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Sugar : What we must know

Sugar and fat are two food items that have seen massive change in opinions over time and honestly it admitted we still do not know a lot. That is why science must always be seen as ----what we know with current knowledge. Tomorrow only tomorrow we will know.

Sugars are carbohydrates. Like all carbohydrates, they provide a source of energy in our diet. Sugar is a term that includes all sweet carbohydrates, although the term is most often used to describe sucrose or table sugar, a ‘double sugar’.

The body breaks down carbohydrates into simple sugars such as glucose, that can be readily used in the body. There are several different sugars. Sugars occur naturally in some foods, such as fruit and dairy products, and are also added to a wide variety of foods. Sugar can take many different forms, including white, raw, or brown sugar, honey, or corn syrup. Too much sugar in diet can make diet high in kilojoules or 'energy dense' and can contribute to health problems like obesity, diabetes, and tooth decay.

Refined (or processed) sugar provides a quick, simple source of energy, but it does not contain other nutrients such as vitamins and minerals. Sugars are popular in the processed food industry because they add taste, colour, bulk and thickness to food products. They also prevent mold forming and act as a preservative.

Sugar in moderation A ‘moderate’ intake of refined sugar can be an acceptable part of a healthy diet. Experts define a moderate intake as about 10% of total energy intake per day. However, people who consume a lot of sugary food and drinks at the expense of more nutritious food choices, may be taking in a lot of ‘empty calories.

Adding a little sugar to nutritious grain foods, such as wholegrain bread and cereals, may encourage people to eat more of these foods by making them tastier.

 Sugar and obesity

The overall quality of the available evidence for changes in body weight in relation to both increasing and decreasing sugar intake in adults and children is moderate. However, there is general agreement that energy (kilojoules) above the body’s needs will be stored as fat. Sugar is a form of carbohydrate and it provides the same amount of energy or kilojoules (kJ) per gram as other forms of carbohydrates found in breads, rice, pasta, and fruits. One gram of carbohydrate provides 16kJ of energy. One gram of fat provides 37kJ. Therefore, fats in food contribute double the energy than the equivalent amounts provided by sugar. Although sugar provides less energy than fat, it can contribute to the ‘energy density’ (number of kilojoules) of foods and drinks. It is easy to overindulge in foods, especially drinks, with high sugar content. Having too much sugar adds to the amount of kilojoules in food and in overall diet. Eating too much of any food, especially those high in sugar, without doing enough exercise, will cause one to become overweight.

How much sugar is recommended?

In 2015, the World Health Organization (WHO) developed evidence-based recommendations on the intake of sugars to reduce the risk of disease risk in adults and children, with a particular focus on the prevention and control of unhealthy weight gain and dental caries (decay):

WHO recommends a reduced intake of free sugars throughout the life course (strong recommendation). In both adults and children, WHO recommends reducing the intake of free sugars to less than 10% of total energy intake (strong recommendation).

Soft drinks are high in sugar Sweetened drinks are heavily advertised, cheap and commonly available. They include soft drinks, cordial, energy drinks, sports drinks, fruit drinks and flavored mineral waters. 300 ml of cold drinks provide around 8 sugar spoons.

Carbohydrates and glucose

Body breaks down carbohydrates and converts them into a simple sugar called glucose. This ready form of energy is carried through the blood and delivered to every cell. The supply of glucose needs to be constant and dependable, so body has developed a number of systems to ensure this supply. For instance, the pancreas secretes a hormone called insulin that regulates the amount of glucose in the blood. Insulin allows glucose to enter body cells. It also helps with the storage of excess glucose in the liver, which supplements blood glucose levels if they start to fall. A person with diabetes has either insufficient or inefficient insulin, which means their blood glucose levels tend to be too high. There are 2 types of diabetes: type 1 diabetes type 2 diabetes.

 Type 2 diabetes is associated with overweight and obesity and can be controlled, or even reversed, through dietary modification. A small amount of sugar is safe for people with diabetes There is no evidence that a diet high in sugar directly causes either type 1 or type 2 diabetes. However, being overweight or obese is a risk factor for type 2 diabetes. Early evidence shows that some people with type 2 diabetes who are overweight and recently diagnosed can reverse type 2 diabetes if they are able to achieve significant weight loss. In the past, people with diabetes were told to avoid eating all foods containing refined sugar. This was because it was believed the sugar would have a bad effect on their blood glucose levels. However, more recent research on the glycaemic index (see below) has shown that sugar affects blood glucose levels less than some other more starchy foods, like refined bread and breakfast cereal. People with diabetes can have a small amount of sugar in their diet. If you are adding sugar, it is best to add it to healthier foods such as wholegrain breads and cereals. People with diabetes should limit or avoid foods in which the main ingredient is sugar, such as sweets and cakes. It is also important to maintain a healthy weight to manage diabetes.

Glycaemic index A food’s glycaemic index (GI) refers to how quickly the carbohydrate is broken down and absorbed into the bloodstream. ‘High GI’ foods enter the bloodstream more quickly than ‘low GI’ foods, causing a greater increase in the level of blood glucose (this is known as the body’s ‘glycaemic response’). The lower the GI, the slower the rise in blood glucose levels will be when the food is consumed. The effect may differ from person to person. Recent studies have suggested a link between foods with a high GI and a number of conditions including: abdominal obesity type 2 diabetes high cholesterol hypertension (high blood pressure) heart disease. There is no direct relationship between a food’s glycaemic index and the degree of processing, level of fiber or even sugar in the food. Some vegetables may even be high in GI. A healthy diet can include moderate amounts of sugar together with a range of low GI carbohydrate choices. People with diabetes need low GI foods The glycaemic index is a useful tool for people with diabetes to help regulate their glucose levels. People with type 2 diabetes need the glucose in their diet to be absorbed slowly. They need to eat foods with a low GI. At least one low GI food is recommended at each meal. The quality and quantity of carbohydrate foods eaten will also affect blood glucose levels. People respond differently to different foods, regardless of the food’s glycaemic index. If you have diabetes, you will need to monitor your blood glucose levels regularly.

Sugar and attention deficit hyperactivity disorder There is no evidence to suggest a direct link between attention deficit hyperactivity disorder (ADHD) and the consumption of sugar.

Tooth decay and sugar

Sugar and tooth decay are closely linked. Dental plaque is a clingy film made up of food particles, bacteria and mucous. The bacteria in plaque depend on sugars to produce acids, which break down the enamel and start tooth decay. All carbohydrates contribute to this process, not just sugar, but large amounts of sugar in sweets and soft drinks are most likely to contribute to decay. Other nutritious foods (like dried fruits) also allow the bacteria in plaque to produce acids. Sticky sugars that cling to the teeth are worse than sugars that are easily swallowed, such as fresh fruit. Ways to reduce the risk of tooth decay include: Cut down on sticky, sugary foods like gummies. Drink water instead of cordials, soft drinks, and juices. Allow at least 2 hours between meals. Brush and floss regularly and after meals.

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