Sugar low


How can something so sweet be so harmful? Is sugar really a health culprit? We spoke with the experts to separate fact from fiction.

Dr Robert Lustig, an American obesity expert specialising in paediatric hormone disorders at the University of California, San Francisco, posted a video of one of his lectures on Youtube in 2009. The lecture was entitled Sugar: The Bitter Truth where he delves into the nuances of sugar and its implications for childhood obesity and sugar-related diseases.

This month he also released the results of his latest sugar study, Sucre – Sugar, Co-Morbidities, Race and Ethnicity. Here are five key takeaways:

  1. Sugar consists of two molecules: glucose and fructose. Fructose makes sugar so sweet and is far more difficult for the body to process than sugar. “The fructose molecule is metabolised differently than the glucose molecule, and these differences have been implicated in the development of various chronic diseases. Research has also suggested that dietary sugar can be addictive,” says Dr Lustig.
  2. Not all calories are created equal: 43 children, ages eight to 19 participated in the study. All were obese and had at least one other metabolic co-morbidity. Their diets were heavy in added sugar. For nine days in the study they were given the same number of calories – in starch, instead of sugar. Just this one substitution, without changing calories or adding exercise, yielded key changes.
  3. Cut out sugar and a change happens: the results of this study were nothing short of dramatic. Nine days of sugar restriction later, “Virtually every aspect of the participants’ health improved.” Diastolic blood pressure decreased, liver function tests improved and fasting blood glucose level was lower as were insulin levels.”
  4. Food – and the types of food we eat – is linked intrinsically to chronic diseases. “When it comes to chronic disease, the quality of our food is as important, and possibly even more important, than the quantity of food consumed. Restriction of added sugar should be a first step in the prevention or treatment of chronic disease in children,” explains Dr Lustig.
  5. Sugar is not the biggest baddie – but it is a “modifiable cause”. What this means, explains Dr Lustig, is that sugar is not the sole or even primary cause of metabolic syndrome, but based on the results of this and other studies, even restricting sugar for just 10 days can mean a world of difference for health issues. “Sugar calories are the worst, because they turn to fat in the liver, driving insulin resistance, risk for diabetes, heart, and liver disease. This has enormous implications for the food industry, chronic disease, and healthcare costs.”

The fructose factor
A 2011 article in Harvard Health Publications explains what makes fructose bad: “When fructose is joined to glucose, it makes sucrose. When extracted and refined, sucrose makes table sugar. Virtually every cell in the body can use glucose for energy, but only liver cells break down fructose, and one of the end products is triglyceride, a form of fat. Triglycerides can build up in liver cells and damage liver function.”

Dietician, Irene Labuscagne from the Nutrition Information Centre Stellenbosch University breaks it down further. “We rarely consume fructose in isolation. The major source of fructose in the diet comes from fructose-containing sugars and sugar (sucrose), in sugar-sweetened beverages and foods. Intake of sugar-sweetened beverages has been consistently linked to increased risk of obesity, type 2 diabetes and heart disease in various populations.”

She notes that fructose and sugar-sweetened beverages have also been linked to the risk of gout in men and non-alcoholic fatty liver disease. “Studies show that the kilojoules in sugar-sweetened beverages do not produce an adequate reduction in the intake of other foods, leading to increased energy intake. Plasma triglycerides are increased by sugar-sweetened beverages, and this increase appears to be due to fructose, rather than to glucose in sugar.”

So, what is the end point here? Do we just cut out sugar completely? There’s no need for extremes, says Labuscagne. But we do need to be mindful. “We are eating too much sugar and it is bad for our health. Learning how to read and understand food labels can help the public to make healthier choices. Some foods will say “no sugar added” but will still be high in sugar (e.g. fruit sugar). These are not good choices.  All sugar should be taken into consideration when planning the overall meal plan.”

Hiding in plain sight: decoding the labels
 less than 0,5 grams of sugar.
Reduced sugar: at least 25 % less sugar for each serving than the original product.
No added sugar: no sugar in any form has been added as an ingredient.

Many terms can be used for sugar e.g. glucose, fructose, sucrose, beet sugar, cane sugar, maltodextrin, dextrose, corn syrup, and molasses.

Sugar mania
90 % of general practitioners surveyed in America, Europe and Asia believe that excess sugar consumption is linked to the sharp increase in Type 2 diabetes or obesity.

(Disclaimer: The purpose of this article is to provide general background information and not to substitute any medical diagnosis or advice received from a qualified healthcare professional.) 

Review: Sugar, the Bitter Truth. May 2010. (Online) Available at Accessed: w/c 2 November 2015
5 Highlights from the Toxic Sugar Video. April 2011. (Online) Available at Accessed: w/c 2 November 2015
Email interview conducted with Dr Robert Lustig (paediatric hormone specialist) 

The Fructose Controversy. March 2015. (Online) Available at Accessed: w/c 26 October 2015
Is Sugar Turning the Economy Sour? October 2013. (Online) Available at Accessed: w/c 26 October 2015 

Is Sugar Toxic? April 2011. (Online) Available at Accessed: w/c 26 October 2015 
Email interview conducted with Irene Labuscagne (dietician)

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