Escaping The Sugar Fix

By Dr. Mark R. Windt

Valentine's Day has just passed and many of us may have enjoyed a lovely box of chocolates — and possibly felt guilty after. However, it's not the occasional indulgence in a sweet treat that is the problem, it is the ongoing, excessive consumption of sugar that is quietly wreaking havoc with our health — and in ways you might not expect. Let's talk about sugar's role in our diet and the changes we can make to reduce its prevalence.

When did sugar become a concern?

From the medical community's standpoint, concerns about sugar (sucrose) are not new. In 1942, the American Medical Association recommended that Americans limit sugar intake and specifically targeted soft drinks as a culprit in adding excess sugar to people's diet. At that time, U.S. production of carbonated soft drinks was 90 eight-ounce servings per person; by 2000, this number had risen to more than 600 servings per person.

Even more compelling, early warning signs of the link between sugar and coronary heart disease emerged as early as the 1950s. The medical community was concerned at the disproportionately high rates of heart disease mortality among American men and thus studies were undertaken. By the 1960s, two prominent physiologists were promoting different dietary causes of heart disease, Dr. John Yudkin identified sugar as the primary culprit, while Dr. Ancel Keys pushed total fat, saturated fat and cholesterol. By the 1980s, the scientific community had started leaning toward Dr. Keys' theory regarding fat as a contributor to heart disease, and reducing sugar in the diet was not promoted in dietary guidelines for heart health.

Now, scientists are taking another look at sugar and its role in terms of heart health. A recent study published in the Journal of American Medical Association Internal Medicine noted that a diet heavy on sugar can lead to heart disease even if you are not overweight. This is a concern since the study showed that one in 10 people get one-fourth or more of their calories from sugar. During the 15-year study, which focused on added sugar and heart disease, researchers found that participants who took in more than 25 percent of their daily calories from sugar were more than twice as likely to die from heart disease as those whose diets included less than 10 percent added sugar. The study clearly showed that the odds of dying from heart disease rose in direct correlation to the percentage of sugar in the diet — and this was true regardless of a person's age, sex, physical activity level or body-mass index (a measure of weight).

Without question, as our consumption of soft drinks and other sugar-laden foods has increased, so have a number of health issues. As to fats, the medical community is begining to change its views on the role of fats in our diet. Healthy fats, such as those found in dairy, meat, eggs and nuts, when eaten in moderation, play an important role in cell development and function. Manufactured trans-fats, such as partially hydrogenated vegetable oil, which is found in a lot of pre-packaged foods, should be avoided. Reducing harmful fats, reducing carbohydrates and then incorporating a modest amount of healthy fat can be the foundation for a healthy diet. (See Dr. Windt's January 2017 column on the low-carb diet.)

Where is the excess sugar coming from?

Soft drinks are a major source; these, along with potato chips, have been shown to be one of the major causes of obesity. In fact, sugar-sweetened beverages such as sodas, energy drinks and sports drinks are the biggest sources of added sugar in the average American's diet, according to the JAMA study. However, it's not just direct consumption of sugar that is the problem.

Sugar is added to foods during processing, as are various syrups, which are also a form of sugar. Why? Most people have a sweet tooth, so adding sweetness to something increases its appeal. However, sugar is also added because it gives baked goods flavor, texture and color. It helps preserve foods such as jams and jellies. It aids in fermentation, helping breads rise. It can also be used as a bulking agent in baked goods and ice cream. Finally, it balances out the acidity of foods that also contain vinegar and tomatoes.

You should also know that sugar goes by many different names based on its source and how it was made. Fructose, glucose, maltose and dextrose are all sugars; so are cane juice and cane syrup (from sugar cane), corn sweeteners and high-fructose corn syrup, fruit juice concentrate and nectars, honey, malt syrup and molasses. If you see sugar listed among the first few ingredients on a product then it is high in added sugars.

Many people are currently confused by how much sugar is in their food. The Food and Drug Administration is looking into how to better update the Nutrition Facts labels to help clarify exactly how much sugar is in foods. Remember, there is no nutritional advantage to honey, brown sugar or fruit juice concentrate over white sugar.

Finally, items that are low-fat are not necessarily healthy. In fact, many foods that are low in fat have had the amount of sugar in them increased to improve taste as compensation for the loss of extra fat.

Why is excess sugar bad?

Here's a bit of biology: Insulin is a hormone that is very important to the body. It allows glucose (the sugar in your blood) to enter cells from the bloodstream and then tells the cells to start burning glucose instead of fat. However, when people eat a lot of sugar, it can cause insulin resistance, which can lead to diabetes among other diseases. When you consume excess sugar, it makes you gain weight and can put you on the path to obesity. (People eat more of foods that taste sweet, so not only are you taking in more sugar, you are taking in more food overall.)

Being overweight increases your risk of cardiovascular disease. Consuming more sugar also increases your triglycerides. These are a type of fat found in the bloodstream and in your fatty tissue. Higher triglyceride levels can increase your risk of heart disease. Nutritionists note that sugary foods only provide "empty calories," meaning calories not partnered with fiber, vitamins, minerals or other nutrients. When you fill up on sugary foods, you are less apt to eat healthy foods that aid your body.

All forms of sugar also contribute to tooth decay. The more sugar you consume, the more at risk you are for cavities, especially if you don't practice good oral hygiene. Tooth decay can allow harmful bacteria to enter the body. Finally, being overweight can lead to hypertension, asthma, joint issues, sleep apnea and many other health concerns.

What should our sugar intake be?

First, consider that natural sugars are found in grains, milk, and fruit. These are not necessarily bad for you, and these foods bring health benefits in the form of fiber, vitamins, minerals, and healthy fats. Keeping track of sugars that are added to foods simply to make them sweeter, as well as your consumption of sugary beverages and treats, is the goal.

The 2015-2020 Dietary Guidelines for Americans recommend that added sugars make up no more than 10 percent of your daily calories.

For a 2,000-calorie diet that means that no more than 200 calories should come from added sugars. The American Heart Association takes a stronger stance, advising no more than 100 calories a day from sugar for most women, and no more than 150 for most men. That's about six teaspoons of sugar for women and nine for men — one teaspoon of sugar has about 16 calories. As an example, a 12-ounce can of regular soda has about 160 calories, or about 10 teaspoons, of sugar. Currently, American adults get 13 percent of their total daily calories from added sugars.

How can I reduce my sugar intake?

Swapping out some key culprits and paying more attention to food labels can make a big difference. Here are some tips:

1. Drink water or other calorie-free drinks instead of sugary sodas, sports drinks and coffee drinks.

2. When drinking fruit juice, make sure it is 100 percent juice with no sugar added. If possible, skip the juice and eat a piece of fruit as that will give you healthy fiber as well.

3. Choose breakfast cereals with less sugar — skip the sugary and frosted cereals. Also consider swapping out cereal on some days for healthy options such as avocado spread on whole grain toast (healthy fat and fiber), scrambled eggs with veggies, or apple slices with peanut butter on whole-grain toast.

4. Choose reduced-sugar versions of syrups, jams, jellies and preserves.

5. Make dessert a true treat and not an every night occurrence. If you need a taste of something sweet after a meal, eat fresh fruit.

6. If you buy canned fruit, look for fruit packed in water or juice not syrup. Drain and rinse the fruit to remove the syrup if that is all that is available.

7. When you need a pick-me-up, skip the candy, pastries and cookies and opt for cheese, whole-grain crackers or veggies and hummus, apples and peanut butter, or low calorie yogurt.

8. As much as possible, buy fresh fruit and vegetables, which will have more flavor and only natural sugars.

9. Cook your own meals as much as you can. You will have better control over how much sugar is in them, as opposed to pre-packaged options.

The good news is that reducing sugar consumption usually shows immediate health benefits, such as weight loss and improvement of conditions such as borderline diabetes.

Dr. Mark Windt is an allergist, immunologist and pulmonologist who has been treating allergies, including food allergies, and respiratory illnesses, for more than 30 years. He is the medical director for the Center for Asthma, Allergy and Respiratory Disease in North Hampton, a facility he started in 1985. Dr. Windt is also an adjunct professor at the University of New Hampshire's School of Nutrition and founder of the Probiotic Cheese Company (www.theprobioticcheesecompany.com). For information, visit www.caard.com or call 964-3392.

---

Story Credit: http://www.seacoastonline.com/news/20170305/escaping-sugar-fix