With the holiday season coming up, there is sure to be more sugar on offer. But when it comes to sweet treats, we’re often in a bind. If you’re at a party and there are wonderful cakes and desserts, you feel you’re missing out if you don’t partake but guilty if you do.
Your doctor or dietitian has told you to avoid refined sugar, and maybe you promised your partner you’d cut back. You’re not alone. “We can’t not use sugar,” said Ria Catsicas, a registered dietitian based in Johannesburg. “In normal life, there are parties and special events. Unhealthy foods serve a purpose. For most of us, if we don’t partake, we feel deprived.”
To stay on the safe side, refined sugar should be less than 10% of the total energy intake of your diet, she said. The American Heart Association recommends no more than nine teaspoons (36g) of added sugar a day for men and no more than six teaspoons (24g) for women. But Catsicas said a good guideline is four teaspoons for women and six teaspoons for men.
However, how much sugar you can safely consume depends on your health status, for example, whether you are fit and exercise or are pre-diabetic or diabetic. Your age, gender, height, budget, fitness levels, weight status, health and lifestyle all play a role. “If you have a condition such as gout, heart disease, high cholesterol and type 2 diabetes, you have to be stricter with sugar.”
Functional medicine specialist Dhesan Moodley said refined sugars are strongly linked with inflammation in the body. “Hence, they can exacerbate inflammatory conditions such as connective tissue disorder (arthritis) and heart disease.”
People who have high cholesterol also need to cut down on sugar. “High blood glucose levels affect the health of the arteries. They lose functionality and elasticity, and their capacity to pump oxygen and nutrient-rich blood to the heart diminishes. The arteries become more inflamed and this affects the health of the heart,” said Catsicas.
She said 60% of South Africans are overweight or obese and they should especially watch their intake of added and refined sugars. “Refined sugar is devoid of fibre. It is a processed, concentrated product,” said Catsicas, adding that consuming sugar-based fizzy cold drinks, cordials and fruit juices is especially problematic. “When we consume sugar as a liquid there is a high and sudden rise in the blood-glucose level. The pancreas has to release a high amount of insulin to get the levels back to normal, namely between four and seven. This exhausts the beta cells in the pancreas as they have to work harder. Over time it causes these cells to produce less insulin, lose their functionality and die off.”
She said we do not need a sugar boost during the day. “Healthy food divided into three meals a day will provide enough energy. When you feel you’re not getting through the day and you need the energy boost that sugar gives, you must first ensure you eat proper meals with good-quality, high fibre carbs that are unprocessed. This ensures your blood sugar levels don’t drop too low.
“Sugar momentarily raises blood glucose levels; it boosts them and then dumps them, and you feel tired. White flour and white bread have the same effect: sandwiches, chips, French fries and chocolates cause dysregulation in blood sugar levels. It becomes a rollercoaster.”
Catsicas said a healthy pancreas can cope with some dysregulation. “But when you are pre-diabetic or diabetic, the pancreas is not functioning at full capacity or producing an adequate amount of insulin. Consuming too much sugar and white flour carbohydrates adds an extra workload to the beta cells of the pancreas. In cases like these, you need to be stricter and avoid sugar 100%. Otherwise you are killing beta cells and creating a highway to diabetes. Use sugar-free cold drinks and sugar-free cordials. A 300ml glass of Oros, for example, contains five teaspoons (25g) of sugar. A 340ml can of Coke contains seven teaspoons (35g). Control the amount and frequency of eating all types of sweets and chocolates. About 100g of sweets and chocolates (milk and dark) contains 18 (90g) and eight teaspoons (40g) of sugar, respectively.”
We may be ingesting sugar without knowing it, in condiments such as chutney and tomato sauce. “This is OK because we use them with other foods, as part of a meal, in a small quantity. Food buffers the effect. You should use condiments and sauces to make your food tasty. They do not cause a high blood-glucose response when used in moderation,” said Catsicas.
You need only worry about high-sugar foods. “If you buy sweets, buy a small quantity. Do not buy a lot and keep them in the house. Buy them for weekends, celebrations, braais, and so on. Have them after a meal. Limit the availability and visibility. If you have a bowl of sweets on display on your table, you may end up eating them every day. A maximum of 20% of all the food you consume in a week can be high-sugar foods such as dessert. Enjoy them once a week, not every day. The same applies to cool drinks and fruit juices.
“Use discernment. If it’s a cheap sponge cake from the supermarket for a colleague’s birthday, say no. But if you’re at a special birthday party and there’s a lovely cake, have one or two pieces.”
When it comes to children, the same rules apply. “Serve high-sugar foods only at a party or on the weekend, but not in their lunchbox.”
While some of us can walk past a sugary treat, many of us feel drawn to it like bees to a honeypot. We experience craving. “It has been said that sugar is the most powerfully addictive substance known to man,” said Moodley. “As such, it is really difficult to give up. It takes strong motivation, and often the assistance of medical professions and certain medications, to avoid these cravings. Similar to other addictions, even if you are sugar free for a while you can retrogress if you have sugar again.”
It can also affect our mood. Catsicas said that when you eat sugar, your blood-glucose level increases, but then it dips. “This equals low serotonin levels, which play a role in appetite regulation. You crave more sugar partly to boost your mood. In addition, sugar mobilises dopamine and opioids, brain substances that act on the pleasure and reward centres of the brain. When sugar is consumed in excess, it hardwires the neural pathways, and you crave more sugar.”
Honey is not a healthier alternative to sugar as it has the same effects on blood glucose levels as white or brown sugar, she said. “To limit your sugar intake, artificial sweeteners can be used. To date, no good research has proved one sweetener superior to another. Use a sweetener that you enjoy, but limit the quantity.”
Much of the information on the internet about artificial sweeteners is not based on good evidence-based research, she said. “There are no conclusive studies that show that if you have aspartame or stevia, you will develop adverse health effects such as headaches or cancer. If you have a large amount of artificial sweetener, it can affect the health of the gastrointestinal tract. Therefore, they should be used in moderation.
“Sweeteners in small quantities are OK for a healthy person and, again, save them for a special occasion. Many pre-diabetic and diabetic people use sweeteners, for example, in sugar-free chocolate. No human studies have been done regarding the harmful effects. We are not rats. Some people have been on sweeteners for 20 years and have not developed cancer.”
If you are unsure about how much sugar you can safely consume or need help reading labels, Catsicas recommends seeing a dietitian. “How much sugar you can use is individual.”
