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Are you confused about sugar?

While we have all heard about its addictive, negative qualities, the topic of sugar is still a confusing one.

Here are some of the common questions…

What is the difference between ‘sugar’ and carbohydrate—or are they the same thing?

Should sugar be eliminated altogether or is there an acceptable level of consumption?

Together, let’s explore the real truth about sugar…

What Is Sugar, Exactly?

Before we talk about sugar, we need to discuss carbohydrates.

Carbohydrates are biological molecules consisting of atoms of carbon, hydrogen and oxygen.  In biochemistry, they are synonymous to saccharides (in Greek, sákkharon means sugar).

Carbohydrates (or saccharides) are classified into 4 chemical groups – monosaccharides, disaccharides, oligosaccharides and polysaccharides.

Sugar is an umbrella name used to describe mono and disaccharides, which are sweet, short-chain, and water-soluble carbohydrates.  A monosaccharide consists of a single sugar unit while a disaccharide is formed when two monosaccharides are joined.

  • Monosaccharides include glucose, fructose, and galactose
    • Glucose occurs naturally in plants and is a product of photosynthesis. Most ingested carbohydrates are converted into glucose during digestion.
    • Fructose, or fruit sugar, is found naturally in fruits. It is also the sweetest of sugars. While many argue that you should limit your sugar intake from fruit, this is simply not true.

However, it is essential to distinguish between the natural fructose found in fruits and the highly processed, stripped variety of fructose that you find in so many packaged foods. The latter has zero nutritional value and is known to
contribute to many serious health issues.

    • Galactose does not occur in the free state but is part of the disaccharide lactose (milk sugar).
  • Disaccharides include lactose, maltose, and sucrose
    • Lactose is the naturally occurring sugar found in milk.  Lactose consists of one unit of glucose and one unit of galactose.
    • Maltose is formed when certain grains are germinated. (For example, when barley is converted into malt). Maltose is formed from two units of glucose.
    • Sucrose is formed by the combination of one unit of glucose and one unit of fructose.  It is found in sugarcane and sugar beet roots. Table sugar and high-fructose corn syrup are both processed, stripped forms of sucrose.  Table sugar is 50% glucose and 50% fructose while HFCS is usually 55% fructose.

Artificial sweeteners such as saccharine and aspartame do have a sweet taste but are NOT considered sugars. We will get to that in a separate post…

The History of Sugar

Until the Indians found a way to turn sugarcane juice into crystals that were easy to store and ship, sugar as we know it did not exist. Discovered by the Imperial Guptas somewhere around the 5th century, the crystals were called Khanda, which is the source of the modern English word, candy.

Sugars make food taste better, give us short-term energy and have addictive qualities. Which is why we use so much of it!

The numbers are staggering. According to the Food and Agriculture Organization of the United States (FAO), across the world, the average person consumes about 53 pounds of sugar each year.  In industrialized countries, that number is as high as 73 pounds of sugar per person per year.  In the US, sugar consumption started as low as 4 pounds per person in 1776 going up to 20 pounds in 1850, 120 pounds by 1994 and is currently close to 160 pounds per person per year!

From Lollipops to Lentils

The terms ‘sugar’ and ‘carbohydrate’ are often used interchangeably, which can be quite confusing.

As mentioned earlier, sugar usually refers to short-chained carbohydrates, i.e. monosaccharides (e.g. glucose and fructose) and disaccharides (e.g. sucrose and lactose).  Oligo and polysaccharides, though also carbohydrates, are different.

Polysaccharides are long-chained carbohydrates consisting of at least 10 sugar units.  Starch is a polysaccharide that stores ‘energy’ in plants.  In the human diet, large amounts of starches can be found in staple foods like wheat, corn, cassava, potatoes, and rice.

Evidently, the problem with the term ‘carbohydrate’ is it stretches across a gamut of foods–from lollipops to lentils

To take this example, a lollipop is made of refined sugar stripped of fiber and nutrients (vitamins, minerals, phytochemicals) while a lentil is a starch, left intact with all of its healthful nutrients and fiber.

To understand carbohydrates (and their importance to a healthful diet), you might want to refer back to an earlier post we wrote, Why Carbs Need to Come Out of the Closet.

How Bad Is Sugar…Really?

The short answer is, “It depends.”

Sugar that is naturally sourced in fruits is full of nutritional goodness; your health will benefit greatly from integrating fruits into your daily diet.

On the other hand, white table sugar has zero nutritional value.

It is important to stress that we cannot lay 100% of the blame for our health woes on sugar’s doorstep. It is the entire fabric of our diet that matters.

The Dose Makes the Poison

In toxicology, there is a guiding principle that says, “the dose makes the poison”.

Even sugar is unlikely to be toxic in small and occasional doses.

So what is a safe sugar dose?

The general rule of thumb is that less than 5% of your daily calories should come from added sugars.

Unfortunately, for most Americans, that number is 3-4 times higher-hovering around 16-20%.

(I would like to stress that the less than 5% rule does not apply to ‘intact’ sugars and starches that we find in a variety of whole plant-based foods including fruits, beans, peas, lentils, rice, and potatoes. The less than 5% rule applies to added sugars only!)

Also, other factors and lifestyle choices play a role in how much added sugar you can ‘take’ in your diet (if you must).

So, sugar is…

  1. Not particularly harmful in small amounts for people with healthful diets and lifestyles.
  2. More harmful in large amounts for people who have healthful diets and lifestyles.
  3. Harmful, but not the biggest concern in small amounts for people who have unhealthful diets and lifestyles. In other words, they have bigger things to worry about — their overall lifestyle.
  4. Very harmful in large amounts for people who have unhealthful diets and lifestyles. But again, their overall concern should be changing the whole diet and lifestyle picture.

Hide and Seek

Added sugars are hiding everywhere. In ketchup and other condiments. Flour-based mixes. Salad dressings. It is important to read the labels to spot the hidden sugars. Check out our free Food Label Cheat Sheet for a handy tool to help read food labels.

But for now, here is an excellent list of what to look for when it comes to sugar on food labels: agave nectar, barley malt, beet sugar, brown sugar, brown rice sugar, buttered syrup, cane (juice) crystals, cane juice, cane sugar, caramel, carob syrup, castor sugar, coconut water (50% sugar), coconut sugar, confectioners powdered sugar, corn sweetener, corn syrup, corn syrup solids, crystalline fructose, date paste, date sugar, date syrup, demerara sugar, dextran, dextrose, diastase, diastatic malt, dried cane syrup, ethyl maltol, evaporated cane juice, fructose, fruit juice, fruit juice concentrate(s), galactose, glucose, glucose solids, golden sugar, golden syrup, grape sugar, high-fructose corn syrup, honey, icing sugar, invert sugar (syrup), lactose, malt syrup, maltodextrin, maltose, maple syrup, molasses, muscovado sugar, panocha, raw sugar, refiner’s syrup, rice syrup, sorghum syrup, sucanat, sugar alcohols (erythritol, mannitol, sorbitol, xylitol), sucrose, sugar, syrup, treacle, turbinado sugar, yellow sugar.

As you can see, that’s a pretty hefty list (and it is not even complete!).

To sum up, when eating packaged foods, make sure that your intake of added sugars is less than 5% of your daily calories.  And, whenever possible, eat whole foods to help ensure you are eating the right kind of sugars and starches.

Rosane Oliveira, DVM, PhD

President & CEO, Plant-Based Life Foundation | Dr. Rosane Oliveira combines a lifelong passion for nutrition with 25 years of genetics research to create programs that help people develop healthy habits on their journey towards a more plant-based lifestyle. She is a Visiting Clinical Professor in Public Health Sciences and was the founding director of the first Integrative Medicine program at the UC Davis School of Medicine. She completed her postgraduate studies in Brazil and did her postdoctoral training in immunogenetics and functional genomics at the University of Illinois at Urbana-Champaign.