Registered dietitian and diabetes nurse educator, Tammy Jardine, educates us on the many hidden names of sugar (there are over 50) and why sugar is seen as a villain.
Sugar is the new villain in the diet industry and making it even more wicked is that sugar is a master of disguise. Historically, the misconceptions about sugar in the greater health industry has revolved around white sugar, otherwise known as table sugar.
White sugar is the end product of refining and processing of cane sugar. During this process, moisture, minerals and compounds that give them their darker colour are removed, as a result forming white refined sugar. With these nutrients removed, sugar provides energy but has no other nutritional value. Sugar is therefore often referred to as empty calories, adding no value to a healthy diet. Cancer, obesity and diabetes have been linked to white sugar consumption.
For decades, it has been advised that people with diabetes avoid sugar as it has a high glycaemic index (GI), which implies a rapid increase of blood glucose after eating.
Daily sugar limit
The Scientific Advisory Committee on Nutrition (SACN) recommends the following limit for added sugars in the diet for the general population.
|Age group||Maximum added sugar value per day|
|4 to 6 years old||No more than 19g|
|7 to 10 years old||No more than 24g|
|11 or over||No more than 30g|
|People with diabetes||25g or less|
For reference:4 grams of sugar is equal to a teaspoon of sugar.
The hidden names of sugar
However, just because you don’t see ‘sugar’ on the ingredient list when scanning a food label does not guarantee the item is sugar or sweetener-free. Sugar goes by a number of different names, making it easily unnoticed. Sugar has over 50 different names. While some of these names are more obvious, like brown and cane sugar, others are trickier to spot (e.g. maltodextrin and dextrose).
Most common names for sugar that you may find on an ingredient list
- Basic Simple Sugars (monosaccharides and disaccharides) – dextrose, fructose, galactose, glucose, lactose, maltose, sucrose.
- Solid or Granulated Sugars – beet sugar, brown sugar, cane juice crystals, cane sugar, coconut sugar, castor sugar, corn syrup solids, date sugar, demerara sugar, malt, glucose syrup, grape sugar, icing sugar, ethyl maltitol, dextrin, maltodextrin, muscovado, raw sugar, sucanat, turbinado.
- Liquid or Syrup Sugars – agave nectar, syrup, barley malt, molasses, rice syrup, caramel, carob syrup, corn syrup, evaporated cane juice, fruit juice, golden syrup, high fructose corn syrup, honey, invert sugar, malt syrup, maple syrup, sorghum syrup, treacle.
Why is sugar added to food?
Sugars are being added to a huge range of foods from bread and hams to more obvious foods, such as cakes and biscuits. Sugar is added to foods to increase the shelf life since sugar is a preservative and it also makes foods more palatable. Most of us will be aware of more obvious sugar, such as sugary fizzy drinks, cakes and biscuits but there are also other foods which contain a lot of sugar that may not be immediately obvious.
However, it’s not just added sugar that can increase blood glucose levels. Sugar is a form of carbohydrate. Carbohydrate is one of three macronutrients found in food. Carbohydrates breakdown to glucose (sugar) through the process of digestion. We now know that all carbohydrate raises blood glucose levels.
Forms of sugar
Sugar can be found in three forms.
- Natural – There are natural sugars found in fruit, milk-based products, honey, and vegetables.
- Added – Also called free sugars, these are the sugars that are added to a whole range of processed foods and drinks, including microwave meals, pasta sauces, breakfast cereals, biscuits, sweetened drinks and desserts. These are the sugars listed above.
- The product of the digestion of more complex carbohydrates – Many of us are unaware that starchy foods like bread, rice or potatoes are broken down by digestion into surprisingly large amounts of sugar. A small slice of whole-meal bread is equivalent to three teaspoons of sugar. It’s important therefore that your diet does not contain too much carbohydrate either (e.g. bread, pasta, rice).
Clarifying Total carbohydrate on nutrition label
Therefore, for somebody with diabetes, it’s the total sugar burden from any of the three sources (natural, added or as a product of the digestion of complex carbohydrate) which need considering to keep blood glucose levels low. This is identified as the total carbohydrate on a nutrition label.
Carbohydrates and sugar raise blood glucose levels quickly and require insulin to be produced (or taken by injection) as high blood glucose levels over time cause damage. Many people find that sugar has addictive qualities meaning that we may crave sugary foods even if we know they’re not good for us. Insulin causes the cells of your body to take up the free glucose in your bloodstream. So, having too much sugar means having or needing more insulin.
Nutrition label laws
By law, all packaged food and beverage nutrition labels must display the carbohydrate and sugar content per serving. The best way to ensure you’re not consuming excess added sugars is to get in the habit of always scanning the ingredient list before you throw the item in your trolley.
Keep in mind that ingredients are listed by quantity from high to low: the closer to the front of the list, the more the product contains. If you spot any of above sugar names listed on a label, keep in mind it’s not automatically a no-go. It’s the amount of sugar that counts. If the total carbohydrate count is 1-2 grams, it’s still fine to have if you’re following a low-carb lifestyle. That’s why it’s also important to always look at the total carbohydrate content.
Three different sources of sugars that make up our total dietary ‘sugar burden’
Shown as 4g teaspoon of table sugar equivalents:
|Naturally occurring sugar (1)||Foods with added sugar (2)||Foods digested down into sugars (3)|
|Sasko brown bread
|Honey (Floaris group Organic raw)
|Spar low fat Milk
|Mc Cains Skinny fries
|Medium fat strawberry yoghurt
|Lindt dark chocolate mint intense
When it comes to picking starchy foods, such as rice, bread and any other products made from flour, it’s best to opt for whole grain versions of these products. This is because the fibre in wholegrains impact upon blood glucose levels more slowly than the more refined forms of carbohydrate. However, portion control is still the most important as higher levels of fibre rich or unprocessed carbohydrate can still raise blood glucose levels substantially.
To identify how much total carbohydrate you can tolerate, test your blood glucose before you eat, and two hours after you eat the food. Ideally your blood glucose should not increase by more than 2mmol/L after the food is eaten.
How to cut down on sugar
The good news is that reducing sugar intake reduces the likelihood of needing medication and diabetes-related complications. Cutting back on all sources of sugar is a great strategy to stay healthy.
- Cut down on sugary drinks – non-diet versions of cola, lemonade, tonic water.
- Swap fruit juices for water and whole fruit.
- Replace sugary cereals with plain porridge, whole grain cereals or lower carb breakfasts.
- Avoid having ready meals on a regular basis.
- Make your own pasta or curry sauce. You can make larger portions and freeze what you don’t need for a future meal.
- Get into the practice of having fruit instead of sugary snacks or desserts.
- Don’t have takeaways more than once a fortnight.
MEET THE EXPERT
Tammy Jardine is a qualified diabetes educator and a registered dietitian. Living with diabetes for over 15 years means that she knows first-hand how difficult it can be to achieve and maintain optimal blood glucose control with good lifestyle habits. She believes that diabetes affects every person differently and takes the time to understand how it’s affecting the individual and to help them manage it effectively. With more than 20 years of experience working as a dietitian in the UK and SA, she has a passion for helping people live a better and happier life with good food. Tammy currently works from Wilgeheuwel hospital. Email: firstname.lastname@example.org