immune response and chronic inflammation.^{[12] [13]}

Consuming excessive refined sugars and carbohydrates negatively impacts our brain function, specifically the hippocampus which is responsible for memory.^[14] In addition, frequent high or fluctuating blood glucose levels (highs and lows) also increases the risk of cognitive impairment and neurodegenerative diseases such as Alzheimer’s.^{[15] [16]}

High sugar intake has been associated with promotion of cancer cell growth. Cancer cells adapt to become very efficient in taking up glucose from the blood for use as fuel.^[17] “This metabolic adaptation to promote growth, survival and proliferation of malignant cells is known as the Warburg effect.”^[18] This suggests that decreasing refined sugar and carbohydrate intake as well as optimizing blood sugar levels may be useful strategies for reducing cancer risk.

Artificial Sweeteners

Consumers who try to manage their sugar intake often look to using artificial sweeteners that provide zero calories in their place. Artificial sweeteners are generally hundreds of times sweeter than sugar.^[19] However, are they a better and healthier alternative?

In Canada, several sugar substitutes (both artificial sweeteners and those derived from natural sources) have been approved for use by Health Canada. These include aspartame, acesulfame-potassium, sucralose, saccharin, thaumatin, neotame, and sugar alcohols like sorbitol, isomalt, lactitol, maltitol, mannitol and xylitol, and naturally sourced stevia and monk fruit extract.^{[20] [21]}

Artificial sweeteners have been scrutinized intensely for decades. Multitudes of studies have been done on the hazardous effects of artificial sweeteners on the body, as well as an enormous amount of research refuting those claims.

Although non-nutritive sweeteners have zero calories, they may not reduce a persons overall caloric intake, such as when some people drink sugar-free beverages to rationalize eating unhealthy fast food. Some theories suggest that the excessive sweetness of artificial sweeteners can lead to craving more sweets.^[22] Fundamentally, artificial sweeteners may do little to help you lose weight and lower your risk of obesity and diabetes.

Doing your own research to understand the pros and cons if you have questions or concerns about artificial sweeteners is a prudent idea to make an informed choice. In the meantime, if you’re trying to watch your sugar intake, perhaps consider a natural non-nutritive sweetener instead, such as those discussed below.

Natural Non-Nutritive Sweeteners

Stevia comes from the Stevia rebaudiana plant, a which is a herb from South America. Ounce for ounce, stevia is 100 to 300 times sweeter than sugar, and it produces compounds called steviol glycosides in its leaves; it is these compounds that have been isolated for use as a non-caloric sweetener.^[23] Not everyone likes the way stevia tastes, as some people find it bitter, or say it tastes of black licorice.

Monk fruit, also known as luo han guo, comes from a small gourd that grows on vines in Southeast Asia, containing compounds that are 100 to 250 times sweeter than sugar.^[24] Some studies have shown that substances present in monk fruit have strong antioxidant properties.^[25] It also provides a sweetness taste similar to sugar.

Sugar Alcohols

Sugar alcohols such as xylitol, sorbitol and erythritol don’t alter blood glucose levels.^[26] They are often used in combination with other sweeteners as their sweetness is on par or a little lower than sugar. You might have noticed xylitol in chewing gum, as it has been found to improve dental health by inhibiting growth of oral bacteria and promoting tooth remineralization.^[27] One of the issues with sugar alcohols is that they have a potent laxative effect and gastrointestinal symptoms such as gas, bloating and abdominal pain when too much is eaten.^{[28] [29]} So baking with xylitol as your sugar substitute and then eating the whole cake at once might keep you in the bathroom for awhile. 😉

Natural Sugars

Clearly, we should watch how much refined sugar, high-fructose corn syrup, and artificial sweeteners we consume. However, this doesn’t mean we should avoid natural sugars in whole, real foods! Sugars that are in whole fruits, berries, or complex carbohydrate vegetables like sweet potatoes, for example, don’t have the same effect on our health as a food that has added sugar. The fiber in real whole foods slows down digestion and the absorption of glucose, mitigating the high glucose blood spikes.^[30] These types of carbohydrates also contain many vitamins, minerals, and other nutrients that support good health.