Sugar seems to have developed a reputation as the big bad wolf in relation to health. Medical News Today have reported on numerous studies associating sugar intake with increased aging, cardiovascular disease, obesity and even cancer. Such research has led to many health experts around the globe calling for reductions in recommended sugar intake, with some saying we should cut out sugar completely. But is it really that bad for our health? We investigate.
Put simply, sugar is a crystalline carbohydrate that makes foods taste sweet. There are many different types of sugar, including glucose, fructose, lactose, maltose and sucrose - also known as table sugar.
Some of these sugars, such as glucose, fructose and lactose, occur naturally in fruits, vegetables and other foods. But many of the foods we consume contain "added" sugars - sugar that we add to a product ourselves to enhance the flavor or sugar that has been added to a product by a manufacturer.
The most common sources of added sugars include soft drinks, cakes, pies, chocolate, fruit drinks and desserts. Just a single can of cola can contain up to 7 tsps of added sugar, while an average-sized chocolate bar can contain up to 6 tsps.
It is added sugars that have been cited as a contributor to many health problems. In December 2014, MNT reported on a study in the journal Open Heart claiming added sugars may increase the risk of high blood pressure, even more so than sodium. And in February 2014, a study led by the Centers for Disease Control and Prevention (CDC) associated high added sugar intake with increased risk of death from cardiovascular disease (CVD).
Perhaps most strongly, added sugars have been associated with the significant increase in obesity. In the US, more than a third of adults are obese, while the rate of childhood obesity has more than doubled in children and quadrupled in adolescents over the past 30 years.
A 2013 study published in The American Journal of Clinical Nutrition suggested that consumption of sugar-sweetened beverages increases weight gain in both children and adults, while a review paper from the World Health Organization (WHO) notes an increase in the consumption of such beverages correlates with the increase in obesity.
Are we becoming addicted to sugar?
In support of these associations is Dr. Robert Lustig, a pediatric endocrinologist at the University of California-San Francisco and author of the book Fat Chance: The Hidden Truth About Sugar, who claims sugar is a "toxic" substance that we are becoming addicted to.
"We need to wean ourselves off. We need to de-sweeten our lives. We need to make sugar a treat, not a diet staple," Dr. Lustig told The Guardian in 2013.
"The food industry has made it into a diet staple because they know when they do you buy more," he added. "This is their hook. If some unscrupulous cereal manufacturer went out and laced your breakfast cereal with morphine to get you to buy more, what would you think of that? They do it with sugar instead."
"The bottom line is that sugar works the addiction and reward pathways in the brain in much the same way as many illegal drugs," she writes. "Sugar is basically a socially acceptable, legal, recreational drug with deadly consequences."
Statistics show that we are certainly a nation of added-sugar lovers. According to a report from the CDC, adults in the US consumed around 13% of their total daily calorie intake from added sugars between 2005-2010, while 16% of children's and adolescents' total calorie intake came from added sugars between 2005-2008.
These levels are well above those currently recommended by WHO, which state we should consume no more than 10% of total daily calories from "free" sugars - both naturally occurring sugars and those that are added to products by the manufacturer.
In 2013, however, MNT reported on a study by Prof. Wayne Potts and colleagues from the University of Utah, claiming that even consuming added sugars at recommended levels may be harmful to health, after finding that such levels reduced lifespan in mice.
Is eliminating sugar from our diet healthy?
The array of studies reporting the negative implications of added sugar led to WHO making a proposal to revise their added sugar recommendations in 2014. The organization issued a draft guideline stating they would like to halve their recommended daily free sugar intake from 10% to 5%.
"The objective of this guideline is to provide recommendations on the consumption of free sugars to reduce the risk of noncommunicable diseases in adults and children," WHO explained, "with a particular focus on the prevention and control of weight gain and dental caries."
In addition, it seems many health experts, nutritionists and even celebrities like Gwyneth have jumped on a "no sugar" bandwagon. But is it even possible to completely eliminate sugar from a diet? And is it safe?
Biochemist Leah Fitzsimmons, of the University of Birmingham in the UK, told The Daily Mail:
"Cutting all sugar from your diet would be very difficult to achieve. Fruits, vegetables, dairy products and dairy replacements, eggs, alcohol and nuts all contain sugar, which would leave you with little other than meat and fats to eat - definitely not very healthy."
Many people turn to artificial sweeteners as a sugar alternative, but according to a study reported by MNT in 2014, these sweeteners may still drive diabetes and obesity.
The study, published in the journal Nature, suggests artificial sweeteners - including saccharin, sucralose and aspartame - interfere with gut bacteria, increasing the activity of pathways associated with obesity and diabetes.
What is more, they found long-term consumption of artificial sweeteners was associated with increased weight, abdominal obesity, higher fasting blood glucose levels and increased glycosylated hemoglobin levels.
"Together with other major shifts that occurred in human nutrition, this increase in artificial sweetener consumption coincides with the dramatic increase in the obesity and diabetes epidemics," the authors note. "Our findings suggest that artificial sweeteners may have directly contributed to enhancing the exact epidemic that they themselves were intended to fight."
Sugar can be part of a healthy, balanced diet
Instead of steering away from sugar completely, many health experts believe it can be consumed as part of a healthy diet, with some noting that sugar also has benefits.
"Like all sources of calories, sugars can be consumed within a healthy, balanced diet and active lifestyle," Dr. Alison Boyd, director of Sugar Nutrition UK, told MNT. "Sugars can often help to make certain nutritious foods more palatable, which can promote variety in a healthy, balanced diet."
Some researchers say our bodies even need sugar. "It's our body's preferred fuel," Dr. David Katz, director of the Prevention Research Center at Yale University in New Haven, CT, told CNN. "There's a role for sugar in our diet. After all, what's the point of being healthy if it's not to enjoy living?"
The American Heart Association (AHA) - who recommend women should consume no more than 100 calories a day (6 tsps) and men should consume no more than 150 calories a day (9 tsps) from added sugars - disagrees, stating that our bodies do not need sugar to function properly.
"Added sugars contribute additional calories and zero nutrients to food," they add. But even the AHA do not recommend cutting out sugar completely.
Tips to reduce sugar intake
While sugar can be a part of a healthy diet, Dr. Katz makes an important point that almost all health experts agree with - "we eat too much of it" - which is evident from the aforementioned reports by the CDC.
As such, health experts recommend reducing sugar intake to within recommended guidelines. The AHA provide some tips to help do just that:
- Cut back on the amount of sugar you may regularly add to foods and drinks, such as tea, coffee, cereal and pancakes
- Replace sugar-sweetened beverages with sugar-free or low-calorie drinks
- Compare food labels and select the products with the lowest amounts of added sugars
- When baking cakes, reduce the amount of sugar in the recipe by a third
- Try replacing sugar in recipes with extracts or spices, such as cinnamon, ginger, almond or vanilla
- Replace sugar on cereal or oatmeal with fruit.
More needs to be done to ensure the public lower their sugar intake
While there are things we can do ourselves to reduce sugar intake, Prof. Wayne Potts told MNT that more needs to be done to encourage us to do so:
"The disease states are a terrible scourge to individuals and the cost to public health care is tremendous. Since individual behavior can make major advances, we should use a variety of methods such as public awareness campaigns, taxation and more firm regulation."
Dr. Boyd pointed out that the food industry has worked hard to offer the general public a good range of sugar-free and no-added-sugar products. "Soft drinks are one good example," she says, "with more than 60% available on the market now being low calorie/no added sugar."
She added, however, that foods lower in sugar may not necessarily be lower in calories. "In some cases, the reformulated recipe can contain more calories than the original. Research shows that diets high in sugar tend to be low in fat, and vice versa." She added:
"The key thing to remember is that sugars occur naturally in a wide range of foods - including fruit, vegetables and dairy products - and can be consumed within a healthy, balanced diet and active lifestyle. As always, balance and variety in a diet is the most important thing for people to remember."