Sugar intake

How Much Does Sugar Contribute to Obesity?

Posted by

0


Last week, the British Medical Journal published a review article titled “Dietary Sugars and Body Weight”, concluding that “free sugars” and sugar-sweetened beverages contribute to weight gain.  But what are “free sugars”, and why does the scientific literature suggest that the relationship between sugar intake and body weight isn’t as straightforward as it may initially appear?



In a new review paper (meta-analysis), Lisa Te Morenga and colleagues review the studies evaluating the link between certain types of sugar intake and body weight in adults and children.  These studies include both observational studies and randomized controlled trials.  They conclude that the intake of “free sugars” and sugar-sweetened beverages are linked with higher body weight in both groups (1).

This conclusion appears sound and I have no quibbles with it.  But what are “free sugars”?  And why does this conclusion seem to be at odds with an older literature suggesting that people who eat more sugar tend to be leaner?

What are “free sugars”?

Here is the definition of “free sugars” they provide in table 1 of the paper, which is a standard definition used by the World Health Organization and the Food and Agriculture Organization:

All monosaccharides and disaccharides added to foods by the manufacturer, cook, or consumer; sugars naturally present in honey, syrups, and fruit juices.

So the term  refers to added sugars and fruit juices, but excludes the sugar that occurs naturally in fruit.  Importantly, it doesn’t refer to total sugar intake, but rather to a major component of total sugar intake.

In plain language then, what the authors found is that added sugar and sweet beverage consumption are associated with a higher body weight in observational studies.  In controlled trials, these sugars increased body weight when calorie intake wasn’t held constant, and had no effect on body weight when calorie intake was held constant.  For me, this conclusion is consistent both with the scientific literature I’ve read, and with common sense.

They do state in the paper that their result applies to specific types of sugar intake, rather than total sugar intake, but at certain points it sounds as if they’re referring to total sugar intake.  For example, the title of the paper doesn’t specify that the paper is specifically about added sugars and sweet beverages.  This could easily lead to misunderstandings about what they actually found.

The relationship between sugar intake and body weight is more complex than you may realize

When I first skimmed through the paper, I thought it was about total sugar intake, and I was surprised to see that they found an association between sugar intake and a higher body weight.  Why?  Because most of the observational studies that have examined the association between total sugar intake and body weight have found that people who eat more total sugar weigh less.  And the remaining studies found no association.  There is virtually no observational evidence that people who eat more total sugar weigh more than people who eat less, or gain more weight over time.

The hypothesis that sugar intake could be linked to weight gain is a pretty obvious one, and it’s been around for a long time.  Consequently, many observational studies have evaluated it, beginning in the 1970s.  James Hill reviewed these studies back in 1995 (2), concluding:

Carbohydrates, particularly refined sugars, are still widely assumed to be fattening. However, there is now a substantial body of epidemiologic evidence refuting this view…  Almost all of the above studies support the contention that a high-carbohydrate, high-sugars diet is associated with lower body weight and that this association is by no means trivial.

Whether or not you agree with this hypothesis, it’s still pretty interesting to note the marked difference between this conclusion and the result recently published by Te Morenga and colleagues, particularly since many of the same studies were available to be included in both review papers.

A major difference between the two review studies is that Hill was concerned with total sugar intake, while Te Morega was concerned with added sugars and sweet beverages specifically.  Today, few diet-health observational studies focus on total sugar intake as an outcome; usually the outcomes are focused on sugar-sweetened beverages, fruit intake, or other subsets of sugar intake.  Maybe people got tired of seeing that total sugar intake is associated with leanness?  Maybe the finding isn’t novel enough anymore?  Or maybe it just makes the sugar-health story a little too complicated?  I find it a bit strange, personally.

These are observational studies we’re talking about here, so we do have to be cautious about interpreting them.  Who knows how well self-reported sugar intake, and components of sugar intake, actually correspond to real intake.  And who knows to what extent differences in body weight are caused by differences in sugar intake, rather than other things that are associated with sugar intake.

Still, I think when we look at all of the data together, including the two papers I discussed in this post, a fairly logical and consistent picture emerges: added sugars and sweet beverages tend to be fattening because they lead us to eat too many calories, but whole fresh fruit isn’t fattening and probably actually tends to be slimming.  When it comes to body weight, it’s not so much the sugar itself, but the way in which it’s packaged.

Sugar is more addictive than cocaine and a serious epidemic

Posted by

0


Sugar damage: Consumption of excess and added sugar is an epidemic.

It’s difficult to stave off sugar cravings once you’ve gotten started. For some, a box of chocolates or a pint of Ben and Jerry’s means that the whole box or pint will be downed in one sitting. For others, two to three Starbucks runs per day probably won’t seem too strange, despite the loads of sugar that are pumped into most of the beverages on the menu.

We think that of course, in moderation, our sugar intake is for the most part harmless. Maybe we have one mocha a day instead of three. Maybe that box of chocolates lasts a week or more. But for many, sugar cravings are signifiers of a very serious and hard to reverse addiction that is similar to a drug and quite possibly just as destructive, reported Burlington County Times, Jan. 4.

According to Burlington, the average person consumes 285 calories worth (20 teaspoons) of sugar per day (one 12 oz. soda contains 8-10 teaspoons of sugar on its own. That’s just under half a cup of sugar and something like 14 teaspoons too many. For those who are addicted, sugar cravings can be so great that “you can’t stop eating it, you lose control eating it and you gain excessive weight from it,” said Dr. Fred Bonanni, director of Abington Health’s Institute for Metabolic and Bariatric Surgery in Pennsylvania. It’s an epidemic that sees Americans eating 156 pounds per year, often times without their knowledge. This is a scary and dangerous fact. According to the New York Daily News, sugar “is eight times more addictive than cocaine.”

Much of the sugar that is consumed in America comes from processed foods and sweetened drinks. Burlington notes that even things like ketchup and spaghetti sauce have sugar added. It’s not just the Coca Cola or cookies that you have to watch out for. Look at the labels of your trusted “healthy” cereal, or your teriyaki sauce, for instance.

Here’s the kicker. The body does need sugar in the form of glucose in order to function properly. In the case of added sugars, which offer no nutritional value aside from energy, caution should be heeded. According to the World Health Organization, added sugar should not exceed 10% of anyone’s daily intake of foods. The American Heart Association recommends sugar intake to take up 7% or less of our daily caloric intake. That means a cut back is in order of bagels and other breads, chips, canned and packaged fruits, yogurt, and many other grocery items high in added sugar content which may shock you.

One of the reasons sugar is so addictive is that when it is processed in the body, it literally “activates the brain’s reward center, where a neurotransmitter called dopamine, or DRD2, triggers sensations of pleasure.” And often, sugar consumption causes a “sugar high” that is also followed by a low. Even those who are really good at eating sugar in moderation have probably experienced this. Many try to get back to the high. “You get this rush, your blood sugar drops and you feel crappy and tired and worn out. You put more sugar in to get the same response, and it becomes this vicious cycle,” said Bonanni. In no time at all, you’re back up to three mochas a day and a box of chocolates. Beyond that, there could be more sugar added to your day, as the more sugar consumed causes a higher level of sugar intake needed in order to reach that sugar high.

It takes a lot of discipline to wean yourself from consuming excess sugar. It is, however, pertinent to wean yourself. Consumption of excess sugar causes things like diabetes, excess fat, depression, migraines, poor eyesight, arthritis (and other autoimmune diseases), gout and osteoporosis. The best bet would be to wean yourself completely from excess and added sugars. But don’t go cold-turkey. If you make changes over time, there will be less chance of relapse into the vicious cycle of sugar highs and lows.

WHO: Sugar intake ‘should be halved’

Posted by

0


People will be advised to halve the amount of sugar in their diet, under new World Health Organization guidance.

The recommended sugar intake will stay at below 10% of total calorie intake a day, with 5% the target, says the WHO.

The suggested limits apply to all sugars added to food, as well as sugar naturally present in honey, syrups, fruit juices and fruit concentrates.

UK campaigners say it is a “tragedy” that the WHO has taken 10 years to think about changing its advice.

The recommendation that sugar should account for no more than 10% of the calories in the diet, was passed in 2002.

It works out at about 50g a day for an adult of normal weight, said the WHO.

Continue reading the main story

“Start Quote

It is a tragedy that it has taken 10 years for the WHO to think about changing their recommendation on sugar”

Katharine JennerAction for Sugar

However, a number of experts now think 10% is too high, amid rising obesity levels around the world.

Announcing the new draft measures, the WHO said in a statement: “WHO’s current recommendation, from 2002, is that sugars should make up less than 10% of total energy intake per day.

“The new draft guideline also proposes that sugars should be less than 10% of total energy intake per day.

“It further suggests that a reduction to below 5% of total energy intake per day would have additional benefits.”

Dr Francesco Branca, WHO’s nutrition director, told a news conference that the 10% target was a “strong recommendation” while the 5% target was “conditional”, based on current evidence.

“We should aim for 5% if we can,” he added.

Facts about sugar

  • Evidence shows most adults and children in the UK eat more sugar than is recommended as part of a healthy balanced diet
  • Food and drinks that have a lot of added sugar contain calories, but often have few other nutrients
  • Sugary foods and drinks can also cause tooth decay, especially eaten between meals
  • Sugar found naturally in whole fruit is less likely to cause tooth decay than juices or blends because the sugar is contained within the body of the fruit
  • Source: NHS Choices.

The plans will now go for public consultation, with firm recommendations expected this summer.

Public Health England said its scientific advisory committee on nutrition was reviewing evidence on sugar in the UK diet.

Director of Nutrition and Diet, Alison Tedstone, said: “Our surveys show that the UK population should reduce their sugar intake as average intake for adults is 11.6% and for children is 15.2%, which is above the current UK recommendation of 10%. ”

Campaign group, Action for Sugar, said it was pressing for 5% to become the firm recommendation.

Nutritionist, Katharine Jenner, said: “It is a tragedy that it has taken 10 years for the WHO to think about changing their recommendation on sugar, which will have had astronomic implications on the millions affected by obesity and type 2 diabetes the world over. ”

The WHO guidelines are based on a review of scientific evidence on the health impact of sugar, including damage to teeth and the effect on obesity.

The obesity study, published last year in the BMJ, found while sugar did not directly cause obesity, those who consumed a lot of it, particularly in sweetened drinks, tended to put on weight as sugary food did not make them feel full.

A review of the link between sugar intake and tooth decay, carried out by UK researchers, found cases of tooth decay were lower when sugar made up less than 10% of daily calories.

Paula Moynihan, Professor of Nutrition and Oral Health at Newcastle University, said: “The less sugar you eat, the lower your risk of dental decay.”

Prof Tom Sanders of the School of Medicine, King’s College London, said a limit of 5% added sugar “would be very tough to meet”.

He added: “5% is untried and untested; 10% we can live with.”

Dr Nita Forouhi, of the Medical Research Council Epidemiology Unit at the University of Cambridge, said the 5% target was “ambitious, and challenging”.

On Tuesday a leading doctor called for a tax on sugar to help combat growing levels of obesity.

Dame Sally Davies, England’s Chief Medical Officer, told MPs: “We may need to move toward some kind of sugar tax, but I hope we don’t have to. “