Excessive sugar consumption represents a massive problem for our current global health status. The American Heart Association recommends a maximum of 25 grams of sugar for women and 36 grams of sugar per day for men. However, added sugar consumption in the United States is now estimated to be more than 100 grams of sugar per person per day. Global consumption of sugar increased by 40% from 1990 to 2016. This massive intake of added sugars comes at a cost.
Excess sugar intake increases the risk of many chronic diseases, including cardiovascular disease, diabetes, obesity, liver disease, cognitive diseases, and dental caries. This is a problem that shouldn't be ignored. This article will discuss how sugar is broken down in the body, the difference between sugar and complex carbohydrates, and how processed sugar impacts our health. We will also determine which sugars are safe to consume and which should be avoided while reviewing specific nutrition plans that avoid processed sugar.
How Do We Break Down Sugar?
Sugars are simple carbohydrates, which means they are made of just one or two sugar molecules joined together in a simple chemical structure.
Most sugar consumed in a typical Western Diet is processed sugar, most often sucrose (table sugar) or high fructose corn syrup (HFCS).
Sugar is broken down into monosaccharides (single molecules, most commonly fructose or glucose) that are then absorbed into the bloodstream. As they are absorbed, blood sugar levels rise, triggering the pancreas to release insulin. Insulin is a hormone that regulates the body's use or storage of glucose. Insulin stimulates the entry of glucose into the body's cells to create cellular energy. Insulin also stimulates glucose to be stored in the liver and muscles as glycogen (the body's storage form of glucose).
Sugar is broken down and absorbed by the body quickly, resulting in a rapid rise of blood sugar levels, which is often accompanied by a burst of energy. We digest and metabolize processed sugar quickly, so an energy crash often follows the quick spike in blood sugar and energy as blood sugar levels fall.
What's the Difference Between Processed Sugar and Complex Carbohydrates?
In contrast to simple carbohydrates (sugar), made of just one or two sugars bound together, complex carbohydrates are made of three or more sugars bound together, forming a more complex structure.
The two types of complex carbohydrates are starch and fiber. These types of carbohydrates take longer to digest, which results in a slower rise in blood sugar levels after consuming them. This slower digestion means they keep you full longer (they are more satiating), and blood sugar and energy remain more stable. Complex carbohydrates also contain vitamins and minerals, making them more nutrient dense and a healthier form of carbohydrate.
How Does Sugar Affect Our Health?
Processed sugar can have a significant negative impact on our health if consumed in excess. Too much processed sugar can increase the risk of obesity, diabetes, heart disease, and other health issues. It's essential to be mindful of how much sugar you consume and ensure you get enough whole foods and fiber in your diet for the best health outcomes.
Processed Sugars Affect on Gut Health
Sugar consumption can cause changes in your gut microbiota (the collection of trillions of microorganisms living in the gut), leading to dysbiosis. Dysbiosis is characterized by several imbalances in gut health, including an overgrowth of harmful bacteria or a reduction in beneficial bacteria, inflammation, and increased intestinal permeability (often called "leaky gut").
The changes in the gut microbiota caused by processed sugars promote the development of non-alcoholic fatty liver disease (NAFLD), a condition associated with cardiovascular disease and type 2 diabetes.
Research also shows that sugar-sweetened beverages cause an increase in the risk of inflammatory bowel diseases (IBD). It's easy to overlook drinks as a source of added sugars, but this is an important reminder to pay attention to both foods and beverages when considering sources of processed sugar in your overall dietary intake.
Processed Sugars Affect on Cardio Health
Consuming too much sugar can increase the risk of cardiovascular diseases. A recent study showed the correlation between higher sugar consumption and increased cardiovascular disease, ischemic heart disease, and stroke. This study also showed that when processed sugars were substituted with complex carbohydrates, there was a favorable relationship with cardiovascular disease and stroke.
Another study observed that sugar places you at risk for cardiovascular disease as well as a significantly increased risk of death from cardiovascular disease.
Excessive amounts of added sugar can lead to obesity, a risk factor for heart disease. A high intake of added sugar can also contribute to high blood pressure, inflammation, insulin resistance, and high levels of triglycerides in the blood, all of which are associated with an increased risk of heart disease.
Processed Sugars Affect on Metabolic Health
Sugar-sweetened beverages may seem harmless or insignificant to some, but evidence links them to several chronic health conditions. Did you know that consuming just one sugar-sweetened beverage per day increases your risk for type 2 diabetes by 13%?
A meta-analysis looked at the impact of sugar-sweetened beverages on metabolic health. The sugar-sweetened beverages consisted of soft drinks, fruit drinks, iced tea, and energy and vitamin water drinks. In addition to sugar causing weight gain, the participants that consumed the highest quantities of sugar-sweetened beverages had a 26% higher risk of developing type 2 diabetes. This study also showed an association between these sugar-sweetened beverages and metabolic syndrome, a collection of biological abnormalities associated with cardiovascular disease and diabetes.
Processed sugar promotes these metabolic diseases directly by dysregulating lipid and carbohydrate metabolism and indirectly by causing weight and fat gain.
Processed Sugars Affect on Brain Health
Alzheimer's disease has been identified as the 6th leading cause of death in the United States and the 5th leading cause for people over 65. Sugar plays a significant role in Alzheimer's disease, which has been identified as "type 3 diabetes". This form of diabetes presents as insulin resistance in the brain, impairing neurocognition (brain function).
In a cross-sectional analysis of the association between sugar-sweetened beverages and brain health, higher intake was associated with lower brain volume and lower performance on memory tests than those who consumed less than one sugary beverage per day. Those who drank fruit juice daily tended to have lower total brain volume, lower hippocampal (a region of the brain primarily associated with memory) volume, and worse memory.
Sugar has associations with other aspects of brain health as well. Consumption of sugar-sweetened beverages results in an increased risk for depression, with an equivalent of 3 cans per day of soda increasing risk by 25%.
Processed Sugars Affect on Skin Health
Glycation is a chemical process in which sugar molecules bind to lipids or proteins, forming substances called advanced glycation end products (AGEs), which damage the proper functioning of the lipids or proteins. Dietary sugar plays a pivotal role in the development of AGEs. AGEs are associated with various health conditions and can negatively impact the health of the tissues they form, including the skin.
Collagen and elastin fibers are proteins that help maintain the skin's youthful structure. Glucose and fructose bind to these fibers, forming AGEs in the skin and impairing skin structure. This AGE formation in the skin leads to wrinkles, poor skin elasticity, yellowing or browning of the skin, and impaired skin wound healing.
Diets high in sugar are also associated with the development of acne, as well as the severity of acne.
Processed Sugars Affect on Cancer Risk
Sugar is associated with increased inflammation, oxidative stress, and insulin resistance, which are all risk factors for cancer. A study evaluating the association between cancer risk and sugar consumption found that higher total sugar intake increased the overall risk for cancer. Breast cancer risk was specifically identified as increasing with higher sugar consumption.
Activating insulin pathways that result from processed sugar intake may be responsible for enhancing tumor growth and lowering breast cancer survival. Evidence shows that breast cancer survivors with the highest consumption of sugar-sweetened beverages have a higher risk for both breast cancer-specific and all-cause mortality.
Processed Sugars Affect on Dental Health
Many people come to know the impact of sugar on dental health at a young age. If you have childhood memories of your dentist drilling into your teeth and reminding you to lay off the candy, you're not alone. Over 52% of children between ages 6 and 8 have had a cavity in their baby teeth, and added sugars are a leading cause of that tooth day. Eating large amounts of processed sugar leads to dental plaque build-up, tooth decay, and cavities.
As we get older, the significance of this issue becomes even more amplified. Up to 80% of the world is affected by dental caries, and almost a quarter of adults in the US have untreated cavities. Caries is considered a lifelong progressive disease.
The World Health Organization (WHO) recommends free sugar intake to be less than 5% of total energy intake based on a systematic review of the evidence. The evidence indicates that intake of free sugar above 5% is associated with a higher incidence of dental caries.
Which Sugars Should We Avoid?
The sugars that should be avoided include simple carbohydrates or processed sugars. These are monosaccharides or disaccharides. Monosaccharides are single, unbound, or free molecules of sugar, most often glucose or fructose. Disaccharides are two single sugar molecules bound together, most often glucose and fructose.
Simple carbohydrates, or processed sugar, include the following:
- Sucrose (table sugar)
- Corn syrup or high fructose corn syrup (HFCS)
- Agave nectar
- Maple syrup
- Dextrose (a simple sugar that’s chemically identical to glucose)
- Cane syrup
- Concentrated fruit or vegetable juices
Are There Any Safe Sugars to Consume?
Sugars that are safe to consume include those naturally found in fruits and vegetables in their whole food form (not juiced or processed). Fruits and vegetables in their whole food form also contain fiber, which slows the digestion of sugar and results in more stable blood sugar levels. Fruits and vegetables also contain vitamins, minerals, and nutrients that contribute to better overall health.
Which Nutrition Plans Are Best For Avoiding Processed Sugar?
Some specific nutrition plans avoid processed sugar and instead focus on nutrient-dense foods. These diets are associated with better health and well-being.
The DASH diet, which stands for Dietary Approaches to Stop Hypertension, is an eating plan designed by the National Institutes of Health (NIH). This nutrition plan was designed to address high blood pressure, both as a treatment and prevention. This diet is low in saturated and trans fats, salt, and processed sugar. The DASH diet focuses on nutrient-dense and high-fiber foods in their whole, natural form and includes fruits and vegetables, beans, whole grains, low-fat dairy, fish, and poultry.
You can find more information on the DASH diet here.
As you might expect, the Mediterranean Diet is a way of eating inspired by the traditional cuisines of people in the Mediterranean region. This eating plan focuses on nutrient-dense foods in their whole form, including seasonal fruits and vegetables, herbs, whole grains, legumes and beans, and healthy fats, emphasizing olive oil. The focus of this nutrition plan is on high-fiber plant-based foods; however, it also allows for poultry, seafood, eggs, dairy, and red wine to be consumed in moderation. Avoidance of added sugars and sugar-sweetened beverages is recommended with this eating plan.
You can find more information on the Mediterranean Diet here.
Blue Zone Diet
Blue Zones are the five areas in the world with the highest percentage of people living to be 100 years or older (centenarians). These areas are Loma Linda, California; Nicoya, Costa Rica; Sardinia, Italy; Ikaria, Greece; and Okinawa, Japan. The Blue Zone diet is a set of guidelines based on how the people in these zones eat.
This eating plan consists of eating 95-100% plant-based foods. Meat, fish, eggs, and dairy are consumed only in small amounts. Legumes and nuts are consumed daily. When bread is consumed, it is sourdough or whole wheat. Other principles include eating whole food, drinking mainly water (coffee, tea, and red wine in moderation), and reducing sugar intake.
There are other lifestyle principles associated with the Blue Zones, and you can find more information on these principles and more in-depth information on the Blue Zone diet here.
The Paleo Diet is based on how our Paleolithic ancestors are thought to have eaten. A Paleo eating plan includes fruits and vegetables, lean meat, seafood, nuts, and seeds. This eating style emphasizes fiber-rich foods, is high in protein, and is moderate in healthy fats. Added or processed sugars, dairy products, legumes, and grains are limited or avoided in this nutrition plan, as our Paleolithic ancestors couldn't access or consume them.
You can find more information on the Paleo diet here.
Excessive sugar consumption has risen to staggering levels globally and has a multitude of negative consequences regarding our overall health. When that innocent daily sugary beverage comes with a side of risks like diabetes, Alzheimer's disease, and cancer, it's cause to rethink what's in your cup.
Thankfully not all sugars are damaging to your health, and nature provides plenty of options. You can enjoy a nutritious and satisfying eating plan that avoids or limits added processed sugars, reducing your risk for chronic diseases and supporting your best health and well-being.
If you're concerned about your processed sugar consumption, talk to your Functional Medicine practitioner about which of these nutritional plans may be right for you.