Sugar

It always surprises me when I run across a patient who is lacking a sweet tooth; they are certainly members of a minority. But let’s keep in mind that sugar is not found only in candy and soda; it’s in most processed foods, from pasta sauces to some peanut butters, rice, bread, crackers, yogurt, and much more. When we rely on quick meals and snacks, we find considerable amounts of added sugar.

Sugar comes in many forms, including sucrose (table sugar), fructose (fruit sugar), lactose (sugar found in dairy products), and syrups (corn, maple, honey, molasses, agave). High fructose corn syrup, used by food manufacturers, is actually a combination of glucose and fructose. The average adult in the United States consumes an estimated 17-22 teaspoons of added sugar each day, and that comes to some 60-80 pounds of added sugar each year!

Let’s start here by listing the benefits of consuming added sugar:

OK; now let’s move on to sugar’s downsides:

• Added sugar can cause weight gain and is a major contributor to our obesity epidemic. Sugar-sweetened drinks like soda, juices, teas and coffees are loaded with high-fructose corn syrup, cane sugar, or a combination. Note that drinking a sugary beverage has actually been found to increase, not curb, our appetite, and that obesity significantly increases the risk of a number of serious diseases.

• High-sugar diets have been associated with an increased risk of heart disease and stroke. Risk factors for atherosclerosis (the thickening and narrowing of the arteries) are increased because excess sugars raise triglyceride levels, increase “bad” cholesterol, and lower “good” cholesterol.

• Sugary foods increase the risk of developing type 2 diabetes. Diabetes is a leading cause of death and shortened life expectancy, and has more than doubled over the past 30 years! While diabetes has a strong genetic component, excessive sugar intake contributes to weight gain and increased body fat, each of which significantly increase the risk of developing diabetes. In addition, high sugar consumption over time leads to insulin resistance, which causes blood sugar levels to rise. Diabetics also have higher rates of fatty liver, which is linked to consumption of added sugar.

• Eating excessive amounts of sugar may increase the risk of developing certain cancers, in particular breast and colon, by increasing inflammation and insulin resistance. Is this link between sugar and cancer due only to weight gain and obesity? This is being investigated.

• A diet high in simple carbs, which includes sugar, has been associated with a higher risk of acne. Foods with a higher glycemic index (such as processed sweets) raise blood sugar more rapidly than do foods with a lower glycemic index (such as complex carbs including fruits, vegetables and whole grains). Sugary foods cause a spike in blood sugar and insulin levels, leading to increased androgen secretion, oil production and inflammation, all of which play a role in acne.

• There is an association between sugar consumption and depression. A diet high in added sugar and processed foods may contribute to changes in mood and emotions, cognitive impairment, memory problems and emotional disorders. Foods high in added sugar quickly spike blood sugar and insulin levels, leading to a rapid increase and then a subsequent crash in energy.

Of course, there’s more. A high sugar diet may also lead to a more rapid aging of the skin, an increased risk of kidney disease, worse dental health, and higher rates of gout. Does all of this mean that we should have none at all? I certainly hope not. However, I do strongly suggest that we make foods with added sugar a treat, and not a staple, in our diet.