The problem with sugar and sweeteners

The problem with sugar and sweeteners

Eating too much sugar is problematic because it can make you gain weight, contribute to inflammation and cause tooth decay.

Sugar occurs naturally in foods like fruit and vegetables but the amount of sugar in these foods is fairly low and the sugars are incorporated into the cellular structure of the food, so take a while to be digested and absorbed into your bloodstream to be used for energy. Milk and milk products also contain a natural sugar, lactose, and again take a while to be digested and absorbed into your body.

Added sugars, also known as free sugars, are a different story. These sugars tend to be digested and absorbed much more quickly and can contribute to high levels of sugar in your bloodstream. The body will work hard to keep blood sugar levels stable and has complex and efficient mechanisms to do so. The hormone insulin is key in moving excess sugar from the blood into body cells to be used as energy or to be stored for later use. If there is too much excess sugar the body will also convert some of this into fat. 

Over time, if we continually consume too much sugar, not only will we likely put on weight but our bodies may find it harder to respond to insulin as efficiently. This means we need to produce more insulin to bring down high blood sugar levels and may swing from high to low blood sugar levels, leaving us with sugar cravings, tiredness and irritability. 

In the longer term there is the risk that the body is not able to respond well to insulin at all, this is known as insulin resistance, which sets the scene for developing serious health conditions such as type 2 diabetes. Type 2 diabetes is a condition where blood sugar levels can no longer be controlled properly resulting in high blood sugar levels and complications such as heart and blood vessel disease, nerve damage, eye damage, poor wound healing and skin conditions.

High blood sugar levels and insulin resistance are also associated with:

  • Obesity, especially weight gain around the middle
  • Increased levels of harmful cholesterol and fat in the blood
  • Raised blood pressure
  • Increased cancer risk
  • Hormonal imbalances like raised testosterone in women, associated with conditions such as PCOS
  • Mood disorders

Studies have shown sudden sugar spikes affect the brain, triggering intense stimulus to the pleasure and reward area of the brain. It is no surprise then that overconsumption of sugary foods is actually quite addictive and can be a hard habit to break.

Breaking habits – the good news is that once you commit to reducing your sugar intake you can lose your sweet tooth and really enjoy the sweetness in a portion or 2 of fruit each day!

The government recommends we consume no more than 30g of free sugars a day, which is the equivalent of around 7 tsp or cubes of sugar. For children aged 7-10 the maximum amount of sugar is 6 tsp a day and for children aged 4-6 the government says no more than 5 tsp a day.

This might sound a lot but the average British man consumes equivalent of 17 tsp sugar a day (National Diet and Nutrition Survey 2018). If we have a look at how much sugar is added to foods you can see how it quickly adds up.

Much of the added sugar is found in obvious sweet foods like confectionary, biscuits, cakes and soft drinks or adding sugar to tea and coffee. But it is also hidden in foods like cereal, yoghurts, snack bars, smoothies, sauces and ready meals.

See how much sugar is in the following foods

Food or Drink Contains equivalent to x teaspoons of sugar (1 tsp sugar approx. 4g)
Can of coke8.75
45g bar of Dairy Milk chocolate6.25
Starbucks Pumpkin Spice LatteTall 9.75. Grande 12.5. Venti 16.
Cereal bars / biscuitsTypically 3 tsp per bar or biscuit
1 tbsp ketchup1
Ready cooking sauces, eg sweet and sourSome contain up to 4 tsp per serving
Flavoured yoghurtsContain 2-4 tsp of added sugar, not including the natural milk sugar in plain yoghurt

Symptoms that may indicate excessive sugar consumption

  • Feeling hungry / irritable after a few hours after meals
  • Concentration dips mid-morning / mid-afternoon
  • Feeling light-headed, shaky or dizzy if you’re late for a meal
  • Craving sweet foods and snacks
  • Experiencing either a huge boost in energy or fatigue after your meal
  • Needing caffeine or sugary snacks ‘to keep going’

How sugar contributes to inflammation

Consuming excess added sugar and refined carbohydrates can result in several changes in the body which help to explain why a diet high in sugar can lead to low-grade inflammation (learn more about inflammation here – link to pain and inflammation page)

Too much sugar, as we have seen, can result in excess fat storage and weight gain. Excess body fat and insulin resistance lead to inflammatory chemicals being released into the bloodstream.

Too much sugar and processed food can negatively affect the balance of bacteria in the gut. This in turn can contribute to increased gut permeability which means bacteria and undigested food particles can more easily move out of the gut and into the bloodstream triggering an immune response and inflammation.

When too much sugar is in the bloodstream it can combine with proteins and fats to form Advanced Glycation End products (AGEs) which are known to promote oxidative stress and inflammation.

Processed and refined foods also problematic

It’s not just the added sugar in foods that causes problems. Foods that are very processed, or refined, get digested and converted into sugar so fast they also have a negative impact and raise blood sugar levels quickly.

A useful measure is Glycemic Load (GL)

Glycemic load measures the blood sugar raising effect per serving of food. It takes into account not only how fast the carbohydrate within in a food raises your blood sugar compared with pure glucose (this is known as glycemic index (GI) but also how much carbohydrate is in a food serving.

In summary:

  • GI tells us about the quality of carbohydrate in a food, whether it is slow or fast-releasing
  • Whereas, GL tells us about the quantity and quality so gives us a much better indication of how quickly blood sugar levels will rise in reality after eating a portion of food

Sugary, processed and refined foods like confectionary, white bread, puffed cereals, biscuits, crackers, breadsticks, noodles, white rice, mashed potato as well as crisps, pop chips and rice cakes are all foods that have a high GL.

On the other hand, whole oats, wholemeal pasta, root vegetables and pulses, like lentils and beans, have a lower GL due to the fibre they contain. It takes the body a lot longer to digest and break the food down so the starches and sugar they contain are released more slowly.

Non-starchy vegetables like leafy greens and salad have a very low GL.

Portion size impacts GL so if you want to enjoy a food like white rice, just have a small portion or switch to brown rice and you would be able to enjoy a bigger portion. The brown or wholegrain is more likely to fill you up for longer and also contains more vitamins and minerals.

Adding non-starchy vegetables, like broccoli, cabbage, lettuce or spinach; a protein-rich food such as eggs, poultry, fish, lean meat, or a handful of fresh nuts to your meal also helps slow down digestion and can help keep you fuller for longer.

You can find a list of some common foods and their GL here (link to a table which I will send later)

Cooking affects the GL and if you cook and cool overnight some foods like potatoes, pasta and root vegetables (you can then reheat them if you want) the GL reduces slightly. This is because some of the starch changes structure slightly and becomes ‘resistant starch’ this is harder for us to digest but is a great food for our friendly gut bacteria!

NB individual responses to food can vary.

Artificial Sweeteners – Not so Sweet?

Due to pressure from the government to reduce the amount of added sugar in foods, food manufacturers are increasingly using artificial sweeteners. At the moment it is believed they are safe to consume in small amounts, however

  • Growing evidence suggests that sweeteners may induce glucose intolerance due to alterations in the gut microbiota
  • They may change the way we taste food / overstimulate sugar receptors
  • May result in increased sweet cravings
  • Because we might think we are reducing sugar intake by switching to a low-sugar, artificially sweetened food or soda we might then think it is ok to consume sugar elsewhere - ‘I’m drinking diet soda, so it’s ok to have cake’
  • Some animal studies have shown saccharine is more addictive than cocaine
  • There are also some studies show people who drank diet soda became more obese than those who drank less, we are not sure why at this point and it maybe because of other unhealthy food and lifestyle choices but until we know more it is sensible to limit the amount of artificially sweetened foods.

Easy swaps

Normal version Healthy alternative
Soft drinks and sodaSparkling water with lemon, lime or orange slices
Fruit juiceWhole fruit or a homemade smoothie (where you whizz up whole fruit)
ConfectionaryA couple of squares of dark chocolate and a small handful of fresh nuts.
Ready saucesPesto. Passata or tinned tomatoes. A drizzle of olive oil and a little grated parmesan. Cook from scratch using herbs like parsley, basil, rosemary and thyme.* Spices like ginger, cumin, coriander. Lemon zest and juice is great for adding flavour.
White bread, pasta, riceWholegrain or brown bread, pasta or rice or root vegetables like carrots, beetroot, parsnips, sweet potato, turnip, swede.