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Sweet measure
The amount of sugar found in regular food
Tea/coffee with a spoon of sugar – 4gm or 20 calories
A 335ml can or bottle of cold drink – 35gm or 175 calories
A regular bar of chocolate – 30gm or 150 calories
Two small gulab jamuns – 25gm or 125 calories
A rasgulla – 30gm or 150 calories
A cup of cornflakes – 18.75gm or 94 calories
A glass of milk (250ml) with health drink (3tbsp) – 40-50gm or 200-250 calories
A cup of grapes – 15gm or 75 calories
A teaspoon of tomato sauce – 5gm or 25 calories |
Almost all of us have a “sweet tooth” and it doesn’t help that as a culture we serve sweets enthusiastically on all occasions — births, engagements, marriages, success in an endeavour. And it is considered rude to refuse.
Unfortunately, sugar works on the same areas of the brain and is as addictive as tobacco or drugs. Constant high intake can trigger withdrawal symptoms with craving, binge eating and mood changes. It is emerging as the actual cause of our present epidemic of obesity, diabetes and metabolic syndrome X. Three out of the following five conditions need to be present to diagnose metabolic syndrome X.
• Central abdominal obesity, which is present if the waist:hip ratio is greater than 0.90 in males; greater than 0.85 in females. The waist circumference alone can be used and should be less than 94cm (37 inches) in males and 80cm (32 inches) in females.
• Blood pressure is 130/90 or more on three or more occasions.
• High blood sugar level, with a fasting blood glucose test result of 100 milligrams per decilitre (mg/dL), or 5.6 millimoles per litre (mmol/L), or more.
• High cholesterol, with a level of triglycerides of 150 mg/dL (1.7 mmol/L) or more and a level of high-density lipoprotein (HDL) cholesterol — the “good” cholesterol — of less than 40 mg/dL (1.04 mmol/L) for men or less than 50 mg/dL (1.3 mmol/L) for women.
• A BMI of 30 or more.
Additional findings which should raise suspicions of metabolic syndrome are fatty liver, gall stones and high CRP (C reactive protein).
Continuous overindulgence in sugar can result in polycystic ovarian syndrome, heart disease and cancer.
Sugar contains 20 calories in 4gm (1 teaspoon is approximately 5gm) but these are empty calories, which provide no nutritional benefit. If it is not immediately required to provide energy (which is usually the case), it goes straight to the liver where it is deposited as fat. An ultrasonogram will often show a “fatty liver” even in a person who appears lean and has a BMI (weight divided by height in meter squared) less than 25. It causes an elevation of bad cholesterol (TGL) and a fall in the level of good cholesterol (HDL). This leads to a fatty plaque build up in the arteries and eventually, heart disease.
You may think that only a teaspoon of sugar (4gm) in your tea or coffee can’t be harmful but if you drink three cups a day that is 12gm. Also, you may be inadvertently consuming “unseen sugars” such as honey, high fructose corn syrup, fructose or “liquid glucose”. A can or bottle (355ml) of an aerated beverage contains seven teaspoons of sugar; a regular bar of chocolate around six teaspoons, two small gulab jamuns five teaspoons, a rasgulla six teaspoons and a cup of cornflakes three-fourth teaspoon. Indian gravies often call for sugar or jaggery. There is 5gm of sugar in a teaspoon of tomato sauce. Many mothers add flavoured health mixes to children’s milk. As much as three tablespoons (90gm) may be added to a tumbler (250ml) of milk. This is with the mistaken impression that the child receive essential nutrients, grow taller and become more intelligent. Half of this, 40-50gm or 10 teaspoons is pure sugar. The child receives a “sugar boost” offering no nutritional benefit and which is detrimental in the long run.
The WHO-recommended intake of refined sugar is 10 per cent of daily calorific intake. That means an adult male on a 2,000-calorie diet can have up to nine teaspoons (45gm) a day from all sources and women, with a lower caloric intake, can have about six teaspoons (30gm). Children actually need less sugar than adults; pre-school children need four teaspoons (20gm), those aged four to eight years three teaspoons (15gm) and teenagers five teaspoons (25gm).
This month WHO has proposed recommending that sugar provide only five per cent of daily calorific intake as even 10 per cent was high enough for some harmful effect.
As processed sugar enters the blood stream, the pancreas secretes insulin in an attempt to keep the sugar within normal limits. The sugar is pushed into the liver and converted into fat. As these episodes become frequent, “insulin resistance,” (a condition where secreted insulin is ineffective) develops. This is the first step in a cascade that leads to metabolic syndrome and eventually diabetes. As more insulin is released, a compound called “insulin-like growth factor” is also released. The two together promote tumour growth and play a role in the growth of cancer cells.
Refined sugar has all these effects, but when sugar from natural sources such as fruits (not honey) it is not as harmful. This is because natural food contains fibre, which slows digestion and the absorption of sugar, protecting the body from a sugar boost. The one exception to this is grapes. One cup of grapes has three teaspoons of sugar and very little fibre. Naturally sweet food also contains micronutrients (vitamins and minerals) and antioxidants, which have a protective effect on the body.
But before you reach for that “sugar fix” consider — is it worth it?
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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