Tuesday, August 10, 2004


Sugar is safe for people with diabetes

Sugar is safe for people with diabetes:


Sugar is one of the simplest forms of carbohydrate. It is made up of the simple sugars, fructose and glucose. Sugar can take many forms - such as white, raw or brown sugar, honey or corn syrup.

Sugar has many properties, both aesthetic and preservative, that make it highly desirable in the processed food industry. It adds taste, colour, bulk and viscosity to food products. It also prevents mould formation and microbiological activity. There are food safety concerns with some formulated low sugar products.

Research finds sugar innocent of past allegations

Until recently, sugar was implicated in many disorders, including obesity, micronutrient deficiencies, diabetes, heart disease and attention deficit hyperactivity disorder (ADHD). Current research, however, is finding that sugar is probably more benign than previously believed. In fact, a moderate intake of refined sugars - about 10 to 12 per cent of total energy - in an otherwise healthy diet is not thought to have any detrimental health effects, apart from tooth decay. In fact, adding sugar or high sugar foods to more nutritious grain foods, such as wholegrain bread and cereals, may encourage people to eat more of these foods by increasing their palatability.

About five per cent of energy intake can be in the form of table sugar; this is equivalent to about one teaspoon per day. This also applies to diabetics, although it is preferable to distribute this amount throughout the day.

Sugar and micronutrients

The micronutrient deficiencies that sucrose and fructose have commonly been associated with are copper and magnesium. Very large doses of fructose and sucrose appear to reduce the absorption, and thus availability, of copper and magnesium. This indicates that there may be an interaction between nutritional status, and fructose and sucrose intake.

Carbohydrates and glucose

The body breaks down carbohydrates into a simple sugar called glucose. This form of ready energy is absorbed from the small intestine into the blood, where it is delivered to each and every cell. The supply of glucose needs to be constant and dependable, so the body has devised a number of fail-safe systems to ensure this supply. For instance, the pancreas secretes a hormone called insulin that regulates the amount of glucose in the blood. Insulin allows glucose to enter body cells and helps with the storage of excess glucose in the liver, which supplements blood sugar levels if they start to wane. A person with diabetes has either insufficient or inefficient insulin, which means their blood sugar levels tend to be too high.

Fats add more weight than sugar

Sugar has been called a source of 'empty calories' because it offers taste but has no nutrients. It has long been advised that if you want to lose weight, you should cut out all sweet and sugary foods from your daily diet. However, there is no evidence to suggest that eating foods high in sugar is associated with excessive food intake or obesity.

Overweight and obesity are caused by regularly consuming more kilojoules (calories) than the body uses. The current thinking is that overeating, in general, causes excess weight gain and obesity, with no one food or food group being solely to blame for the condition.

Watch out for fats in sweet foods

Sugars are often associated with a high fat content in foods and can increase the palatability of fat. It is fat that is associated with obesity. Some studies suggest that people who are overweight or obese have a 'fat tooth' rather than a 'sweet tooth'. They tend to eat more fat and less sugar than normal weight people. Fats contain approximately double the amount of kilojoules per gram than sugar, other carbohydrates and protein. Fat (especially saturated fat as opposed to fats from unsaturated sources, such as fish and olive oil) may be the culprit that causes obesity rather than sugar. This is something to worry about because many commercially produced sweet foods, such as cakes and biscuits, contain high levels of predominantly saturated fat.

Glycaemic index

A food's 'glycaemic index' (GI) refers to the time it takes for the carbohydrates to be absorbed into the bloodstream and how much it causes blood glucose to rise (glycaemic response). High glycaemic foods enter the bloodstream more quickly than other foods.

Recent studies have suggested a link between foods with a high glycaemic index and conditions like:

* Abdominal obesity
* Diabetes
* Elevated blood lipids (high cholesterol)
* Hypertension
* Heart disease.

Foods high in sugar don't necessarily generate higher glycaemic responses. Latest research indicates that other, more starchy foods - such as potato, refined bread and breakfast cereals - are much more readily absorbed than sugar and other high sugar foods. This suggests that it is not sugar but a diet with a large proportion of high glycaemic foods, which may contribute to negative health outcomes.

Sugar is safe for people with diabetes

There is no evidence that a diet high in sugar directly causes either Type I or Type II diabetes. Being overweight or obese is a risk factor for diabetes Type II, and perhaps someone who eats too much may also consume high amounts of sugar.

Diabetics in the past were told to avoid eating foods high in refined sugar, based on the idea that sugar would adversely affect blood glucose levels. However, more recent research on the GI indicates that sugar affects blood sugar levels to less of an extent than other more starchy foods, such as refined bread and breakfast cereal. Sugar is now viewed far less negatively in diabetes control. The GI has become a useful tool for diabetics to use in the regulation of blood sugar levels.

People with diabetes need low GI foods

People with Type II diabetes benefit from a slow absorption of glucose, which means they need to eat a diet of foods with a low GI. At least one low GI food is recommended at each meal. A little sugar (equivalent of two tablespoons or 50g over a day) added to otherwise healthy and lower GI foods, such as spreading honey on wholegrain bread, is generally acceptable and will not adversely affect blood sugar levels.

Foods with a high GI also have a useful role in managing blood glucose levels, especially when blood glucose falls below normal levels. High glycaemic foods can quickly deliver glucose to the bloodstream to restore blood glucose to normal levels.

Sugar and attention deficit hyperactivity disorder

There's no evidence to suggest a direct link between attention deficit hyperactivity disorder (ADHD) and the consumption of sugar.

Tooth decay

The association between sugar and tooth decay has long been established but it still sparks discussion. Dental plaque is a clingy film made up of food particles, bacteria and mucous. The bacteria in plaque depend on sugars in order to produce acids, which break down the enamel and start tooth decay. However, carbohydrates in general contribute to this process, not just sugar. For instance, nutritious foods (like dried fruits) also allow the bacteria in plaque to produce acids. Furthermore, tooth decay occurs in populations that do not use sugar or other processed food, showing that sugar is not the only cause of caries (teeth cavities). Sticky sugars that cling to the teeth are worse than sugars that are easily swallowed, such as sweetened drinks.

Ways to reduce the risk of tooth decay include:

* Cutting down on sticky sugary foods.
* Drinking water after consuming sugary foods and drinks.
* Allowing a period of at least two hours between meals.
* Brushing and flossing regularly and after meals.
* Chewing gum for around 20 minutes after meals.
* Drinking fluoridated water or using fluoride treatments.
* Visiting the dentist.

Where to get help:

Your doctor
Things to remember
Sugar is a form of carbohydrate that is converted by the body into glucose.
Contrary to popular belief, sugar doesn't directly cause heart disease, diabetes or obesity. Small amounts of sugar, as part of a meal, are not likely to have a detrimental effect on health. Sugar, like all carbohydrates, is a contributing factor in tooth decay. It is OK to sprinkle a little sugar on healthy foods to improve their flavour; however, limit the intake of added sugar to about five teaspoons per day and choose foods with naturally occurring sugars in preference to those with added sugar.
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