Written by Dr. Vanessa Craig

The term “sugar” often leads to confusion, not least because it encompasses a variety of types, each interacting distinctly within our bodies. At its core, “sugar” denotes a category of sweet-tasting, water-soluble carbohydrates. Among the myriad of sugars, glucose and fructose stand out as the primary types we consume. Despite their nearly identical chemical structures, our bodies metabolise them in remarkably different ways, with fructose being notably sweeter.

Crucially, the origin of the sugar matters significantly for our health. Natural sugars, found in fruits, vegetables, and other carbohydrates, differ vastly from added sugars, which stealthily make their way into over 70% of supermarket products under various guises, making them easy to inadvertently consume in large quantities.

UNDERSTANDING SUGAR’S ROLE IN OUR BODIES

Exploring how sugar functions within our bodies reveals a fascinating process, particularly when distinguishing between glucose and fructose, which are metabolised distinctly.

Glucose serves as the primary energy source for our cells, readily utilised by every cell for energy, especially favoured by brain and nerve cells.

When glucose enters the bloodstream, it prompts the release of insulin, facilitating glucose uptake by cells and normalising blood glucose levels. Excess glucose might be immediately used for energy, stored as glycogen in muscles, or, when abundant, stored as fat. Thus, a greater muscle mass can enhance blood sugar regulation and metabolic health.

Fructose, in contrast, is not directly used by cells for energy—remarkably, only sperm cells can use it directly, with no preference over glucose. Instead, fructose is directed to the liver, where it’s processed in a manner akin to alcohol, leading to its nickname “alcohol without the buzz” due to its similar effects on the liver without intoxication. Fructose’s metabolism reflects an ancient energy storage pathway, being converted into glucose or stored as fat, with minimal insulin impact. However, it increases ghrelin levels, the “hunger hormone,” potentially leading to increased food intake and weight gain. This mechanism, reminiscent of animals consuming fructose-rich diets for energy storage pre-hibernation, also explains fructose’s role in raising blood pressure and retaining sodium, likely an evolutionary advantage under conditions of dehydration or salt scarcity.

Yet, fructose’s capacity to simulate starvation, ramping up hunger and encouraging fat storage, should not deter fruit consumption. The fibre and antioxidants in whole fruits mitigate these effects.

However, both glucose and fructose can trigger the brain’s dopamine reward pathway, intensifying cravings for more sugar—mirroring the addictive patterns seen in substance dependency. This underscores sugar’s potent influence on our eating habits and the need for mindful consumption.

THE POISON IS IN THE DOSE

The paradox of sugar lies in its dual nature: while excessive consumption is harmful, a certain level is crucial for biological functions. Glucose, acts as the primary source of energy across all cells, particularly vital for brain function. Glucose is so important that our bodies inherently produce glucose through the metabolism of proteins, fats, and other carbohydrates. This process underscores the absence of “essential” carbohydrates in human nutrition, unlike essential fatty acids and amino acids which must be obtained from our diet.

However, fructose does not share this physiological necessity. Our body doesn’t naturally produce fructose, highlighting its non-essential role in our diet.

WHAT ARE THE BIGGEST PROBLEMS ASSOCIATED WITH SUGAR?

The major health issues linked to sugar intake span from inflammation to obesity, and beyond, painting a complex picture of its impact on our well-being.

Inflammation and Chronic Disease: Excessive sugar consumption fuels persistent inflammation, setting the stage for chronic diseases like heart disease, cancer, and Alzheimer’s. With chronic diseases responsible for 85% of deaths in Europe and affecting over half of Switzerland’s population, the stakes couldn’t be higher. Cutting down on sugar can markedly reduce inflammation and the risk of these conditions.

Obesity’s Escalating Crisis: Sugar’s role in the obesity epidemic is clear, with over 50% of the Swiss population grappling with being overweight, including 10% of children. The consumption of high-fructose diets is particularly concerning for its ability to increase dangerous visceral fat, which can lead to further health complications.

The Sugar and Diabetes Link: While Type 1 diabetes is autoimmune, Type 2 diabetes is closely tied to diet, with sugar consumption playing a pivotal role in insulin resistance and impaired glucose regulation. Switzerland sees a significant toll, with hundreds of thousands living with Type 2 diabetes and related fatalities.

Dental Health at Risk: The mouth is another battleground, where sugar feeds bacteria that cause tooth decay, a problem exacerbated by the sugar industry’s historical efforts to obscure research linking sugar to dental issues.

Heart Disease and Sugar: It is now well accepted that high sugar intake is associated with an increased risk of heart disease. The sugar industry tried their best manipulate the link. The Harvard sugar scandal of the 1960s, where prominent researchers at Harvard were funded by the sugar industry to downplay sugar’s health risks and blame dietary fat for heart disease, catalysed the low-fat, high-sugar movement. This misguided dietary shift contributed significantly to skyrocketing obesity levels in the 90s, as it led to an increased consumption of sugar-laden foods under the guise of heart health.

Accelerated Aging: Sugar significantly accelerates the aging process through glycation, where sugar molecules attach to proteins, affecting their function and leading to signs of aging like wrinkles. Each spike in glucose can contribute to this process, emphasizing the importance of moderating sugar intake to slow down aging.

Gout: Fructose, in particular, is notorious for raising uric acid levels in the blood, a byproduct of its metabolism, which can lead to gout, a painful form of arthritis.

Mental Health Concerns: Excessive sugar disrupts hormonal balance and neurotransmitter function, potentially leading to depression, anxiety, and cognitive decline, with high blood sugar levels also implicated in the development of Alzheimer’s disease.

Cancer Connection: While sugar itself isn’t carcinogenic, its contribution to obesity and inflammation heightens cancer risk, supported by epidemiological and preclinical studies.

Accelerated Aging: Sugar accelerates the aging process through glycation, where sugar molecules attach to proteins, affecting their function and leading to signs of aging like wrinkles.

Gut Health Compromised: A high-sugar, low-fibre diet disrupts gut health, leading to an imbalance in intestinal bacteria and potential digestive issues.

HOW MUCH IS TOO MUCH?

The World Health Organization (WHO) recommends adults limit sugar to 50 grams (about 12 teaspoons) daily to reduce obesity and dental decay risks. The American Heart Association suggests tighter restrictions: 24 grams for women and 36 grams for men.

Influence from sugar lobbyists has muddled guidelines, with threats to WHO funding, highlighting the battle over dietary recommendations.

In Switzerland, the typical consumption far exceeds these guidelines, with an average intake of 100 grams of added sugar per day, showcasing how easily one can surpass healthy limits through everyday beverages and snacks. A typical 600ml Coca Cola contains 64g sugar. Children should limit added sugar to 12 grams, yet many products targeted at children contain much more. For example, a Capri Sun has a whopping 17g added sugar per serve.

The prevalence of excessive sugar consumption can be traced back to the ubiquity of sugar in our food supply and the myriad of terms used to disguise it. From “fruit juice concentrate” to “Gerstenmalzextract,” these aliases enable sugar to infiltrate our diet under the radar.

Excessive sugar consumption stems from its hidden presence in foods, with various names masking its inclusion. Fruit juice concentrate and Gerstenmalzextract may sound healthier but they are not. The food industry, aiming to enhance flavor and addictiveness, adds sugar to even unexpected “non-sweet” products from bread to chips, to trigger the brain’s reward centres similarly to narcotics.

Fast food is especially rife with added sugar. In Ireland, Subway has to legally classify it’s bread as cake due to its high sugar content. In the 1980s a McDonald’s burger contained 2.6g sugar, now it contains close to 10g.

We like to think that our diet is shaped by our ancestors and traditions but sadly the food corporations have taken complete control. Our great, great, grandparents would be shocked by what we eat daily.

HOW CAN I REDUCE MY SUGAR INTAKE?

Reducing your sugar intake starts with knowledge. Many are unaware they’re on the brink of prediabetes. Begin with checking the blood glucose marker HbA1c to understand your average blood glucose levels over recent months, giving you a clearer picture of your sugar intake’s impact.

Here are some effective strategies:

• Don’t drink your sugar
• Check Labels Carefully: Aim for foods where sugar isn’t in the top three ingredients. A rule of thumb is to choose products with 5 grams or less of added sugar per 100 grams, alongside a favourable carbohydrate to fibre ratio of 5:1 or better to prevent sugar spikes.
• Choose Whole, Slow Carbs: You don’t need to eliminate carbs, just opt for those that are high in fibre and digest more slowly, reducing cravings.
• Acid and Bitter Tastes: Adding lemon juice, lime juice, or vinegar to meals can help manage blood sugar levels. Similarly, a dash of cinnamon (no more than 1.5 teaspoons daily) can be beneficial.
• Prioritize Sleep: Lack of sleep can increase sugar cravings.
• Exercise: Find healthy ways to boost your dopamine levels, such as exercise, to replace the quick fixes sugar provides.
• Natural Supplements: While not necessary for everyone, supplements like glutamine and berberine can support blood sugar management, though it’s essential to proceed with caution and consult a healthcare provider.

SHOULD I USE SUGAR ALTERNATIVES?