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All About Sugar

By Elliot Fisher MS, ATC, CSCS, PES

In pursuit of health, researchers have tried to pinpoint some of the big risk factors for disease. It was believed that obesity and chronic disease was due to consuming excess fats, but now that blame has shifted to sugar. However, there is some debate if sugar is really the culprit or if it’s just another health belief that will turn out to be overhyped in the future. In this article, we’ll cover the benefits, and negatives to sugar in the diet.

Sugar is typically a monosaccharide (one sugar) or disaccharide (two sugars combined). Types of sugar include glucose, sucrose, fructose, galactose, lactose, etc.1 When any carbohydrate is consumed, it will be broken down into glucose for fuel or storage. If used for fuel it will be released into the blood for energy. If stored it will become glycogen (stored carbohydrate in the muscle and liver) or will be converted to fat if glycogen stores are full.(1)

Sugar can be an important part of a diet. As previously mentioned carbohydrates need to be consumed in order to produce energy or store glycogen. An advantage sugar has over starchy carbohydrates is that they digest much faster. So, if you are going to workout it would be better to drink a sugary drink rather than eat oatmeal because you’ll be able to access the nutrients faster, and it won’t be as hard on the digestive system (in comparison to eating oatmeal or another whole food).(2) You can also drink sugar during your workout or after for the same benefits. In this case, sugar is beneficial in comparison to whole foods. Another benefit is that sugar is hyperpalatable meaning it tastes really good.(3) This is a benefit if you are struggling to eat enough carbohydrates throughout the day. Certain athletes, specifically strength or even more so endurance athletes should be eating a very high carbohydrate diet, maybe 500-1000 grams of carbohydrate/day (depending on the athlete, I typically eat 500 grams/day as a powerlifter when maintaining weight, about 650-700+ grams/day when gaining weight). It can be hard to eat that much carbohydrate from oatmeal, rice, pasta, bread, etc. Sugar can play a huge advantage here because it is way easier to down a Gatorade, eat some fruit, or eat a bowl of kids’ cereal.

Some of the drawbacks to consuming sugar. If eaten in excess, it can raise blood triglycerides, as well as LDL cholesterol and decrease HDL cholesterol, which can increase the risk of cardiovascular disease.(4) Excess may seem ambiguous. To be eating excess sugar you would have to be eating in a caloric surplus, while also being overweight, and most likely be physically inactive. If you are not eating in a caloric surplus it’s tough to be eating excess as you are burning pretty much every nutrient you are eating. Additionally, if you aren’t overweight then if you were putting excess nutrients into your body from sugar you most likely won’t suffer any health negative as you’re not at an unhealthy weight.(2) It’s also possible you are physically active. Physical activity is important for health and raises insulin sensitivity, meaning you are able to handle more insulin better (which directly affects how your body handles sugar).(5) Another consideration with sugar is if consumed in excess it can increase your blood sugar very fast which over time will make you more insulin resistant and being continually worse at handling dietary carbohydrate (think diabetes). However, it is important to consider the entire diet/meal with this, as if you consume sugar by itself it will spike blood sugar really fast. But, if consumed with fat, protein, or fiber (basically any meal) that blood sugar spike isn’t nearly as drastic. (1,6) Meaning if you eat sugar with other foods it probably doesn’t have nearly the same negative effect. Another drawback to sugar is that it’s hyperpalatable (that’s right, this is both a benefit and a negative). Sugar tasting good can be bad if you eat too much and you’re eating more than you should. Some people have trouble consuming too many calories and eating sugar can make that issue worse. If you find that once you eat something very sweet and you lose control, try to eat less sugar. Finally, when fructose is consumed in excess it can lead to liver diseases, such as fatty liver.(7) One thing to note here is that most of these health consequences only arise when you are eating in excess, and could be prevented if you are at a healthy weight/physically active. Rarely do people have these issues otherwise.

Another thing to note is the difference between natural sugar and added sugar. It is often said that natural sugar is good, and added sugar should be avoided. This is probably true when it comes to the hyperpalatability of sugar but it doesn’t change much of the other health concerns. If you eat 300 grams of sugar from grapes versus cereal it probably has the same net effect on your health, the only difference is that it’s hard to eat 300 grams of sugar from grapes, and maybe much easier to eat from Gatorade or kids’ cereal. Another consideration is that added sugar is most likely going to be less nutrient dense compared to sugar naturally found in foods (like fruits). This doesn’t make added sugar bad, as much as it just makes natural sugar sources healthier than added sugars.

In conclusion, sugar is not actually that bad in itself. Sugar tastes really good so it can help you get more calories in if you need more, or may be tough to stop eating if you have problems eating too much. As far as performance eating sugar around your workout can be beneficial for strength and endurance by buffering and maintaining glycogen and blood sugar levels. If you eat sugar in excess (remember this can be fairly tough unless you eat tons and tons) you can become more insulin resistant and become diabetic, increase cardiovascular disease risk, or develop liver issues. Bottom line, if you have healthy blood glucose levels, aren’t struggling with eating too many calories, and enjoy eating sugar, you probably don’t need to worry about consuming too much.

References

  1. Dunford, Marie, and J. Andrew Doyle. Nutrition for sport and exercise. Cengage Learning, 2011.

  2. Johnson, Richard J., and Robert Murray. “Fructose, exercise, and health.” Current sports medicine reports9.4 (2010): 253-258.

  3. Levine, Allen S., Catherine M. Kotz, and Blake A. Gosnell. “Sugars and fats: the neurobiology of preference.” The Journal of Nutrition133.3 (2003): 831S-834S.

  4. Welsh, Jean A., et al. “Consumption of added sugars and indicators of cardiovascular disease risk among US adolescents.” Circulation(2011): CIRCULATIONAHA-110.

  5. Balkau, Beverley, et al. “Physical activity and insulin sensitivity.” Diabetes57.10 (2008): 2613-2618.

  6. Gannon, Mary C., et al. “An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes.” The American journal of clinical nutrition78.4 (2003): 734-741.

  7. Ouyang, Xiaosen, et al. “Fructose consumption as a risk factor for non-alcoholic fatty liver disease.” Journal of hepatology48.6 (2008): 993-999.

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