contributes to tooth decay if eaten in excessive amounts. But we also know that, if eaten in moderation, when blood sugar control and weight are maintained, sugar is not necessarily harmful to our health. Let’s clear up some of the confusion about sugar by looking at the upside and the downside of this controversial carbohydrate.
The Downside
Extra calories
Many empty-calorie foods such as candy, cake, and ice cream give you fuel and pleasure but none of the benefits of vitamins, minerals, fiber, and protein. If you are taking in 15–20 grams of carbohydrate from a candy bar instead of from a piece of fruit, then you will not only be taking in more calories (from fat), but you are also trading a healthy food for a not-so-healthy food. Even the fat-free versions of many of these empty-calorie foods will give you extra calories, because food manufacturers have to add more carbohydrate (sugar and/or starch) to stabilize the product when the fat is removed. Therefore, dessert foods should not replace healthier foods on a regular basis, regardless of whether you have diabetes.
Small portion sizes
Often if you eat a food that has a lot of its carbohydrate coming from sugar, you may have to eat a smaller quantity. For example, 1 cup of Cheerios contains about 22 grams of total carbohydrate:
1 gram comes from sugar
3 grams come from fiber
18 grams come from starch
However, if you decide to eat 1 cup of Frosted Cheerios instead of the regular Cheerios, you will get 25 grams of total carbohydrate:
13 grams come from sugar
1 gram comes from fiber
11 grams come from starch
So, if you are taking in 30 grams of carbohydrate from a cereal, you could have about 1 3/4 cups of Cheerios but only 1 1/4 cups of the Frosted Cheerios. You can leave it up to your appetite to decide which one you want.
Dental caries (cavities)
The digestive process begins in the mouth as soon as we start chewing food. Both sugar and starch break down into glucose in the mouth and equally contribute to tooth decay. Bacteria in the mouth thrive on food and ferment the sugars in carbohydrate foods. During the fermentation process, the bacteria produce and leave behind an acid that eats away at tooth enamel. The whole decaying process actually depends on how long the food stays in the mouth. However, regular brushing and flossing along with limiting large amounts of sticky carbohydrate foods will help prevent dental cavities.
The Upside
Moderation is the key
Moderation is the key When eaten in moderation, sugar does not cause health problems such as obesity, hyperactivity, diabetes, and heart disease. However, sugar can contribute to weight gain and obesity if eaten in excess. It has actually been documented that obese people eat less sugar than do thin people.
Sugar does have positive traits as an additive
Sugar serves as a food additive to enhance and balance flavor and aroma by adding color and texture (that brown, crusty texture in baked goods). Sugar also acts as a preservative by keeping foods fresh. It adds bulk to ice cream and baked goods, helps to retain air in light-textured products, balances acidity, and lowers the freezing point of foods. Sugar also softens acidity and prolongs shelf life.
HERE’S WHAT YOU CAN DO
1. Use sugar as part of your total carbohydrate intake. This does not mean that you should eat unlimited amounts of sugar or dessert foods, but rather eat these foods in moderation. Totally eliminating sugar is unnecessary and impossible.
2. Reduce the amount of sugars and dessert foods in your diet, whether you have diabetes or not. Relate the amount of these foods in your diet to your level of activity and exercise.
3. Read food labels to determine how much of that food’s carbohydrate is coming from sugar and if the food is nutritious rather than just an empty-calorie food. For instance, instead of chocolate cookies, eat oatmeal cookies; instead of frosted cereals, eat plain-type cereals and add berries for sweetness.
4. Use the Serving Size as your guide when eating high-sugar foods. Most average-size cookies list one or two cookies as a serving size, whereas ice creams list 1/2 cup as a serving size. Most people eat at least twice as much.
5. Be sensible, but enjoy your new food choices. You are not “cheating” if you eat foods that have sugar in them as long as your meals are within the context of healthy eating, meaning that you balance those foods with your carbohydrate intake. You are not a bad person for enjoying all foods. You are a normal person who happens to have diabetes and who has to live in the real world.
SUMMARY
Although it has been many years since nutrition guidelines for diabetes have become more realistic, people with diabetes still believe that avoiding sugar is the main goal of nutrition therapy. After years of educating people with diabetes about the dangers of sugar and giving them lists of “good” and “bad” foods, we now know that sugar is just a form of carbohydrate. With proper education from a registered dietitian, you can learn how to choose your carbohydrates wisely.
YOUR TURN
Now it’s your turn to recall some key points from this chapter. Let’s see how you do!
1. Natural sugars found in fruits, vegetables, and milk make up about one-half of the sugar intake in the U.S. Added sugars such as those in cookies, soda, cakes, and candy make up the other half. True or false?
2. The primary naturally occurring sugar found in milk is called ____________ and is often called milk sugar.
3. Three examples of “empty-calorie foods” include:
_____________________
_____________________
_____________________
4. You are “cheating” on your meal plan if you eat foods that have added sugar in them. True or false?
See APPENDIX A for the answers.
FERN: I recently read an article that said Americans should be adding more fiber to their diets and that fiber was also good for blood sugar and weight control. I wanted to start doing this, but I found that most high-fiber
