Sugar and health

Sugar and health

Sugar and health

In the Nordic Region, the consumption of sugar has essentially remained unchanged for the past fifty years. Interest in health issues is high, and in this section we have gathered together some scientifically supported information about sugar and health.

Read our information brochure "Facts about sugar and health"
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Why is there sugar in food?

Why is there sugar in food?

Besides bringing sweetness, sugar also contributes to several of our food’s sensory properties such as colour, texture and taste. In some products, sugar can act as a natural preservative.

The primary function of sugar in food is to add sweetness. Sugar has a clean, sweet taste with no aftertaste and it is the reference against which other sweeteners are compared. Beyond its sweetening properties, sugar provides structure and volume and, while enhancing some flavours such as fruit flavours, it suppresses bitter and sour flavours; it also helps give an appetising colour to many foods. In other foods such as jam, sugar also acts as a natural preservative; decreasing the sugar content decreases the shelf-life. The sugar content can be replaced or reduced in some foods, but no single ingredient can replace sugar in all foods and replicate its many functions at the same time. Therefore replacing sugar often results in the use of several additional ingredients and additives.

How much sugar do fruit, berries and vegetables contain?

How much sugar do fruit, berries and vegetables contain?

Sugars occur naturally in varying amounts in fruit, berries and vegetables. Sugar beet and sugar cane are the only plants that contain so much sugar that it is worth extracting.

Sugars occur naturally in varying amounts in fruit, berries and vegetables. Sugars are formed from water, sunlight and carbon dioxide. Table sugar is called sucrose. Sucrose consists of equal parts glucose (grape sugar) and fructose (fruit sugar). Sucrose occurs together with fructose and glucose in all fruits and vegetables.

The concentration of sugars in fruit, berries and vegetables varies according to type and variety – for example, different varieties of apples contain different amounts of sugars.

Sugar beet and sugar cane are the only plants that contain so much sugar that it is worth extracting.

Other types of sugars include lactose, which is present in milk products, and maltose, which is present in starch from grains such as wheat and barley.

All sugars are carbohydrates and have an energy content of 17 kilojoules (kJ) per gram (4 kcal per gram).

Are sugars in fruit and berries healthier than added sugars?

Are sugars in fruit and berries healthier than added sugars?

The body cannot distinguish between added sugars and naturally occurring sugars from fruits and berries.

When we talk about sugar, we generally mean the white sugar (sucrose) that we use every day or that is added to food products. But sugars are also found naturally in many fruits, berries and vegetables. The human body does not differentiate between sugars that are naturally present in food and added sugars, as they have the same chemical and physical characteristics and are therefore digested in the same way.

Most national dietary guidelines differentiate between added sugars and naturally occurring sugars from fruit, berries and vegetables. Food and beverages containing added sugars should only be consumed occasionally/sparingly/in moderation. On the other hand, a high intake of fruit, berries and vegetables is recommended, since these foods provide vitamins and minerals.

In accordance with EU regulations on foods labelling, the product’s total content of sugars per 100 grams must be stated in the nutrition declaration, i.e. both the added and naturally occurring sugars.

The types of sugars included in the product must be stated in the product ingredients list. If the sugars are added to an ingredient used in the product, it is the name of that ingredient that is to be included in the ingredients list.

In all cases, the total amount of sugars contained in a food or drink must be stated in the nutrition declaration on the label.

Does sugar make you fat?

Does sugar make you fat?

If you consume more energy than your body use in the course of the day, you will become overweight. It’s all about finding your energy balance.

The role of sugars in obesity and the development of non-communicable diseases, such as type 2 diabetes, is much debated. However, the risk of overweight and obesity relates more closely to energy balance or energy imbalance – energy intake exceeds the energy expended by the body – than it does to the sugar content of the diet. Overweight and obesity develops when an individual’s energy intake is greater than his or her energy expenditure, which is why the whole diet is relevant and not one single food. Excessive consumption of calories from any source is the main cause of obesity, not the foods providing the calories.

Development of overweight is a result of interaction between a number of different factors including genetics, diet and exercise habits, and psychosocial aspects. Research also indicates that overweight is correlated with social status and education. So there are many factors to take into consideration when we want to solve the overweight problem. Unfortunately, it is not enough to focus solely on one single factor such as the sugar content of various products or the number of PE lessons at school.

Do we eat more sugar now than we used to?

Do we eat more sugar now than we used to?

The debate may give the impression that we are eating more sugar than we used to, but statistics show otherwise. Although it varies from country to country, overall we are not eating more sugar.

According to the Food and Agriculture Organization of the United Nations, the supply of sugar to EU countries has remained relatively stable over the past forty years (EU average of 36 kg sugar available for consumption per person/year – not intake). Please see figures for selected countries below.

By comparison, national dietary surveys reports lower figures. However, meaningful
data measuring the actual sugar(s) “intake” is difficult to obtain. First of all, the availability of such data varies a lot among EU countries. Where intake data exists, it is limited by the fact that there is no standardised method for collecting intake data across Europe.

Various intake figures are not comparable due to the use of different data sources and methodologies across countries. Dietary surveys also have high levels of misreporting.

A review looking at dietary surveys from 13 countries in the developed world shows the development in dietary intake of sugar from the latest national surveys of dietary intake. The authors conclude that performing comparisons is complicated, since the definitions of dietary sugars are highly variable. Generally it was found that dietary sugar intake was either stable or decreasing, with increases seen only in certain subpopulations.
(link to study by Newens and Walton).

The actual national sugar intake is assumingly higher than the figures reported in national dietary surveys (due to underreporting), but lower than the average national sugar supply, because wastage accounts for a large proportion of the supply statistics and consumption.
Looking at the average figures, it is important to remember that consumption is not evenly distributed across the population. Some groups, especially among children and young people, have a higher sugar intake than others.

 

How to calculate sugar intake

There are two methods for calculating sugar intake.

The first method is to use supply statistics (gross)
This method looks at how much sugar is available to industry and households, and hence to consumers. The starting point is a country’s production of sugar, adjusted for imports and exports, either directly or as sugar content in end products. The result is divided by the number of citizens and produces the amount of sugar that is available for consumption to each consumer. The disadvantage of this method is that it does not take wastage into account, i.e. all the food products and food leftovers that are thrown away by shops, restaurants and private homes. Some surveys suggest that up to 20–30% of our food goes to waste. This means that the actual intake will usually be less than that shown by the supply statistics. Sugar supply figures broken down by country can be found here. Read more Choose “Food Balance”, “Food Supply – Crops Primary Equivalent” and then choose “Country”, “Element” Food Supply Quantity (kg/capita/year), Item “Sugar, Refined Equivalent”.

The second method is dietary surveys (net)
In this method, selected individuals are asked what they have eaten during the course of, for example, a week. The disadvantage of this type of survey is that people – consciously or unconsciously – state that they have eaten less than their actual intake of sweets and cakes. It is therefore likely that the actual intake of sugar is higher than the dietary surveys indicate. Dietary surveys are carried out by national food authorities.

Is sugar unhealthy?

Is sugar unhealthy?

It is far more relevant to look at eating habits and lifestyle as a whole, rather than focusing on one single ingredient or food product.

Opinion on this is undoubtedly divided. Nordzucker does not believe that it makes sense to talk about healthy and unhealthy foods. It is more important to look at eating habits and what we eat over time as a whole; it is about health and unhealthy eating habits.

Sugar does not contain vitamins and minerals. We actually eat very little sugar in its pure form. Sugar is often used to make products containing vitamins, minerals and dietary fibre taste better.

As with any nutrient, excessive consumption can have a negative impact on health. Sugar should therefore be eaten in moderation within a balanced diet and alongside an active lifestyle that promotes a healthy body weight.

Is sugar empty calories?

Is sugar empty calories?

Whether sugar is “empty calories” depends on the composition of the food or meal.

The term “empty calories” describes the fat or sugar in a food that has no or limited nutritional value, for example soft drinks, sweets, cakes or snacks. These foods contain energy, but (generally speaking) no vitamins and minerals.

Whether the sugar is “empty calories” depends therefore on the composition of the food or meal.

Sugar is mostly used for sweetening and contributes to several of the food’s sensory characteristics such as: colour, texture, aroma and flavour. In this way, sugar can increase the selection of foods that you have a desire to eat. For example, sugar often makes high-fibre products or sour and bitter berries taste better. Studies have also shown that people with a moderate sugar intake rarely lack vitamins and minerals.

Does “reduced sugars” mean fewer calories?

Does “reduced sugars” mean fewer calories?

“Reduced sugars” or similar claims in food do not necessarily mean fewer calories. It is important to read nutrition declarations on food and drinks, which compare the total energy content per 100 grams or ml.

In recent years, many products have been marketed with claims such as “low sugar content” or “no added sugar”. A recent consumer survey shows that consumers usually expect foods with a “reduced sugars” claim to also be lower in energy – but this is not necessarily the case.

The reason is that volume of sugar has to be replaced with other nutrients – which contain at least as much energy as sugar (other types of carbohydrate, protein or fat). This means that the food’s energy content per 100 grams is basically unchanged – or in some cases even higher. The energy content is only reduced if sugar is completely or partly replaced by water in liquid foods. In solid products, the volume of sugar will be replaced by other energy-releasing nutrients which have the same energy content.

So it is not solely the energy from added sugar that you have to think about if you want to lose or maintain weight. It is important to read the nutrition declaration and compare the foods’ total energy content per 100 g.

One example is breakfast cereals, for which there is often an emphasis on sugar content. However, the tables show lower sugar content, not fewer calories.

Does sugar cause cavities in your teeth?

Does sugar cause cavities in your teeth?

Frequent intake of food products containing fermentable carbohydrates like sugar and starch may increase the risk of developing dental caries, especially in people with poor dental hygiene.

Cavities are caused by acid attacking the tooth enamel. The acid is formed when bacteria in the mouth convert the carbohydrates in food into acids. The bacteria occur normally in the mouth and form a thin layer of plaque on the teeth. The plaque builds up on clean teeth – even when there is no food in the mouth. Food containing carbohydrates, including sugar and starch, promote the build-up of plaque. The amount of plaque and its composition affect the caries process. The longer the plaque and carbohydrate-containing food are in the mouth, the greater the risk of cavities in the teeth. Poor dental hygiene increases the risk of developing cavities in the teeth, as does the frequency – rather than the amount – of sugar and starch intake. So sugar may well contribute to forming cavities in the teeth, but does not necessarily do so.

Development of caries is the result of interplay between several factors including genetics, diet, eating frequency and dental hygiene. The amount and composition of saliva, for example, also has a role to play in caries development.

Brushing teeth twice a day with fluoride toothpaste has been shown to reduce the risk. This is evidenced by the development of children’s dental health. WHO and OECD data shows that in Western countries, the trend of dental caries prevalence in children and adolescents has declined between 50–90% over the past 35–40 years while the average sugar supply has remained constant.

Can you get diabetes from eating sugar?

Can you get diabetes from eating sugar?

Type 2 diabetes is a so-called “lifestyle disease”. Sugar has not been established as a direct cause of diabetes. Obesity and lack of physical activity are reported to be major risk factors for type 2 diabetes.

Many people believe that sugar causes diabetes. This comes from the fact that the disease manifests itself through an elevated content of sugar in the blood. But sugar has not been established as a cause of diabetes. Like fat, protein and other carbohydrates, sugar provides energy. If you take in more energy than your body expends, over time you may become obese, which is a major risk factor for developing type 2 diabetes.

Type 2 diabetes is a lifestyle disease. This means that the development of the disease is closely linked to the individual’s overall lifestyle. The biggest risk factors for developing type 2 diabetes are being overweight, not exercising enough, genetic factors and age. Type 2 diabetes develops gradually when the body can no longer produce enough insulin and/or has an impaired capacity to react to insulin. Type 1 diabetes develops when the body loses the ability to produce insulin and is thus unrelated to lifestyle. Type 1 diabetes is predominantly genetics, and not preventable.

People used to believe that diabetics could not tolerate even the tiniest bit of sugar.
However, dietary advice for people with diabetes has changed over the past few decades. The latest scientific advice in guidelines provided by the European Association for the Study of Diabetes support that a moderate intake of “free sugars” can be part of a healthy balanced diet. Diabetics with satisfactory blood glucose levels can consume up to 50 grams per day of “free sugars”, divided between various meals. For individual dietary advice, people should consult their healthcare professional.

Does sugar cause large blood sugar fluctuations?

Does sugar cause large blood sugar fluctuations?

Blood sugar fluctuations after a meal are natural. It is nothing to worry about if you are otherwise healthy. The body regulates itself between meals.

Intake of carbohydrates – including sugar – causes blood sugar to rise. However, there is a difference in how fast the carbohydrates are absorbed into the bloodstream. If a food has a high glycaemic index (GI), the carbohydrates are quickly converted to glucose and absorbed. This results in a rapid increase in blood glucose. Foods with a low GI take longer to be absorbed into the bloodstream. The glycaemic index is a measure of how different types of foods with the same content – normally 50 grams – affect the blood sugar level compared to a reference food, which is normally white bread or glucose.

Sugar (sucrose) is not one of the carbohydrates that produce the largest rise in blood sugar. This is because sugar (sucrose) is a combination of glucose and fructose, in which glucose (which is also called grape sugar) produces a high blood sugar increase while fructose produces a low blood sugar increase (see table below).

Foods with a low GI are considered by some to be healthy because they produce a lower increase in blood sugar. Other people believe it is a good idea to go for a low GI if you want to lose weight; however, these ideas have not been scientifically proven.

It is normal for the blood sugar to fluctuate between narrow limits during the day (between about 4 and 8 mmol/L). It is highest after you have eaten and, generally, lowest when you get up in the morning. Blood sugar fluctuations are natural and nothing to worry about if you are otherwise healthy. The body regulates itself. See the graph below.

Is brown sugar healthier than white?

Is brown sugar healthier than white?

Brown cane sugar contains small quantities of minerals. However, its contribution to the recommended daily intake is negligible. Therefore brown cane sugar is not healthier than white sugar.

Brown cane sugar is extracted, as indicated by its name, from cane sugar, while white sugar can be extracted from both cane sugar and sugar beet. Brown cane sugar products are a mixture of sugar crystals and syrup residues. It is the syrup residues that give cane sugar its brown colour and caramelised flavour. When producing sugar from sugar beet, the syrup must be removed because it has a bitter taste – leaving the familiar white sugar that we know and recognise.

The syrup residues in the brown cane sugar contain small quantities of minerals. However, compared with other foods, the mineral content in brown cane sugar is very low and its contribution to the recommended daily intake is therefore negligible. It is not possible, therefore, to say that brown sugar is healthier than white sugar.

The amount of vitamins and minerals in foods – including different types of sugars – can be seen at in English at http://www.frida.fooddata.dk/index.php?lang=en.

Do children become hyperactive from too much sugar?

Do children become hyperactive from too much sugar?

Scientific studies have found no relationship between children’s sugar intake and problems in their concentration or behaviour.

Even though the media and popular debates often promote a relationship between sugar intake and hyperactivity in children, there are no scientific reports to support this.

Scientific studies have found no relationship between children’s sugar intake and problems in concentration or behaviour. Current research suggests instead that genetics play an important role.

In general, regular and healthy eating habits are essential for concentration, performance and behaviour. This goes for all of us – not just children.

For further information please read the references:

  1. Benton D (2008). Sucrose and behavioral problems. Crit Rev Food Sci Nutr, 48, 385-401.
  2. Wolraich, M. L., Wilson, D. B. & White, J. W (1995). The effect of sugar on behavior or cognition in children. A meta-analysis. JAMA, 274,1617-21.
  3. Stevenson J (1992). Evidence for a genetic etiology in hyperactivity in children. Behavior Genetics,22:337-344.

Can you become addicted to sugar?

Can you become addicted to sugar?

Specific foodstuffs, nutrients or food additives do not cause addiction in the sense of substance-based addiction.

A lot of attention has been given to this question in recent years. The assumption is that sugar causes physical dependency and plays a role in eating disorders, and may therefore play a role in connection with overweight.

The most recent reports, including those under the remit of the EU, which have looked at the overall research on this subject conclude that there is no evidence that specific foodstuffs, nutrients or additives cause addiction in the sense of substance addiction.

Eating palatable food affects the brain’s reward system. The brain releases dopamine, a substance that causes sensations of well-being and pleasure. However, the release of dopamine caused by palatable food, sex, social interaction and intensive training, is far less than that caused by intoxicating substances. Dopamine release caused by intoxicating substances is between a hundred and a thousand times greater.

Psychological aspects also appear to be involved in the need for palatable food, because eating can alleviate depression and negative feelings. Therefore there are strong indications that some highly-predisposed people can develop a form of addiction-like eating behaviour to palatable food.

For further information please read the consensus opinion on food addiction from NeuroFAST on
http://neurofast.gu.se/digitalAssets/1455/1455240_consensus.pdf