Is sugar ‘Sweet Poison’? Should we avoid it at all costs? Rebecca Gasche RD takes a considered look in light of the fact that Easter, along with its accompanying sweet treats, is almost here! 

A quick google search of ‘sugar’ leads you to numerous articles, including ‘Sugar is killing us’, ‘Sugar linked to cancer’ and ‘Sweet Poison’.With Easter fast approaching and our consumption of chocolate eggs, hot cross buns and sweet treats sky rocketing, it’s enough to send sugar-phobes into a frenzy. But what really is the deal with sugar?

Sugar is a form of carbohydrate and comes in various forms. It may occur naturally in foods such as dairy in the form of lactose and fruit in the form of fructose. The typical white sugar we know is sucrose.

Fructose, along with glucose, is a monosaccharide carbohydrate – the simplest form of carbohydrate – meaning it cannot be broken down into smaller and simpler compounds. Sucrose and lactose are disaccharides, meaning they contain two monosaccharide molecules.

SO, WHAT ABOUT THOSE HEADLINES!

There have been studies demonstrating that too much sugar can be linked to obesity, tooth decay and Type 2 diabetes.^1,2 However, there is currently no strong evidence to suggest that sugar can directly lead to cancer or death. Saying this, it is important to note that too much sugar may lead to obesity, which is a risk factor for cancer and early mortality. Therefore, sugar is not necessarily the enemy, but the whole picture of health must be looked at.

The Scientific Advisory Committee on Nutrition (SACN) describes free sugars as ‘those added to food or those naturally present in honey, syrups and unsweetened fruit juices, but exclude lactose in milk and milk products’ and advises that these should make up less than 5% of our daily dietary intake.¹ This is equivalent to:³

• 19g or 5 sugar cubes for children aged 4 to 6
• 24g or 6 sugar cubes for children aged 7 to 10
• 30g or 7 sugar cubes for 11 years and over, based on average population diets

These recommendations can easily be exceeded, as often foods we wouldn’t necessarily expect to contain high levels of sugar in fact do. This includes foods such as baked beans, tomato ketchup or your regular latte. In fact, a typical medium-sized latte from a well-known chain contains a whopping 18g of sugar,⁴ that’s over half the recommended daily amount for adults.

Below are some examples of sugar found within food and drinks:⁵

+ tomato ketchup (27.5g/100g)
+ stir-in sweet and sour sauce (20.2g/100g)
+ salad cream (16.7g/100g)
+ frosted corn flakes (37g/100g)
+ chocolate spread (57.1g/100g)

Table 1: Sugar content in typical Easter treats^8-12

Food	Sugar content
1 Cadbury’s Crème Egg	26.5g
1 Hot cross bun	14.5g
Cadbury’s Mini Eggs 30g bag	20.5g
Maltesers Easter Egg 248g	101.5g
Lindt Gold Bunny 100g	55g

FREE SUGARS OR NATURAL SUGARS?

So, you’re scared of sugar. Does this mean you’re going to completely avoid all sweets, cakes, fruit and dairy? I doubt it. Whilst it’s a good idea to reduce our intake of free sugars for reasons already mentioned, as well as the fact they contain little nutritional value (in other words ‘empty calories’), it is important to distinguish the difference between free sugars and natural sugars.

Take fruit, for example. Fruit provides us with an abundance of nutrients for our health, including vitamin C, phytochemicals, antioxidants and fibre. As the sugar in fruit (fructose) is digested with fibre, its absorption into the body is slowed down, compared to what would be seen when consuming free sugars.

AND ARTIFICIAL SWEETENERS?

If you are wanting to swap some of your free sugars for sweeteners, no problem! Sweeteners have been proven safe to use,^6,7 despite numerous scare mongering headlines, and can play an important role if you’re wanting to reduce overall calories or take care of your dental health. However, for some people with irritable bowel syndrome (IBS), sweeteners may be more difficult to digest and can cause symptoms such as bloating and loose stools.

EVERYTHING IN MODERATION

In conclusion, we should be trying to reduce our intake of free sugars, but sugars as a whole, do not have to be limited completely. My take home message – enjoy Easter… in moderation!

Rebecca Gasche RD
Specialist Dietitian, Countess of Chester Hospital NHS Trust

Rebecca has a keen interest and specialises in gastroenterology dietetics within the NHS and is the dietetic lead for the gastroenterology service within West Cheshire.

References

1. Scientific Advisory Committee on Nutrition (2015). Retrieved from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/445503/SACN_Carbohydrates_and_Health.pdf
2. Eshak ES, Iso H, Mizoue T, Inoue M, Noda M, Tsugane S (2013). Soft drink, 100% fruit juice and vegetable juice intakes and risk of diabetes mellitus. Clinical Nutrition 32; p 300-308 [online] Available at: www.clinicalnutritionjournal.com/article/S0261-5614(12)00170-7/abstract
3. Starbucks, accessed April 2020 via: www.starbucks.com/menu/product/407/hot?parent=%2Fdrinks%2Fhot-coffees%2Flattes
4. British Dietetic Association (2017). Accessed April 2020 via: www.bda.uk.com/resource/sugar.html
5. NHS (2017). Accessed March 2020 via: www.nhs.uk/live-well/eat-well/top-sources-of-added-sugar/
6. Cancer research UK (2016). Accessed April 2020 via: www.cancerresearchuk.org/about-cancer/causes-of-cancer/diet-and-cancer/food-controversies#food_controversies1
7. European Food Safety Authority (EFSA). Aspartame. Accessed April 2020 via: www.efsa.europa.eu/en/topics/topic/aspartame
8. www.cadbury.co.uk/products/cadbury-creme-egg-11467
9. www.tesco.com/groceries/en-GB/products/254946119
10. www.cadbury.co.uk/products/cadbury-mini-eggs-11466
11. www.tesco.com/groceries/en-GB/products/281879837
12. www.lindt.co.uk/shop/seasonal-chocolates/gold-bunny/lindt-gold-bunny-milk-100g