By Ali Nasser, M.D. FACC Cardiologist
Food manufacturers of processed food, soft drinks and artificial fruit juices with added sugar, are not required to list how much sugar is added versus natural sugar contents. Food makers can also use sweeteners (alcohol sugar) that aren’t technically “sugar.” The body doesn’t distinguish between natural or added sugars, so paying attention to total sugar is the key while buying sugary items.
Soft drinks are a prime source of extra calories in the United States that contribute to weight gain, without any nutritional benefits. Studies indicate sweetened beverages are less filling than the solid condiments, therefore causing people to continue to feel hungry after drinking such sugary drinks. Food manufacturers are coming under increased scrutiny for their contributions to the development of type-2 diabetes, heart disease, and other chronic conditions, such obesity, a major health problem in the United States. Obesity is a definite cause of cardiovascular disease and many other systemic morbidities, beginning with dental and gum disease, sleep apnea, joint disease, high blood pressure, cancers, depression, gallstones, and impaired quality of life, not to mention the rapidly increasing cost of health care. The best indicator of obesity is measuring the waist circumference at the naval above belt-level. A waist circumference of greater than 38 inches in men and 36 inches for women is associated with a higher risk of obesity and all of the above mentioned morbidities and heart disease.
Nurses’ Health Study showed that women who consumed large quantity of sugary items had an increased risk of heart disease and obesity. Shorter-term studies show consistent adverse effects of high sugar consumption on lowering HDL (good cholesterol), which could accelerate coronary artery disease. High sugar consumption can worsen diabetes control and its complications, and it will lead to formation of the harmful chemicals made of sugar with proteins and fats which is harmful to arteries, brain and in particular, the kidneys.
May be Plump but Malnourished: Diets high in sugar may cause malnutrition as well. The prevalence of obesity in the United States in 2012 ranged from 20% in Colorado to 35% in Louisiana. Majority of these individuals, though overweight, were found to be malnourished in various forms. High sugar diet adversely affects nutritional adequacy due to intake of pure calories without essential nutrients such as vitamins and minerals. Education and culture play an important role for shopping and cooking, and since sugary foods are less expensive, they tend to become the main ingredients on dinner tables in our society. Dinners are mostly cooked using macaroni-and-cheese mixes or mashed potato and white bread with high fructose syrup additives and processed ingredients. Expensive items such as fresh fruits and vegetables are eaten less due to socioeconomic issues. Low Fat or Fat-free foods (Skimmed milk, low fat yogurt) are often high in calories because of added sugar to improve taste and they may create a false sense of security in the consumers and higher amount of intake.
How to Lower the Risk? Risks may be lowered by education and legislation. American Heart Association dietary guidelines stress consumption of fresh fruits, vegetables, grains, and less harmful complex carbohydrates so that nutritional requirements for vitamins and minerals are met. Foods high in added-sugar displace wholesome foods (e.g., soft drinks displace milk and natural juice consumption) and contribute to additional calories that lead to obesity and malnutrition.
When dietitians advise having complex carbohydrates, they are usually referring to whole grain foods that are less harmful. However, refined or simple carbohydrates (more harmful), can result in harmful blood sugar spikes. When it comes to picking starchy foods, such as rice, bread and any other products made from flour, it’s best to opt for whole grain versions with higher fiber contents (look for greater than 5 grams of fiber per serving). Adults need from 25 to 40 grams of fiber daily. Whole grain foods (high fiber) impact upon blood glucose rise is more slowly (less harmful) than simple carbohydrates.
Mexico’s 10% tax on soft drinks led to 6% reduction in consumption. The United Kingdom is on its way to levying taxes by end of this year as well.
How Much Complex Carbohydrate? Generally speaking, complex carbohydrates should supply about half the daily required calories on your plate (1,000 calories/day). One fourth a plate can hold items, such as reduced calorie whole wheat bread, brown rice, potatoes or whole wheat pasta. You can accomplish both by eating a diet rich in colorful veggies, whole grains and nuts. The last quarter can be some grilled or baked meat, poultry or fish (size of the palm), or you can choose a vegetarian protein source such as lentils or beans. Eggs can be an important and nutritious source of proteins as well. An egg contains 7 grams of proteins and no sugars.
Munroe Regional Medical Center
Why Limit Sugar Consumption?
By Ali Nasser, M.D. FACC Cardiologist