By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Overeating sugar – one of the most dangerous dietary habits of all – has become a worldwide problem, resulting in soaring diabetes and obesity rates. Take my short sugar test and see how sugar-smart you are…
Test Your Sugar IQ
- True or False: The average American consumes about 25 teaspoons (about 100 grams) of added sugar a day.
- True or False: Most people get extra sugar in their diet from cookies, cakes, and pies.
- True or False: Eating too much sugar can cause premature skin wrinkling.
- True or False: Sugar has been shown to be highly addictive.
- True or False: Milk and other dairy products are sugar-free.
- True or False: Even though it can make you fat, consuming lots of sugar strengthens your immune system.
- True or False: Cancer cells cannot process and use sugar for energy.
- True or False: Excess sugar consumption can lead to arthritis.
- True or False: Thirty to forty percent of healthcare expenditures in the USA are linked to the excess consumption of sugar.
Answer: Sugar is a simple carbohydrate that your body converts to energy. It carries no other nutritional value. Sugar occurs naturally in milk, vegetables, fruit, and some grains. Fructose, for instance, is the sugar found in fruit. Lactose is in dairy. Glucose and sucrose are in vegetables. But for most people, this isn’t the sugar that causes health issues.
2. What is added sugar?
Answer: Added sugar is the big problem. It mainly consists of refined sugar and syrups that food manufacturers add to processed food and drinks for the same reason you add sugar to your cereal or coffee: to provide a sweeter and more palatable taste. In food processing, added sugar is used to help preserve food (like jams), bulk up products like ice cream, and promote the fermentation of breads and alcohol. Sugar, sugar cane, fructose, and high-fructose corn syrup are common added sweeteners. Most processed foods have them and it means more calories. When eaten routinely, they increase the potential for weight gain and other serious health problems. Bottom line – your body doesn’t need added sugars, and certainly not at the present level of consumption.
In 2014, the U.S. Food and Drug Administration announced proposed updates to the familiar nutrition facts label found on most food packages. The label, introduced 20 years ago, helps consumers make informed food choices. If adopted, the proposed changes would include information about “added sugar” content in the hope that consumers may start paying more attention and, ideally, reduce consumption of added sugar.
Answer: I regard sugar as the No. 1 enemy of heart health. Not cholesterol, but sugar and sweeteners. But the problem goes beyond the cardiovascular system. According to a 2013 report (see Null G.) commissioned by Credit Suisse, a leading global bank based in Switzerland, approximately “30-40 percent of healthcare expenditures in the USA go to help address issues that are closely tied to the excess consumption of sugar.” Among the issues that research has linked to overconsumption are heart disease, diabetes, metabolic syndrome, cancer, obesity, hypertension, fatty liver disease, osteoporosis, chronic kidney disease, suppression of the immune system, eating disorders, dental cavities, learning disorders, and even dementia through the buildup of toxic proteins in the brain.
4. How does sugar damage the body?
Answer: In many ways, researchers believe. You’ll get the picture with these few examples:
- Sugary foods skew appetite. The more of them you eat, the less you tend to eat foods that count; foods that contain essential nutrients. There is potential for malnutrition and certainly for undernutrition and shortchanging your body.
- Sugar intake has an association with cancer. Cancer cells have a different metabolism than normal cells and thrive on sugar. This understanding was first brought to public attention by the research of Nobel Laureate Otto Warburg in the 1920’s.
- High consumption of sugar inhibits the immune system. Among the effects is a weakened ability of important immune cells called neutrophils to surround and destroy bacteria and cancer cells.
- Sugar accelerates aging of the body through a process called glycation, in which sugar compounds bond with collagen, proteins that make up the body’s structural connective tissue, such as ligaments, tendons, and skin. Loss of collagen is a cause of wrinkles. But more seriously, it also leads to rigid, less functional blood vessels and organs, and weakened musculature. Furthermore, in diabetics, high blood sugar stokes glycation reactions even further, contributing to nerve, artery, and kidney damage.
- Over time, a constant overload of refined carbs can cause chronic inflammation in the body, which can lead to numerous health complications. Refined carbohydrates, including sugars, are broken down very quickly by the body during the process of digestion. Hence, when we eat excess amounts of them in one sitting, our bloodstreams are flooded with too much blood sugar, and subsequently, excess insulin. When it is the norm, rather than the exception, excess insulin release causes weight gain, a pre-diabetic condition called insulin resistance, followed by diabetes, and an increased risk of cardiovascular disease. In this epidemic scenario, a chain reaction of biochemical reactions sets the stage for arterial inflammation and plaque, thick blood, increased clotting, free radical oxidative damage to cells, blood vessel spasm and constriction, and hypertension.
- Added sugars, often from habitual soft drink consumption, powerfully contribute to obesity among both children and adults. Obesity substantially raises the risk of heart disease, diabetes, hypertension, osteoarthritis, gallbladder disease, some cancers, and even low back pain, just to name a few conditions.
Answer: About 14 percent of total dietary calories. The average American today consumes about 22 teaspoons (there’s about 4 grams of sugar in a teaspoon) of added sugar a day!!!!! That means an unnecessary and nutritionally devoid, additional 350 calories. The overconsumption of added sugars is associated with an underconsumption of essential nutrients. In other words, eating too much of the sweet stuff leads to eating too little of the good, nutritious stuff.
6. Who has the highest intake?
Answer: Teenagers at a whopping 34 teaspoons a day (550 calories)! This helps explain why so many youngsters have prematurely developed obesity and diabetes. They are eating too much of the wrong food and drinking too many soft drinks.
7. Isn’t this just about a “sweet tooth?”
Answer: Not at all. It’s about excess, ignorance, and overdoing it on a daily basis. People are influenced by advertising, they don’t read labels and they make unhealthy food choices. Masses of people are hooked on junk food and have no clue about the damage being done to their bodies. Research has also documented that sugar addiction can cause pronounced dependence and even withdrawal symptoms, similar to drugs, when it is stopped. In animal studies (see Grimm JW), sugar actually has been found to have a similar effect on the brain as highly addictive drugs like cocaine.
8. Where do people buy their added sugar?
Answer: Most of it, 65-76 percent, at supermarket or grocery stores, according to a 2014 analysis of U.S. national nutritional surveys (see Drewnowski A) of more than thirty-one thousand Americans 6 years old and up; 6-12 percent from fast food restaurants and pizza parlors; and 4-6 percent from full-service restaurants.
Answer: Beverages like sodas, along with energy and sports drinks, top the list at 34.4 percent; then come grain desserts (cookies, cakes, and pies) at 12.7 percent; fruit drinks, 8 percent; and dairy desserts at 5.6 percent. During the past three decades or so, total calorie intake has increased by an average of 150 to 300 or more calories per day, and about half of this increase comes from liquid calories – sugar-sweetened drinks.
10. Should we limit our intake of added sugars?
Answer: Absolutely and dramatically so. According to recommendations from the American Heart Association (see Johnson RK), a prudent upper limit of intake is no more than 100 calories per day for women (about 6 teaspoons or 36 grams) and 150 calories for men (9 teaspoons or 36 grams) from added sugars. As I said a moment ago, there is no nutritional need or benefit from added sugars (unless it is D-ribose).
Take the Sinatra Challenge
In a recent Facebook video, I challenged my followers to cut out one serving of food per day that includes sugar. Can you do it? Check out the video and read some of the comments posted there. Maybe you’ll get some inspiration. If you are overweight and a sugarholic, you need to act. Prevention is ALWAYS easier than a cure!
- U.S. Food and Drug Administration. Proposed Changes to the Nutrition Facts Label. Published online 2014 at http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm385663.htm#Summary
- Null G. Sugar: Killing us Sweetly. Staggering Health Consequences of Sugar on Health of Americans. Center for Research on Globalization, Feb. 2014. Published online at http://www.globalresearch.ca/sugar-killing-us-sweetly/5367250
- Grimm, JW, et al. Incubation of sucrose craving: effects of reduced training and sucrose pre-loading. Physiol Behav, 2005;84(1):73–79. Online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2880539/
- Drewnowski A, Rehm CD. Consumption of added sugars among US children and adults by food purchase location and food source. Am J Nutrition, 2014;100(3):901-7. Online at http://ajcn.nutrition.org/content/early/2014/07/16/ajcn.114.089458
- Johnson RK, et al. American Heart Association Scientific Paper: Dietary sugars intake and cardiovascular health. Circulation, 2009;120(11):1011-20. Online at http://circ.ahajournals.org/content/120/11/1011.full
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