You’ve got problems.
All of us do. Having problems isn’t nearly as exhausting as the prospect of solving them, though. Who has time to read The 7 Habits of Highly Effective People (or practice it!), who can afford the weekly therapy investigating our suboptimal behaviors satisfying our inner needs, and who’s got the patience to develop a mindfulness-based approach to our email, let alone the real stress points of our lives. Doesn’t someone have an easy answer to everything?
They DO! Enter a limelight-seeking Dr. or celebrity or worse, both at the same time: they come out with a book or go on a talkshow and ask “Are you stressed out? Are you overweight? Are you fatigued? Do you feel you are not living up to your potential?” We predictably scream “YES!”, or at least eek out a tear-filled nod, if you catch us at the right spinally-challenged-camel moment.
Then comes their solution. They know what’s causing all of our ills. It’s not the 10 hours of sitting per day. It’s not the fact we are constantly surrounded by all types of foods and we can pretty easily exist without taking so much as 3 steps during a day. It’s not the high pressure to be insanely productive, be the perfect nurturing and attentive parent, have the best relationship, live in a pristine and organized house, and also be ready at any moment to pose for the cover of Glamour. Nope. None of that matters. What is ruining your life is just this: sugar.
Really? Is sugar a toxin? Or is true that, aside from swallowing hypodermic needles, the dose makes the poison?
So wait, when you say sugar you mean high fructose corn syrup, not natural cane sugar, right?
Wrong. High-fructose corn syrup is made from corn, and chemically is about 55 % fructose and 40 % glucose, (plus some other sugars and ingredients). Sucrose, or table sugar, is 50% glucose and 50% fructose. Metabolically speaking, there is no evidence that our body responds gram for gram any differently to these sugars.
But isn’t “natural” better? Chemicals are bad!
If something is chemically the same as the “natural” source, our intestines don’t know the difference. They don’t throw you a parade, and you get no bonus points.
All right, so why do I just hear about high-fructose corn syrup being the evil Children of the Corn?
High-fructose corn syrup is cheap, so it can be used in lots of products without jacking up the price. Therefore it’s readily available. So it’s easy to eat a lot of it. Therefore it just happens to be the sugar form that we are consuming a ton of. If it was the other way around and we were producing sucrose at an insanely cheap price and throwing it into everything, my guess is we’d be hating on sucrose as the Lucifer of our lives. But no evidence shows high-fructose corn syrup is treated any differently than the similar compound of sucrose (nor, for that matter, a constructed 50-50 glucose / fructose mixture).
Fine, so sucrose = high-fructose corn syrup. So are they both making us fat?
Well, first things first. I would say that as a nation we are consuming too much sugar, mostly in the form of sugar-sweetened beverages. So overconsuming anything (if it outnumbers your calorie expenditure) is going to contribute to weight gain.
Is sugar itself making us fat? It’s controversial. For one, our sugar intake actually has decreased between 1999 and 2008, but obesity is still on the up. So it’s obviously not the only contributor to our problem.
Also, the studies that actually give people sugar and then watch what happens are very short-term, and usually testing such large amounts of sugar or forms of sugar not present in an everyday diet (we don’t consume an isolated source of fructose, for example, especially in the amounts given to people in fructose load studies!). So there is no evidence that supports sugar being a unique compound that independently contributes to obesity.
But if you eat sugar you can’t LOSE weight, right?
Actually, yes you can. One recent study pitted sucrose against high-fructose corn syrup for weight loss. For 12 weeks, 247 overweight / obese peeps were randomly assigned to 1 of 5 groups: 4 groups were assigned to exercise plus a hypocaloric diet of either 10% of 20% of their calories as either added sucrose or added high-fructose corn syrup; the 5th group was an exercise only control group. The exercise started out as 15 minutes 3 days a week and progressed to 45 minutes 3 days a week. All groups lost body weight and reduced total cholesterol, triglycerides, and LDL. The 4 diet + exercise groups showed decrease in body fat as well.
Dr. Klurfeld, the national program leader for Human Nutrition USDA agricultural Research service, was quoted saying that “the concept that sugar is toxic simply has no credibility. We have no data to tell us about how much is too much for any health endpoint we ask about.”
Wait, so then if a calorie is a calorie, how would sugar even be correlated with weight gain?
First, sugar makes things taste really good, so we are more likely to eat more of the foods that have added sugar, and also eat them more often. Second, sugar-sweetened beverages are widely promoted and advertised, providing a major source of calories in our beverages, which is where a huge part of the problem lies. Not only are they being offered to us everywhere, but when we drink sugar calories, our body doesn’t recognize that the same way we recognize calories consumed…so if we don’t physiologically react to it, we don’t get full. We don’t compensate for those calories in ad-libitum food intake.
What about honey?
OK, so honey has glucose and fructose as well as some other sugars in it. Metabolically our body
appears to treat it the same as sucrose and high-fructose corn syrup. The difference, however, is that honey seems to have some added components in it that are health promoting (antioxidants, polyphenols, anti-bacterial properties, etc.). Also, rats show a slightly different metabolic response with honey compared to sucrose, and it can lower their anxiety even compared to a sugar-free diet!! This is an exciting topic for another day, though. I digress too easily…
So then sugar is good for me? I knew it! Cuz sugar is my energy!
Hang on. First, when you say “energy,” what do you mean? Sugar does not make you hyper (see this blog for this answer!). But sure, it is “quick” energy in the sense of calories, depending on what you eat it with. Fruit juice or sugar sweetened “Gu” is a popular ergogenic aid for marathon runners and other athletes.
If you are working out 90 minutes or longer, you should definitely have some quickly-digestible carbohydrates, such as a sugar based Gu, during your workout. And carbohydrates in general are the primary fuel for either acute high-intensity exercise or prolonged exercise.
But that doesn’t mean you should mainline sugar, either. It’s nutritionally bereft in its pure form, and often comes in nutritionally anemic foods as well. The American Heart Association recommends that for added sugar (not naturally found fruit sugar, which is DIFFERENT than added sugar!) you cap at about 100 calories per day for females and 150 for males (not fair!). So try to stick with that unless you’re running a half marathon.
So take home this: sugar isn’t GOOD for you meaning it won’t do anything for you, unless you’re an athlete in the middle of a huge gym-detonating workout. But given what we know now, it’s not causing all of our problems, either.
Til our next panacea promise…guess it’s time to hit up that yoga class.
MS, RD, PhD
Super Interesting Sources to read to your friends / kids:
The study below found that added sugar has significantly decreased between 1999 and 2008 while the obesity prevalence has continued to rise:
Welsh, J.A., Sharma, A.J., Grellinger, L., & Vos, M.B. (2011). Consumption of added sugars is decreasing in the United States. American Journal of Clinical Nutrition, 94(3), 726-34.
Honey is yummy, but it may make us feel better, too? The following study found that honey-fed rats had less anxiety and better spatial memory than those on a sugar-free or sucrose fed diet. More on this study in a later blog, cuz it’s super cool:
Chepulis, L.M., Starkey, N.J., Waas, J.R., & Molan, P.C. (2009). The effects of long-term honey, sucrose or sugar-free diets on memory and anxiety in rats. Physiology & Behavior, 97(3-4), 359-368.
Does sugar negate weight loss? Study below says nope.
Abstract clipped summary: The replacement of sucrose with HFCS in food products has been suggested as playing a role in the development of obesity as a public health issue. The objective of this study was to examine the effects of four equally hypocaloric diets containing different levels of sucrose or high fructose corn syrup (HFCS). This was a randomized, prospective, double blind trial, with overweight/obese participants measured for body composition and blood chemistry before and after the completion of 12 weeks following a hypocaloric diet. The average caloric deficit achieved on the hypocaloric diets was 309 kcal. Similar decreases in weight and indices of adiposity are observed when overweight or obese individuals are fed hypocaloric diets containing levels of sucrose or high fructose corn syrup typically consumed by adults in the United States:
Lowndes, J., Kawiecki, D., Pardo, S., Ngyuen, V., Melanson, K.J., & Zhiping, Y. (2012). The effects of four hypocaloric diets containing different levels of sucrose or high fructose corn syrup on weight loss and related parameters. Nutrition Journal, 11, 55.
High-Fructose-Corn-Syrup vs Sucrose research:
Fructose metabolism is tough to trace, and we rarely eat fructose in pure form like some of these fructose studies test. Also, some fructose gets converted to glucose, and this can only be truly tracked with isotopic tracers. Sucrose, honey, 50:50 glucose-fructose mixtures and HFCS all appear to be similarly absorbed. See below source for an interesting read:
Sun, S.Z, & Empie, M. W. (2012). Fructose metabolism in humans – what isotopic tracer studies tell us. Nutrition and Metabolism, 9, doi:10.1186/1743-7075-9-89.
This recent study found that fructose was not related to our metabolic issues. The authors note that daily fructose intakes with the American diet averaged approximately 37% of total sugars and 9% of daily energy. Fructose was rarely consumed solely or in excess over non-fructose sugars. Fructose and non-fructose sugar ordinary consumption was not positively associated with indicators of metabolic syndrome, uric acid and BMI:
Sun, S.Z., Anderson, G.H., Flickinger, B.D., Williamson-Hughs, P.S., & Empie, M.W. (2011). Fuctose and non-fructose sugar intakes in the US population and their associations with indicators of metabolic syndrome. Food and Chemical Toxicology, 49(11), 2875-2882.
This systematic review found no randomized controlled trials showing that high fructose corn syrup or fructose increased levels of cholesterol relative to other sweeteners:
Wiebe, N., Padwal, R., Field, C., Marks, S., Jacobs, R., & Tonelli, M. (2011). A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes. BMC Medicine, 9, 123.
This review highlights the fact that limited data are available about the metabolic effects of HFCS compared with other caloric sweeteners. The data suggest that HFCS yields similar metabolic responses to other caloric sweeteners such as sucrose:
Angelopoulous, T.J., Lowndes, J., Zukley, L., Melanson, K.L., Nguyen, V., Huffman, A., & Rippe, J.M. (2009). The effect of high-fructose corn syrup consumption on triglycerides and uric acid. Journal of Nutrition, 139(6), 1242S-1245S.
PS- Dr. Klurfield’s quote was from Today’s Dietitian October 2012 Issue cover article on sugar.