Spotlight on sugar

If you’re anything like us, you probably love sugar. And it’s certainly hard to avoid it now that it’s added to pretty much every food product going.

It’s been demonised a lot recently, however, and is typically seen as a contributory factor to obesity in particular.

But is it inherently bad? Like most things, it depends on the detail, so let’s take a closer look.

Firstly, it’s important to note that there are several different types of sugar. Anything that ends in “-ose” is typically one, like lactose in milk. But most is either sucrose (a complex sugar), glucose or fructose (both simple sugars). And they all behave differently.

Ultimately, all of them break down into glucose and fructose, which are absorbed directly by the body.

Glucose is absorbed most quickly, raising blood sugar levels. It’s used immediately as energy, or stored as glycogen for later use. Fructose raises blood sugar more slowly, and has to be converted to glucose (by the liver or intestines [1]) before it can be used as energy. Sucrose has to be broken down into glucose and fructose before it can be absorbed by the body, so it doesn’t directly raise blood sugar levels.

In moderation, none of this is problematic for us, and glucose is the body’s preferred source of energy. Problems arise when we eat too much of it though, especially fructose. If we eat more than the body can easily convert to glucose, the excess is turned into cholesterol and fat. This can then lead to diabetes [2], kidney disease [3], obesity and a host of other ailments [4].

excess fructose can lead to diabetes, kidney disease and obesity

Fructose is particularly found in fruit though, and to a lesser extent veg, both of which we’re encouraged to eat as much of as possible.

So what’s going on?

The problem is that an increasing amount of our sugar consumption is added, or “free” sugars. When you eat whole fruit or veg, the other nutrients such as fibre can counter the negative effects of the natural sugars, slowing the absorption down for instance.

When sugar’s added as an ingredient, however, it’s absorbed by the body more quickly. And the same applies when the naturally occurring sugars aren’t bound together with other nutrients like fibre. In both cases the sugar is free, increasing the chances of a detrimental health impact.

Because of this, the Scientific Advisory Committee on Nutrition recommends no more than 19g (4-6 year olds) to 30g (11+) a day of free sugars. And that they should be replaced by the sugars within the cellular structure of fruits and veg (whole foods) [5]. These weights are equivalent to 5% of suggested daily calorie intakes.

the Scientific Advisory Committee on Nutrition recommends no more than 19g (4-6 year olds) to 30g (11+) a day of free sugars

The naturally occurring sugars in fruit and veg juices, smoothies and purees are considered to be “free” [6], as is the date paste used in most fruit based snack bars.

And studies show very different responses to them compared to the sugar in whole fruit. For instance, whereas blood sugar quickly returns to a normal level after eating apple slices, drinking apple juice or smoothie prompts the release of too much insulin and results in a hypoglycemic dip. This is a reduction in blood sugar below normal levels, which can lead to over-eating and, ultimately, diabetes [7]. The effect was attributed to the lack of fibre in the juice, and the destruction of the fibre / sugar bond in the smoothie.

Erratic blood sugar movements are particularly problematic for people that are already diabetic.

But studies show no ill effects on diabetics from eating whole fruits [8]. Quite the opposite actually – whereas the consumption of fruit juice is associated with a higher risk of diabetes, consumption of some whole fruits like apples is associated with lower risk [9].

Their free sugar content is largely why the NHS recommends limiting juices and smoothies to 150ml a day. And it only allows them to be considered as one of your five a day irrespective of their size [10]. Action on Sugar doesn’t want them to be considered as portions of fruit or veg at all! The smallest smoothies you can typically buy, however, are 250ml, often containing almost an entire day’s recommendation of free sugar.

So it’s probably no surprise to hear that most people typically consume at least twice as much free sugar as recommended. And it’s closer to three times as much for some children / teenagers [11]. No wonder we’ve got an increasing obesity problem!

it’s probably no surprise to hear that most people typically consume at least twice as much free sugar as recommended

Why do we eat so much?

Sugar can have functional benefits in terms of binding ingredients together and extending shelf-life. But it’s probably not lost on food manufacturers that it can be addictive [12] (especially fructose) and increase our appetite [13], both of which would increase demand for their high sugar products…

Our increasingly hectic lives also play a part too of course. With increasing demands on our time, highly processed foods (which typically have a lot of free sugars) are often the most convenient options. And by adding a superfood or two, or saying “zero fat”, we often perceive them to be healthier than they really are. Fruit juices and smoothies are a good example of this.

What can we do about it?

The simplest thing is just to swap processed foods for whole foods like an actual apple. Where that’s not possible, look for options with no or limited free sugars and plenty of whole food fibre. The NHS recommends only eating products with free sugars occasionally, or not at all [14].

The NHS recommends only eating products with free sugars occasionally, or not at all

It’s worth noting here that sugars come in a variety of forms, and you’ll rarely see just “sugar” as an ingredient.

Things like syrups and fruit juice concentrates are also added sugars, as is honey. Whilst there are arguments to say that honey, as a whole food, is relatively good, it still contains a lot of fructose. Some other natural sugars like agave nectar are 70-90% fructose [15] and apparently have little to offer nutritionally. Blackstrap molasses and date sugar do have nutritional benefits [16], but in most cases there’s little benefit to using natural / unrefined added sugars over refined ones.

These added sugars are useful binders, but they’re one of the largest ingredients in a lot of snack bars. And whilst some bars claim to be lower sugar than others, that’s not a good thing if they’re free sugars rather than whole food ones. So always check the label! We’ll blog more about this shortly so make sure to sign up to our newsletter below.

As mentioned in a previous blog, experts suggest looking for foods where the carbs to fibre ratio is five max. This is seen as a good way of identifying less-processed options that typically take the body longer to break down, giving it plenty of time to deal properly with the sugar.

Remember to keep an eye on your dried fruit consumption too. Although some studies suggest otherwise (for raisins in particular) [17], the NHS believes it can increase the risk of tooth decay. So they recommend only eating it as part of a meal rather than as a snack [18].

the NHS recommends only eating dried fruit as part of a meal rather than as a snack

Fruit’s typically also much higher in fructose (and glucose) than veg, which is mainly sucrose. Dates are roughly half fructose and half glucose, for instance, but carrots are as little as 13% fructose and at least 43% sucrose. And veg are usually higher in fibre than fruit, further slowing the absorption of the natural sugars.

The high fructose content of fruit isn’t seen as a cause of diabetes and obesity when consuming whole fruit [19]. But it does make a lot of them high FODMAP, which can cause IBS in some people. Indeed, fructans (a collection of fructose molecules) are increasingly seen as responsible for the symptoms typically associated with gluten sensitivity [20]. There’s also evidence of fructose rich fruits causing gout in men [21]. As with many other elements of nutrition, therefore, it’s important to ensure that you eat as wide a variety of fruit as possible.

What about sweeteners?

In the move to reduce sugar content, manufacturers often turn to sweeteners, but these typically have their own problems. Unnatural ones like aspartame, for instance, have been linked to side effects including headaches [22] and high blood pressure [23]. And natural ones like sorbitol and xylitol aren’t well absorbed by the body so can cause digestive issues. Natural erythritol is better digested and may even have some antioxidant properties though [24].

Whilst potentially harmless, however, studies show that because sweeteners are calorie free, they don’t suppress hunger. So you may end up eating more of the product containing them than otherwise. They also maintain your dependency on all things sweet [25], which probably isn’t a good thing.

Made from c.50-70% whole food veg, and with no free sugars or sweeteners (or other additives), vedge bars are a great way to help reduce your free sugar intake without sacrificing taste or convenience. They’re also:

  • high in whole food fibre (the only macronutrient we don’t eat enough of)
  • have a carb to fibre ratio of four and a half or less (compared to nine for most date-based bars or fruit leathers, most of whose sugar is free)
  • and are at least one of your five a day.

For those on low FODMAP diets, five of our bars have been certified as FODMAP friendly and we expect to get more certified in the future.

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p.s. no-one we know is perfect, and certainly not us. Despite doing all the research and writing this post, we still need a free sugar fix occasionally and have a smoothie once in a while, and we don’t feel bad about it! We think the key is to make it count. So try to avoid free sugars in products that really don’t need them, like snack bars. But do treat yourself to high quality ice cream and chocolate when you feel the need!

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[1] https://www.princeton.edu/news/2018/02/06/mouse-study-reveals-gut-effects-too-much-fructose
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC552336/
[3] https://www.ncbi.nlm.nih.gov/pubmed/21880837
[4] https://www.healthline.com/nutrition/sucrose-glucose-fructose#absorption-and-use
[5] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/489906/Why_5__-_The_Science_Behind_SACN.pdf
[6] https://www.diabetes.org.uk/Guide-to-diabetes/Enjoy-food/what-to-drink-with-diabetes/Fruit-juices-and-smoothies#confused
[7] https://www.ncbi.nlm.nih.gov/pubmed/71495

[8] https://www.ncbi.nlm.nih.gov/pubmed/23497350
[9] https://www.bmj.com/content/347/bmj.f5001
[10] http://www.nhs.uk/Livewell/5ADAY/Documents/Downloads/5ADAY_portion_guide.pdf
[11] https://www.gov.uk/government/collections/national-diet-and-nutrition-survey#current-ndns-results
[12] https://www.sciencedirect.com/science/article/pii/S0002822310006449
[13] https://www.ncbi.nlm.nih.gov/pubmed/15181085
[14] https://www.nhs.uk/live-well/eat-well/how-does-sugar-in-our-diet-affect-our-health/

[15] https://www.healthline.com/nutrition/56-different-names-for-sugar#section5
[16] https://www.ncbi.nlm.nih.gov/pubmed/19103324

[17] https://www.researchgate.net/publication/41172062_The_Effect_of_Raisin-containing_Cereals_on_the_pH_of_Dental_Plaque_in_Young_Children
[18] https://www.nhs.uk/livewell/goodfood/pages/how-to-get-more-fibre-into-your-diet.aspx
[19] http://diabetes.diabetesjournals.org/content/62/10/3307

[20] https://www.epainassist.com/diet-and-nutrition/can-fructan-not-gluten-be-responsible-for-your-stomach-issues
[21] https://www.bmj.com/content/336/7639/309
[22] https://www.ncbi.nlm.nih.gov/pubmed/18627677/
[23] https://www.ncbi.nlm.nih.gov/pubmed/18708962
[24] https://www.ncbi.nlm.nih.gov/pubmed/19632091
[25] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892765/



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