Who can resist the temptation of chocolate eggs and edible bunnies at Easter. While the odd indulgence is okay, sugar receives a pretty bad wrap. But should we quit it completely?

Sugar is the villain of the day in the health and wellness sector. Slowly but surely fats are shedding their bad-boy status, and sugar is taking over as the most detrimental dietary ingredient to our waistlines, health and general wellbeing.

We outline the bad rap sugar has been attracting and look into the question on everybody’s taste buds – should we banish it from our diet once and for all?

What is it?

At a molecular level, sugar is a crystalline carbohydrate. There are many different types of sugar – glucose, fructose, lactose, maltose and sucrose (sucrose is your typical table sugar, and is composed of glucose and fructose).

Some of these sugars occur naturally in fruits, vegetables and other food groups. However, it’s the added sugars, used to enhance flavour and add sweetness, that have been blamed as a culprit in a myriad of health issues. These sugars are usually delivered in the form of sucrose or fructose corn syrup, and it is fructose, more than glucose, that is receiving the most negative attention.

The highest quantities of added sugars are found in soft drinks, fruit juices, cakes, chocolate and desserts. According to Medical News Today, just a single can of cola can contain up to seven teaspoons of added sugar, while an average-sized chocolate bar can contain up to six teaspoons.

At present, the World Health Organisation’s (WHO) recommended daily dose of sugar is less than 10 percent of your daily total energy intake. WHO suggests a further reduction to less than five percent for beneficial health outcomes.

Many nutritionists recommend against consuming more than 13 teaspoons a day.

Is sugar addiction possible?

The book Sweet Poison: Why Sugar is Making Us Fat by David Gillespie, published in 2008, marked a turning point in the way we consider sugar consumption. In the book, Gillespie investigated the relationship between sugar, the ever-increasing obesity rates of the Western world and the most prevalent diseases in the 21st century.

It was Gillespie’s personal story, however, that set people on the path of quitting sugar. From being 40kg overweight, he immediately started losing weight, and kept it off, by cutting sugar (specifically fructose) from his diet. He claims sugar is addictive – a fact exploited by food manufacturers – and a rare resource to which we don’t have an in-built “off switch”, meaning we can keep eating it without feeling full, leading to weight gain and a myriad of health effects.

One study by Nicole Avena, Pedro Rada and Bartley Hoebel (2008) looked into the addictive properties of sugar. It examined the physiological response to sugar intake in rats, and how the rats behaved when “on” and “off” sugar.

“Sugar is noteworthy as a substance that releases opioids and dopamine and thus might be expected to have addictive potential.”

“Food addiction” seems plausible because brain pathways that evolved to respond to natural rewards are also activated by addictive drugs,’ the report states. ‘Sugar is noteworthy as a substance that releases opioids and dopamine and thus might be expected to have addictive potential.’

After a month “on” sugar, the animals showed a series of behaviours similar to the signs of drug abuse.

‘These are categorised as “bingeing”, meaning unusually large bouts of intake, opiate-like “withdrawal” indicated by signs of anxiety and behavioural depression and “craving” measured during sugar abstinence as enhanced responding for sugar.’

So, are we all junkies?

According to the Harvard School of Public Health, the average American consumes 22 teaspoons of added sugar a day, equating to an extra 350 calories. Scarily, these 22 mouthfuls of sweetness are easily consumed – added sugar is difficult to avoid.

Gillespie claims food manufacturers are taking advantage of our collective sugar addiction and are “lacing” non-sweet products – such as bread, sauces, soups and cereals – with the poison to ensure we stay hooked. And he’s not alone in this thinking.

Dr Robert Lustig, a paediatric endocrinologist at the University of California-San Francisco and author of the book Fat Chance: The Hidden Truth About Sugar, says the food industry is purposefully sweetening up our diets.

‘The food industry has made sugar into a diet staple because they know when they do, you buy more,’ he told The Guardian in 2013. ‘This is their hook. If some unscrupulous cereal manufacturer went out and laced your breakfast cereal with morphine to get you to buy more, what would you think of that? They do it with sugar instead.’

Is it really that bad?

Sugar has been linked to high blood sugar, cardiovascular disease mortality, diabetes and cellular ageing.

An article published in the online journal Open Heart found sugars are probably more instrumental in increasing the risk of hypertension (high blood pressure) and cardiovascular disease (CVD), as compared to dietary sodium (salt).

‘Compelling evidence from basic science, population studies, and clinical trials implicate sugars, and particularly the monosaccharide fructose, as playing a major role in the development of hypertension,’ the researchers state. ‘Moreover, evidence suggests that sugars in general and fructose in particular may contribute to overall cardiovascular risk through a variety of mechanisms.’

shutterstock_275840702

Furthermore, a study published in the JAMA Internal Medicine journal, conducted by researchers at the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention, associated a high added sugar intake with a heightened risk of CVD.

The study found that people who consumed between 17 and 21 per cent of their daily calories from added sugar exhibited a 38 percent higher risk of CVD mortality, compared to those whose added sugar intake was maintained at around eight percent. For those whose daily intake of added sugar was more than 21 percent of their daily calories, they had double the risk of CVD mortality. And, in participants who consumed 25 percent of their daily calories from added sugar, their risk of CVD mortality was tripled.

Cellular ageing

The anti-ageing world is full of talk about telomeres – or the protective DNA that caps the end of cell chromosomes. The common consensus is the longer the telomeres, the longer the quality of life. The trick? Telomeres continuously shorten as our cells replicate, getting shorter and shorter as we age.

Ongoing research is furiously exploring the possibilities in lengthening telomeres to reduce the rate of ageing or ways to prevent their ever-persistent shortening. But sugar, according to scientists from the University of California-San Francisco, is one sure-fire way to shorten your telomeres before their time. The research, led by Prof. Elissa Epel, assessed 5,309 participants and found those who drank larger amounts of sugary soda tended to have shorter telomeres in their white blood cells, making them susceptible to inflammation and chronic disease.

‘Regular consumption of sugar-sweetened sodas might influence disease development,’ says Epel. ‘Not only by straining the body’s metabolic control of sugars but also through accelerated cellular ageing of tissues.’

Diabetes – sugar’s off the hook (somewhat)

Type 2 diabetes is caused when blood levels of glucose become chronically elevated. Although diabetes is the fastest growing chronic condition in Australia according to Diabetes Australia – with the total number of diabetic and pre-diabetic Australians estimated at 3.2 million – sugar is somewhat off the hook in this particular epidemic.   

As we eat, the sugar and carbohydrates in our food cause our blood sugar level – or the amount of glucose in our blood – to rise. In response to this, insulin is released from beta cells in the pancreas, and its job is to send glucose back into cells, so it’s not reaping havoc in the blood stream.

When you eat high quantities of foods that cause a steep rise in blood sugar, higher levels of insulin are released to combat this. Over time, these repeated floods make the body less sensitive to the hormone, leading to a condition called insulin resistance and, following this, diabetes.

An emerging school of thought holds that fructose may lead to insulin resistance. However, this is not certain and sugar is not the sole culprit here. Instead, foods with a high glycemic index (GI) – which measures how much the carbohydrates raise the blood sugar levels – have a greater impact on blood sugar. Interestingly, refined grains and starches actually have a higher glycemic index than sugar.

There is also no differentiation in the body’s insulin response to the source of sugar – the fructose found in sucrose and the fructose found naturally in fruits will incur the very same insulin response. The only reason added sugars might be related to diabetes is because the foods they are founds in are more likely to lead to weight gain – a high risk factor in diabetes.

Should we quit it?

Certainly, the myriad of health problems associated with high sugar intake is enough to quieten anyone’s sugar cravings, but is it healthy to eliminate sugar from our diet completely?

Sugar is found naturally in fruits, vegetables and dairy products, which means that to eradicate it completely from our diet would leave us with little other than meat and fats.

‘I am quite comfortable with dietary sugars if they come from whole foods such as fresh fruits and vegetables, as the sugar is diluted with water, fibre and other nutrients,’ health expert Professor Kerin O’Dea from the Sansom Institute for Health Research told the ABC.

As for added sugar, the alternative options – in the form of artificial sweeteners – are not necessarily any better for you. A recent study published in the journal Nature found artificial sweeteners interfere with gut bacteria, increasing the chances of obesity and diabetes.

‘Our findings suggest that artificial sweeteners may have directly contributed to enhancing the exact epidemic that they themselves were intended to fight,’ the researchers from the Department of Immunology at the Weizmann Institute of Science in Israel state.

Myth busting: raw vs white vs brown sugars

Hopeful sugar lovers have ventured the suggestion that brown sugar or raw sugar might indeed by healthier than the super-refined white sugar seen on most coffee-shop tables. Unfortunately, their hopes are dashed.

Although they go through slightly different processes, raw, white and brown sugar are derived from the same source and hold very little nutritional difference – ie, all are equally bad for you.

Sugar crystals are made from the juice of sugar cane or sugar beet. The juice is filtered, evaporated, boiled – which produces molasses – centrifuged and dried to yield raw sugar. White, or refined sugar, undergoes further washing, bleaching, filtering, processing and drying. Brown sugar is created through the addition of molasses to refined white sugar.