Vail Daily health feature: Sugar, sweetener or substitute?
February 17, 2014
Seeing as how it was Valentine's Day on Friday, some of us are probably still in a sugar coma from eating all the candy and chocolates we received. While it's normal to eat more sweets on Cupid's holiday, many Americans eat too much sugar on a regular basis. Overdoing our sugar intake can lead not only to cavities but is also linked to obesity, diabetes and cardiovascular disease. The American Heart Association (AHA) recommends that women consume no more than 100 calories, and men no more than 150 calories, of added sugar per day. Currently we're getting 15 percent of our daily calories from added sugar — well above the suggested amount.
A hidden addiction
If we know that eating too much sugar is bad for us, why don't we stop?
Eliza Klearman, a naturopathic doctor and acupuncturist in Eagle, said the addictive properties of sugar cause us to crave more than our body actually needs.
"Addiction has to do with stimulating the opioid receptors in the brain," Klearman said. "Sugar definitely stimulates those receptors; it triggers the brain's production of natural opioids. Opioids make you feel good; they make you happy, so of course you want more and more, because you want to keep that opioid level high."
More sugar has snuck into our food over the years. It's even added to foods we don't associate with a sweet taste, such as tomato sauce.
"(Almost) all processed food has added sugar," Klearman said. "Even if someone is trying to eat well by buying things like organic cereal, that stuff has sugar in it too. Even crackers have sugar in (them); it's everywhere."
The artificial sweetener debate
Some think the solution to cutting back on our sugar intake is to switch to an artificial sweetener, but not everyone agrees on how healthy (or unhealthy) they are. Artificial sweeteners, such as aspartame (found in diet soda) and sucralose (commonly sold as Splenda), are made from different compounds than sugar (also known as sucrose). Klearman said because artificial sweeteners have been modified in a lab, our bodies aren't able break them down as easily as sugar. Sucralose is made up of one sucrose molecule and three chloride molecules, whereas sugar is made up of glucose and fructose.
"We don't have the enzymes to break down the chloride when it's attached to the sucrose," Klearman said. "(With) pure glucose, we process glucose all the time. Every time you have a carbohydrate, your body ingests and absorbs (it). Your body knows what to do with the glucose molecules."
Rhonda Galer, registered dietitian and clinical nutrition manager at Vail Valley Medical Center, said artificial sweeteners are safe to consume. Galer said our current daily intake of low-calorie sweeteners is well below the acceptable daily intake determined by the Food and Drug Administration (FDA).
"As far as being bad for you, I don't think (artificial sweeteners) are, and I don't think the medical community finds (them) to be unsafe either," Galer said. "Health authorities around the world have verified that low-calorie sweeteners are safe."
Galer said switching from sugar to a low-calorie sweetener could be a step in the right direction for people looking to lose weight. While Galer doesn't recommend drinking diet soda all day long, she doesn't see the harm in consuming a beverage or food with a low-calorie sweetener as a way to satisfy a sugar craving.
'Natural' but not always healthy
In addition to artificial sweeteners, sugar substitutes derived from plant sources, such as stevia and agave syrup, have popped up on the market and grown in popularity over the past few years. Just because a sugar substitute comes from a plant doesn't necessarily mean it's healthy. Klearman said agave syrup is anywhere from 70 to 97 percent fructose, which is even higher than high fructose corn syrup, which contains about 55 percent fructose.
"It's a worse sweetener than high fructose corn syrup," Klearman said. "When you intake fructose, it doesn't raise your blood sugar, so you don't have an insulin surge. You don't suppress the hormones that make you feel satisfied or full. This makes you hungry and makes you eat more. … It (also) elevates your triglycerides and your cholesterol levels."
Stevia is a plant with sweet-tasting leaves, but not all products labeled "stevia" are the same. The FDA has not approved the stevia plant itself as a food additive. In 2008, the FDA approved rebaudioside A (reb A), a chemical found in stevia. Products such as Stevia In The Raw, PureVia and SweetLeaf contain reb A and other additives, while Truvia and Zevia contain very little stevia and instead use erythritol, a sugar alcohol.
Galer doesn't see much difference between stevia-based products and other artificial sweeteners, pointing out that "there's no legal definition of natural," she said.
Klearman used to grow stevia plants in her backyard and thinks that, in it's original leaf form, stevia is better for your body because it does not raise your blood sugar level.
Hold the sugar, please
With so much debate surrounding artificial sweeteners and sugar substitutes, is it better to just stick to regular old sugar? Klearman and Galer agree it's less about what kind of sweetener we eat but how much.
"Whether we eat stevia or high fructose corn syrup, in the American diet, we just eat too much sugar," Klearman said.
Klearman said if someone wants to wean themselves off, it takes about three to seven days of eating no sugar in order for the body to adjust and stop feeling addicted to it. Galer said one should focus on eating a balanced diet and that moderation is key, with using the American Heart Association's recommendation of 100 to 150 calories of added sugar a day as a good yardstick to measure your sugar intake.
According to the U.S. Department of Agriculture, Americans on average consume up to 165 pounds of added sugar a year. The candy we consumed on Valentine's Day is only the tip of the sugar-coated iceberg. It can be difficult to start reading food labels and learn just how much added sugar is in some of our favorite foods. Decreasing our sugar intake might be difficult, but necessary for our health. Now that we know the detrimental effects sugar has on our body, maybe next Valentine's Day we can tell our loved ones to hold the sweets but definitely still send roses.