Introduction
It sneaks in everywhere, hiding behind a long list of different names
and clever disguises. It creeps into tomato sauce, lurks in every salad
dressing, and infiltrates otherwise-innocent canned soups. Even bacon
isn’t safe! If you spend any time at all on the Paleo diet, you
practically start to see sugar peering out from behind every corner,
shrouded in a black trench coat and hatching nefarious schemes to trap
you in its clutches.
http://paleodietlifestyle.com/sugar-and-paleo/
Assigning personality to a food can itself be unhealthy, but in this
case, the food doesn’t even deserve all its bad press. Of course, like
any other food, sugar is unhealthy when eaten to excess, or when eaten
in a processed, refined, and artificial form. Some people would do
better to avoid it – just as some people would do better to avoid
nightshades, dairy, or eggs. But in the context of a diet rich in
nutrients, sugar – especially sugar from whole foods like fruit or dairy
– is not the kiss of death.
What Is Sugar?
Most of us think of “sugar” as the white powder we like to add to our
coffee, but in biological terms, sugar is nothing but the building
blocks of carbohydrates. Sugars come in several different types,
including single sugars and double sugars (combinations of two single
sugars). Since your body digests them all differently, the distinctions
among all these types of sugars are actually quite important.
Any food with a carb content greater than zero will have some sugar
in it. Even foods we don’t usually think of as “sugary,” like potatoes,
contain sugar in the form of glucose. Refined foods like white flour and
table sugar are called “simple carbohydrates” because their molecular
structure includes single or double sugars. Whole grains and legumes are
called “
complex carbohydrates”
because they’re made of three or more sugars. When you eat simple
carbohydrates, your body can use them for energy right away (this is why
you can get a “sugar rush” from eating too much candy); when you eat
complex carbohydrates, your body has to break them down into simple
carbs first. Since this process takes some time, most people don’t get
the same immediate rush of energy from complex carbohydrates.
The role of these complex carbohydrates, also called
starches,
in the diet is itself a fascinating topic, but this article will focus
on simple carbohydrates and the way we break them down. Understanding
what sugar is, and the different forms that it can take, is important
for everyone attempting to maintain a healthy diet in the face of the
post-industrial food environment. As sugar has come under intense
scrutiny for potentially contributing to the modern obesity crisis, this
knowledge can help us interpret the reams of conflicting studies and
chart a sane and healthy course between binging on Jolly Ranchers and
panicking over every strawberry.
Sugar and the Science of Obesity
The number of studies on the relationship between sugar and weight
gain is enormous, but unfortunately, this mass of scientific literature
has not managed to produce anything like a consensus. The studies that
exist are frustratingly inconclusive, and seem to contradict each other
more than they agree. An hour of searching for scientific studies will
give you a huge pile of evidence that sugar is the underlying cause of
every modern health problem, and an equally huge pile proving that sugar
is actually harmless – in some rodent studies, a higher sugar intake
even appeared to promote leanness!
Making sense out of this huge mass of contradictory data is daunting. One fairly comprehensive
review
of studies on sugar and weight gain concluded that the decisive factor
is not sugar, but calories: only hypercaloric trials (trials where sugar
intake caused a net increase in caloric intake) produced weight gain,
and that this might just as easily be due to the calories. Thus, it’s
important to separate the effects of sugar specifically from the effects
of simply adding calories to the diet.
This is especially true if the subjects are already overeating, as in
this study.
In a conclusion that shouldn’t surprise anyone, scientists discovered
that a group of overweight and obese adults experienced all kinds of
negative effects (including weight gain and metabolic damage) when they
added sugar-sweetened beverages to their diet as 25% of their daily
calories. However, this study is a perfect illustration of the many
complexities involved in determining the effect of sugar in the diet.
First, obese people are already metabolically deranged: people with a
healthy metabolism might not react the same way. Second, 25% of calories
is nowhere near a moderate sugar consumption; finally, the consequences
of drinking highly processed sweetened beverages do not necessarily
extend to natural sources of sugar like fruit.
All of these confounding factors suggest that something much more
complicated is at work than the simplistic idea that “sugar makes you
sick and fat.”
Anthropological studies
of traditional hunter-gatherer diets have also failed to find a
conclusive link between sugar and health problems: while some
hunter-gatherers do eat a diet very low in sugar, others, such as the
Hadza in Tanzania or the Kuna in Panama, eat a diet fairly high in sugar
without any noticeable difference in health or body composition.
The reams of contradictory evidence about sugar consumption make it
clear that just talking about “the effect of sugar on the body” is very
imprecise, because it fails to specify three very important points. What
type of sugar, how much, and whose body? The effects of sugar also
depend on what kind of food you get the sugar from: chugging a liter of
Coke is a world away from eating an orange, even though they both
contain sugar. Making a blanket statement about how all sugar is always
harmful for everyone sounds very tough-love and inspiring, but it isn’t
necessarily true.
What Type of Sugar, How Much, and Whose Body?
As noted above, “sugar” is a term that can actually refer to one of
several different compounds.
Table sugar is just one of these compounds. Instead of assuming that
all types of sugar are the same, it’s important to read any research on
“sugar” with a crucial question in mind: what kind?
As noted above, sugars are generally separated into two broad
categories: single and double. Single sugars include glucose (found in
fruits and starchy carbohydrates), fructose (found only in fruits), and
galactose (found in dairy). Double sugars are combinations of these
single sugars: one very common double sugar is sucrose (table sugar),
which is a 1:1 mix of glucose and fructose. Lactose is a mixture of
glucose and galactose. High fructose corn syrup sounds like it should be
80 or 90% fructose, but the ratio of glucose to fructose that it
contains is closer to 1:1. Honey is another double sugar, but the ratio
of glucose to fructose in honey varies, depending on the bees that
produced it.
Each different single sugar is digested differently.
Glucose,
for example, can be sent directly into your muscles and other cells,
and either used immediately or stored as glycogen for future energy.
Fructose,
on the other hand, needs to be processed by your liver first, and
either turned into fat (in a process called de novo lipogenesis) or
glucose. Because it’s harder to metabolize, many people have trouble
digesting fructose, while negative reactions to glucose are much less
common. Seeing fructose metabolism as nothing but a less efficient way
of getting glycogen, many Paleo researchers have concludes that fructose
is the “bad sugar.” Glucose (the sugar found in “safe starches” like
yams and white rice) might be acceptable, but fructose is out.
The problem with this approach is that it ignores another important question: how much?
Excess sugar or a huge dose of fructose is clearly harmful. If
nothing else, eating too much sugar makes it very easy to eat too many
calories – especially if you get that sugar through sweetened drinks
that don’t fill you up for very long. Metabolizing large amounts of
sugar, especially fructose, is also stressful to the body: too much
fructose can put a heavy strain on your liver, and cause oxidative
stress and inflammation.
Excess fructose
interrupts your normal production of leptin (the hormone that tells
your body when to stop feeling hungry), making it very easy to gain
weight. Too much sugar of any kind – glucose or fructose – can also lead
to all the problems of a
high carbohydrate diet: insulin resistance, weight gain, inflammation, and diabetes.
Eating too much sugar is dangerous, but this doesn’t necessarily
prove that any level of sugar consumption is bad: eating too much of
anything is problematic. Vitamin A could also be considered a “
dose-dependent toxin” (something that harms your body if you eat too much of it), but this doesn’t mean we should avoid it altogether!
So how much sugar is too much for the body to process safely? The
answer depends on yet another question: whose body? Many foods do not
have the same effect on everyone who eats them. A perfect example of
this is dairy. If you don’t have the gene that allows you to produce
lactase, the lactose in dairy can make you feel very sick. If you do
have that gene, you can enjoy dairy products without a problem. So it’s
silly to say that dairy is a “safe food” or a “harmful food:” whether
it’s safe or harmful depends on the person eating it.
In many ways, the same is true of any kind of sugar. Since digesting
sugar requires a healthy metabolism and a certain degree of insulin
sensitivity, the upper boundary of a healthy sugar intake is probably
much smaller for people who already have trouble with insulin
metabolism, such as diabetics or people who are already obese. On the
other hand, people with a healthy metabolism might not have any problems
digesting a moderate amount of sugar.
As with any carbohydrate, the amount of sugar that you can eat
healthily also depends on your activity level: very active people
frequently burn through the glycogen stored in their muscles, so when
they eat carbohydrates, the glucose goes to replenishing the glycogen
stores, not to creating fat. On the other hand, sedentary people need to
be much more moderate with their carb intake, since they don’t have as
great a need for glucose in the diet.
Additionally, some people with specific digestive disorders should avoid certain types of sugars. People with
Irritable Bowel Syndrome (IBS) very frequently suffer from a problem called
fructose malabsorption, an
intolerance
to fructose that can cause a variety of digestive problems. In this
case, avoiding fructose can provide significant relief of IBS symptoms.
People sensitive to FODMAPs should avoid foods high in fructose and
several other types of sugars like sugar alcohols, since these can
irritating to the gut. It can also be beneficial to steer clear of
sugars in general if you’re struggling with an overgrowth of harmful gut
bacteria like Candida: since sugar is these bacteria’s favorite food,
avoiding it can help get your gut flora back under control.
Physical problems aren’t the only reasons why someone might want to
avoid sugar. It can also be a very problematic food for anyone
recovering from a binge
eating disorder.
Switching to a Paleo diet high in nutrients and cutting out all food
toxins and processed foods can do a world of good for your body, but it
doesn’t remove the emotional and psychological issues that underlie an
eating disorder. It’s not uncommon for recovering binge eaters to have
trouble moderating their intake of some foods on the Paleo diet, and
foods high in natural sugars (like fruits) are among the most
problematic. Thus, if you’re recovering from an eating disorder, it
might be helpful to restrict your sugar intake, at least at first.
In short, the answer to “What effects does sugar have on the body?”
is, “It depends.” It depends on what kind of sugar, how much of it, and
exactly whose body. An overweight, diabetic, and sedentary office worker
digesting a bowl of ice cream and a lean, healthy athlete digesting a
bowl of strawberries are both, technically, metabolizing sugar. But
these two situations are so different that they barely deserve the same
name.
Where is it From?
The example above illustrates another important consideration with
sugar: how you get it. Think of the difference between meat and protein
shakes. There’s nothing wrong with eating meat that contains protein,
but protein powders and shakes are generally harmful. Why? Because
protein powders provide protein in an artificial, processed, and highly
concentrated form that our bodies don’t digest well, accompanied by a
hefty wallop of preservatives, sweeteners, and other chemicals. There’s
nothing wrong with eating protein, but where you get it from matters.
The same is true for sugar. People don’t eat pure fructose or galactose;
they eat foods, and foods have much more to them than sugar.
First, some sugar-containing foods also contain other valuable
vitamins and minerals: one orange, for example, contains 12 grams of
sugar, but also significant amounts of Vitamin C, Folate, Calcium, and
Potassium. Four ounces of Coke provide the same amount of sugar, no
vitamins or minerals, and a Nutrition Facts label full of
unpronounceable chemicals and additives. It shouldn’t come as a surprise
that the orange and the Coke will have a very different effect on your
overall health – especially since many people eat one orange and then
stop, while almost nobody drinks just 4 ounces of Coke at a time (a
standard can is 8 ounces; a bottle is 20 ounces).
Studies that try to link sugar and obesity seem to have come to the
same conclusion. Natural forms of sugar don’t appear to be reliably
linked to obesity; the problem comes with refined and processed forms
like high fructose corn syrup. Most studies that attempted to correlate
overall sugar intake with weight gain in humans couldn’t find a clear
connection, but sugary drinks (which contain very highly processed
sugars) were clearly linked to a higher rate of obesity. This is why
hunter-gatherers eating traditional diets can include sugar as a high
percentage of their daily caloric intake, but stay lean and healthy with
none of the metabolic problems associated with the first world. Many of
these groups are even famous for the great efforts they make to get
honey – and yet they don’t see the same health problems from it as we
see from the sugar in Coke and Skittles. In other words, where you get
your sugar matters.
One possible explanation for this has to do with
food reward. As discussed in a previous article about
obesity,
the food reward theory states that “hyperpalatable” foods (processed
food products that present us with tastes and textures much more intense
than anything found in nature) cause obesity because they confuse our
natural appetite regulation systems. Highly processed foods and
beverages definitely fall into the category of superstimuli that we
aren’t designed to handle. Fruit and other natural sources of sugar, on
the other hand, are not hyperpalatable, so they don’t cause the same
negative metabolic reaction. One study even fed the same sugar water to
two groups of mice: one group that was capable of tasting sweetness, and
another group that wasn’t. The group that could taste sweetness got
fat; the group that couldn’t, didn’t.
Whether or not the food reward theory can adequately explain the
difference between natural and artificial sugars, it’s clearly important
to consider what kind of foods we get our sugar from. Sugary drinks do
promote obesity, but this doesn’t mean that a whole, natural food like a
banana will have the same metabolic effect as a glass of soda loaded
with all kinds of refined and processed chemicals.
Table Sugar Substitutes: Other Natural Sweeteners
Since processed sugar is so much more harmful than natural sugar from
whole foods, one common question about refined table sugar is whether
other, more natural sweeteners are preferable. The idea of these foods
as “sugar substitutes” is somewhat misleading, since common “sugar
substitutes” like honey and maple syrup do also contain sugars. We’ve
chosen to refer to one type of sugar as “sugar” and another type as
“honey,” but in the end they’re both biologically made up of sugars. All
natural sweeteners contain some form of sugar, even if we call them by
another name.
Nevertheless, some replacements for table sugar do have other
advantages that are worth noting. Honey, for example, has several
beneficial compounds (although the specific content will depend on the
flowers available).
Chemically,
honey is approximately 40% glucose, 36% fructose, and 24% other sugars,
although the exact proportions vary depending on what the bees ate.
While the high fructose content can cause trouble for some people with
fructose malabsorption problems, the fructose in honey is accompanied by
an equal amount of glucose, which makes it much
easier to digest.
Furthermore, honey has the advantage of a long evolutionary history:
humans have been going to incredible lengths to get it since we figured
out how delicious it was. Several
preindustrial peoples
consumed a significant percentage of their daily calories from honey on
a regular basis: one 10,000-year-old painting from Spain shows two men
gathering honey from a beehive. Raw honey (as opposed to pasteurized
honey) is also a completely unprocessed food, while even other natural
sweeteners like maple syrup and molasses require some processing.
If there’s any such thing as a “Paleo sweetener,” honey is probably
it. But honey is far from the only naturally-occurring sweet substance.
Maple syrup is relatively low in fructose (making it a good option for
the fructose-intolerant), and contains manganese, potassium, iron, and
calcium. Molasses is essentially table sugar, but with nutrients: it
contains minerals like iron, calcium, and magnesium that are stripped
from table sugar when it’s refined and processed to get its white,
powdery consistency.
Coconut palm sugar
is a relative newcomer, and not very common, but it contains higher
amounts of magnesium, nitrogen, and Vitamin C than any other natural
sweetener.
Agave Nectar
is a health-food darling, best known for its very low glycemic index.
In other words, it doesn’t cause as large of an insulin rush as other
sweeteners. On the other hand, agave is also 90% fructose, which can
cause serious problems for people who don’t digest fructose well. It
also contains saponins, one of the same toxins that make
grains and legumes
so harmful. Although the lack of an insulin spike is tempting, agave is
definitely the worst of the “all-natural” group: avoid it when you can.
Thus, although all of these natural sweeteners contain approximately
as much sugar as the table sugar, some of them do at least give you a
significant amount of nutrients along with the calories. This makes them
preferable to the refined, chemically processed table sugar that most
of us think of as “sugar.” Even though they aren’t healthy to consume to
excess, honey, molasses, and maple syrup are superior to table sugar,
and can make relatively harmless replacements in the occasional Paleo
treat.
Table Sugar Substitutes: Artificial Sweeteners
Since all of these natural sweeteners do contain sugars, many people
searching for a non-caloric sweetener turn to artificial compounds
instead. The major types of artificial sweeteners are Aspartame (added
to diet soft drinks or sold as Equal and NutraSweet), Saccharine
(Sweet’n’Low), Stevia, and Sucralose (Splenda).
As with actual sugar, artificial sweeteners are hotly debated. Their
main selling point is, of course, that they have no calories. As with
the studies supposedly demonstrating the evils of
salt,
studies linking these sweeteners to cancer are not seriously
concerning: they showed that rats who ate the equivalent of several
hundred cans of soda every day did get a form of bladder cancer, but
humans don’t even have the specific protein that causes this cancer, and
nobody eats that much Splenda anyway. On the other hand, “no calories”
doesn’t always translate into “no insulin response:” many types of
zero-calorie sugar substitutes (with the exception of sugar alcohols,
discussed below) may still contribute to metabolic problems and weight
gain even though they don’t have any caloric value themselves.
Essentially, when your body senses that you’ve eaten something sweet, it
releases insulin, expecting to have some kind of carbohydrate (sugar)
to digest. Even if you don’t follow up the sweet taste with any
calories, the sudden rush of insulin can contribute to insulin
resistance, and confusing your body like this can prompt you to overeat
later.
Sugar alcohols are one type of artificial sweeteners that avoid this
problem. These include xylitol, sorbitol, malitol and erythritol (if
it’s a sweetener that ends in –ol, it’s probably a sugar alcohol). These
chemicals have a much lower glycemic index than sugar, because they’re
very difficult for the body to digest. This isn’t necessarily a point in
their favor, however: except for erythritol, sugar alcohols are
polyols
(the P in FODMAPs), meaning that they’re not the best choice for people
with FODMAPs intolerance. Even people who don’t otherwise react to
FODMAPs can have trouble with sugar alcohols:
one study,
for example, found that subjects who drank a xylitol-sweetened beverage
reported higher rates of nausea, bloating, and other digestive
troubles. Thus, sugar alcohols aren’t necessarily harmless for everyone,
and if you react to them, they’re best avoided.
One noncaloric sugar substitute that gets slightly better press than
the others is Stevia, an herbal extract frequently promoted as a natural
alternative to products like Equal and Splenda. Although the raw leaves
of the plant are also sweet, the “stevia” (sold under several brand
names, including Truvia) that you can buy at the store as a liquid or a
powder is a processed, refined version of those leaves. The scientific
evidence on Stevia is just as self-contradictory as the evidence about
sugar: some studies seem to demonstrate that Stevia does cause an
insulin spike, and others suggest that it doesn’t. It may also have some
beneficial effects on hypertension, memory, and blood lipids, but on
the whole, the research doesn’t conclusively support one side or the
other.
In short, artificial sweeteners are somewhat of a mixed bag, and more
research is clearly needed on their effects before anyone can say with
any certainty that they’re either harmful or harmless. If you do choose
an artificial sweetener, erythritol seems to be one of the better
choices – the jury is still out on chemicals like aspartame and
sucralose, but sugar alcohols definitely don’t spike blood sugar, and
erythritol is the sugar alcohol least likely to cause gastrointestinal
problems and IBS-like symptoms. Stevia is another intriguing option that
may be just as good – especially if you can get the whole leaves rather
than the processed powder form. In general, while these substitutes
won’t add anything nutritious to your diet, they probably won’t cause
significant harm either, so consuming small amounts of them isn’t
problematic for most people.
Conclusion: Dietary Recommendations for Sugar
Since the effects of sugar in the diet can vary so greatly depending
on the source and composition of the specific sugar in question, the
health of the person eating it, and the amount of sugar consumed, there
is no one-size-fits-all recommendation. Not all people need to avoid
sugar entirely. In many ways, it’s useful to think of a healthy sugar
intake as falling on a spectrum: on one end of the scale is a very
low-carbohydrate diet (meat and non-starchy vegetables) with as little
sugar as physically possible. This kind of diet is perfect for diabetics
and people with metabolic syndrome, people who react very poorly to
starches and sugars in general, and some people trying to recover from
an eating disorder.
A step above that would be a diet with some sugar-containing foods
(fruit) but no added sweeteners. This more moderate approach is probably
fine for healthy people who get regular exercise, especially if they
don’t react poorly to fructose. Some people can even go further than
that, and use small amounts of added sweeteners like honey, maple syrup,
or even sugar itself without a problem. Serious athletes do need higher
levels of carbohydrates than most other people, and even people who
don’t enjoy endurance sports won’t see much harm from the occasional
treat. Beyond this level, sugar consumption probably becomes unhealthy:
eating large amounts of added sweeteners, especially processed chemical
sweeteners like high-fructose corn syrup, isn’t good for anyone.
Ultimately, the most important consideration with sugar is your own
reaction to it – and the only way to discover this is by experimenting.
Try some
Paleo chocolate pudding sweetened with a small amount of honey, or this
meatloaf
with a honey sauce and notice how you feel afterwards. Unless you’re
diabetic or have another life-threatening metabolic disorder, there’s no
need to be demonically strict about avoiding all sugar – and as we head
into sugar season (the unholy trinity of Halloween, Thanksgiving, and
Christmas), a sweet Paleo treat might even help banish cravings for
candy corn, and chocolate Santas, helping you stay on track with your
diet but keep your sanity intact.
http://paleodietlifestyle.com/sugar-and-paleo/
P.S. Be sure to check out the
Paleo Recipe Book. It’s a cookbook I’ve created to help you cook the best food for your health. It contains
over 370 recipes and covers absolutely everything you need.
Source: http://paleodietlifestyle.com/sugar-and-paleo/
