carbohydrate) because these are the carbohydrates that many people with diabetes think they have to avoid.
The Monosaccharides
Glucose is the largest, the most common, and the most complicated of all of the sugars. Glucose is always found as one of the two sugars in disaccharides and is the basic unit of starch and fiber. Glucose is simply the form that carbohydrate takes in the body as our fuel.
When carbohydrates are digested, they are converted into glucose and our blood sugar levels rise. Almost 100% of carbohydrate foods break down into glucose and are available as fuel. Therefore, carbohydrate is our main source of energy. We do not always use all of the blood sugar from carbohydrate right away. With insulin’s help, some glucose is stored in the liver, where is it changed into a storage form of glucose called glycogen. This glycogen can give you quick energy if you should need it and takes care of your energy needs while you are sleeping. Fuel is also stored in muscle as glycogen, but this storage does not last long, especially during exercise.
Fructose is the sweetest of the sugars and, in combination with glucose, is a component of table sugar (sucrose). Fructose occurs naturally in fruits, berries, vegetables, and honey. It is also used as an additive in products sweetened with high-fructose corn syrup, a food additive that people with diabetes should cut down on. Although many people with diabetes believe fructose may be a better choice as a sweetener, the American Diabetes Association states that the “use of added fructose as a sweetening agent in the diabetic diet may have no overall advantage over other sweeteners.”
Galactose is not as common as glucose and fructose. It is one of the three monosaccharides common in foods but its sugar block is always connected to another sugar block to form lactose, the sugar in milk.
The Disaccharides
The disaccharides are double sugar blocks of the three sugars above, with glucose being a part of all three sugars.
Maltose consists of two glucose units and is only a part of a few foods. Maltose appears when starch is broken down, such as during digestion, when seeds germinate, and when alcohol is fermented.
Sucrose consists of fructose and glucose and forms what we know as table sugar. This is the most common of all the sugars and gets its sweet taste from fructose. The main food sources of sucrose are the juice from sugar cane and sugar beets. Sucrose is processed to make brown, white, or powdered sugar. Today, sucrose can be part of an eating plan for anyone with diabetes. It is no longer forbidden or restricted for people with diabetes, although it should be used in moderation.
Lactose consists of galactose and glucose and is a disaccharide found in the milk of mammals. Lactose is the main carbohydrate found in milk and often referred to as milk sugar.
WHERE IS IT FOUND?
Natural or Added?
So now you know that sugar—any kind of sugar—is just a type of carbohydrate and is only one type of sugar among several that are found in foods. Although we now know that sugar has a similar impact on blood sugar as do many other carbohydrates, let’s think about how sugar occurs in food: is it found naturally in food or is it added to the food? Natural or added sugars still have the same effect on blood sugar levels; however, the foods that contain these sugars may not be equally healthy or nutritious.
For instance, an apple contains carbohydrate in a natural sugar (fructose), whereas a candy bar contains its carbohydrate from an added sugar (sucrose). You know the apple is healthier because it is a good source of many vitamins, minerals, and fiber. The candy bar, on the other hand, is what we call an empty-calorie food, which means that although it may taste good, it doesn’t offer any health benefits. It also contributes a great deal of fat and calories. Remember, though, that you can choose to occasionally have an empty-calorie food as long as you substitute that food for another carbohydrate food. This is because your body does not necessarily recognize the natural or added sugars, but instead reacts to the total amount of carbohydrate you have eaten.
Finding the Sugar
One way to find the sugars in food is to look at the Nutrition Facts on a food label, under the Sugar category. But generally, you should look at the grams of Total Carbohydrate instead. Here’s why.
If you look in the ingredient list, the sugars in the product will be individually listed, but often listed under an alias that most consumers do not recognize as sugars. The sugar listed on the label could include any of the following:
| Brown sugar | Honey |
| Confectioners’ | Invert sugar |
| sugar | Lactose |
| Carob | Maltose |
| Corn syrup | Maple syrup |
| Dextrose | Molasses |
| Fructose | Sucrose |
| Galactose | Turbinado |
| Glucose |
Some sugars listed in the ingredient list, but not necessarily listed next to sugar on the upper part of the label, include the sugar alcohols—hydrogenated starch hydrolysate, sorbitol, mannitol, maltitol, isomalt, and xylitol. The manufacturer is not required to list these sugar alcohols on a food label unless the food product clearly states that the food is “sugar-free.” These may be listed next to “Other” or “Sugar Alcohols,” directly under “Sugar,” or they may be found only in the ingredient list. However, all sugars must be added to the grams of Total Carbohydrate. So overall, it is more important to look at grams of Total Carbohydrate than the grams of Sugar.
Some of the foods listed below will give you an idea of what one serving of a “sugar” food can look like:
| 2-inch square brownie | 1 Tbsp 100% fruit spread |
| 1/2 cup nonfat chocolate | 1/2 cup regular gelatin |
| milk | 1 Tbsp regular syrup |
| 2-inch square unfrosted | (no fat) |
| cake | 1 granola bar |
| 1/4 cup sherbet or | 1/2 sweet roll or Danish |
| sorbet | 1/2 cup light or regular ice |
| 2 Tbsp light syrup | cream |
| (no fat) | 2 sandwich cookies |
WHY DO WE NEED IT?
We don’t really need sugar; however, sugar is found in many healthy foods and it tastes good. Natural sugars, such as those found in fruit, vegetables, and milk, make up about one-half of the sugar intake in the U.S. Added sugars, such as those found in cookies, soda, cakes, and candy, make up the other half of our sugar intake.
THE UPSIDE AND THE DOWNSIDE OF SUGAR
Sugar has received bad press for many years. Aside from the sweet taste that sugar adds to food, the only proven information that
