Are some sugars better than others?

Sugar is still dominating the media headlines and along with increasing evidence to support a lower sugar diet, there is some confusion about the health benefits (or otherwise) of the different types of sugar. This isn’t helped by the proliferation of “sugar-free” recipes which are promoted for being "refined sugar-free” but have switched out the white stuff for a less-processed sugar which is still . . . just sugar.

Yes, a less-processed version, but right now, we don’t know enough to suggest that the more “natural sugars” are nutritionally superior to table sugar. Though some may contain more nutrients over all, the amounts that would need to be consumed to make an appreciable difference in the nutrient content of the diet would prevent me from recommending them as a one-to-one substitute for sugar. And when looking to lower overall sugar intake, there isn’t any difference.

Fructose

We do, though, know more about the different sugars when we look at their chemical structure. There are three monosaccharides (simple sugar molecules) that all carbohydrate foods are broken into: glucose, galactose and fructose. Fructose is a type of sugar we do know more about.

It’s a monosaccharide that, unlike other types of carbohydrate, is delivered directly to the liver and has little effect on the bloodstream. This was once thought to be beneficial, particularly for people with high blood sugar who are at risk for type-2 diabetes, and products using fructose were sold as the safer alternative to glucose.

We’ve since realised that too much fructose can have deleterious effects on our health: it causes the liver to synthesise fat, which can lead to high blood triglycerides and inflammation. Fat can build up in our liver (leading to non-alcoholic fatty liver disease), it can increase uric acid and contribute to the presence of gout, and impair our appetite-regulatory hormones.

Fructose is the primary sugar source in fruits and vegetables, and makes up 50 per cent of sucrose, a disaccharide and the sugar most commonly added to processed foods in New Zealand. Does this mean we are best to minimise our fruit consumption along with the packaged goods?

It’s not that simple. Generally, healthy individuals don’t need to be concerned about their fruit intake; fructose in fruit is packaged alongside fibre, vitamins, antioxidants and phytochemicals that make it an awesome addition to the diet.

You just don’t want to be consuming too much fruit a day, as you may be eating it instead of other nutritious food choices that contain essential fats and proteins required for optimal health. Fructose in processed food, however, is typically delivered alongside readily digestible carbohydrates, polyunsaturated omega 6 fats, or both, with little other nutritive value.

This highly palatable combination can be particularly damaging for our body in the long term, causing the production of free radicals which promote oxidative stress, inflammation and cell damage — the underlying process from which disease begins in the body.

If these foods are the mainstay of the diet, there is less likelihood you’ll be consuming the nutrients that are required to fight this free radical damage and keep you healthy.

Fruit juice

Even freshly pressed fruit juices are best kept for a treat and not an everyday food item. Recent research has shown carbohydrate (of any sort) that has been broken down (and had the outer layers and husks removed) can have a greater negative impact on our health than when the whole food is eaten intact. Along with flours and processed foods, refined sugars may produce inflammatory microbiota in the upper part of our gastrointestinal system, which leads to metabolic damage long term.

Even some vegetable juices free of fruit deliver a hefty load of fructose and sugar. This will hit the bloodstream, ramp up your blood glucose levels and likely deliver a hefty blow to your energy level as they come crashing down an hour later.

Juices (alongside honey and juice concentrates) are considered “added sugar” by the World Health Organization, which recommends no more than 6 tsp (24g) of added sugar for women, 9 tsp (36g) for men, or 5 per cent of daily energy intake.

Sugar-free products

Unfortunately, consuming sugar-free products doesn’t get us off scot free either. Replacing sugar with aspartame (commonly found in diet soft drinks) and sucralose (Splenda, commonly found in “lite” yoghurts) can affect blood sugar control in people who already experience these challenges.

Scientists have recently discovered in animal models that when the sweet flavour is delivered without the expected calories (as happens when you use artificial sweeteners), it confuses the brain. The brain no longer believes the sweet taste is associated with an influx of calories, and ramps up the production of an enzyme that signals hunger, promoting overeating.

It also affects the ability to control blood sugar and can lead to anxiety, insomnia and hyperactivity. Though the same studies have yet to be carried out in humans, as I see it, we don’t know what effects long-term consumption of these products can have, so it’s always a better idea to steer clear of them.

And what of stevia, a plant-based sugar alternative? Again, research is thin on the ground, though it has been found in human trials that stevia does not cause the same blood sugar increase after a meal that sucralose does. However the bitter taste of stevia can take some adjusting to, and food manufacturers are finding its acceptability is enhanced when combined with sucrose (normal table sugar).

Though it is a good look for a company to use these, it doesn’t always turn the product into a low-sugar option; a 600ml bottle of soft drink that has stevia added may be lower in sugar than the regular version, but will still deliver 10 tsp of added sugar —above the WHO’s recommendations.

Research suggests the demand for products using a perceived natural alternative to both sugar and artificial sweeteners is increasing among health-conscious individuals, particularly parents. But, as little is known about the long-term use of the most common types of stevia, it’s best to use these sparingly.

To my mind, if looking to lower your sugar intake, the less-processed varieties (such as coconut sugar) may offer more nutrients, or the sugar alternative (such as stevia) fewer calories, but the best approach is to consume less in general. Though food products containing natural sugars may contain better quality ingredients overall, they can still drive an appetite for the sweet stuff.

It doesn’t take long to adjust your tastebuds when you drop the sugar; for some it can happen in as little as a week. Lowering your overall expectation for sweet food will make you appreciate the taste of other foods that haven’t had sugar added. And that’s a delicious way to eat.

Sugar-free roasted tomato sauce

Try your tastebuds on Michael Van de Elzen's sugar-free tomato sauce. Get the recipe

Bitter chocolate tart

For those times when you really do want a sweet treat Nick Honeyman's sugar-free bitter chocolate tart will do the trick. Get the recipe

Through her subscription service of meal plans and nutritional support, nutritionist Mikki Williden helps people manage their diets in an interesting way, at a low cost. Find out more at mikkiwilliden.com