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The Dark Side of Sugar / by Michael Barnes / February, 2019

This might be hard to swallow, but humans didn’t always possess such a sweet tooth for sugar. Sugar was once considered a “fodder” crop, which meant very little of it found its way into human diets. It’s presumed that in ancient times people chewed on sugarcane stalks occasionally. In the 1960s big sugar paid off scientists to downplay the effects of sugar on heart disease, and instead convinced them to place the blame on saturated fat as the nutritional scapegoat. These deceptive efforts persist to this day. In 2015, The New York Times found that “big sugar” behemoth Coca-Cola funded scientists who downplayed the link between sugar and obesity. The following year, The Associated Press revealed that “big sugar” companies funded studies claiming that children who eat candy weigh less than those who don’t. Fortunately, today’s scientific research on sugar isn't as artificial as it was a few decades ago.

There’s no way to sugarcoat it: the massive consumption of the sweet crop is at the heart of global health crisis and America’s ever-increasing obesity epidemic. According to the Center for Disease Control (CDC) the percentage of children and adolescents affected by obesity have more than tripled since the 1970s, placing a costly burden on America’s medical costs to fight the epidemic. A 2018 study by the American Public Health Association estimates that it costs around $344 billion to combat obesity. That’s excluding the $327 billion per year it costs America to fight diabetes, according to an American Diabetes Association (ADA) 2018 study. That’s $641 billion per year in medical costs for two diseases alone.

The bittersweet truth

The dangers of sugar come in many forms, but few products have such a deleterious impact on health than soft drinks. A typical 20 ounce soda contains anywhere from 15 to 18 teaspoons of sugar, twice the amount of the recommended daily intake. The rise of sugar in our diets corresponds to the rise in popularity of soft drinks in America. Before the 1950s, most standard soft drink bottle sizes were 6.5 ounces, a decade later the figure nearly doubled in size to 12 ounce bottles and cans. The figure rose to what would become the “new norm” of 20 ounce bottles and cans, reaching an all-time high of sorts with the release of a 42 ounce bottle in 2011.

“Sodas are in the top five of the most damaging products masquerading as food in the world today. They offer no benefits with the exception of a bit of hydration if they aren’t caffeinated,” says San Rafael-based Clinical Nutritionist Kia Sanford, Masters of Science. “But that hydration comes at a high cost. Sugar is pro-inflammatory, meaning it will drive up symptoms and accelerate the decline of many disease states, including diabetes, arthritis, cardiovascular disease and cancer. And, this is straight sugar without anything to slow down its entry into the bloodstream. When caffeine is added to the mix, you accelerate the entrance of the sugar into the bloodstream even faster.”

A 2015 study published in the journal, Circulation, reveals that sugary drinks are responsible for more than 25,000 deaths in the U.S. every year. The U.S. claims the world's third highest total of sugary drink sales by country in terms of calories sold per person, averaging more than 160 per day. Despite the decline of fizzy drink sales of Coca-Cola and Pepsi in recent years due to new research on the damage of such beverages; juices, energy, and sports drinks infused with added and hidden sugars have spiked sales by growing in popularity during the past five years.

“Clients will tell me they switched to lemonade, then I show them that it’s about the same amount of sugar as a soda. If someone is trying to cut out soda, I recommend drinking more water,” says Tawnya Dorn, registered dietitian for Napa’s Queen of The Valley Wellness Center. “If the water isn’t enough to cut the craving, many of my clients are successful with switching to sparkling water that contains no sugar and most do not contain sodium either. It’s the carbonation that many people miss.”

Strung-out on sugar

Sugar can appear to be harmless, fun and innocent, and is often associated with anniversaries, birthdays and weddings. These magic moments end in some type of magical concoction of sugar-filled bliss, which is why it’s easy to develop a habit of indulging in sweets as a reward.

“Sugar lights up the receptor sites in the brain the same way that opioids do. Add to that problem the fact that sugary foods are not only acceptable to consume, they are celebrated in modern culture, and you have a much bigger problem,” Sanford says. However, rewarding yourself and your loved ones with sugar is as dangerous a custom as the running of the bulls. But in this case, the bull isn’t some primal beast manically trampling over you; it’s a deadly poison killing you over time. Sugar is an addictive drug. And the tragic link between sugar and addiction lies in the dramatic role played by dopamine.

Dopamine is a chemical that functions as the brain’s neurotransmitter, serving as a messenger service between brain cells. When an excess amount of dopamine is released into the brain, the body is stimulated by a pleasurable high. This stimulation causes the brain to repeatedly seek out and indulge in this experience. An irregular spike in dopamine levels leaves our brains unsatisfied with the lesser, normal, healthier levels of dopamine. Rather, the brain requires increased amounts at a higher frequency of stimulation. In other words, the brain becomes strung-out with a substance abuse problem. “We’ve seen that the brain is stimulated by sugar in the same way drugs stimulate the brain. So of course, sugar can be very addicting to many,” Dorn says. “Many times eating sugar is a habit. I have several patients tell me they’ll always have to have a sweet after one or all of their meals.”

As with any addictive drug, sugar is a substance that is all too easily abused. It rewards destructive behavior. Several studies have gone as far to suggest that sugar can prove to be more addicting than cocaine.

Added and hidden sugars

Not all sugars are created equal, and it takes more than the “Pepsi challenge” to detect the differences between them. Added sugars are hard to spot since there can be more than 60 names used to identify them in a product. Added sugars are often times listed as a form of syrup, like corn syrup or rice syrup. They are also commonly dress up in scientific terms, labeled as ingredients ending in “ose,” such as dextrose, glucose and maltose. Consuming too much added sugars over long periods of time can affect the natural balance of hormones that drive critical functions in the body. “The main culprits in weight gain are sugar sweetened beverages and refined, processed, packaged foods,” says Galen Hegarty, M.D., a physician at Kaiser Permanente Santa Rosa Medical Center. “The food industry monitors dietary trends and is aware that people are now looking for whole food and plant based products. They’ve created marketing gimmicks to support the need for pre-prepared, convenient snacks and meals, so it’s important to be skeptical; read food labels and avoid packaged foods.”

What makes hidden sugars particularly threatening is that they are just that: hidden. These sugars come disguised in many forms, and hide in plain sight among the nutritional information of a given product. The ancient Chinese strategist Sun Tzu wrote of the importance in “knowing the enemy” and if sugar is the enemy, it’s essential to know how to spot the surreptitious practices conducted by food companies when it comes to labeling the sweet nectar. “Don’t get fooled by the many ways food product manufacturers hide sugar. Everyone’s default should be: real food. Your body needs building blocks for maintenance and repair, and it can only use what you give it. Give it materials that are real and that it knows what to do with,” Sanford says.

The nutritional facts label on a product is intended to divulge the amount of sugar that exists in that particular product. However, until recently, the label was not required to separate the amounts of “naturally occurring sugars” from that of “added sugars.” In 2016, the Food and Drug Administration (FDA) succeeded in implementing changes for nutritional information concerning sugars. “Thankfully, the new food labels that are slowly being entered into the supermarkets are helping us to determine how much is added sugar,” Dorn says. “Unfortunately, the regulations for these new labels continue to be pushed back, so not all food labels are telling us the added sugar amount.”

The FDA-imposed label changes were rolled out by a number of companies throughout the last few months, and are expected to take effect on all nutritional labels by 2020. New FDA requirements stipulate that all sugars used in processed foods must be identified on food labels, in addition to exactly what percentage of the foods is comprised of sugars and added sugars. This advancement in transparency is a huge win for wellness in the battle against diabetes and obesity, considering that an estimated 74 percent of packaged goods contain some form of added sugars.

Natural sugars

It may seem like all sugars ending in “ose” are dubious, scientific concoctions developed in laboratories, but fructose and lactose are two types of sugars that occur naturally in foods. Lactose is the major carbohydrate found in milk, which provides an impressive cocktail of nutrients such as calcium, Vitamin D and riboflavin. Unless you’re lactose intolerant, lactose is an integral nutrient to a healthy diet. Naturally occuring sugars are healthier for you than artificial or refined sugars but still must be taken with a grain of salt.

“We aren’t supposed to consume dairy after about age 6. But, if you descended from the northern tribes of Europe thousands and thousands of years ago, you probably have a gene mutation that leaves the lactase enzyme system on. This mutation allowed those northern tribes to continue to consume milk into adulthood,” Sanford says. “When politics pushed our country into creating non-fat milk, we essentially created another soda with a bunch of sugar and little bit of damaged protein. Interestingly enough it’s full-fat dairy that contains a substance called CLA (conjugated linoleic acid), which helps the body to support lean mass and let go of fat mass. If you have low or non-fat dairy you’re missing out on this vital component necessary for proper weight maintenance.”

When combined with glucose, fructose creates sucrose or what we know as common table sugar. While excessive consumption of high-fructose corn syrup (commonly found in soft drinks) is a primary factor in most sugar-related diseases, fructose intake from fruit is a different story. You shouldn’t shy away from consuming too much fruit out of fear of consuming too much fructose. “Eat fruit. Whole fruit instead of fruit juices. Eat whole vegetables instead of vegetable juices. My clients come in proudly claiming to drink 16 ounces of freshly juiced fruits and vegetables multiple times a day and I cringe. What they don’t understand is how much sugar they’re ingesting without anything to slow it down, similar to the soda problem,” Sanford says.

“As an example, consider someone is juicing enough vegetables to make a 12 ounce drink including 4 ounces of carrot juice, 4 ounces of apple juice, 2 ounces of celery juice, 1 ounce of cucumber juice, 1/2 ounce of lemon juice and 1/2 ounce of ginger juice. That all sounds healthy right? Well here’s the rough nutritional breakdown: 138 kilocalories, 33 grams of carbohydrate of which 30.5 grams become blood sugar. If you use a juicer that removes the pulp (aka the fiber), you have nothing to slow that sugar down. The good feeling that person gets after drinking their ‘healthy juice’ is actually a sugar high.”

Artificial Sugars

To combat the seemingly insurmountable mound of sugar consumption in America, which leads to obesity, type 2 diabetes and numerous cardiovascular problems, the FDA has approved six artificial sweeteners to date. Although these sweeteners provide a healthier alternative to sugar, these substitutes are not without risks themselves. Proceed with caution when turning to non-nutritive sweeteners such as sucralose, marketed as Splenda, and saccharin, marketed as Sweet ‘N Low; the overall health effects of these low-calorie alternatives are inconclusive, with most research thus far revealing mixed findings. A general concern with artificial sweeteners is the possibility that the products can alter our taste buds to certain foods. These sweeteners are far more potent than sugar, ranging from 180 to 20,000 times sweeter than regular sugar. The danger of overstimulation from frequent usage of these alternatives threatens our tolerance for foods with complex tastes.

“They can perpetuate the problem because it leaves the “sweet meter” on high. It sets the body up biochemically to expect a lot of sugar to be hitting the system very soon after the taste hits the brain,” Sanford says. “The pancreas overshoots the mark with insulin production to meet the sugar that never comes, and pushes the system into storage instead of burn which is one theory about why people tend to gain weight on sugar substitutes even though the calories aren’t there. Your body understands sucrose and fructose. It doesn’t understand aspartame (Nutrasweet) and sucralose (Splenda). There are reports of people drinking six to 12 cans of diet soda per day and ending up with blood alcohol levels of 0.5, and that’s before even considering the next metabolite, formaldehyde, which is used in embalming fluid. When it comes to artificial sweeteners, just don’t.”

Essentially, the more someone turns to artificial sweeteners, the more they run the risk of shunning foods like fruits and vegetables due to their relative lack of sweetness, potentially rejecting them altogether. Researchers are still unsure of how these sweeteners affect the body; however, recent studies show negative health impacts on blood sugar, trouble maintaining an appetite, and a disruption of gut bacteria. When turning to sugar-free replacements, Hegarty advises proceeding with caution. “Calorie-free artificial sweeteners and food additives do not affect blood sugar levels, which is a big industry sales pitch to consume more of these sweeteners,” he says. “However, these sweeteners can raise insulin levels, which puts the body into an energy storage mode, as opposed to energy use mode, and leads to storage of nutrients in the liver and fat cells and weight gain. Also, these sweeteners have been shown to increase hunger and lead to increased consumption of food during meals. Artificial and low-fat sweeteners are best avoided.”

Sanford advises her clients that the best way to cut back on sugar is to eat only natural foods. “When you make your own food from real ingredients, you know exactly what’s in your meal because you were the one that put it there,” she says. “Apples don’t come with nutrition labels because it’s obvious it’s an apple. The more sugar and artificial sweeteners we use, the less we taste. Turn down the ‘sweet meter’ and let your taste buds recover. After two weeks off sugar and sugar substitutes, you’ll have the best apple you’ve had in your life because you’ll actually be tasting it.”

dairy do's and don'ts

Kia Sanford, a clinical nutritionist in San Rafael, recommends consuming dairy are as follows:

Get really picky and demand organic only dairy.

Plain, full-fat dairy is closer to a real food than low or non-fat.

Consider the health of the animal and what they were fed because that all affects the composition of the dairy the animal produces.

Know that dairy is the breast milk of another mammal meant to grow baby cows, not humans.

daily sugar intake

The World Health Organization (WHO) recommends that no more than 10 percent of your calories, ideally less than 5 percent should come from either added or natural sugars. Consider the recommended daily 2,000-calorie diet, 5 percent is equivalent to 25 grams of sugar. There are 39 grams of sugar in a 12-ounce bottle of Coke, nearly double the recommended intake.

The United States Department of Agriculture (USDA) estimates that Americans consume 150 to 175 pounds of refined sugar per year or around 218 grams per day. Now compare that with the American Heart Association’s (AHA) recommendations for daily sugar intake, which is only 25 grams per day for adult women, and 36 grams per day for adult men. The AHA shows that those who eat 49 grams of sugar or more per day increase their risk of dying from heart disease by nearly one-third more than those who consume less.

s.m.a.r.t. tips to combat obesity

Need an obesity fighting cheat sheet? Dr. Hegarty, M.D., has assembled a convenient system to commit to memory to counter the disease.
S = Set a goal. Without this, how can you know where you’re heading and stay on track? It could be a goal weight, pants size, body fat percentage, working towards a 5K, etc.
M = Monitor your progress. This will help you meet your goals so that when you hit a plateau or have a set back you’ll have perspective, and be able to modify your process to continue towards your goal. For example: weigh yourself daily or weekly, track your daily steps, count your calories, track your daily exercise patterns and be aware of how stress affects your eating habits.
A = Arrange your world to meet your goals. Prepare healthy home cooked meals, plan ahead and bring healthy snacks or meals if you won’t be able to eat at home. Clean out your home so unhealthy foods are not available, so when you reach for something you will only have healthy choices available.
R = Recruit a team to help you meet your goal. You are not alone. So many of your friends, family and neighbors have the same goal as you. Recruit an exercise partner. Join a hiking group, fitness center, or support program. Tell your friends and family your goals and how you are trying to achieve them so they can support you in your lifestyle changes.
T = Treat yourself once you reach your goal. Not to a caloric treat, but to something you have wanted to do for a long time. For example, put $5 to $10 in savings for every pound lost to travel or do something special.