by Martha Wetmore

Sugar Is Not So Nice

Sugar and spice are not so nice, it turns out.

Sucrose is a combination of fructose and glucose, sweet tasting soluble carbohydrates. The use of sugarcane originated in India, as early as the 8th century BC, but its origins were as an ayurvedic medicine, not a ubiquitous food ingredient. While currently we can find sugar in everything from baked beans to pizza sauce, sugar’s role has historically been very different. Prior to the 18th century, sugar was a luxury in Europe, consumed sparingly and only by the wealthy. It became progressively more popular and available until the 19th century, when it started to be considered a necessity. If we look even further back to our prehistoric ancestors, sources of naturally occurring sweeteners were limited to honey and wild fruits. These difficult-to-find foods were seasonal and limited in quantity. Based on this ancient environment of scarcity, we are wired to prefer once-rare, sweet-tasting foods.

Sugar Here, Sugar There, Sugar Everywhere

Producing sugar involves a complex series of processes, from harvesting the initial sugar-rich crop (generally beets or sugarcane), to extracting and purifying the sweet, thin, juice, reducing the juice to syrup and finally to granules which may be left “raw” or further refined into the white crystals we spoon into our coffee. It’s about as far from its natural state as it can get (yes, even raw sugar has been heavily processed, and no, it’s not any better for you). Finding out which foods contain added sugar can be a bit of a scavenger hunt, as there are at least 61 different words used on food labels that mean sugar. Even so-called health foods can be loaded with extra sweeteners. These alternate names range from the obvious (sucrose) to the not-so obvious (barley malt, panocha, treacle). It’s a safe bet that any ingredient ending in -ose, or including the word “syrup” is sugar in disguise.

North Americans consume a staggering 66 pounds per year of added sugar. If you’re eating anything that comes out of a package, there’s a solid chance you’re consuming added sugars, whether you realize it or not. If everybody’s doing it, it can’t be that bad, right? Well, no. The rise in sugar consumption correlates with a dramatic rise in obesity and diabetes. Not only does consuming sugar have significant health impacts, it’s a self-perpetuating habit. Eating sugar only makes you want more. People joke about being “addicted” to sweets, but they are closer to the mark than they realize. Intermittent sugar binges in rats cause neural adaptations that change dopamine and opioid receptor binding, rendering the animals sugar-dependent. Dopamine is a neurotransmitter associated with addiction. 1

Sugar Is Killing Us

Sugar is classically linked with diabetes, and for good reason. Globally, the prevalence of diabetes has more than doubled over the last thirty years, leaving almost 1 in 10 adults affected by the condition. No other food category (oils, meats, tubers, vegetables, and fruits) has been found to correlate with this rise in diabetes, nor has any other food been found to affect or increase diabetes rates. The availability of sugar out-influences other, supposedly healthy foods… if you’re eating sugar at Western rates, no amount of low-carbohydrate vegetables, nuts, or whole grains will protect you from its effects. Every 150 calories per day of sugar that a person ingests (about the amount in one can of soda) increases the chance of developing diabetes by a little over 1 percent. Consuming 150 extra calories of any other food causes only a .1 percent increase in the disease’s prevalence. Happily, the effect is reversible; reducing sugar availability in a population reduces the incidence of diabetes. 2, 3

If sugar is so obviously bad for us, why is it in everything? The short answer is that we are predisposed to seek out sweet flavors. As mentioned above, our ancestors did not have easy access to sweet foods. Honey, for example, represents a uniquely dense source of calories and energy, a valuable asset for a hungry hunter-gatherer. Fruit, in season, offers vitamins and nutrients along with its tasty packaging. By separating out the sweetness from its context, we’ve been hot-wiring our survival instincts with candy bars.

The longer answer is that while many studies have found correlations with negative health outcomes, major large-scale studies are difficult to organize for several reasons. One roadblock is that finding a control group of sufficient size who do not consume sugar is a daunting task. Another difficulty is that these studies cost money to conduct, and finding funding for a study to prove that sugar is dangerous and unhealthy is an uphill battle. In spite of these challenges, it turns out the scientific community has known just how bad sugar is for us for quite some time. This knowledge dates back to a research project sponsored by the Sugar Research Foundation in 1965 and published it in the New England Journal of Medicine. Without disclosing that they funded the project, the Sugar Research Foundation not only set the literature review’s objective and suggested revisions on drafts of the project, but also contributed articles to be included in the review. The result was a research program in the 60’s and 70’s that minimized sucrose consumption as a risk factor for coronary heart disease, instead pointing the finger at fat and cholesterol. 4

The Sugar Research Foundation terminated a project called Project 259 without publishing its results. While the reasons the study was ended prematurely are unclear, what’s known is that Project 259 compared rats fed a high-sugar diet to rats fed a high-starch diet. The rats fed the high-sugar diet had elevated levels of beta-glucuronidase, an enzyme associated with bladder cancer in humans, in their urine. These results would have led to further scrutiny of sugar as a potential carcinogen. 5

In more recent research, sugar has been confirmed to encourage breast cancer. In mice fed diets comparable in sugar content to the modern Western diet, tumor growth and metastasis were significantly increased. 6

The sad truth is that sugar has become ubiquitous in the Western diet, and we are paying the price with our health. With a little intentional research and label-reading, however, it’s possible to avoid a sucrose overload and its associated health risks. While some are quick to label the elimination of sugar as “orthorexia”, it’s not as cut-and-dried as that. Sugar is addictive and carcinogenic, as well as a major contributor to the development of metabolic syndrome and coronary heart disease. Avoiding sugar may seem like an extreme choice in the context of Western dietary culture, but it’s a solid strategy for optimal health.

References

  1. Avena, N.M., P. Rada, and B.G. Hoebel, Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Biobehav Rev, 2008. 32(1): p. 20-39.
  2. Basu, S., et al., The relationship of sugar to population-level diabetes prevalence: an econometric analysis of repeated cross-sectional data. PLoS One, 2013. 8(2): p. e57873.
  3. Danaei, G., et al., National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet, 2011. 378(9785): p. 31-40.
  4. Kearns, C.E., L.A. Schmidt, and S.A. Glantz, Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents. JAMA Intern Med, 2016. 176(11): p. 1680-1685.
  5. Kearns, C.E., D. Apollonio, and S.A. Glantz, Sugar industry sponsorship of germ-free rodent studies linking sucrose to hyperlipidemia and cancer: An historical analysis of internal documents. PLoS Biol, 2017. 15(11): p. e2003460.
  6. Jiang, Y., et al., A Sucrose-Enriched Diet Promotes Tumorigenesis in Mammary Gland in Part through the 12-Lipoxygenase Pathway. Cancer Res, 2016. 76(1): p. 24-9.