The Sugar Spectrum and Nutrient Density of the Diet
Where do you sit on the “sugar spectrum”? The possibilities run the gamut from sugar-shunners, the moderation crowd, or worshippers of all things Sweet. The nutrition and health experts and writers who make sugar out to be a toxin, a dangerous food, and have sparked the sugar-free diet trend with films and celebrity diets (Davina McCall, Sarah Wilson, Gwyneth Paltrow) argue that sugar is addictive and causes metabolic changes that have fueled the obesity epidemic in ways that are more sinister than just adding additional, unneeded calories to the diet. The diverse number of entities like the FDA, the British Dietetic Association, and the World Health Organization, and nutritionists (Rosemary Stanton, Dr David Katz), have accepted that people like the taste of sugar, and appreciate that sweet foods play an important role in many cultures, although sugar is a poor source of nutrients except for carbohydrates and excessive intakes should be avoided. One the other hand, organizations such as The Sugar Association promote sugar consumption as a healthy part of a diet, searching for “chocolate chip cookie recipe” on Google produces over 9 million hits, and it seems that in at least 18 countries in the world, the average person consumes more than 65g of sugar per day, the comfortable US upper guideline for sugar intake.
From the crowd arguing for moderation, we hear that adding sugars to foods increases their energy content without adding other nutrients, and this is the subject of a recent publication by Louie and Tapsell. They used data from around 4000 Australian children and adolescents to work out the effect of added sugars on dietary nutrient density. Participants were grouped according to quintiles of added sugar and total sugar intakes, and average intake of other nutrients (protein, fat, carbohydrate, fiber, calcium, iron, phosphorus, magnesium, zinc, potassium, iodine, sodium, vitamins A, B1, B2, C, D, E, and folate) per quintile were calculated. The average added sugar intake in the lowest quintile of sugar intake was 36 g per day, and this increased to 83 g per day in the highest quintile of sugar intake, while total sugar intakes were 102 g per day in the lowest quintile compared to 140 g per day in the highest quintile.
The authors found that as added sugar intakes increased, intakes of all nutrients except carbohydrates declined significantly. For each unit increase in added sugar, the risk for not meeting nutrient reference values varied from 5% for iodine up to 37% for iodine. The results using total sugar intake (which includes sugar from food containing naturally-occurring sugars, which tend to be more nutrient dense), were less consistent. Even so, it seems that although people in the highest quintile of added sugar intake were more likely to not meet recommendations for LC PUFA, iron, thiamin, vitamin E, zinc, they were more likely to meet the recommendations for calcium, vitamin C, folate, potassium, iodine and sodium. Perhaps the addition of certain micronutrients, including folate, to sweetened children’s breakfast cereals is beneficial to nutrient intakes.
This research supports the idea that added sugar, which contains only carbohydrate, “dilutes” other nutrients from the diet. We need to balance our energy intake with output. Given the obesity epidemic, we need to be critical of the energy that we consume, and aim to meet nutrient intake recommendations within our dietary energy allowance. Inform and empower yourself: use tools such as the USDA’s Supertracker to make sure your diet and lifestyle are in balance. Visit a registered dietitian if you need help. And enjoy sugar, in moderation.
Jimmy Chun Yu Louie and Linda C. Tapsell. Intake of total and added sugars and nutrient dilution in Australian children and adolescents. British Journal of Nutrition, available on CJO2015. doi:10.1017/S0007114515003542.
Robert H. Lustig, Laura A. Schmidt & Claire D. Brindis. Public health: The toxic truth about sugar. Nature 482, 27–29 (02 February 2012) doi:10.1038/482027a. Published online 01 February 2012