With obesity and concomitant insulin resistance and diabetes becoming the number one disease worldwide, there is lots of talk nowadays around sugar.  Unfortunately, as a result of conflicting advise or misunderstanding the advice to avoid sugar to stem the development or progression of these conditions,  often loses it’s punch!

What is sugar?

Sugar is a the simple term for food components also called carbohydrates. Sugar occurs naturally in all foods that originate from plants as well as dairy products such as cows milk. There are different types of sugar, for example glucose, fructose, sucrose and lactose as well as starch and fibre.

Are all sugars equal?

The body will respond differently to the different types of sugars from foods. In addition, other nutrients, e.g. vitamins, minerals, fibre, protein, fat will also influence the metabolism of sugar. Physical conditions such as how fast you eat, how well you chew your food, hormone levels, time of day and the composition of previous meals are all factors that further influence inherent response to carbohydrate or sugar rich foods.

To complicate the ‘sugar is all bad’ issue, certain sugars, for example plant fibres (also a ‘sugar’) are in fact vital for health.

Quasi foods

Although it is indisputable that refined sugar – a ‘quasi-food’ without any nutritional value except energy that should be avoided as far as possible, the recommendation to avoid ‘sugars’ should be qualified!

It makes obvious sense that ‘refined sugary foods should be minimised or avoided by anyone concerned with healthful eating. That would include obvious sources of high sugar foods such as  table sugar or products like fizzy drinks that consist of water and a form of pure sugar but also less obvious foods such as  commercial flours and bread, biscuits, breakfast cereals and crackers made with these refined flours,  foods that have been parboiled and even foods that are concentrated sources of ‘natural’ sugars for example fruit juices.

What’s bad about sugar?

Carbohydrate and protein foods  can result in raised blood sugar levels. Raised blood sugar in itself is part of normal physiology. The issue here is however abnormal blood sugar ‘spikes’ and altered insulin function.

Although production of insulin is a normal mechanisms in our bodies by which we are able to utilise carbohydrate energy from foods or de novo glucose production in the body as a result of e.g. stress or metabolic disorders, issues arise when insulin levels are continuously elevated or spiked. The latter  contributes to the development of insulin resistance, which in turn will result in difficulty losing weight or maintaining weight. If not treated, insulin resistance and obesity may develop into full blown diabetes.

The above certainly applies to healthy individuals.

Diabetics are often advised to  CUT carbohydrates to facilitate blood sugar management. This in itself naturally makes sense as carbohydrate rich foods – which would include foods that contain added sugar or has been made using refined ingredients as well as foods that are naturally rich in carbohydrates – have the most pronounced effect on insulin requirements. However, although the reduction and in some cases complete exclusion of carbohydrates is an important treatment modality to be employed to manage diabetes, there’s more to well controlled blood sugar levels than mere avoidance of sugar and/or carbohydrate rich foods.

Complete avoidance of carbohydrates would also imply that a large array of nutrient dense foods – many types of vegetable, unrefined grains and seeds and fruit has to be excluded from the diabetic’s diet. This is both inadvisable and for many, almost impossible in the long run. It is also not always the best treatment option with particular  reference to genetic predisposition some individuals may have where unrefined carbohydrate rich foods will actually help protect them agains insulin resistance and development of diabetes.

Does this mean diabetics can eat whatever they want to? Definitely not! The amount of food eaten at a specific time, the type of food and the rest of the meal are important factors that contribute to blood sugar control.