The summary on sugar
Which types of sugar to eat, how much, and how to read labels.
If I had a dollar for every time someone said to me, “oh I don’t eat sugar, only honey/ agave/ coconut sugar/ fruit/ etc.” I would probably have enough to book myself a week-long wellness retreat. Let me start with what you don’t want to hear: no matter what you call it, sugar is sugar. The effects on your health will vary based on its provenance, and there are some notable benefits to eating a cup of raspberries versus a cup of candy. But things get trickier when you talk about a cup of raspberries versus a cup of dried mango or a glass of fruit juice. Even worse are the seemingly healthy foods, with labels that say “0 added sugar” which fool people into believing they are not eating sugar. To help you cut through the noise, I’ll do a breakdown of what sugar is, where you find it, what it does, and how to read labels correctly.
What is sugar?
All sugars are carbohydrates, alongside starches and fiber. At a chemical level, there are two types of sugar: monosaccharides (simple sugars) and disaccharides.
Simple sugars include:
Glucose: often referred to as “blood sugar”, glucose is the body's primary source of energy and is naturally present in fruits and vegetables.
Fructose: found in fruits, some vegetables, honey, and root vegetables; fructose is very sweet and is metabolized directly by the liver.
Galactose: less sweet than glucose and usually found in dairy products as part of lactose.
Disaccharides include:
Sucrose: common table sugar, derived from sugarcane or sugar beets; it is composed of glucose and fructose and is used in processed foods and beverages.
Lactose: known as milk sugar, it is found in milk and dairy products and is composed of glucose and galactose.
Maltose: formed from two glucose molecules, maltose is found in malted drinks and foods, and is a product of starch digestion.
Where do you find sugar?
Fructose, glucose, lactose and maltose are naturally occurring sugars (found inherently in whole foods). Added sugars are those incorporated into foods during manufacturing or cooking and include sucrose, High-Fructose Corn Syrup (HFCS), dextrose, syrups (maple, agave, molasses), coconut sugar and even honey (although natural, when added to products during processing, it counts as added sugar).
Does that automatically make naturally occurring sugars “good” and added sugars “bad”? It depends.
From a nutritional content standpoint, foods with naturally occurring sugars, such as fruits, vegetables, and dairy products, also contain essential nutrients such as vitamins, minerals, fiber, and protein. Eating whole foods with naturally occurring sugars tends to have a less dramatic impact on blood sugar levels compared to eating foods with added sugars. This is partly because the fiber in whole foods slows the absorption of sugar, stabilizing blood sugar levels. But that’s only true if you consume the fiber - aka, have a whole apple, not dried apple or worse, apple juice. The more fiber you remove from a food - be it whole or processed - the faster that carbohydrate is digested and absorbed, leading to a rapid rise in blood sugar levels.
When it comes to added sugars, those tend to be present mostly in processed foods which you should limit as much as you can. Yes, it’s fine to have desert or sweet treat here and there, but when you do, don’t fool yourself that it will be “better” for you if made with coconut sugar or agave instead of regular sugar.
To put this into perspective, regular table sugar is almost entirely sucrose (about 99% or more), while coconut sugar is a mix of about 70-80% sucrose along with glucose and fructose. The presence of inulin in coconut sugar gives it a slightly lower glycemic index than regular sugar, but he difference is not significant enough to make a major impact on health for most people.
What about honey?
Honey is often considered "better" than refined sugar due to its natural composition (fructose and glucose). However, honey only contains trace amounts of vitamins and minerals and only small quantities of antioxidants and bioactive compounds that can have anti-inflammatory and antimicrobial effects. Again, if you want to eat honey because you like it, that’s fine, but at a molecular level, it’s still sugar by a different name.
What about fruit?
As outlined above, fruit is great because it contains a ton of fiber and micronutrients. But that’s only if you consume it whole, not dried or juiced. For reference, one cup of raspberries has approximately 5.5 grams of sugar, while one cup of dried mango has a whopping 90 grams (!!!) of sugar.
Fruit is also high in fructose which metabolizes directly in the liver, and if you have insulin resistance, type 2 diabetes or fatty liver disease, it’s best to stick with low-glycemic fruit such as berries, kiwi and citrus.
What does sugar do?
Sugar (glucose) is the most easily accessible form of energy available to cells and provides energy to the brain, muscles, and other organs. Sugars can also be precursors for the synthesis of other essential substances, including certain amino acids and fats.
The good news is that the human body does not actually require added sugars to function. We produce glucose, the primary energy source needed for cellular function, from other carbohydrates and, in the absence of sufficient carbohydrates, from proteins and fats through a process called gluconeogenesis. You can get all the sugar you “need” from whole-food sources of carbohydrates such as vegetables, fruit and starches such as grains and legumes.
What about the bad things it does?
The list, here, is longer:
High sugar intake often leads to increased calorie consumption, contributing to weight gain and obesity.
Consuming too much sugar can cause rapid spikes in blood glucose levels, followed by sharp drops, which can lead to energy fluctuations and hunger spikes, affecting overall energy levels.
Over time, high sugar intake can lead to higher levels of glucose in the blood, which may cause the body's cells to become less responsive to insulin. This can eventually lead to type 2 diabetes.
Excessive sugar consumption is linked to an increase in risk factors for heart disease, such as increased triglyceride levels, high blood pressure, and inflammation.
Sugar is a major contributor to tooth decay. The bacteria in the mouth use sugar from food and drinks to produce acids that dissolve and damage the teeth.
High intakes of fructose can lead to an accumulation of fat in the liver, which can contribute to nonalcoholic fatty liver disease (NAFLD)
Diets high in sugar can accelerate skin aging through a process known as glycation, where sugar in the blood attaches to proteins to form harmful molecules that can damage collagen and elastin in the skin.
Sugar can trigger the release of dopamine, which can lead to addiction-like symptoms, including cravings and withdrawal symptoms.
Research on the link between sugar consumption and cancer risk has yielded mixed results, but multiple studies suggest a potential indirect link between sugar consumption and cancer risk through obesity and metabolic syndrome.
How much sugar do you need?
While there are no guidelines for naturally occurring sugar, The American Heart Association (AHA) suggests women limit sugar consumption to no more than 6 teaspoons (about 24 grams) of added sugar per day and no more than 9 teaspoons (about 36 grams) for men.
Think vegetables with every meal, a few starchier carbs such as root veggies or grains and a cup of berries and that’s your 25-30 grams of sugar per day.
How do I read labels?
If your diet consist mostly of whole, unprocessed foods, it’s easier to gauge your sugar consumption using the guidelines above. Packaged foods, however, are a minefield. Brands will often use clever marketing to trick into thinking you are making good choices by saying things like “no added sugar”, “sweetened with just dates”, or “sweetened with just coconut sugar”. But if you want to truly know what you’re putting in your body, it’s best to read the labels - aka the nutrition facts.
In the example below, the front of the packaging says “0 added sugar”, but if you look at the label and check Total Carbohydrates, you’ll see that it has 27 grams of carbs per serving out if which only 5 grams are fiber and 19 grams are sugar. If your total daily intake should be between 25-30 grams, well, 19 grams is quite a lot in a single serving.
As a rule of thumb when it comes to carbs, you want the fiber content to be as high as possible and the sugar content as low as possible.
TL;DR:
all sugars are carbohydrates
sugars from whole, complex carbs such as fruit, vegetables and grains are better than added sugars because of their high fiber and micronutrient content
fruit is fine if eaten whole: a whole apple > dried apple > apple juice
one cup of raspberries has approximately 5.5 grams of sugar, while one cup of dried mango has 90 grams (!!!) of sugar
honey, coconut sugar, agave, maple syrup, brown sugar - it’s ALL SUGAR; have it if you like it, but don’t fool yourself that it’s better for you
your body needs sugar to make energy, but it gets it from veggies and fruit, it doesn’t need cookies (sorry!)
dessert is fine, just not all the time (double sorry!)
too much sugar from processed foods leads to all kinds of bad things: diabetes, weight gain, non-alcoholic fatty liver, heart disease, skin aging, addiction, and cancer
women should limit sugar consumption to no more than 25 grams of added sugar per day and men to no more than 35 grams
read to learn labels and always look at the Total Carbohydrates where you want the fiber content to be higher than the sugar content
PS: I enjoy researching and writing this newsletter, and I’d love to know whether you find this type of information useful. Please let me know what other topics you’d like me to write about. Drop me a line here, on Instagram or at sabina@kahla.com