William W. Li, MD, is a world-renowned physician, scientist, speaker, and author of EAT TO BEAT DISEASE – The New Science of How Your Body Can Heal Itself. He is best known for leading the Angiogenesis Foundation. His groundbreaking work has impacted more than 70 diseases including cancer, diabetes, blindness, heart disease, and obesity. His TED Talk, “Can We Eat to Starve Cancer?” Dr. Li has served on the faculties of Harvard Medical School, Tufts University, and Dartmouth Medical School.
Sugar consumption then vs. sugar now
There was a time when we humans only consumed sugar in the form of fruits and vegetables, and only when those fruits and vegetables were in season. Now, sugar hits come all year round – when we put dressing on our salad, drink a soda, eat a bowl of cereal, open a jar of pasta or stir-fry sauce, and even when we bite into a slice of bread.
Research suggests that ‘added sugar’ is now the main source of sugar in our diets and that on average Americans consume more than 22 teaspoons of added sugars per day. One major problem with added sugar is that it is often not bound up with other crucial nutrients, such as fiber.
The World Health Organization (WHO) recommends that, for optimum health, our daily intake of added sugars should be kept to around 5% of our daily calorie intake, which, for the average person, is just 6 teaspoons.
To give you an idea of what that equates to, these foods and beverages contain the following amount of added sugar:
1 can of Coca-Cola: 39 grams(almost 10 teaspoons)
1 jelly donut: 6 grams(1.5 teaspoons)
1 bowl of Cocoa Krispies: 12 grams(3 teaspoons)
1 tbsp ketchup: 3.7 grams(1 teaspoon)
½ cup Marinara sauce: 10 grams(2.5 teaspoons)
Sugar in all its forms
Sugar comes to us in many forms. There are those found naturally in the foods we eat, such as fructose, lactose, sucrose, and glucose and then there are others, like high fructose corn syrup, which are man-made. ‘Added sugar’ includes table sugar, sweeteners, syrups, fruit juices, and sugar that is extracted, refined, and added to food and drink to improve the taste.
Sugary drinks, which usually use high fructose corn syrup, have been central to research examining the effects of sugar on our health and have been linked to obesity and reduced insulin sensitivity. As a result, added sugars are thought to increase the risk of developing health problems like high blood pressure, high cholesterol, diabetes, and heart disease.
Sugars that lower our defenses
Man-made and added sugars are instantly absorbed by the digestive system, which can cause our blood sugar levels to spike. A number of scientific studies have determined that high blood sugar levels can incapacitate our regenerative defense system. This is because food and beverages that raise blood sugar block the production of stem cells, lowering your body’s ability to repair organs.
Elevated blood sugar levels have also been shown to cripple and kill important stem cells across the board, from endothelial progenitor cells to bone progenitor cells to cardiac stem cells.
Therefore, if you need your stem cells to be at their best, take a low-glycemic (GI) approach by minimizing or altogether-avoiding sweetened and processed foods containing little or no fiber. These foods, which include the sugary soft drinks and pre-packaged foods I listed earlier, can cause our blood sugar to spike and contribute to a range of life-threatening health problems.
Don’t demonize sugar
There is no question that multiple, important links exist between man-made sugars and poor health. The current emphasis on added sugars, however, has created an environment that is “sugar centric” and risks exaggerating the effects of the sugar-component of foods while ignoring other important nutritional components where health benefits exist.
We also risk confusing foods and drinks with added sugar that lack other essential nutrients, like sugar-sweetened beverages, with healthy foods that have sugars, like fruit and manuka honey.
In my book, Eat to Beat Disease, I list hundreds of foods that are high in naturally occurring sugars and that also do a wonderful job of strengthening our defense systems and healing our bodies.
So please – don’t stop eating bananas!
Sugar intake for diabetics
People with diabetes know that controlling their blood sugar level is very important but, in a 2017 study, it was found that a predominantly plant-based diet with about 40 grams of fiber per day, rich in fruits, vegetables, whole grains, and low-GI foods such as beans, oats, sweet potatoes, improved insulin resistance and controlled blood sugar three times more effectively than a traditional diabetes diet that limits sugar, calories, and carbohydrates.
Despite what you might have been told, complex carbohydrates – which include whole grains, vegetables, nuts, and beans – are not the enemy. They’re made up of sugar molecules which are broken down by digestion into glucose and used by every cell in the body to generate energy and fuel the brain. Because of their high-fiber content, complex carbohydrates allow sugars to be slowly released into the bloodstream. This helps with digestion and blood sugar control, and will also mean you’ll feel fuller for longer: a plus if you want to eat less!
Keep it fruity
If you’re a diabetic or someone who’s been trying to lose weight, you’ve probably also been told to avoid fruits that are high in sugar, like cherries and mangoes. But with that sugar comes fiber, vitamins, minerals, healthy bioactive molecules, and disease-fighting compounds.
If we look at the science, sugar, and carbohydrates from natural sources like fruits, vegetables, and whole grains are consistently associated with positive health outcomes, and should not be avoided out of fear over too much sugar, or carbohydrate, in the diet. They are also key components of a healthy and balanced diet.
Added or ‘free’ sugars, on the other hand, are not necessary for a balanced diet and need to be consumed in moderation. Free sugars are also found in fruit juices, as they do not tend to contain the fiber found in whole fruit.
Final notes
I do not recommend excessive consumption of added sugars because of the well-established risk factors for obesity, diabetes, and cardiovascular disease.
However, I would also agree with the assertion in the Dietary Guidelines for Americans (2010) that overconsumption of calories (not sugars) represents the single greatest health threat to individuals in the United States – and elsewhere – in part due to overall consumption patterns in what has been called the Western diet.
As previously mentioned, I recommend taking a low-GI approach by minimizing or avoiding all sweetened and processed foods that contain little or no fiber and consuming a mostly plant-based diet rich in fiber, fresh fruits, vegetables, whole grains, and low-GI foods. However, when it comes to diabetes, there is no single meal plan or eating pattern that works for everyone, and sugar intake should be individualized for each patient based on his or her health goals, culture, and health literacy. Those with diabetes should be referred to a registered dietitian who has in-depth knowledge of food and nutrition to help develop an individualized meal plan for them.
Try to avoid artificial sweeteners: these may have negative consequences for our gut bacteria, weaken our blood-sugar metabolism, and even promote weight gain. Instead, if you’re looking for a good alternative to sugar then stevia can be useful for sugar-free baking. Stevia is a natural sweetener derived from a plant. It is virtually calorie-free, does not affect blood sugar levels and does not cause tooth decay.
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