Health & Sugar

The Great Sugar Debate By Carol Herbert

Few food ingredients have stimulated as much debate as sugar. Sugar has been enjoyed by man for centuries. Down the ages it has been prized as a spice, medicine and preservative. Sugar contributes to the taste, palatability, texture and variety of foods available to us.
Yet there are still people who try to avoid sugar. Marketers encourage food producers to manufacture "sugar free", "no sugar added" or "low sugar" varieties of a range of food products to meet the needs of this section of the market. Are these needs real or perceived? What is the state of research regarding sugar in human nutrition?

Can Sugar be included in a healthy diet?

The effects of sugar on health have made news headlines for over four decades. Claims have been made that attribute a variety of health conditions to the consumption of sugar. The positive effect of the controversy was that it sparked off a lot of research into the actual effect - and this research has provided useful findings. The research has been considered by government bodies such as the Food and Drug Administration of the USA and the conclusions reached do not support the view, as some people would have us believe, the sugars, at usual intake, have an adverse effect on our health.
These research results have been taken into consideration when dietary guidelines have been compiled, and the advice given on sugar consumption recognises the place it has in balanced diets.

What do consumers believe?

The message regarding sugar communicated by the health authorities in the USA is reaching consumers. In a survey done on 801 shoppers two years ago, the researchers noted that "Concern about sugar is down lower than we have ever seen it. People continue to look to food as a major source of pleasure. Seventy five percent of the women surveyed said that sugar is an important part of the pleasure of eating and that they would eat sweets if they were lower in fat."

The results of consumer surveys such as these cannot be translated directly to a South African context - but they do illustrate an important trend. The scientific battle to prove that sugar can be included in healthy diets has been won - but the communications battle has a long way to go. As the message reaches consumers and they learn that sugar is not a "bad food" they will learn to identify the problem areas of their diets and adjust their food choices accordingly.

Non-nutritive sweeteners will not disappear off the market, but consumers who choose to use them instead of sugar will not necessarily do so because they believe that sugar is bad. Substituting sugar with non-nutritive sweeteners will probably not improve the diet and may well result in a subconscious increase in intake of fat.

The sugar-fat see-saw

This inverse relationship between the amount of sugars in the diet, and the amount of fat has been dubbed the sugar-fat see-saw. Any elevation of fat in the diet tends to make the diet more promotive of obesity, coronary heart disease and certain cancers, and is thus undesirable. Based on these findings Professor Jennie Brand Miller of Australia suggested the recommendation that the population at large should cut down on fat intake is difficult if sucrose is removed from the diet.
Interestingly, in terms of palatability and satiety it is far easier to overeat fat than sugar. Fat in foods does not always taste fatty and thus very high levels of fat intake can be reached without the consumer being aware of it.

Conversely sugar usually tastes sweet - and high levels become too sweet, thus consumption is limited. Foods that contain sugar and fat, such as chocolate and ice-cream, will taste sweet, not fatty - and then sugar gets the blame for the fact that the food is fattening.

What makes food fattening?

The alarming increase in the prevalence of overweight and obesity in most developed countries has led to the examination of habits that may contribute to obesity. Lack of physical activity is a prime risk factor in the development of obesity, and still not addressed adequately by most dieters, many of whom still believe that removing sugar from the diet will help them to get rid of unwanted fat. Although carbohydrates, especially refined sugars, are still widely assumed to be fattening, a substantial body of evidence refutes this. In studies done on more than 11000 adults a strong and highly significant inverse relationship between sugar intake and obesity was found. This means that thin people eat more sugar than fat people.

Therapeutic uses of Sugar and Wound Healing

For 4000 years the wound healing properties of honey have been recognised. They include cleansing, absorption of oedema, antimicrobial activity, deodorisation, promotion of granulisation and tissue formation.

Doctors now report the use of granulated sugar as a dressing to clean wounds after cardiac surgery, and to assist granulation. Interestingly results "possibly better than those obtained by conventional treatment" were reported.

Sugar has recently been shown to be of value as a painkiller for new-born infants. Infants who were given small quantities of sucrose solution cried less than those who were given water during painful hospital procedures such as blood collection.

Sugar has been used as a carrier for micronutrients in a food fortification programme in Guatemala. Sugar was a suitable food because it is produced centrally from a few well equipped factories, is used in most homes and the end product is stable.

Sugar and the hyperactive child

The belief that sugar can have a detrimental effect on behaviour has been fostered by publications of personal testimonies which have associated sugar consumption with a variety of adverse behavioral outcomes. Many parents, teachers and physicians believe sugar to be a cause of hyperactivity in childhood. Recent careful investigations have shown that any negative effect of sugar is by no means adverse, prevalent or as uncontrolled as popular opinion would suggest. Current research has shown that sugar consumption does not induce psychopathology where there was none before, but on occasion it may aggravate existing behaviour disorders.

In the field of reviews it is suggested that diets free from added sugars can be burdensome and socially inhibiting and they should not be put into practice on the basis of anecdotal evidence.

Sugar and Diabetes Meilitus

When a person eats carbohydrate foods - sugars and starches - they are converted in part to glucose, a simple sugar, which is absorbed into the bloodstream and used by the body for energy. The hormone insulin regulates the availability of glucose to the body cells. It is the key that unlocks the cells and allows the glucose to enter. Diabetes is a condition linked with the inability of the pancreas to manufacture sufficient insulin. The cells are then starved of glucose while there is an abnormal build up of blood sugar (blood glucose).

Two decades ago, most authorities considered that the primary cause of diabetes was a high sugar intake. However this perception has been shown to be incorrect. While the exact cause of the condition remains uncertain an inherited disposition and obesity are risk factors.
The aim of diabetes treatment is to normalise the blood glucose levels. Previously it was believed that starchy foods evoked much lower glycaemic (blood glucose) responses than did sugars, and thus consumption of sugars was restricted in the diets of people with diabetes. However it has been shown that many starchy foods elicit responses as high as that from a similar load of glucose. This effect is quantified using a scale called the Glycaemic Index (GI) - the GI ranks of food on the basis of their acute glycaemic impact. Meals for diabetics must emphasise low GI foods, and sugar is not excluded.