tag:theconversation.com,2011:/au/topics/sugar-series-50720/articlesSugar series – The Conversation2018-03-09T04:54:12Ztag:theconversation.com,2011:article/920302018-03-09T04:54:12Z2018-03-09T04:54:12ZYes, too much sugar is bad for our health – here’s what the science says<figure><img src="https://images.theconversation.com/files/209644/original/file-20180309-30954-1lyaz7h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">More than half of Australians consume too much sugar.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/-vgLTTWPesg"> Sharon McCutcheon</a></span></figcaption></figure><p><em>This is the final article in our four-part series on sugar. Catch up on the other instalments on <a href="https://theconversation.com/white-brown-raw-honey-which-type-of-sugar-is-best-91074">how the different types of sugars compare</a>, whether it’s <a href="https://theconversation.com/if-sugar-is-so-bad-for-us-why-is-the-sugar-in-fruit-ok-89958">better to substitute sugar with fruit</a>, and <a href="https://theconversation.com/you-dont-need-to-quit-sugar-to-improve-your-health-92032">why you don’t necessarily have to quit sugar to be healthy</a>.</em></p>
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<p>The <a href="http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/">World Health Organisation recommends limiting</a> “free sugars” to less than 10% of our total energy intake. This equates to around 12 teaspoons a day for an average adult.</p>
<p>But more than <a href="http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.011">half of Australian adults exceed this limit</a>, often without knowing. “Free sugars” don’t just come from us sweetening coffees and teas or home-cooked dinners; they are added by manufacturers during processing. </p>
<p>It’s often a surprise to learn just how many teaspoons of sugar are added to popular foods and drinks:</p>
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<img alt="" src="https://images.theconversation.com/files/209425/original/file-20180307-146697-dz17ou.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/209425/original/file-20180307-146697-dz17ou.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=796&fit=crop&dpr=1 600w, https://images.theconversation.com/files/209425/original/file-20180307-146697-dz17ou.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=796&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/209425/original/file-20180307-146697-dz17ou.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=796&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/209425/original/file-20180307-146697-dz17ou.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1000&fit=crop&dpr=1 754w, https://images.theconversation.com/files/209425/original/file-20180307-146697-dz17ou.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1000&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/209425/original/file-20180307-146697-dz17ou.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1000&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><span class="source">The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p>Most of the concern about excess sugar consumption has been focused on weight gain, and rightly so. Our livers can turn <a href="https://www.ncbi.nlm.nih.gov/pubmed/15640457">sugar into fat</a>. Too much sugar – and too much soft drink, in particular – can cause fat to <a href="https://www.ncbi.nlm.nih.gov/pubmed/22205311">be deposited on our waist</a>. This is known as visceral fat. </p>
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Read more:
<a href="https://theconversation.com/health-check-how-much-sugar-is-it-ok-to-eat-57345">Health Check: how much sugar is it OK to eat?</a>
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<p>Visceral fat is especially harmful because it increases the risk of heart disease and <a href="https://theconversation.com/explainer-what-is-diabetes-11842">type 2 diabetes</a>, even when blood sugar levels are higher than normal. </p>
<p>But what does the science say about sugar and the raft of other conditions we see in the headlines every other week? Let’s look at two examples: dementia and cancer. </p>
<h2>Dementia</h2>
<p><a href="https://www.dementia.org.au/statistics">Dementia</a> is an umbrella term for brain disorders that cause memory loss, confusion and personality change. It’s the greatest cause of disability among older Australians and the third-biggest killer. Alzheimer’s disease is one type of dementia. </p>
<p>The research does not show that sugar <em>causes</em> dementia. But there is emerging research that suggests high-sugar diets may increase the risk of developing the disease. What we can say is that there is a <em>link</em> between high-sugar diets and dementia, but we don’t have evidence to show that one <em>causes</em> the other.</p>
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<img alt="" src="https://images.theconversation.com/files/209648/original/file-20180309-30979-1xpvyov.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/209648/original/file-20180309-30979-1xpvyov.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/209648/original/file-20180309-30979-1xpvyov.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/209648/original/file-20180309-30979-1xpvyov.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/209648/original/file-20180309-30979-1xpvyov.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/209648/original/file-20180309-30979-1xpvyov.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/209648/original/file-20180309-30979-1xpvyov.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Too much sugar makes us gain weight but there are also other ways it an increase our risk of diseases.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/my-homemade-cookies-1041261127?src=zL3rxEXeAsf26huf4imRdg-1-98">Giuliana M/Shutterstock</a></span>
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<p>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899713/">2016 New Zealand study</a> of post mortems on human brains assessed seven different regions of the brain. The researchers found that the areas of greatest damage had significantly elevated levels of glucose (sugar). Healthy cells don’t usually have elevated levels of glucose. </p>
<p>This was also found in a <a href="https://www.ncbi.nlm.nih.gov/pubmed/29055815">separate analysis</a> of post-mortem brain and blood samples from Baltimore in 2017. Using blood samples collected from the patients over a 19-year period before they died, the brain glucose concentration at death was found to be highest in those with Alzheimer’s disease. What’s more, this glucose level had been slowly increasing for years. </p>
<p>The levels of blood glucose were not indicative of diabetes. So otherwise healthy people could have rising levels of glucose in the brain well before any obvious signs of disease prompt any action. </p>
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Read more:
<a href="https://theconversation.com/how-australians-die-cause-3-dementia-alzheimers-57341">How Australians Die: cause #3 – dementia (Alzheimer's)</a>
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<p>Together, these studies tell us that the brains of people with Alzheimer’s disease struggle to metabolise sugar for energy. The changes in the brain seem to be linked to persistent increases in blood glucose over a long period of time. And the damage to brain cells is occurring well before overt symptoms of Alzheimer’s appear. </p>
<p>We don’t know if simply consuming high amounts of sugar results in the build-up of glucose in the brain. But other research also supports this theory.</p>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pubmed/28274718">recent analysis</a> of more than 3,000 people found that those who drink sugary beverages were more likely to have smaller brains and perform worse on a series of memory tests.</p>
<p>The researchers calculated that consuming one to two or more sugary drinks per day could be equivalent to up to 13 years of additional brain ageing. And a separate analysis of soft drink versus fruit juice reported similar affects. </p>
<h2>Cancer</h2>
<p>Cancer is a condition in which the cells in the body mutate and rapidly multiply. It’s Australia’s <a href="https://theconversation.com/how-australians-die-cause-2-cancers-58063">second biggest killer</a> and will affect <a href="https://canceraustralia.gov.au/affected-cancer/what-cancer/cancer-australia-statistics">half of Australians</a> if they live to 85. </p>
<p>There is no evidence that sugar <em>causes</em> cancer, but there are at least two ways in which they are <em>linked</em>. </p>
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<img alt="" src="https://images.theconversation.com/files/209646/original/file-20180309-30961-j85v2g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/209646/original/file-20180309-30961-j85v2g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/209646/original/file-20180309-30961-j85v2g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/209646/original/file-20180309-30961-j85v2g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/209646/original/file-20180309-30961-j85v2g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=423&fit=crop&dpr=1 754w, https://images.theconversation.com/files/209646/original/file-20180309-30961-j85v2g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=423&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/209646/original/file-20180309-30961-j85v2g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=423&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Too much soft drink can cause fat to be deposited on your waist.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/bangkok-thailand-march-3-2018-cocacola-1037436079?src=tyUcUqjJXaH9HooxJ-rF2g-2-9">Dilok Klaisataporn/Shutterstock</a></span>
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<p>First, if you are overweight or obese, you have an <a href="https://www.wcrf.org/int/cancer-facts-figures/link-between-lifestyle-and-cancer-risk">increased risk</a> of developing 11 different types of cancer. Consuming too much sugar (and too many kilojoules overall) leads to weight gain, which increases the risk of cancer. </p>
<p>A second, more direct pathway linking sugar to cancer is the capacity for sugar to stimulate insulin secretion. This is a potent hormone signal for cell growth. Cancer cells also <a href="https://www.ncbi.nlm.nih.gov/pubmed/19460998">rely on sugar for energy</a> to fuel their continual growth.</p>
<p>This suggests that independent of any change in your weight, consuming too much sugar may increase your risk of developing cancer.</p>
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Read more:
<a href="https://theconversation.com/how-australians-die-cause-2-cancers-58063">How Australians Die: cause #2 – cancers</a>
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<p>But we need to be cautious about the quality of data available directly linking cancer to sugar consumption. </p>
<p>A <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/consumption-of-sugarsweetened-and-artificially-sweetened-soft-drinks-and-risk-of-obesityrelated-cancers/14DB5E8634853560209984B07CED68B1#">recent study of 35,000 people</a>, for instance, reported a link between higher obesity-related cancer risks and heavy consumption of soft drink. But the authors point out that it was impossible to specifically separate drinking soft drinks from other unhealthy behaviours, such as smoking or lower levels of physical activity.</p>
<h2>What does it all mean?</h2>
<p>Much of the current discussion about sugar focuses on the effects of excess energy intake and weight gain, and the subsequent risk of diabetes, heart disease, cancer and some forms of dementia. </p>
<p>But while being overweight or obese increases your risk of these diseases, excess weight is not a prerequisite.</p>
<p>While the development of diseases are no doubt also based on genes and lifestyle factors other than diet, the evidence of the potential harms of high-sugar diets is accumulating. It’s certainly compelling enough for many to consider limiting how much sugar we eat and drink. </p>
<p>Whether or not the sugar itself is the culprit, sugary foods are linked to health problems – and that should be reason enough to cut down.</p><img src="https://counter.theconversation.com/content/92030/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kieron Rooney receives funding from the ARC and has previously received funding from the NHMRC and Meat and Livestock. Kieron is a council member of the Australian and New Zealand Obesity Society. </span></em></p>The research shows a link between high-sugar diets and diseases such as dementia and cancer. It doesn’t show that sugar causes them, but it’s compelling enough to prompt us to cut down on sugar.Kieron Rooney, Senior Lecturer in Biochemistry and Exercise Physiology, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/899582018-03-08T02:45:07Z2018-03-08T02:45:07ZIf sugar is so bad for us, why is the sugar in fruit OK?<figure><img src="https://images.theconversation.com/files/209443/original/file-20180308-146697-nzrkvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">All types of sugars will give us the same amount of calories, whether they are from fruit or soft drink.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/female-hand-holding-banana-on-blue-1040612479?src=Et-jPh8H_ZN8dtYHeL6XYQ-1-6">Shutterstock/Dulin</a></span></figcaption></figure><p><em>This is the third in a four-part series on sugar, which covers sugar-free diets, how the different types of sugars compare, and the links between sugar and disease. Catch up on the other instalments <a href="https://theconversation.com/au/topics/sugar-2207">here</a>.</em> </p>
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<p>We hear regularly from <a href="http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/">health organisations and experts</a> that we should eat less sugar. But we’re also told we should eat more fruit. </p>
<p>All types of sugar will give us the same amount of calories, whether they are from fruit or soft drink. But the health risks of eating sugar are <a href="http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/">related to consuming too many “free sugars” in the diet</a>, not from eating sugars that are naturally present in fruits or milk.</p>
<h2>Types of sugar in food</h2>
<p>Sugar in food and drinks comes in various forms. Sugar molecules are classified as monosaccharides (single sugar molecules such as glucose and fructose) and disaccharides (more complex structures such as sucrose and lactose). </p>
<p>Fruit contains natural sugars, which are a mix of sucrose, fructose and glucose. Many people have heard that sugar is bad, and think that this must also therefore apply to fruits.</p>
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Read more:
<a href="https://theconversation.com/you-dont-need-to-quit-sugar-to-improve-your-health-92032">You don't need to quit sugar to improve your health</a>
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<p>But <a href="https://www.ncbi.nlm.nih.gov/pubmed/23594708">fructose is only harmful in excess amounts</a>, and not when it comes from fruit. It would be incredibly difficult to consume excessive amounts of fructose by eating whole fruits. </p>
<p>It’s much easier to consume excess sugar from foods and drinks that contain “free sugars”. </p>
<p>Free sugars include these same sugars (fructose, glucose, sucrose), but in this case they have been removed from their naturally occurring source (rather than being eaten as natural parts of fruits, dairy products, and some vegetables and grains). This includes sugar that is added to food and drinks by food companies, cooks or consumers.</p>
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<span class="caption">The source matters most.</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
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<h2>Health risks come from free sugars, not fruits</h2>
<p><a href="http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/">Evidence</a> shows that the health risks from sugars, such as tooth decay and unhealthy weight gain, are related to consuming too many free sugars in the diet, not from eating sugars that are naturally present in fruits or milk.</p>
<p>For this reason it is recommended that no more than <a href="http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/">10% of your daily calories come from free sugars</a>. For the average adult, this is about 50g or only slightly more than the amount of sugar in a can of regular soft drink or soda. It’s estimated that Australians get around <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.011%7E2011-12%7EMain%20Features%7EHow%20much%20sugar%20was%20consumed%3f%7E8">60% (65g) of their sugar intake</a> from free sugars. </p>
<p>Foods that are sources of free sugars, such as juices, soft drinks, biscuits and lollies, are often high in calories and have little other nutritional value. It is often easy to consume more of them compared with fresh fruit and they also may be replacing other nutritious foods in the diet.</p>
<p>Consider a bottle of fruit juice – you would have to eat six whole oranges to get the same amount of sugar you consume in the juice. And because the fruit is in juice form, it counts towards your daily limit of free sugars.</p>
<p>Calories from drinks that contain sugar often become an addition to the calories you are eating from food, which may lead to weight gain over time. </p>
<p>Eating large amounts of dried fruit is also not a good idea if you are limiting your sugar intake. Through the process of removing water from the fruit, nutrients are concentrated, such that dried apricots, for example, contain about six times as much sugar (40g per 100g) as fresh apricots (6g per 100g).</p>
<h2>We need to eat fruit</h2>
<p>Unlike many foods that are high in free sugars, fruits are packaged with lots of nutrients that help provide us with a balanced diet for good health. </p>
<p>For starters, fruit is an excellent source of fibre. An average banana will provide 20-25% (6g) of your recommended daily fibre intake. Getting enough fibre in the diet is important for <a href="https://www.wcrf.org/sites/default/files/Second-Expert-Report.pdf">protecting against bowel cancer</a>. There is clear room for improvement in our fibre intake – adults in many countries consume only about half of the <a href="https://www.nrv.gov.au/nutrients/dietary-fibre">recommended amount each day</a> (25g for Aussie women and 30g for Aussie men).</p>
<p>The fibre in fruit, which is often absent in many foods and drinks with free sugars, <a href="https://www.sciencedirect.com/science/article/pii/S019566630800620X#bib30">may also help to fill you up, which means you eat less</a> overall at a meal. It’s not clear exactly why this is, but it could be related to the volume of the food (especially compared with liquids) and the chewing involved. </p>
<p>Fruit is also a good source of other nutrients such as potassium, which <a href="https://www.nrv.gov.au/nutrients/potassium">can help lower blood pressure</a>, and flavonoids, <a href="https://link.springer.com/article/10.1007%2Fs11883-013-0368-y">which may reduce</a> your risk of heart disease. </p>
<p><a href="http://www.bmj.com/content/349/bmj.g4490">There is evidence</a> that eating whole fruits (alone and in combination with vegetables) <a href="http://www.bmj.com/content/349/bmj.g4490">reduces your chances</a> of dying from cancer, obesity and heart disease.</p>
<p>Despite this, <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001%7E2014-15%7EMain%20Features%7EDaily%20intake%20of%20fruit%20and%20vegetables%7E28">only about 50% of Australians</a> eat at least two pieces of fruit per day. </p>
<p>Most national dietary guidelines encourage eating fruits and vegetables, with an emphasis on the vegetables. To try and eat your <a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups/fruit">recommended two pieces of fruit per day</a> remember that a piece could be a banana, apple or orange, or two smaller fruits like plums or apricots, or a cup of grapes or berries. </p>
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Read more:
<a href="https://theconversation.com/food-as-medicine-why-do-we-need-to-eat-so-many-vegetables-and-what-does-a-serve-actually-look-like-76149">Food as medicine: why do we need to eat so many vegetables and what does a serve actually look like?</a>
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<p>When it comes to other sources of sugars, try to choose foods that have little or no sugar listed in the ingredient list, and drink water instead of sugary beverages when you are thirsty.</p><img src="https://counter.theconversation.com/content/89958/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kacie Dickinson receives funding as an Endeavour Research Fellow from Australian Government Department of Education and Training and The Foundation for High Blood Pressure Research.</span></em></p><p class="fine-print"><em><span>As part of her PhD studies, Jodi Bernstein has received funding as a Fellow in the CIHR Collaborative Training Program for Public Health Policy, the CIHR Strategic Training Program in Population Intervention for Chronic Disease Prevention, and currently receives funding from an Ontario Graduate Scholarship. Jodi is also a co-investigator on a CIHR Sugars and Health Operating Grant and a Centre for Child Nutrition and Health Public Policy Collaborative Grant.</span></em></p>We often hear that we need to reduce our sugar intake. But don’t skimp on the fruit – eating whole fruit (not juice) is much healthier.Kacie Dickinson, Accredited Practising Dietitian; Lecturer in Nutrition and Dietetics, Flinders UniversityJodi Bernstein, PhD Candidate in Nutritional Sciences, University of TorontoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/910742018-03-07T01:02:01Z2018-03-07T01:02:01ZWhite, brown, raw, honey: which type of sugar is best?<figure><img src="https://images.theconversation.com/files/206783/original/file-20180216-50550-11l9rs8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Sugar is sugar in the body. But the way they're processed can make small differences. </span> <span class="attribution"><span class="source">from www.shutterstock.com</span></span></figcaption></figure><p><em>This is the second in a four-part series on <a href="https://theconversation.com/au/topics/sugar-2207">sugar</a>. Stay tuned for articles covering the link between sugar and diseases, and whether it’s better to substitute sugar with fruit. Catch up on the first instalment, about whether we should quit sugar, <a href="https://theconversation.com/you-dont-need-to-quit-sugar-to-improve-your-health-92032">here</a>.</em></p>
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<p>In nutrition, sugar refers to simple carbohydrates consisting of one or two basic carbohydrate units such as glucose, fructose and galactose. Consumers often use “sugar” to describe simple carbohydrates that taste sweet, but not all sugars are sweet. </p>
<p>There are many different types of sugars we add to our baking or hot drinks such as white sugar, brown sugar, raw sugar and honey. But when we’re looking at a packaged product the ingredients list will have many more options still. Corn syrup, palm sugar, molasses, maple syrup and agave nectar are but a few.</p>
<p>Despite the large variety of sugars, they are very similar nutritionally. They are comprised predominantly of glucose, fructose and sucrose, which are the basic forms of sugar. Glucose and fructose are slightly different in chemical structure, while sucrose is a sugar composed of one glucose and one fructose. </p>
<p>The factors that distinguish sugars are their sources (from sugarcane, beet, fruit, nectar, palm or coconut saps), flavour profiles, and the levels of processing. </p>
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<strong>
Read more:
<a href="https://theconversation.com/multigrain-wholegrain-wholemeal-whats-the-difference-and-which-bread-is-best-89538">Multigrain, wholegrain, wholemeal: what's the difference and which bread is best?</a>
</strong>
</em>
</p>
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<h2>Types of sugar</h2>
<p><strong>White sugar</strong>: also called table sugar, is the final product of the processing and refining of sugarcane or beet. During the refining process, moisture, minerals and compounds that give sugars their colour are removed, and white refined sugar is formed. The byproduct containing the removed compounds during sugar refining is known as <strong>molasses</strong>. </p>
<p><strong>Raw sugar</strong>: is formed if the final refining process is bypassed. </p>
<p><strong>Brown sugar</strong>: is refined white sugar with varying amounts of molasses added. Raw sugar, brown sugar and molasses are higher in compounds that provide colour, from natural sources or byproducts of the breakdown of sugar (caramel) during sugar processing.</p>
<p><strong>Honey</strong>: is sugar-rich nectar collected by bees from a wide variety of flowers. Fructose is the main sugar found in honey, followed by glucose and sucrose. The sweet taste of honey is attributed to its higher fructose content, and fructose is known to be sweeter than glucose or sucrose. Honey is about 17% water.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/206785/original/file-20180216-50550-1lryy52.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/206785/original/file-20180216-50550-1lryy52.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/206785/original/file-20180216-50550-1lryy52.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=444&fit=crop&dpr=1 600w, https://images.theconversation.com/files/206785/original/file-20180216-50550-1lryy52.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=444&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/206785/original/file-20180216-50550-1lryy52.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=444&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/206785/original/file-20180216-50550-1lryy52.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=558&fit=crop&dpr=1 754w, https://images.theconversation.com/files/206785/original/file-20180216-50550-1lryy52.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=558&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/206785/original/file-20180216-50550-1lryy52.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=558&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Honey contains a sweeter type of sugar, meaning you don’t have to use as much. It also contains more water than table sugar.</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
</figcaption>
</figure>
<p><strong>Syrups</strong>: can be produced from a wide range of plant sources in the forms of sap and fruits. Some examples include agave (a desert succulent), corn, date, grape, maple and pomegranate syrup. </p>
<p>Because agave and corn are more complex carbohydrates, they’re first broken down into sugar during food processing before being concentrated into syrup. Corn syrup is often further processed into the sweeter version, high fructose corn syrup. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/you-dont-need-to-quit-sugar-to-improve-your-health-92032">You don't need to quit sugar to improve your health</a>
</strong>
</em>
</p>
<hr>
<p><strong>Fruit sugar</strong>: can be made from the drying and grinding of fruits such as dates. Sugar produced through this process shares similar nutrient composition with the fruit (such as fibre and minerals) but it is lower in water content. </p>
<h2>Which type is best?</h2>
<p>Several <a href="http://care.diabetesjournals.org/content/33/11/2477.short">studies</a> have reported adverse effects of white sugar and high fructose corn syrup on our health. So should we substitute these types of sugars with another?</p>
<p><strong>Sweetness and sugar content</strong></p>
<p>Some sugars such as honey and agave syrup are higher in fructose. Fructose is sweeter than glucose and sucrose, hence a smaller amount may be needed to achieve similar level of sweetness from white sugar. Honey and syrups also have a higher water content. So the sugar content is less than the equivalent weight of white sugar.</p>
<p><strong>Antioxidant capacity</strong></p>
<p>Due to the different levels of processing and refining, sugars that are less processed and refined tend to have higher contents of <a href="https://www.sciencedirect.com/science/article/pii/0308814694901546">minerals</a> and compounds that give plants their colour. These compounds have been found to increase antioxidant capacity, which reduces the cell damage in the body that causes several chronic diseases. </p>
<p>Although the antioxidant capacity of date sugar and molasses is many-fold higher than white sugar and corn syrup, it’s still relatively low compared to antioxidant-rich foods. For example, more than 500g of date sugar or molasses need to be consumed to get the same amount of antioxidant contained in a cup (145g) of blueberries. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-are-antioxidants-and-are-they-truly-good-for-us-86062">What are antioxidants? And are they truly good for us?</a>
</strong>
</em>
</p>
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<p><strong>Glycemic index</strong></p>
<p>Different types of sugar raise the amount of sugar in our blood at different rates after being consumed. The glycemic index (GI) concept is used to compare the ability of different carbohydrate-containing foods in raising blood sugar levels over two hours. </p>
<p>Pure glucose is used as the reference carbohydrate and it’s given a value of 100. Higher GI indicates greater ability of a food in raising blood sugar levels, and having high levels of sugar in the blood can lead to disease. High GI foods tend to be <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1753-4887.2000.tb01855.x/full">less filling</a> too.</p>
<p>The GI values in the table below are compiled from the <a href="http://www.glycemicindex.com/foodSearch.php">GI database</a>. Corn syrup has the highest GI as it is composed mainly of glucose. White sugar, composed of 50% glucose and 50% fructose, has slightly lower GI. Based on available values in the GI database, agave syrup has the lowest GI value. Therefore, it’s a better option than other sugars in term of blood sugar management.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/206515/original/file-20180215-124918-11hatj3.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/206515/original/file-20180215-124918-11hatj3.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=358&fit=crop&dpr=1 600w, https://images.theconversation.com/files/206515/original/file-20180215-124918-11hatj3.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=358&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/206515/original/file-20180215-124918-11hatj3.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=358&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/206515/original/file-20180215-124918-11hatj3.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=450&fit=crop&dpr=1 754w, https://images.theconversation.com/files/206515/original/file-20180215-124918-11hatj3.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=450&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/206515/original/file-20180215-124918-11hatj3.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=450&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Glycaemic Index of sugars.</span>
<span class="attribution"><span class="source">Source: GI database</span></span>
</figcaption>
</figure>
<p><strong>Antimicrobial activity</strong></p>
<p>Honey has been reported to possess several <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Honey%3A+a+sweet+solution+to+the+growing+problem+of+antimicrobial+resistance%3F">germ-killing capabilities</a> due to the presence of several naturally-occurring compounds. But it’s still unclear how the antimicrobial property of honey may be obtained. </p>
<p>In the end, sugar in our body is still sugar. So while honey, raw sugar, date sugar and molasses are “better” than white and other types of sugar, everyone should try to cut down their sugar intake.</p><img src="https://counter.theconversation.com/content/91074/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sze-Yen Tan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Next time you’re baking a cake or putting a spoonful of something sweet in your coffee, here’s which sugar you should choose and why.Sze-Yen Tan, Senior Lecturer in Nutrition Science, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/920322018-03-06T01:21:07Z2018-03-06T01:21:07ZYou don’t need to quit sugar to improve your health<figure><img src="https://images.theconversation.com/files/208591/original/file-20180302-65511-1up8xpu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Alternatives such as dates have the same number of kilojoules as sugar.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/8qDTh2VuY2E"> Artur Rutkowski</a></span></figcaption></figure><p><em>This is the first in a four-part series on <a href="https://theconversation.com/au/topics/sugar-2207">sugar</a>. Stay tuned this week for articles covering how the different types of sugars compare, what the research says about the raft of diseases sugar has been linked to, and whether it’s better to substitute sugar with fruit.</em> </p>
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<p>Not long ago, fat was the evil dietary villain. Before that it was salt. Now the sugar-free diet has exploded onto the health and wellness scene – and seems to have topped many people’s list of New Year’s resolutions.</p>
<p>Sugar-free diets encourage people to avoid table sugar (sucrose), sweeteners such as honey and maple syrup, refined flours, condiments, soft drinks, sweets and some fruits such as bananas. Some also recommend eliminating or restricting dairy products. </p>
<p>The diet’s advocates rightly note that <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/sugar">excessive sugar consumption</a> may lead to obesity and therefore increase the risk of type 2 diabetes, heart disease and some cancers. </p>
<p>And it’s true that Australians are eating too much of the sweet stuff, with <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.007%7E2011-12%7EMain%20Features%7EDiscretionary%20foods%7E700">35% of an adult’s total daily calories</a> now coming from “discretionary foods”, which includes lollies, chocolates and soft drinks. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-how-much-sugar-is-it-ok-to-eat-57345">Health Check: how much sugar is it OK to eat?</a>
</strong>
</em>
</p>
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<p>But you don’t need to quit sugar to lift your game on healthy eating. Quitting sugar is unlikely to improve your health any more than cutting down on ultra-processed foods, eating more vegetables, cooking food from scratch and <em>limiting</em> how much extra sugar you eat and drink. </p>
<p>At best, the sugar-free diet is confusing and imposes an arbitrary set of rules that aren’t based on scientific evidence. At worst, such a restrictive diet can create food fear or an unhealthy relationship with food. </p>
<h2>Diet mentality</h2>
<p>The sugar-free diet is restrictive, with lists of “allowed” foods (such as whole grains, blueberries and grapefruits) and “not allowed” foods (such as white bread, bananas and raisins). This inadvertently promotes a diet mentality and causes followers to worry about accidentally eating something that’s not allowed. </p>
<p>People who <a href="https://ac-els-cdn-com.ezproxy.usc.edu.au/S019566631400213X/1-s2.0-S019566631400213X-main.pdf?_tid=bc4f2592-194d-11e8-8417-00000aab0f6c&acdnat=1519468410_86bee2be9522e47e19a490d36c69280e">worry about food are more likely to diet</a>. This may be because they are worried specifically about their weight, or about the impact certain nutrients have on their health.</p>
<p><a href="https://escholarship.org/uc/item/2811g3r3">Research shows</a> dieting is not effective over the long term and can lead to greater weight gain over time. The brain interprets dieting and restriction as a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139007/">famine</a>, which causes the storage of fat for future shortages. </p>
<p>Dieting is stressful. In response to this, our body releases stress hormones such as <a href="http://onlinelibrary.wiley.com/doi/10.1002/oby.21733/full">cortisol</a>, which may cause the body to store fat, particularly in the abdominal area. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/208595/original/file-20180302-65544-10m4ier.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/208595/original/file-20180302-65544-10m4ier.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/208595/original/file-20180302-65544-10m4ier.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/208595/original/file-20180302-65544-10m4ier.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/208595/original/file-20180302-65544-10m4ier.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/208595/original/file-20180302-65544-10m4ier.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/208595/original/file-20180302-65544-10m4ier.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Restrictive diets can cause food anxiety.</span>
<span class="attribution"><a class="source" href="https://unsplash.com">Soroush Karimi</a></span>
</figcaption>
</figure>
<p>Worrying about food can lead to <a href="https://www.ncbi.nlm.nih.gov/pubmed/10502362">stress</a>, anxiety and depression, and is one of the defining features of the condition known as <a href="https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia">orthorexia</a>. </p>
<p>Orthorexia is the overwhelming preoccupation with eating healthily. People with orthorexia spend a lot of time thinking and worrying about food and eliminating foods that are deemed impure or unhealthy. Some experts suggest this behaviour is a precursor to, or a form of, an eating disorder. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/orthorexia-nervosa-when-righteous-eating-becomes-an-obsession-36484">Orthorexia nervosa: when righteous eating becomes an obsession</a>
</strong>
</em>
</p>
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<p>Estimates suggest anywhere between <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539385/">7% and 58% of the population</a> may have the condition. There are no clear diagnostic criteria, which makes it difficult to measure its prevalence. </p>
<p>But we know <a href="https://www.eatingdisorders.org.au/key-research-a-statistics">15% of women will experience an eating disorder</a> at some stage in their life. So we need to ensure nutrition advice, however well-intentioned, doesn’t promote or encourage disordered eating.</p>
<h2>Cutting out the good stuff</h2>
<p>Some sugar-free diets advise people to cut out or restrict healthy foods and food groups such as fruit and dairy, without evidence to support their exclusion. This perpetuates the food fear/dietary restriction cycle and may contribute to nutrient deficiencies. </p>
<p>These diets also recommend people avoid fruit for a <a href="https://iquitsugar.com/confused-what-fruit-to-eat-pyramid/">period of time, and</a> then re-introduce a limited list of expensive “healthy” fruits (such as berries) while avoiding the cheaper “unhealthy” fruits such as bananas. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/208594/original/file-20180302-65516-jhiw73.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/208594/original/file-20180302-65516-jhiw73.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/208594/original/file-20180302-65516-jhiw73.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/208594/original/file-20180302-65516-jhiw73.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/208594/original/file-20180302-65516-jhiw73.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/208594/original/file-20180302-65516-jhiw73.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/208594/original/file-20180302-65516-jhiw73.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Bananas are usually on the list of foods to avoid or limit.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-multiple-bananas-selective-focus-1036026196?src=Et-jPh8H_ZN8dtYHeL6XYQ-1-59">Toni Schmid/Shutterstock</a></span>
</figcaption>
</figure>
<p>Whole fruit is a <a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups/fruit">wonderful source</a> of fibre, essential vitamins and minerals, as well as antioxidants. Two serves of fruit per day can reduce the risk of developing some cancers, type 2 diabetes and heart disease. Given only <a href="http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.001">half of Australians eat the recommended two serves of fruit per day</a>, the advice to restrict fruit further could result in people missing out on these benefits.</p>
<p>Many sugar-free followers also avoid plain dairy products such as milk, yoghurt and cheese, due to the assumption these contain sugars. </p>
<p>The sugar in plain dairy products is the natural lactose (a carbohydrate), which is nothing to fear. Unnecessarily <a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups/milk-yoghurt-cheese-andor-their-alternatives-mostly-reduced-fat">avoiding dairy may increase the risk of osteoporosis</a> if not replaced with adequate levels of calcium from other sources.</p>
<h2>Sugar replacements</h2>
<p>Strangely, many of the <a href="https://www.thehealthychef.com/2012/09/naked-chocolate-cake/">sugar-free recipes</a> use expensive sugar alternatives – such as rice malt syrup (due to its low fructose content), maple syrup (which is sometimes allowed and sometimes not) and dates – to replace sugar. </p>
<p>However, these are still sugars and contain the same number of calories per gram as any other sugar. These alternatives offer no additional nutritional benefits other than rice malt syrup, which is a useful option only for those with a fructose malabsorption issue, and dates, which contain fibre. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/fact-or-fiction-is-sugar-addictive-73340">Fact or fiction – is sugar addictive?</a>
</strong>
</em>
</p>
<hr>
<p>People often eat more of the food containing these alternatives under the <a href="https://www.sciencedirect.com/science/article/pii/S0195666308006089">guise of it being sugar-free</a>, which could lead to unintentional weight gain. <a href="https://www.sciencedirect.com/science/article/pii/S0195666308006089">One study found</a> people ate about 35% more of a snack when it was perceived as healthy than when it was seen as unhealthy.</p>
<h2>What to do instead</h2>
<p>Eat plenty of plants, enjoy whole grains, beans and legumes. Fruit is your friend – not your enemy.</p>
<p>Most people could probably eat a little less sugar, a little less often, but you don’t have to quit it for good to be healthy.</p>
<p>Savour every mouthful of that chocolate cake or “sometimes food”. Turn off technology and eat the cake mindfully, so that your brain can register that you have eaten it. That way you can get pleasure and satisfaction from it, and you won’t be craving it again an hour later.</p>
<p>No matter how we choose to eat, remember that health is not simply about the number on the scale, the size of our waist, or the foods we avoid. It’s also about our psychological health and our relationship with food, which is just as important as our physical health.</p><img src="https://counter.theconversation.com/content/92032/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tara Leong does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Quitting sugar is unlikely to improve your health any more than cutting down on ultra-processed foods, eating more vegetables and cooking food from scratch.Tara Leong, Lecturer in Nutrition and Dietetics, University of the Sunshine CoastLicensed as Creative Commons – attribution, no derivatives.