The Hidden Dangers of Sugar to Your Health

A great deal of we thought we knew and have been taught about heart health and nutrition is likely wrong.  You will be hard pressed to find someone who hasn’t heard that you must cut down on fatty and salty foods to protect your heart.  In recent years, experts around the world are coming to realise that fat and salt are only part of the equation, and that the real threat to our hearts and main contributor to heart disease may be sugar.

Beware added sugar

Added sugars have long been known to contribute to obesity, high blood pressure and high cholesterol, but this is the first time scientists have linked the amount of sugar in a person’s diet with their risk of dying from heart disease. According to a study published in the Journal of the American Medical Association (April 2014), those who consumed between 17 and 21 percent of their calories from added sugar had a 38 percent higher risk of dying from cardiovascular disease (heart disease and other diseases involving the blood vessels e.g. stroke) compared with people who consumed eight percent or less of their calories from added sugar. The study factored in some sociodemographic, behavioural, and clinical characteristics such as age, ethnicity, level of schooling, smoking, medication use, and others. The relative risk of dying from cardiovascular disease was double for those who consumed 21 percent or more of their calories from added sugar.

There are two types of sugars in our diets: naturally occurring sugars which are found naturally in foods such as fruit (fructose) and milk (lactose) and added sugars which include any sugars or caloric sweeteners that are added to foods or beverages during processing or preparation (such as adding sugar to your cereal or coffee).  Added sugars or sweeteners can include healthier-sounding ones like natural brown or white sugar, agave, date syrup, cane sugar, molasses, and honey as well as other caloric sweeteners that are commercially manufactured (ex. high fructose corn syrup).

Check your consumption of added sugar

The American Heart Association (AHA) recommends limiting intake of added sugar to six teaspoons (25 grams) for women and children (ages 2-18) and nine teaspoons (36 grams) for men. They recommend no added sugar for children less than 2.  For reference, one 355 ml can of cola contains about 8 teaspoons (about 32 grams) of added sugar, greater than or equal to the recommendations. For adults, the World Health Organization recommends no more than six to 12 teaspoons daily of added sugar. According to the WHO, an adult from the UK consumes an average of 17 teaspoons of sugar daily and from Portugal, 25 teaspoons. According to the AHA study, most US adults consume about 22 teaspoons of added sugars a day.

Counting your consumption of added sugars can be challenging since packaged foods don’t list the number of teaspoons of sugar or differentiate the processed sugar from naturally occurring sugar (as in fruit yogurt which contains processed sugar and naturally occurring sugar in the form of lactose). Here are some important numbers to remember: there are about 4 grams per teaspoon of sugar. So if a label says it has 24 grams of sugar that equals six teaspoons.

The major sources of added sugars are regular colas, sugars, candy, cakes, doughnuts, cookies, pies, fruit drinks, dairy desserts and milk products (ice cream, sweetened yogurt and sweetened milk), and other grain based products (honey-nut waffles, croissants, muffins, bagels).

Unfortunately, you can’t tell easily by looking at the nutrition label if the food contains added sugar. The line for “sugars” includes both added and natural sugars. Any product that contains milk (such as yogurt, milk or cream) contains some natural sugars.

Reading the ingredient list on a processed food’s label can tell you if the product contains added sugars, just not the amount if the product also contains natural sugars. Names for added sugars on labels to watch for include: agave, barley malt, beet sugar, brown rice syrup, brown sugar, cane juice, corn sweetener, corn syrup, fruit juice concentrate, high-fructose corn syrup, honey, invert sugar, malt sugar, molasses, raw sugar, sugar, sugar molecules ending in “ose” (dextrose, fructose, glucose, lactose, maltose, sucrose) and syrup. Remember that if a product has no milk products or fresh/dried fruit in the ingredients, all of the sugars in the food are from added sugars. If the product does contain fresh/dried fruit or milk products, the total sugar per serving listed on the label will include added and naturally occurring sugars.

Approximate added sugars in common foods:

• Sweetened yoghurt (2 tsp/8 grams)
• Doughnut (6 tsp/24 grams)
• Can of cola (355 ml) (8 tsp/32 grams)
• Juice (240 ml) (6 tsp/24 grams)
• Bread/croissant (1 piece) (1/2 tsp/2 grams)
• Muesli (2 tsp/8 grams)
• Granola bar (3 tsp/ 12 grams)
• Salad dressing- 1 tsp (1 tsp/4 grams)
• Ketchup/pasta sauce- 1 tbsp (1 tsp/4 grams)

Again, the focus and recommendations are for added sugars in processed and prepared foods, as well as those in honey, syrups and fruit juices. The guidelines do not apply to naturally occurring sugars in fruit, vegetables and milk, since those come with essential nutrients.

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How to cut down on added sugar

Ideas for cutting down on added sugar:

• Substitute/switch out sugar with unsweetened applesauce in recipes (use equal amounts)
• Replace it completely- enhance foods with spices/extracts instead of sugar. Try cinnamon, allspice and vanilla extract
• Reduce the serving - when baking, cut the sugar called for in your recipe by one-third to one-half and often you won’t notice a difference
• Add fruit - instead of adding sugar to oatmeal or cereal, add fresh fruit
• Compare food labels and choose products with the lowest amount of added sugars
• Swap out the soda/sports drinks - sugar-sweetened beverages like soda and sports drinks are the number one source of added sugars in our diets. Replace them with water which is best. Also, unsweetened tea and coffee
• Get rid of the table sugar (brown and white), syrup, honey and molasses - cut back on the amount of sugar added to things you eat or drink regularly like coffee, tea, cereal and oatmeal. Try cutting the usual amount in half and wean down from there.
• Buy plain - flavoured foods often indicate “sugar added”. For example, buy plain yogurt and put fresh strawberries on top instead of buying strawberry flavored yogurt
• Drop drinkable sugar - a large amount of added sugar consumption is from drinks. Limit or cut out completely soda, sweetened tea, lemonade, fruit juices, sweetened coffee beverages and smoothies
• Try a 30-day sugar detox

Try a sugar detox

Sugar has addictive qualities. When you consume sugar, it triggers the release of dopamine, the brain’s natural feel-good chemical. As a result, the brain craves even more sugar. Artificial sweeteners are no better. Studies suggest they confuse the metabolism and can actually lead to weight gain.

A sugar detox reboots the body by lowering inflammation, creating a healthier digestive environment, and better regulating blood sugar. In addition, taking a break allows taste buds to recalibrate, so you’re less likely to enjoy the taste of overly sweet foods.

Eliminate all added sugars, such as refined sugar (including high fructose corn syrup), honey, stevia, artificial sweeteners, etc. You are still able to eat foods containing natural sugars, including veggies, fruit (including dates) and dairy.

Sometimes people can stop cold turkey and others need to stop gradually for more success. For those people, you can gradually lessen your sugar consumption for the first three days of the detox. Be sure to drink plenty of water.

Cravings can hit hard in the first few days when you’re committed to a sugar detox. Other symptoms during the first week can include feeling foggy and depressed, headaches, irritability and shakiness. These symptoms usually begin to decrease after the first week and the cravings will start to pass. People start to taste whole foods better because taste buds adjust to the newly recognized natural sugar and sweetness of fruits. Overall, you are also likely to have increased mental clarity and energy.

Dr. Melanie Childress is a Consultant Internal Medicine at Mediclinic Mirdif.
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