By Nadia Marshall

One of the biggest health fads sweeping the nation for a while is the sugar-elimination diet. When people started turning up at our Zen retreats last month with ‘fructose intolerance’ and ‘no sugar’ as a dietary requirement (and I am the chef) I thought it was about time I attempted an impartial investigation of the idea.

Being an Ayurvedan (that isn’t a word) and a recovering dietary fanatic, I am committed to a moderate approach to eating. The idea of eliminating any food from my diet tends to sound off my alarm bells. The idea of quitting sugar when I’ve finally allowed myself to embrace the sweetness of jaggery and less-refined sugars without guilt…. sounds them off even more!  

But I wanted to understand where these sugar-free folk are coming from. And perhaps you do too?  So here is the low down for your reading pleasure….

Why are people giving up sugar?

The idea of giving up sugar is based on a shift in thinking. We’re used to thinking of sugar as ‘empty calories’ or energy without nutrition. But not many of us think of sugar as something extremely harmful to our bodies (unless we’re diabetic). To our teeth, yes… to our livers and pancreas, maybe… but not many of us think of sugar as a poison.

Proponents of the sugar-elimination approach do. They argue that sugar is an extremely harmful substance to the human body… and they have a lot of good science to back it up.  They argue that giving up sugar will lead to weightloss, improved digestion, fewer cravings, increased energy, balanced hormones, increased longevity, improved immunity and will directly decrease the likelihood of developing metabolic syndrome, obesity, diabetes, hypertension, heart disease, kidney diseases, liver diseases and cancer (1 & 3). Just a few of the biggest diseases facing our population!

Is it all sugar we need to give up?

If you do any amount of reading on this approach, you soon realise that not all sugar is considered poison to the body. Just one is - Fructose. Most of you will immediately associate fructose with the sugar found in fruit but fructose is actually found in most foods of plant origin (including tree and vine fruits, berries, grains and most root vegetables). It is also now found in virtually all processed food.

Here’s a quick lesson on sugar. There are three monosaccharides (simple sugars/simple carbohydrates) in our diet – fructose, glucose and galactose. Fructose and glucose often combine in nature to form sucrose. Glucose and galactose combine to form lactose (the sugar found in milk). Complex sugars/carbohydrates refer to long chains of simple sugars joined together and are found in starchy grains and vegetables.(1)

Dietary Mono-saccharides

Fructose, Glucose, Galactose

Dietary Di-saccharides

Sucrose = Fructose + Glucose

Lactose = Glucose + Galactose

Fructose vs Glucose Metabolism

Glucose is pretty important for the body. In fact, it is the energy of life. Every single cell in the human body can use glucose as a source of energy. When we eat glucose, we release insulin which tells the liver, muscle and fat tissues to take up the glucose and store it in its non-toxic form (glycogen) for later use. Therefore, glucose is also known as ‘blood sugar’ and is measured when working out G.I. levels of food. Another good thing about glucose is when we eat it, our hunger hormone (ghrelin) is suppressed so our brain knows we’re full.  For every 100 calories of glucose we eat, less than about 2% is turned into fat (2).

Fructose is metabolised in a completely different way to glucose. The only cells in the body that use fructose for energy are sperm cells, so unlike glucose, it isn’t readily used as an energy source. When we eat fructose, insulin isn’t released and our hunger hormone isn’t suppressed so there is no ‘off’ switch for eating fructose. Fructose is either bonded to cellulose and transported out of the GI tract or processed by the liver into uric acid (which causes gout and hypertension), citrates (acids), aldehydes (toxic to the body), lipid droplets (fat) and free fatty acids. The free fatty acids affect the insulin receptors in the liver which can directly lead to liver insulin resistance (i.e. type 2 diabetes). Fructose metabolism also leads to the formation of very low density LDL cholesterol - the type of bad cholesterol that causes plaques in our arteries. And, fructose is 7-10 times more likely to form AGEs than glucose metabolism (AGEs are advanced glycation end-products and have been implicated in the progression of age-related diseases like Alzheimers, heart disease and stroke). For every 100 calories of fructose we eat, about 30% is turned into fat (2)…. but because of its effect on the brain, we still think we’re starving and eat more!

What is fructose in?

Fructose is in nearly everything so it is pretty difficult to avoid altogether. It is in fruit, dried fruit, some root vegetables, most grains, honey, agave nectar, maple syrup and anything containing sucrose (including all sugars). Tree fruits, berries and melons all have moderate levels of fructose while dried fruits have more concentrated levels of fructose.

Fructose is also found in very high quantities in soft drinks, fruit juices, concentrated fruit drinks, sports drinks, sauces and condiments, chocolate, cookies, museli bars, cereals, yoghurt, lunch meats and most other processed food (especially low-fat foods). In many processed foods, it is found in the form of High Fructose Corn Syrup (HFCS).

Hard-core proponents of the sugar-elimination approach argue that there is no difference between natural sugars and man-made sugars as they are metabolised in the same way (and from a purely biochemical perspective, they are right). So, they suggest you give up most of the above!

High fructose corn syrup = 42-90% fructose

Agave nectar = up to 90% fructose

Table sugar, Raw sugar, brown sugar = 50% fructose

Honey = 50% fructose

Maple syrup = 48% fructose

Dried fruits = 10-20% fructose

Most tree fruits = 4-8% fructose

sources: (1) & (3)

Why do processed foods contain so much fructose?

When westerners still ate home-cooked meals, our sugar intake was pretty normal and epidemic rates of hypertension and obesity didn’t exist. Even when food processing first arrived on the scene, the situation was still okay.

This all changed in the 1970s with the simultaneous discovery of LDL cholesterol, the invention of high fructose corn syrup in Japan and a study by the American Scientist, Ancel Keys. It was at this time, as a result of Ancel’s work, that the ‘lipid hypothesis’ was truly taken on board – the idea that dietary fat causes heart disease (2). In response to this idea, food manufacturers started taking all the fat out of our food. Unfortunately this made it taste like cardboard! The solution? Add more salt and more sugar. Much more!

At the same time, President Nixon was keen to get food off of the political agenda by making it cheaper… and sugar was expensive. But High Fructose Corn Syrup was about half the price – and so began the infiltration of HFCS onto supermarket shelves (2). Fructose is 1.73 times sweeter than sucrose so you’d think they wouldn’t need to use as much (1). Wrong. They use more. Since that time, the amounts of HFCS have gone up and up and our low fat diets have been making us all fatter and sicker than we’ve ever been before…

Is HFCS so bad?

The corn industry in America would argue HFCS is no worse than sucrose because it contains about the same levels of fructose and glucose (although there are actually three types of HFCS with varying levels of fructose from 42% to 55% and up to 90%) (1). All short-term studies on the stuff indicate it has a similar affect on the body as sucrose. The only real difference I could find between HFCS and your average table sugar is the fructose and glucose in HFCS exist in a ‘free’ state (as mono-saccharides rather than as a di-saccharides) so they are even more ‘simple’ (1). The other troubling thing I found was a 2009 study which reported almost half of the commercial brands of HFCS had detectable levels of mercury in them – a cross-contamination bi-product of the production process.

As there have been no long-term studies into the affect of HFCS on the body compared to sucrose, all I can really conclude is: the main reason HFCS is so bad is because it is super cheap to produce and so readily available. This means it is used by manufacturers without hesitation or moderation.

Someone who eats a processed western diet consumes at least four times as much fructose as someone who eats home-cooked meals and a natural consumption of fruits and vegetables. Teenagers are particularly at risk, because they tend to eat even more.(2)

Where does GI fit in to all this?

GI or the Glycemic Index is a measure of the effect of carbohydrates in food on blood sugar levels. It estimates how much each gram of available carbohydrate in a food raises a person's blood glucose level after eating, relative to the consumption of glucose. The GI chart can be measured from 0 to 100 with glucose having a GI of 100.(1)

From a GI perspective, foods with a high GI (70 or more) are considered bad for us because our bodies have to release a huge hit of insulin to mop up the glucose from our blood stream. This can result in blood sugar swings – from high blood sugar to lower than normal blood sugar, creating moodiness and sugar cravings. If we ride the blood sugar roller coaster for too long, our insulin receptors may get worn out, resulting in type 2 diabetes. Eating low GI foods (55 or less) is encouraged – to help moderate blood sugar levels and give our poor pancreas, liver and insulin receptors a break.

Anything that slows down the metabolism of sugar decreases its GI. And the two things that slow the metabolism of sugar the most are fibre and fat. These are also the two things that have been taken out of all of our processed food!

An interesting point here is - fructose sweeteners are often recommended for low GI diets or people with diabetes because no insulin is required to metabolise it. It therefore has a much lower GI than other sugars.  But, hopefully you now understand this is a bad idea because fructose directly affects our insulin receptors in the liver at a later stage of metabolism! It is a cause of diabetes, perhaps even more so than glucose.

The problems with the approach

The main problem I can see with the sugar-elimination approach, as with all reductionist approaches is it can promote fanaticism if taken out of context. Without appropriate research, people can miss the point.

For example, if people don’t understand that the antidote to fructose is fibre (because fructose bonded to cellulose is excreted), they may give up eating fruit altogether (although if you're a fruit-a-holic, cutting back on your fruit consumption isn't a bad idea). This approach may also lead to people cutting out complex carbohydrates as well as simple ones – that is, giving up wholegrains as well as sugar. I noticed that some proponents of the approach tell you to give up fruit but say you can still drink alcohol – even though ethanol is made from the fermentation of sugar and is metabolised with even more detrimental effects to the body than fructose.

Another problem with this approach is that a lot of the ‘replacement’ snacks and foods recommended in sugar-elimination diets (like cheese, meat and coconut products) are actually quite heavy and difficult to digest so may have there own deleterious effects on digestion.

Some people in a fructose-fearing-frenzy may decide to give up fructose in favour of glucose. They may buy dextrose (used to make beer) from the supermarkets and use that as their sole sweetener of choice. Not a bad idea, in theory, but the problem is glucose doesn’t exist as a di-saccharide with itself in nature so this is frankin-sugar (which makes me a little nervous)… with a high G.I.

But the biggest problem of all is… no matter how you dress it up, giving up sugar is about deprivation. And anything that is based on deprivation is rather depressing and usually not sustainable beyond the first wave of weightloss euphoria. In my experience, a more moderate approach is usually required for long-term success.

The great things about the approach

The most fantastic thing about this approach is it encourages people to reduce their consumption of soft drinks, processed foods and fast foods… and to make more home-cooked meals. If we all just did these three things, the health of the Western world (and the Eastern world adopting the Western diet) would be completely transformed.

Another very exciting part of this approach is it tends to encourage people to start eating moderate levels of healthy fats again, including full-fat milk. It has brought attention to the fact that fat is not necessarily the great evil it has been made out to be and that the excessive consumption of fructose may infact be the cause of most of our Western health problems.

The Ayurvedic view

Ayurveda, as usual, has a slightly more holistic view but reaches many of the same conclusions as this approach. Rather than looking at sweet as molecules, it looks at Sweet as a taste, made up of elements and qualities which all have an effect on the body and mind. In addition to the bio-chemical understanding, Ayurveda provides us with a bio-energetic and bio-spiritual understanding of food.

Before I delve into the detail, it should be noted that the Sweet taste is considered by Ayurveda as the most important of all of the six tastes and should be eaten in the largest quantity. But by Sweet, Ayurveda means naturally sweet foods including milk, ghee, rice, wheat and other grains and legumes, as well as sweet fruits, dates, honey, jaggery and sugar.

Composed of Earth and Water, the Sweet taste is generally cooling, heavy and unctuous. Ayurveda teaches that the Sweet taste nourishes and invigorates the mind, relieves hunger and thirst, increases all of the tissues and improves the immune system. Importantly, it is associated with the positive emotions of happiness, contentment, calmness, cheerfulness, love and satisfaction when eaten in appropriate amounts.

However, if eaten in excess, particularly at the wrong time of the year, Ayurveda says that the Sweet taste can contribute to high ama, dull agni/digestive fire, heaviness, obesity, diabetes, parasites, obstructed circulation, vomiting, gas, lethargy, asthma, hayfever and congestion (undigested food waste or ama correlates to the western view of very low density LDL cholesterol and AGEs). Excessive sweet can also feed attachment, complacency and greed in the mind.

If you are following an Ayurvedic diet to the letter, you will naturally be avoiding processed foods including soft drinks, sports drinks, condiments, cereals, sweeties etc. You’ll also tend to have less fruit and fruit-juice because you only eat (or drink) it between meals, rather than with everything.  You mostly eat home-cooked meals made from wholegrains, legumes, vegetables, spices, fats/oils and full-fat milk – all low fructose and low GI. Although you do eat small quantities of dry fruit and natural sweeteners in your porridges and home-made sweeties, they’re usually consumed with wholegrains and spices (i.e. fibre) and ghee (i.e. fat), both of which slow down the metabolism of sugar. And, you eat loads of cinnamon which helps to regulate blood sugar levels. Importantly, you also introduce Sweetness to your life in other ways… not just through your food.

Some people take the ‘eat lots of sweet’ things in Ayurveda a little too literally and decipher it as ‘eat lots of sugar’. This tends to manifest in the form of ultra-sweet chai drunk throughout the day! But this is not the actual teaching of Ayurveda and is definitely not something a practitioner would advise you to do. Ayurveda is a science of long-term moderation combined with well-timed and precise restraint.

The main difference between the Ayurvedic view and the western view is Ayurveda believes every single sugar is different due to its qualities.  

For example, honey is sweet and heating, has the specific effect of ‘scraping fat’ from the body and it pacifies Vata and Kapha while increasing Pitta. Jaggery is sweet and cooling, has a heavy, strengthening effect on the body and pacifies Vata while increasing Pitta and Kapha. White sugar and HFCS on the other hand, are sweet, heating, have a stimulating effect on the body and aggravate all of the doshas (Vata, Pitta and Kapha).

This demonstrates the more ‘gross’ effects on the body/mind. However, perhaps the biggest difference comes when looking at the ‘subtle’ effect of these substances on the body/mind through the three universal qualities of Sattva, Rajas and Tamas. Less processed sugars like jaggery, honey and maple syrup are considered more Sattvic, having a peaceful effect on our minds. Highly processed sugars like white sugar and HFCS as well as synthetic replacement sweeteners, on the other hand, are Rajasic and Tamasic – creating strong outward-seeking desire combined with dullness, depression and ignorance in the mind.

So, from an Ayurvedic perspective, sugars ain't sugars! You should always choose more natural sugars over their highly processed counterparts!

The Sweet taste is the natural antidote to aggravated Vata (Air/Ether). We live in a world that constantly aggravates our Vata so we naturally look to Sweet to ground ourselves. Unfortunately, highly processed sugar and HFCS are the only types of sugar that increase Vata rather than decreasing it. So, as we reach out to pacify our Vata, we actually end up aggravating it further which leaves us wanting more and more Sweet! Vaidya Dr Smita Naram teaches that the majority of obesity these days is Vata-type obesity (rather than Kapha-type). Our light-headedness longs for grounding so we eat and eat to try and ground ourselves… but just get more light-headed, and hungrier (and fatter) due to the  junk we're eating!

My conclusion

After reading, watching and thinking about sugar for many days, the conclusion I come to with all this is the same as any other dietary article I’ve written or ever considered writing.

And that conclusion is… don’t worry too much about the details.  Instead, pick up on the important take home message which is:

Take back control of your food. Stop eating so much processed food. Stop drinking soft drinks, sports drinks and poor-quality sweeties entirely. Cut down your consumption of coffee and alcohol. And...start cooking at home… with love! Especially for your kids! Eat more plants. Stop eating so much. And get some moderate exercise, everyday.

And, if you want to take things further than that, start learning about Ayurveda.

It is pretty unlikely I'll ever give up sugar personally but I do feel better about my limited fruit consumption and I’m extra motivated to make my own sweet treats rather than buying toxic cookies from the supermarket!  I also now understand why others might choose to give up sugar (at least for a little while). “Whatever works”, I say!

References/More reading/More watching

1) Wikipedia searches - Sugar, Fructose, Glucose, Sucrose, Dextrose, Maltose, HFCS

2) “Sugar: The Bitter Truth” http://www.youtube.com/watch?v=dBnniua6-oM&ob=av3e

3) I Quit Sugar eBook & Website by Sarah Wilson

4) “Pure, White and Deadly”, John Yudgin

5)“Sweet Poison”, David Gillespie

**Please Note - if you're suffering from any serious symptoms of indigestion or other pathologies, we'd advise you to go and see an Ayurvedic Practitioner for specific dietary advice individualized for your state of imbalance.**