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The Truth About Sugar

Excess sugar consumption could be held partly responsible for rising obesity rates, so are artificial sweeteners the solution?

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Treating obesity and its consequences costs the NHS in excess of £5 billion every year in the UK, including the cost of medication and bariatric surgeries (gastric bypasses, stomach stapling etc.). Obesity also greatly increases the risk of developing a range of detrimental health problems and diseases, including type 2 diabetes, cancers, heart disease, stroke and osteoarthritis. Currently, the majority of England’s population is deemed to be at an unhealthy weight, with 24% of adults being obese and 36% overweight. But it doesn’t start there - nearly 1 in 10 children starting primary school in England are already obese, and this doubles to nearly 2 in 10 children by the time secondary school is reached.

It is widely accepted that the root cause of obesity, aside from genetic predisposition, is a combination of excess dietary energy and lack of physical exercise. One major factor in excess calorie consumption is the amount of sugar we eat.

When sugar is ingested, it passes into the small intestine, where it is broken down into glucose. Glucose then travels via the bloodstream to the liver to be converted to glycogen. Glycogen is stored in the liver at a limited capacity, so any excess sugar is oxidised, where it is released as energy for cell processes, or otherwise converted to fat. The liver turns sugar into fatty acids, which then migrate around the body to be stored as fat cells. The oxidation of sugar is favoured by the body over the oxidation of fat, so another result of sugar overconsumption is that fat is stored instead of used for energy. This is how eating or drinking too much sugar leads to weight gain.

So how much sugar is too much sugar? Currently the guidelines in the UK state that sugar should make up 10% of total calorie intake, but actual figures show we consume on average 12-15% of daily calories from sugar. Moreover, the Scientific Advisory Committee on Nutrition has concluded the maximum sugar intake should not exceed 5% of daily calories. The UK population is consuming nearly 3 times as much sugar than these new recommendations suggest is safe.

The UK government is well aware of this need for sugar reduction in the diet, as the recent sugar tax mentioned in the 2016 Budget will apply levies to drinks over two different tiers – those with a total sugar content of over 5g/100mL and a higher rate for a content of over 8g/100mL. As a comparison, regular Coca Cola has about 10g of sugar per 100mL – which equates to 7 teaspoons in one can of coke.

But could the replacement of sugar with artificial sweeteners help overweight individuals and the strain on the NHS?

Artificial sweeteners were discovered in the late 19th century and were originally for the use of diabetics, but later began to be marketed towards dieters. Artificial sweeteners like saccharin are hundreds of times sweeter than the natural sugar sucrose but contain no calories. Both artificial sweeteners and sugar bind to the same sweet taste receptors on the tongue, and transmit sweetness information to the brain. However only sugar increases the blood glucose levels needed for the aforementioned fat cell formation and increase in weight – artificial sweeteners do not have this effect on the body.

Sugar-sweetened beverages are high in calories (with an average of 150 calories per beverage) and easily absorbable sugars, but don’t actually provide any greater feeling of fullness than drinking an artificially-sweetened beverage or plain water. So those calories are consumed without any subsequent reduction in the amount of food eaten. This is the way short term studies have provided evidence that sugar drinks lead to more weight gain, and replacing them instead with artificially-sweetened drinks lead to either weight loss or decreased weight gain in comparison.

In the long term, the results of studies have proved more contradictory. On average, body weight gain and BMI actually increased more for those who were having diet drinks than sugar drinks. This can mostly be explained by dieters. Dieters are much more likely to already have a weight-management problem and are using diet drinks as a way to lower calorie intake, without reducing calorie intake in other areas of the diet. They can fall into the psychological trap of believing they have “saved calories” with their diet drink, and therefore can have more calorie-rich food. What is interesting therefore, is when participants do not know which drink type they are having, those consuming artificially-sweetened beverages put on less weight than those having sugar-sweetened beverages.

Perhaps a good way to reduce sugar consumption may be to replace sugar in drinks and foods with artificial sweeteners, but not to promote these as “diet”. The same sweetness will be achieved, but less calories will be present so there will be less weight gain.

But for now, an easy way to decrease your sugar intake seems to be swapping sugar drinks for diet drinks – but be careful not to think that because you are having a diet coke you can have an extra slice of cake!

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