The sugar debate

Refined sugar sneaks into our diets in everything from the obvious cookies and candies to less-apparent packaged goods, such as pasta sauce and frozen food. And added sugars, such as high-fructose corn syrup, aren't the only problem; processed carbohydrates (such as that white bagel you wolfed down between meetings this morning) break down similarly in the body. How can you avoid getting too much?

Ever since I was a kid, I've craved sweets. Now that I'm a new mom, however, I pay closer attention to what my family eats, and I do my best to limit the amount of sugar in our diets. Aaron Cypess, MD, PhD, research associate and staff physician at Joslin Diabetes Center in Boston, agrees that most of us — kids and adults — could take another look at our daily sugar consumption. “Take those huge sodas everyone is drinking these days,” says Cypess. “Your body is just not meant to deal with that much sugar.”

How does sugar affect the body?

In fact, our cells need sugar to function. What they don't need is refined sugar, explains Ann Louise Gittleman, PhD, CNS, in the 2nd edition of her book Get the Sugar Out (Three Rivers, 2008).

Refined sugar sneaks into our diets in everything from the obvious cookies and candies to less-apparent packaged goods, such as pasta sauce and frozen food. And added sugars, such as high-fructose corn syrup, aren't the only problem; processed carbohydrates (such as that white bagel you wolfed down between meetings this morning) break down similarly in the body. Whatever the source, these simple sugars have an immediate effect: The pancreas has to work extra hard to manufacture insulin (the blood sugar-balancing hormone), and whatever energy the body can't use gets stored as fat, resulting in unhealthy weight gain and even insulin resistance, a precursor to diabetes.

Sugar and obesity

Obesity and insulin resistance aren't the only health issues related to dietary sugars, say researchers. Sugar impairs immunity and may contribute to depression, hypertension, osteoporosis, premenstrual syndrome, and high cholesterol, among other conditions. “There is increasing evidence that it can be a direct and independent risk factor for cardiovascular disease,” says Cypess. The chronic inflammation caused by high blood sugar levels can also lead to certain types of cancer and arthritis, says Stephen T. Sinatra, MD, a cardiologist based in Manchester, Connecticut, and co-author of Sugar Shock! (Penguin, 2007). Sugar's effect on cells also has sparked speculation about its role in Alzheimer's disease.

Curbing sugar intake isn't as hard as it seems, says Roberta Anding, RD, a Houston-based spokeswoman for the American Dietetic Association. She suggests focusing on reducing rather than eliminating sugar altogether. “And don't regard cutting back on sugar as some sort of deprivation,” says Connie Bennett, certified holistic health counselor and co-author of Sugar Shock! (Penguin, 2007). “Look at it as a way to feel better.” Bennett, who removed refined sugars and carbs from her diet, says, “I went from an exhausted, moody, irritable, headache-ridden bump-on-a-log to a woman filled with energy, vitality, enthusiasm, and good cheer. And I've heard from hundreds of people that cutting out sugar has changed their lives, too.”

Is juice OK?

When it comes to quenching your thirst, fruit juice can be a healthy option — if you read the label and drink in moderation. “Stay away from those with added sugar,” says Roberta Anding, RD, “but there is some redeeming value in 100 percent juice.” Although juice lacks the fiber content of whole fruits, it is still a valuable source of vitamins, minerals, and phytonutrients. Christine Gerbstadt, MD, RD, says that in moderation juice can help meet the recommended nine servings of fruits and vegetables daily. “To satisfy one of those servings, adults can drink one 4-ounce serving of 100 percent juice per day,” she says, and adds that toddlers and small children should not drink more than 2 ounces per day. Watch intake carefully, however: Most on-the-go bottled juices come in 8- to 16-ounce containers — as much as four to eight times the recommended amount.
— K.R.

10 ways to CUT BACK on sugar

  • Stick to natural sources. Fruits, vegetables, legumes, whole grains, and even milk contain plenty of natural sugars that satisfy a body's requirements, says Anding. If you eat adequate amounts of these healthful foods, they will likely provide enough energy — along with other important vitamins and minerals — to get you through the day, says Christine Gerbstadt, MD, RD, of Sarasota, Florida. And though fresh fruit is high in natural sugars, you don't have to feel guilty about eating it. Not only does fruit contain health-boosting vitamins, minerals and antioxidants but its fiber slows down sugar absorption, says Cypess.
  • Watch refined carbohydrates, such as white bread, white rice, regular pasta, and chips. “Your body treats refined carbs very similarly to simple carbs [sugars, jellies, jams, syrups],” says Ryan Bradley, ND, director of the Diabetes and Cardiovascular Wellness Program at the Bastyr Center for Natural Health in Seattle.
  • Limit some natural sugars. “Honey and molasses are often thought of as being good for you, but physiologically your body processes these sugars only slightly differently [than refined sugar],” explains Anding, “so eat them in moderation.” Honey may have a slight edge when it comes to healthfulness because it contains antioxidants and phytonutrients. “But that doesn't mean you should be drinking six cups of tea a day each with 2 tablespoons of honey,” she says. Molasses offers calcium, potassium, iron, and magnesium, but it also doesn't warrant unlimited consumption.
  • Sensitize your palate. “Retrain your taste buds so that you can taste the subtle nuances of sugar in healthier foods,” says Gerbstadt. For example, if you cut back on megasugary foods, you should be able to taste the hint of sugar in whole-wheat bread. “Sprinkle a little cinnamon on it for a healthy, sweet snack,” she says.
  • Add protein and fiber. According to Gittleman, craving sugar or refined carbs can be a sign that your body needs more protein. Pairing protein with sugary treats can also stabilize blood sugar so it won't spike as much, says Gerbstadt. So if you plan to eat a piece of cake after dinner, make sure high-quality protein is part of the main course. “Or combine the sugar with something high in fiber,” suggests Sinatra.
  • Spice it up. Gittleman suggests cooking with cinnamon, cloves, and bay leaves, which not only taste great but may help regulate blood sugar, according to studies conducted at the USDA's Vitamin and Mineral Laboratory.
  • Stock up on healthy snacks. It's easy to succumb to cravings when you're in a hurry or if you're particularly stressed out. Instead of sugary pick-me-ups, pack your pantry or tote bag with quick, sugar-free foods such as nuts, whole-grain crackers, or cheese, suggests Gittleman. These will be much more satisfying in the long run.
  • Take B vitamins and chromium. “Having enough B vitamins in your body will help stabilize mood, energy, appetite, and blood sugar,” says Gerbstadt. And according to Bradley, chromium improves meal satiety and can reduce sugar cravings by balancing mood and improving the brain's sensitivity to insulin. Talk to your health care practitioner about specific doses.
  • Don't squander your daily sugar allowance. “If your family really enjoys an occasional splurge on ice cream, then cut out all soft drinks during that day,” says Anding. “Personally, I will not drink a soda because I would rather have a piece of dark chocolate.”
  • Model good habits. “Clean up your own diet first,” says Bennett. “Show your kids that you can still eat sweet foods without all the added sugar. Try freezing your favorite fruits and then blending them with plain yogurt.” Sinatra agrees: “Children follow what you do, not what you say.”

Labeling sugar

Reading a label for sugar can be tricky. Added sugar comes under many guises in the ingredients list, while naturally occurring sugars (which aren't so bad for you) can show up in the nutrition facts — such is the case with milk. So read the ingredients list first. Aside from “sugar” and “evaporated cane juice,” look for ingredients that end in -ose, or items with the word “syrup” (see “Other Names for Sugar,” below). Then look at the sugar under nutrition facts.

Other names for sugar

barley malt
beet sugar
brown sugar
buttered syrup
cane-juice crystals
cane sugar
carob syrup
corn syrup
corn-syrup solids
date sugar
diastatic malt
ethyl maltol
evaporated cane juice
fruit juice
fruit-juice concentrate
glucose solids
golden sugar
golden syrup
grape sugar
high-fructose corn syrup
invert sugar
malt syrup
raw sugar
refiner's syrup
sorghum syrup
turbinado sugar
yellow sugar
— Radha Marcum

Sources: Roberta Anding, RD; Get the Sugar Out by Ann Louise Gittleman, PhD, CNS (Three Rivers, 2008).

The high-fructose phenomenon

Eating too much regular cane sugar may be unhealthy, but eating even modest amounts of high-fructose corn syrup (HFCS) could be even worse, say experts. The refined fructose in HFCS affects your body differently than other types of sugars, absorbing quickly into cells while bypassing your body's natural appetite-control mechanisms. This means you stay hungry and keep eating. What's more, fructose increases body fat more readily. So read labels carefully and avoid HFCS whenever possible.
— R.M.

Source: Get the Sugar Out by Ann Louise Gittleman, PhD, CNS (Three Rivers, 2008).

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