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Sticky situation: How sugar affects our health

132244825_dbf0e21d9f_zHere's a shocking statistic: On average, Americans consume three pounds of sugar each week, or 3,550 pounds in an entire lifetime. This leads some to blame the sweet stuff for the increase of chronic disease in modern society. But simply reducing our sugar intake is easier said than done, in part because identifying foods with added sugars can be tricky.

This Thursday, Alison Ryan, a clinical dietician with Stanford Health Care, will deliver an in-depth talk on sugar and our health as part of a Stanford Health Library lecture series. Those unable to attend can watch the presentation online here.

In the following Q&A, Ryan discusses the controversies surrounding sugar and the role of sugar in our diet, and she offers tips for making sure your consumption doesn't exceed daily guidelines.

Why does our body need sugar?

Sugar, in the form of dextrose or glucose, is the main fuel or energy source for the cells of the human body. Without glucose, our body has to get creative and rely on other metabolic pathways, like ketosis, to keep our brain and other organs running. There is an optimal range for our blood sugar levels, and our bodies are making constant efforts to keep blood sugar within this range.

Our body can make glucose from any carbohydrate that is consumed, so consuming monosaccharide (glucose and the like) is not biologically required. This is one of the reasons it's difficult to determine the right amount of sugar that is required for the human body. Do we think of the optimal amount as the amount needed to function at peak level? Or an amount not to go over in order to avoid detrimental effects on our health?

Sugar intake has been on the rise in human diets. Why do you think that is?

At one time, sugar used to be a seldom available food item. It is now ubiquitous and more of a hallmark for highly processed, low nutritional value foods. Now, consider the food industry and the politics of sugar. Soda companies, makers of desserts, cakes, sugary snack foods, the sugar and corn syrup refiners all lobby to keep their products “part of a balanced diet.” The food industry is deeply involved (or at least vocal about) the food and nutrition guidelines in the U.S. Then there's the reality that sugar tastes good! Most people enjoy the taste of sweet foods and are drawn to consuming them.

What are some of the health risks of consuming too much sugar?

Sugar has been implicated as playing a role in some obvious ways, like obesity, diabetes, and tooth decay; but also in less direct appearing ways such as heart disease, chronic inflammatory conditions, cancer, etc. Often, when we're consuming foods high in sugar, we're not consuming foods that are rich in nutrients. These calorie-dense foods displace the nutrient-dense foods. The net effect is higher intake of calories, with concurrent lower intake of vitamins, minerals, phytonutrients, protein, etc.

This year a government committee is recommending specific limits on sugar and advising that only 10 percent of calorie intake come from added sugars. Where is added sugar commonly found in our diets?

Added sugars, sometimes referred to as “free” sugars, are sugars that are added to foods. Added sugars are found in: sodas, sports drinks, energy drinks, sugar, syrup, cookies, cakes, desserts, candies, juices; and some not-so-obvious foods like: breakfast cereals, flavored yogurts, salad dressings, sauces and marinades, breads, fast foods, peanut butter, snack bars, granola bars, protein bars, and more! Added sugars are different from the naturally occurring sugars found fruits, milk, and certain other plant foods.

To provide some perspective, less than 10 percent of calorie intake would range from about 180-200 calories (for most people) or about 12-13 teaspoons per day. The American Heart Association recommends even less than this amount at less than 6 teaspoons per day for women and less than 9 teaspoons per day for men.

Guidelines are a funny thing, and their true purpose and benefit are hard to define. They certainly help shape public-health initiatives and hopefully raise some awareness for public-health concerns. But: Are people changing their food choices based on governmental guidelines? According to data from the U.S. Food and Drug Administration, added sugar intake increased 30 percent from 1977 to 2010. Although added sugar intake has recently started to decline, our intake is still way above recommended limits.

What tips can you offer on ways to reduce sugar consumption?

I encourage people to try to limit the added sugars or “free” sugars as much as possible. Focus on cutting back on pastries, desserts, candies, sodas and juices. Choose fresh fruits to quell your sugar cravings. Set one day of the week for that sugar splurge, but try to keep added sugars as the treat that they are and less a part of your daily routine. And focus on the big picture and major sources of added sugars in the diet, not on how much sugar is in a banana versus an apple. This is taking attention away from much bigger problems.

Limit processed, packaged foods and be sure to read their labels. Sugar comes in a variety of forms and names. Check the ingredient list for these types of sweeteners and lesser known ones such as dextrin, malt syrup, beet sugar or crystalline fructose.. The proposed new nutrition labels should be listing added sugars separately from the naturally occurring sugars. This should help consumers determine how to make food choices with lower added sugars, but these changes won’t be implemented until around the year 2016 or 2017.

Previously: A physician realizes that she had "officially joined our nation of fellow sugar addicts," Sugar intake, diabetes and kids: Q&A with a pediatric obesity expert, New evidence for a direct sugar-to-diabetes link and Should sugar be blamed for all our health woes?
Photo by Uwe Hermann

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