The not so sweet scoop on sugar and chronic disease
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A spoonful of sugar may help the medicine go down, as sung in the 1964 Walt Disney musical Mary Poppins, but that sweet song has turned into a sour tune over the years. There’s no doubt we love our sugar. In the United States, the average person consumes 80 grams or 20 teaspoons each day. In 2012, this averaged out to be about 130 pounds of sugar per person consumed a year. Over the years, our love affair with everything sweet has become a bitter pill to swallow with respect in how it’s harming our health.
Health conditions linked to excess sugar
It used to be thought sugar’s only vice was tooth decay but research has shown excessive sugar intake may be linked to even more harmful health conditions than previously thought. Here are some possible health conditions that may be linked to excess sugar intake - keeping in mind these are multifactorial diseases with excess sugar being just one component to their development:
Currently, about 34.9% of adults in the United States are obese. Carrying excess weight makes a person more vulnerable to developing heart disease, stroke, diabetes, and certain types of cancer. Consuming excess sugar means consuming excess calories leading to weight gain which can cause insulin resistance. When there is insulin resistance along with elevated triglycerides, this can interfere with the signal reaching the brain of a hormone called leptin. Here are some facts on leptin:
· A hormone made by fat cells helping to regulate energy by balance by inhibiting hunger.
· It acts as our energy thermostat.
· It tells the brain that we are satisfied.
· Speeds up metabolic rate.
· Decreases the reward/pleasure system.
When we gain weight, we secrete more leptin because of it being made from the increased fat mass. But the increased secretion of leptin is not getting to the brain to signal to stop eating due to insulin resistance and higher triglyceride levels interfering with that signal. This is known as leptin resistance. Because of this, the reward/pleasure system is not diminished as rapidly with eating food and therefore a person will still feel hungry, wanting to eat more food. To prevent this interference, triglyceride levels need to come down and in order for that to happen, excess sugar consumption needs to decrease.
Hypertension (HTN) or high blood pressure occurs in 29% of US adults. Several prospective cohort studies have shown a link between excess sugar, particularly in sugar-sweetened beverages (SSBs) and HTN. The Nurse’s Health Study demonstrated a 28-44% increased risk for HTN of people with high intakes of SSBs along with the Framingham Study which showed a 20% higher risk for HTN in individuals drinking more than one SSB daily compared to those who never drank SSBs. The NHANES study revealed that adolescents with a higher SSB intake had higher blood pressure. The impact of sugar on HTN appears to be due to one of the components sugar is made of, fructose, which can increase uric acid levels. High levels of uric acid have been linked to HTN; when uric acid levels are elevated, this decreases urinary sodium excretion which may lead to high blood pressure.
Hyperlipidemia is when there is an abnormally high concentration of fats or lipids in the blood. This means excess total cholesterol, triglycerides and the “bad” fat, LDL cholesterol are roaming through the bloodstream contributing to plaque buildup along the artery walls. Around 31.7% of Americans have LDL levels of 130 mg/dl or higher, putting them at a greater risk for heart disease and stroke. Studies have found that when the percentage of total calories coming from sugar increases, the “good” HDL cholesterol decreases while the “bad” LDL cholesterol increases.
Type 2 diabetes now affects 9% of the US population as of 2014. Prediabetes affects 37% of adults age 20 and over based on 2009-2012 data. One of the drivers of this is excess sugar and particularly the highly concentrated amounts found in SSBs. However, SSBs are not the only source of added excess sugar – there are numerous other sources of added sugar found throughout our food supply. This excess consumption of sugar leads to increased insulin resistance. Insulin resistance is when insulin, a hormone secreted by the pancreas in response to high blood glucose or sugar levels, is not working effectively to get glucose out of the bloodstream and into the cells of the body. The pancreas will compensate by pumping out more insulin but eventually it may put out less and less insulin or quit working altogether leading to the development of diabetes.
With cancer, excess sugar intake has been shown in various studies to appear to increase the risk of breast, endometrial and colon cancers. The possible mechanisms of sugars impact lies in the increased insulin levels that occur which may directly increase tumor growth. Studies have shown having diabetes seems to be linked to an increases risk for breast, endometrial and colon cancer suggesting a link between blood sugar, insulin and inflammatory pathways and cancer development.
What amount of sugar can a person consume?
It is recommended by the American Heart Association that the maximum amount of added sugar – does not include sugar found naturally in foods such as fruit – should be 150 calories a day(9 teaspoons or 37.5 grams) for men and 100 calories a day (6 teaspoons or 25 grams) for women.
Sources of added sugar
Sugar is in a lot more foods than people may realize. Reading the nutrition facts labels on foods can be an eye-opening experience to the amount of sugar some foods contain. Here are some primary sources of where this excess sugar is coming from:
· Sodas
· Other sugar sweetened beverages such as sports drinks, energy drinks, sweetened tea and sugary coffee beverages
· Yogurt, energy bars and breakfast cereals
· Desserts
· Hidden sugars found in foods such as:
*Baked beans – 12 g per ½ cup
*Tomato soup – 10 g per ½ cup
*Tomato sauce – 9 g per ½ cup
*Salad dressing – 5 g per 2 tablespoons
*Ketchup – 3 g per tablespoon
Here are some additional added sources of sugar in foods you may think twice about before consuming:
*Dairy Queen blizzard, small – 50 g
*Chocolate chip Frappe, 16 oz. – 57 g
*Chai-latte, 16 oz. – 19-30 g
*Apple pie, 1/8 of 9” pie – 21 g
*Frosted Flakes, 1 cup – 15 g
Dissolving the sugar habit
Breaking the habit to consume sugary foods can be done but it does take willpower and a self-disciplined mindset to put the lid on sugar intake once and for all. Below are steps to take to reduce sugar intake to a bare minimum:
· Make a list of foods with added sugar usually eaten and look up the sugar content. Avoid those with more than 3 g of sugar per serving.
· Eat a high-protein breakfast to keep cravings away. Consider having high protein foods such as eggs, a protein shake or peanut butter.
· Avoid eating sugary foods in the morning as it can lead to swings in blood sugar levels.
· Use smaller bowls for desserts like ice cream.
· Avoid buying sweets – out of sight, out of mind.
· Brush teeth – highly sweetened foods don’t taste as good after brushing.
· Eat regular meals to avoid hunger pangs making you crave something sweet.
· Keep well-hydrated – drinking water, plain coffee, unsweetened tea or herbal tea can help curb sugar cravings.
· Get enough sleep. Feeling tired makes it harder to resist sweets.
· If you crave desserts after a meal, set a timer for 15 minutes. During that time do normal activities and see if you still have the desire for dessert when the time is up.
· Make a list of things to do when sugary foods are tempting you – read a book, call a friend, go for a walk, listen to music.
By learning which foods are high in sugar and understanding why excess sugar can be harmful to our health, we can begin to reduce our sugar intake, one teaspoon at a time.