By Carolyn Katzin
Just how nice is sugar? Sugar is associated with pleasure beginning with our first food—breast milk—which is very sweet, and many of us continue to find comfort in sweet foods. But when you’re challenged by a cancer diagnosis and looking to support your overall health, you want to make choices that are not only comforting but also good for your body. When it comes to sugar, the key is to make educated choices that will provide you with lasting fuel and extra nutritional benefit.
Not All Sugars Are Created Equal
Sugar is a broad term to describe chemicals that usually end in –ose (such as glucose and fructose); they provide about 4 calories per gram (g) and are also called simple carbohydrates. You may notice that food labels list sugar and added sugars separately. The commercial source of sugar is usually from sugar beet but may also be from sugar cane.
Refined sugar is extracted from the raw material by heat clarification to remove impurities and then concentrated by evaporation under vacuum, leaving a white crystalline product that is 99.9 percent pure sugar. This product is called cane sugar (even if it originated from sugar beet). Turbindo, or raw sugar, is from the first pressing of the sugar cane, which leaves coarse sugar crystals that are washed of debris. Sometimes, as with Demerara sugar, which comes from Guyana, this natural raw sugar is named from its place of origin. In the United States, natural raw sugar is from Hawaii. True brown sugar has not been decolorized and has been coated with a molasses syrup that provides flavor, color, and some trace elements, including iron. Unfortunately, most brown sugar sold today is actually white sugar that has been colored with caramel (heated white sugar that turns brown). Added sugars, like xylitol, which is often added to chewing gum, include sugar alcohols.
Many of us get a lot of our daily sugar from the starch we consume. Starch, a carbohydrate, is composed of long chains of mostly glucose and makes up the majority of staple foods that provide many of us with most of our daily calories. Wheat, corn, rice, and other cereal crops are predominantly composed of starch, which is broken down in our bodies into simple sugars (mostly glucose) and is then metabolized to provide energy.
How Much Is Too Much?
We are consuming much more sugar today than at any time in history. As with most health recommendations, there is no “one size fits all” answer to the question of how much sugar we should be consuming, although a high-sugar diet is usually high in other shelf-stable, processed foods and low in nutrients. In 2003 the World Health Organization reviewed the scientific evidence on sugar and recommended that to reduce the risk of tooth cavities and obesity, calories from sugar should not exceed 10 percent of a person’s total calories. More recently, the American Heart Association suggested that most women limit their sugar intake to 100 calories, or about six teaspoons per day. Although the science linking sugar consumption to obesity is inconsistent, we do know that obesity rates have soared since the 1980s, which coincides with the period when overall consumption of sugar and corn syrup solids (high-fructose corn syrup included) soared.
When incorporating these guidelines into your diet, the most basic principle is to stay away from processed foods in which sugar serves as a preservative and a flavor enhancer and to aim instead for fresh foods that provide you with sustained energy. Whole-grain cereals and beans, for example, are great choices. They are referred to as low-glycemic-index foods, as they deliver glucose into the bloodstream slowly. Whole-grain bread provides a lower glycemic index than white bread, so it is a healthier choice. When baking, try substituting natural raw sugar for white table sugar where possible and reduce the amount. Most recipes will tolerate a 25 percent reduction in the amount of sugar called for but will be less shelf-stable as a result. If the recipe will tolerate it, try substituting sugar with honey in the comb, which includes pollen, enzymes, and antioxidants and has been used as a health remedy since ancient times.
Those who notice that their energy level is particularly sensitive to sugar or who have been advised to cut back on sugar for health reasons (including metabolic syndrome or prediabetes) should seek out low-glycemic-index foods, which contain about 15 g of sugar or less per serving. Though it may seem intimidating to make these changes if you are used to consuming a lot more sugar, consider starting with small, easy changes. For example, if a cup of apple juice provides 25 g of sugar or 100 calories, a smart way to include apple juice in your healthy eating plan would be to dilute it with water to lower the sugar concentration while still enjoying its sweet flavor. Eating the apple in its natural state would be an even better choice, as you would also benefit from the dietary fiber included in the whole fruit.
Sweet foods are associated with pleasure, and who doesn’t need that? The key is to savor the pleasure and enjoy the flavors and the textures associated with natural sweetness but avoid overconsumption. When selecting sweet foods, choose natural sources as often as possible, as these include other nutrients as well, such as B vitamins and trace elements, whereas pure table sugar or high-fructose corn syrup provide only calories—without the additional nutrients found in their natural source foods.
To reduce sugar in a recipe, try these substitutions.
Not All Fruits and Veggies Are Created Equal
Though it may seem that you can’t go wrong in reaching for fruits or vegetables, when you’re paying attention to sugar consumption it’s important to know that some choices are healthier than others—even in the produce aisle.
Root vegetables, such as beets, rutabagas, carrots, and turnips, tend to be higher in sugar. Leafy veggies that grow aboveground—like spinach, cabbage, kale, and bok choy—have very low quantities of sugar. Fruits generally have a higher sugar content than vegetables. Pitted fruits—like cherries, plums, peaches, and nectarines—have the most. Melons are also high in natural sugars, as are grapes and sweet apples. Berries have the lowest amount of natural sugar and have the added benefit of also including the highest levels of active antioxidants.
Check out the following list to see which other fruits and vegetables have a low glycemic index, then stock up your grocery cart or your famers’ market basket with these delicious choices.
Try this delicious dessert recipe with low glycemic load (delivers glucose slowly into the bloodstream for optimal insulin activity).
Rhubarb and Cinnamon Flan
1 cup whole-grain graham cracker crumbs
2 tablespoons unsalted organic butter, melted
1 pound fresh rhubarb
¼ cup natural raw sugar
2 tablespoons 100 percent whole-wheat flour
2 tablespoons 2 percent organic sour cream
½ teaspoon powdered cinnamon
fresh whipped cream
Combine graham cracker crumbs with melted butter and press into an 8-inch baking pan. Prepare rhubarb by washing, removing any blemished or coarse parts, and slicing and cutting into ½-inch pieces. Place rhubarb in piecrust. Mix sugar, flour, sour cream, and cinnamon and spoon over the rhubarb. Bake in preheated oven at 425º for 30 minutes. Allow to cool. Serve with fresh whipped cream garnished with a little cinnamon.
Prep time: 10 minutes
Baking time: 30 minutes
Cholesterol: 10 milligrams
Protein: 1.5 g
Fat: 5 g
Percentage of calories from fat: 13 percent
Carbohydrates: 22 g
Sugars: 13 g
Dietary fiber: <1 g
Carolyn Katzin, MS, CNS, is a nutritionist with 25 years of experience in clinical nutrition, with an emphasis on optimizing health and wellness and special expertise in oncology. Carolyn is president of Fountain Resources, Inc., a nutrition consulting business for individuals, groups, and industry. Her nutrition practice includes Beverly Hills Cancer Center, Eisenhower Lucy Curci Cancer Center in Rancho Mirage, and the Premiere Oncology Foundation. At the University of California, Los Angeles (UCLA), she consults with the university executive physical program director, A. Shawn Veiseh, MD. Carolyn is a lead volunteer with the American Cancer Society (ACS), serving on its National Nutrition, Physical Activity, and Cancer Control Workgroup as a member of the California Division Board of Directors (2002–2010), as chair of the Wellness Team, as a member of the Los Angeles Regional Council (1998–2010), and as past president of the LA Coastal Cities Unit. Carolyn is a media spokesperson for the ACS California Division and represents the ACS and UCLA’s School of Public Health as past chair and as a member of the California Dialogue on Cancer Prevention Team. She also serves on the California Governor’s Council on Physical Fitness and Sports Advisory Board as a representative of the ACS. She is a member of the Wellness Community West Los Angeles Medical and Professional Advisory Board and a member and past chair of the Dean’s Advisory Board for UCLA’s School of Public Health. Carolyn is fascinated with the emerging science of nutrigenomics and has completed two certification programs in the field. She is the author of three books and is working on her fourth: Carolyn Katzin’s The DNA Diet.