Talk on following a “sugar free” diet has become so prevalent that I’m pretty sure that even tribal communities in far flung regions of our planet have had conversations about this latest dietary craze.
We feel it is important to examine the evidence around by looking at some key points.
Many of you reading this may be tempted to click away, thinking that this is a simplistic article opening with an obvious question. I plead with you to continue to read on! The problem today is that there is a liberal use of the term sugar which has instilled fear into food lovers.
Fact – most foods will contain sugar. The term “sugar-freer” seems to have been used as a marketing tool and attached onto a plethora of food products/ recipes and diets. The problem is, it has left us more confused than ever before about what is in our food and what implication that does or doesn’t have on our health.
So let’s unpick the different definitions to discover the sweet truth!
As explained in an article featured on the British Nutrition Foundation website (well worth a read) the headlines that made the newspapers were in retaliation to an article ‘The toxic truth about sugar’ published in a commentary by a Professor of Clinical Paediatrics at the University of California (1). This commentary expressed the author’s opinions on the role they believe sugar has to play in the development of diet-health related disease and was not a robust scientific review or a presentation of novel research (2). However, they do mention a couple of published research papers to support their case, one of which is written by Lustig (introducing possible bias) (2). Also, there was no critical appraisal (carefully critiquing the results to decipher their impact) of the evidence regarding the relationship between sugar and diet-related disease development. It would seem that these headlines may be portraying a slightly false picture.
A report published in 2015 by Scientific Advisory Committee on Nutrition (SACN) looked at randomised controlled trials and found that sugar-sweetened drinks (compared to low calorie drinks) resulted in increases in weight gain and body mass index in children and adolescents. It is being overweight which increases a risk of diet-health related diseases. SACN’s report emphasised that no association between developing type 2 diabetes and total or individual sugars intake. However, prospective cohort studies associate greater consumption of sugar sweetened drinks with an increased risk of developing type 2 diabetes (3).
We are all individual and therefore this is not an easy question to answer.
Sugar is a highly dense source of energy (calories) and so can be useful for those trying/needing to gain weight. Dietitians may recommend having high energy containing foods/ fortifying your diet with sugar based foods as strategies for adding extra energy in a concentrated food source. This is often the same with fat sources.
However, for many, the sugar content of the diet is something to watch out for. Excess sugar in the diet could mean excess energy (calories) intake. This may lead to weight gain. It is the weight gain (being overweight/obese) that puts us at risk of diet reacted diseases such as type 2 diabetes and heart disease. People with diagnosis of diabetes may be advised to limit the amount of sugar in the diet or advised to “carbohydrate count” in order to adjust medications and insulin regimens.
Recent guidelines published in July 2015 by SACN advise that the average intake of “free sugars” (previously known as non-milk extrinsic sugars ) should be no more than 5% total energy intake. This is half of the previous recommendations for 10% total energy intake (3).
5% of total energy intake (as calculated by Public Health England) means:
This equates to ~ 5 sugar cubes!
This equates to ~ 6 sugar cubes!
This equates to ~ 7 sugar cubes!
The report highlighted that only 13% (1 in 8) of adults already achieve this 5% recommendation!
Make sure you check out DINE’s video reviewing Change 4 Life’s Sugar Smart App – a useful tool to help keep track of your sugar intake.
Sugar can be given a variety of names so the skill of label reading becomes important when analysing a food’s nutritional composition.
Labels on food packaging will state “Carbohydrates” and “Carbohydrates (of which sugars)”. “Carbohydrates” refer to the starchy carbohydrate content as well as the sugars and so should not be used as a sole interpretation of a food’s sugar content. The “Carbohydrates (of which sugars)” figure refers to the sugar content in the food – including naturally occurring sources found in milk or fruit as well as added sugar.
Be aware! Sugar is not only present in “obvious” sweet tasting processed foods e.g. cakes/biscuits/ chocolates or sweets, but can be added sneakily to savoury snacks, salad dressings and pasta sauces etc.
Therefore, in order to work out whether a food contains lots of added sugar, you need to check the ingredients list.
Hopefully the list above has highlighted something important… just because “table”/ “caster”/ “granulated” SUGAR may not be listed, it doesn’t mean it’s sugar-free! These are all sources of sugar (some are natural and found in less processed foods).
This is often where the confusion arises. Many glamorous recipes for batches of sumptuous “sugar-free” brownies will in fact contain plenty of sugar in the forms of honey/ maple syrup/ agarve syrup/ dates or some other dried fruit!
Perhaps these recipes should be renamed “wholefood” or “less processed” rather than “sugar-free”. There is no denying that these recipes contain superior nutritional profiles compared with refined, processed or manufactured versions, but that is often not what is being promoted.
Our hope is, that with a better understanding of the term “sugar”, you will be able to see past this marketing ploy and make an informed decision on how regularly this appears in your diet.
For example orange juice vs a full sugar cola drink.
Orange juice though also high in sugar, if “not from concentrate” will contain vitamin C and 150mls will count as one of your 5 a day. Whereas a full sugar cola drink merely contains a sugar hit, caffeine and empty calories.
(1): British Nutrition Foundation (2012) Is sugar really toxic? Available at https://www.nutrition.org.uk/nutritioninthenews/previous-facts-behind-the-headlines/sugar.html [last accessed 24/03/16]
(2): Lustig, R.H., Schmidt, L.A., Brindis, C.D. (2012) Public health: The toxic truth about sugar. Nature 482; 27-29.
(3): SACN (2015) The Scientific Advisory Committee on Nutrition’s recommendations on sugars. Available at https://www.nutrition.org.uk/attachments/article/872/sugars%20factsheet.pdf [last accessed 24/03/16]
For further information make sure you check out some of these links!