Sugar

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Stephanie Legin, RD, LDN

Renal Dietitian

Sugarcane was introduced to the Caribbean by Christopher Columbus in 1493.  Since then, the sugar industry flourished and sugar has become a major factor in the growth of the food industry. This has resulted in  the overconsumption of added sugars in the American diet.

Carbohydrates (CHO’s) are an essential nutrient to human life.  There are two categories of CHO’s; complex and simple.  Complex CHO’s actually contain carbohydrate plus  fiber.  Most of our CHO consumption should be from complex CHO’s. Simple ­CHO’s  contain no fiber and are responsible for the sweet taste in many foods.  Sugar is a simple CHO and has 4 “empty” calories per teaspoon, which means it contains no nutritional value.  Due to its negligible nutritional content, simple sugar should be limited in the diet.

The suggested daily limit of simple sugars based on a 2,000-calorie diet would be 5% or 25 grams.  The recommended daily sugar limit  is 6 tsp. (25 g) for women, and 9 tsp. (38 g) for men; however, the average American consumes approximately 19.5 teaspoons (82 grams) every day which translates into about 66 pounds of added sugar consumed each year, per person.  Excessive sugar intake is stored as fat and can lead to obesity, which  is a huge risk factor for developing type 2 diabetes.

Insulin plays a major role in the way the body uses digested food for energy. When the digestive tract breaks down carbohydrates into its simplest form, glucose, it is absorb into the bloodstream and insulin helps cells absorb glucose to use for energy.  In a healthy person, these functions allow blood glucose and insulin levels to remain in the normal range.

In individuals with insulin resistance, cells do not respond properly to insulin and cannot easily absorb glucose from the bloodstream. As a result, the body needs higher levels of insulin to help glucose enter cells.  Over time, the stress on the body from the over secretion of insulin can increase the risk of developing prediabetes and type 2 diabetes.  Studies show that weight management, regular physical activity, and making healthier food choices such as consuming foods lower in glycemic index can prevent or slow the progression of chronic disease.  The following video explains insulin resistance in detail:  https://nutritionfacts.org/video/what-causes-insulin-resistance/

The Glycemic Index (GI) is a relative ranking of carbohydrate in foods according to how they affect blood glucose levels.  Foods are assigned a score based on how much they raise blood sugar levels, from 0-100.  Glucose, a pure simple sugar, has a glycemic index of 100 and is considered the reference food.  Low glycemic foods do not raise blood sugar levels as much as high glycemic foods.

Low GI= < 55     Medium GI= 56 – 69       High GI=  >70

Consuming low GI foods may help to facilitate the management of diabetesweight loss, and weight loss management, and reduce the risk of developing type 2 diabetes. It also may help to reduce complication of diabetes, and possibly delay  and/or prevent other chronic diseases, like CKD.  In fact a low GI diet may provide health benefits for everybody across all stages of life.

Natural Sugars and Alternatives

Find a comprehensive listing and explanation of several sugars, alternative sugars, natural sweeteners, and artificial sweeteners by clicking HERE.

Also, the graph below compares the glycemic index between some sugars, natural sweeteners, artificial sweeteners and sugar alcohols:

Low GI= < 55     Medium GI= 56 – 69       High GI=  >70

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. KidneyChef urges you to seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition. KidneyChef advises you to never disregard professional medical advice or delay in seeking it because of something you have read on the Website.

If you think you may have a medical emergency, call your doctor or local emergency service immediately. KidneyChef does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the website. KidneyChef does not guarantee the accuracy of information on the Website and reliance on any information provided by KidneyChef is solely at your own risk.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836749/

https://www.ncbi.nlm.nih.gov/pubmed/24007486

https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance

http://sugarscience.ucsf.edu/the-growing-concern-of-overconsumption/#.WgxnddKnHcs

“Portion Control.” American Diabetes Association. http://www.diabetes.org/for-parents-and-kids/diabetes-care/portion-control.jsp

https://www.fda.gov/AboutFDA/Transparency/Basics/ucm194320.htm

http://www.glycemicindex.com/foodSearch.php

Jenkins, D. J.,Wolever, T. M.,Taylor, R. H.,Barker, H.,Fielden, H.,Baldwin, J. M.,Bowling, A. C.,Newman, H. C.,Jenkins, A. L., andGoff, D. V. ( 1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. Am. J. Clin. Nutr. 34, 362–366.

Ludwig, D. S. ( 2002) The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA 287, 2414–2423.

Goyal, S.K., Samsher and Goyal, R.K. (2010). Stevia (Stevia rebaudiana) a bio-sweetener: A review. International Journal of Food Sciences and Nutrition, 61, 1, 1-10.
Kobylewski, S. and Eckhert, C.D. (2008). Toxicology of rabaudioside A: A review. Retrieved July 20, 2011.

Bogdanov S, Jurendi T, Siebe R, Gallman P. Honey for nutrition and health: a review. J. Am. Coll. Nutr.27,677–689 (2008).CrossrefMedlineCAS

https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/glycemic-index-diet/art-20048478?pg=2

“How Sugar Affects Diabetes.” WebMD. http://diabetes.webmd.com/how-sugar-affects-diabetes

https://nutritionfacts.org/video/what-causes-insulin-resistance/

Michael Greger M.D. FACLM  January 6th, 2017  Volume 33

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