The war on sugar: When the sweet goes sour

People need to re-train their palate so they can eat savoury and not crave sugar says Helen O’Callaghan

The war on sugar: When the sweet goes sour

IRISH people eat bread as if it were cake, says dietician Orla Walsh, who describes a typical breakfast — two slices of toast with butter and jam. “What’s the difference between bread and cake?” Walsh asks, before answering: butter (fat) and sugar. “Every morning in Ireland, people are turning their bread into cake by adding butter and jam.”

Add to this a 250ml glass of orange juice (five teaspoons of sugar) and the average person has consumed nine teaspoons of sugar before he has left the house (30g of jam, the amount you’d spread on two slices of bread, has four teaspoons of sugar). Only five to six teaspoons a day are recommended for adults with normal BMI.

We indulge in the sweet stuff. 15% of our calories come from sugars added to food. The sugars found naturally in dairy and fruit are not the problem. These, says Ruth Charles, paediatric dietician with Irish Nutrition and Dietetic Institute (INDI), are “acceptable but also self-limiting — you’re not going to take too much”. We’re talking about sugars added to food, for flavour, by the manufacturer, cook or consumer — raw cane sugar, high-fructose corn syrup, honey, molasses, nectars, syrup (maple, malt) or anything ending in –ose (sucrose, maltose, dextrose).

Scientists are classifying sugar as pure white poison, as one of the greatest threats to human health. In 2002, the World Health Organisation recommended that less than 10% of our total energy should be from sugar — they recently revised this down to 5%. In Ireland, says Walsh, we’re getting, on average, 14.6% of our calories from added sugars. Plus, the majority of us (three in five Irish adults) are overweight or obese — and sugar packs a higher toxic punch the more overweight you are.

“A high-sugar diet is worse for you the more overweight you are. The more fat you have on your body, the less able your system is to break down and use sugar properly, especially when that fat is around your middle,” says Walsh. People who get 17-21% of calories from added sugar have a 38% higher risk of dying from heart disease, compared to people who consume 8% of their calories from added sugar.

We all know the obvious high-sugar foods — buns, biscuits, chocolate, cake, sweets and soft drinks. We ration them. The trouble is we’re consuming sugar in unlikely foods — such as breakfast cereals, which are considered healthy. Many cereals would be better-suited to the confectionery aisle, says Walsh. “Fibre is often taken out of the grain and salt and sugar added. And for adults, 30g servings are suggested — most people take two to three times that.” A 30g serving of a fruit-and-fibre cereal has two teaspoons of sugar, flakes with honey and nuts have two teaspoons, a 50g serving of granola has three teaspoons (half your recommended daily intake), and a cereal bar has three teaspoons.

Your lunchtime sandwich might contain minimal sugar — whether it’s BLT, chicken or chicken tikka wrap — but relish, ketchup or coleslaw up the sugar factor. A tablespoon of ketchup contains a teaspoon of sugar — the same is found in one serving (15g) of relish and in one tablespoon of shop-bought coleslaw. While these are small amounts, they all contribute to total daily added sugar intake. Even if you don’t have a sweet tooth, hidden sugars leave no room for complacency. Shop-bought tomato pasta sauces are often packed with sugar. One-third of an average-sized jar (roughly 150g) will have three teaspoons of sugar, as will a single serving of stir-fry sauce (half-sachet). A 425g jar of curry sauce can contain eight to 10 teaspoons. The same size jar of sweet-and-sour sauce has 15 to 18 teaspoons of sugar — twice the amount in a 350ml can of coke.

One-quarter of us rarely or never consult food labels, say the Food Safety Authority of Ireland. We are easily hoodwinked by foods marketed as ‘healthier’ — ‘low fat’, ‘antioxidant’, ‘gluten-free’. “Many people think gluten-free food is really healthy for you. The reality is ‘gluten-free’ gives a false sense of security. Gluten gives elasticity and moistness in cakes, biscuits and bread — when it’s removed, extra sugar is often added to compensate,” says Walsh.

Dr Cliodhna Foley-Nolan, Safefood’s director of human health and nutrition, has noted the huge rise in the last 20 years of the number of food products that have nutrition and health claims. Yet the population’s weight has soared. University of Ulster-led research found foods marketed as ‘healthier’ are seen by consumers as a licence to over-eat — the portion sizes chosen by survey volunteers were 28% to 71% larger than portion sizes recommended on the label.

You need to be vigilant to wage war on the sneaky sugars lurking in our processed diets. Arming ourselves with the facts is the first step. On food labels, look for ‘carbohydrate, of which sugars’ — the ‘of which sugars’ tells how much sugar is added.

Sugar is high if it’s among the top three in the ingredient list. High-sugar food has more than 22.5g of sugar per 100g of food; it’s low-sugar if there’s less than 5g per 100g of food. Ideally, aim for less than 5g ‘of which sugars’ and greater than 6g of fibre (per 100g of food). “Higher sugar in a product is less detrimental to health if fibre’s high — fibre slows down sugar release in the body,” says Walsh.

Instead of eating processed foods with their multi-ingredients, eat one-ingredient foods. Forget the two slices of toast with butter and jam — opt for oats, milk, fruit and nuts. You won’t see the added sugar — not because it’s hidden, but because it’s just not there.

Refined sugar is killing us softly

BRITISH professor John Yudkin was one of the first to say sugar is killing us in his 1972-published book, Pure White and Deadly. In 2008 came David Gillespie’s Sweet Poison — the Australian author had been six stone overweight, failed every diet, quit sugar, shed the weight and kept it off.

But it was Robert Lustig’s lecture, Sugar: The Bitter Truth — on YouTube since 2009 and getting over four million hits — that sparked the global kickback against sugar.

Lustig, Professor of Paediatrics at University of California and author of Fat Chance: Beating the Odds against Sugar, Processed Food, Obesity and Disease, argues the low-fat, processed diets we’ve been consuming since the 1980s are killing us. And sugar is the toxic element.

“When the industry cut fat, the food tasted like cardboard so they started adding sugar. Of the 600,000 food items in the American grocery store, 80% are spiked with added sugar. Excess sugar is turned into liver fat, which revs up the cellular ageing reaction.”

Doctors, says Lustig, blame obesity for metabolic syndrome diseases – Type 2 diabetes, hypertension, stroke, heart disease, cancer and dementia. So why, he asks, do 20% of the obese “live a normal life, die at a normal age and not get any of these diseases”? And why do 40% of normal-weight people manifest the “same biochemical problems and some aspect of metabolic syndrome”? Obesity is increasing worldwide by 1% per year. Yet, says Lustig, diabetes is increasing globally at the annual rate of 4%. “If obesity is the cause of diabetes, then how is diabetes increasing faster?”

Lustig believes sugar is an independent risk factor for disease. He points to the radical change over the last 30 years in the nutritional composition of the average American diet — processed foods and sweets accounted for 11.6% of dietary intake in 1982; by 2012, it had doubled to 22.9%.

“Fructose [one of two main carbohydrates in refined sugar] — and sugar in general — is an energy source but it isn’t a nutrient. There isn’t one human biochemical reaction that requires dietary fructose,” says Lustig. He warns: after you ingest a large amount of fructose, it goes straight to the liver where it overwhelms your body’s natural capacity to metabolise it — so it gets converted into fatty acids. These either get packaged into Very Low Density Lipoproteins, promoting cardiovascular disease, or get stuck in the liver, where they lead to fatty liver disease, promote weight gain and put you at risk for Type 2 diabetes.

In Ireland 30,000 new cancer cases are diagnosed each year. About 10,000 die here annually from cardiovascular disease, while 200,000 have diabetes. And because these diseases mostly don’t kill quickly — diabetes is a ‘20-year until death disease’ — they cost billions.

For Lustig, sugar is the “alcohol of the child”and the only treatment is reduction of consumption.”

70% of children may be obese adults

IRISH children are in an obesity crisis. One in four — 30,000 primary schoolchildren — are overweight or obese. If the trend isn’t reversed, 70% of them will face adult obesity. An obesity treatment programme at Temple Street Children’s Hospital examined 300 children between 2008 and 2013. Forty percent had high cholesterol and half had high blood-sugar levels, putting them on course for early Type 2 diabetes. Seven in 10 had musculo-skeletal problems.

Ruth Charles, paediatric dietician with INDI, says being overweight has immediate consequences for a child. “Excess weight carried by a [young child] puts pressure on immature bones. Children’s bones are softer than adults’ — they need to be allowed develop. This is hindered if young, small bones are trying to carry extra weight.”

According to the 2012-published study, ‘Irish Health Behaviour in School-Aged Children’, 37% of children eat sweets once a day or more, while 21% consume soft drinks daily or more. If children consume sugar-loaded drinks, they’re one and a half times more likely to become overweight or obese. And half of 12-year-olds and three-quarters of 15-year-olds have decay in permanent teeth.

In 2005, Irish Universities Nutrition Alliance reported that 87% of children had sweets, chocolate or savoury snacks in their school lunch-boxes — 75% had biscuits and cakes. Thanks to school eating policies, lunch-boxes have become healthier. The latest Bord Bia PERIscope study confirmed this — lunch-box staples include sandwiches and yogurt. Three in four had fruit.

Charles says naturally occurring sugar (in milk and fruit) has different health effects to added sugar in, for example, cereal bars, yogurt drinks, cordial, biscuits and nutella. She’s concerned that children are consuming well above the six-teaspoon-a-day added-sugar limit recommended for adults. “If they have a breakfast cereal like Coco Pops (20g serving = 2tsps added sugar) and at school break have a cereal bar (3tsp added sugar) and a yogurt drink (up to 2tsps added sugar), by small break they’re already at, or over, six teaspoons.”

Better to swap for porridge at breakfast and, for small break, a carton of milk and slice of wholemeal bread — or a handful of peanuts or crackers and cheese. These contain minimal added sugar. Dr Marian Faughnan, Safefood’s chief specialist in nutrition, recommends milk and water for children. “Unsweetened fruit juice (only 100ml a day) is fine — parents should look for ‘100% fruit’. Fruit should be the only ingredient in a juice drink.”

For healthy lunch-box fillers, opt for tuna/pasta salad, fresh salmon sandwich with celery on wholemeal bread, hummus on wholegrain pitta bread, wholemeal bread sandwich with cheese, lettuce and tomato, or home-made vegetable soup. Visit www.safefood.eu; www.fooddudes.ie.

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