No, not all sugars are created equal.

[mikey3000]

Very good article on different types of sugars and their separate effects on the human body.

https://www.theglobeandmail.com/lif...ss-all-sugars-arent-the-same/article18406886/

I chose to look into this when my own endocrinologist said that all sugars are the same. No, they are not.

 

[KaraBulut]

...I chose to look into this when my own endocrinologist said that all sugars are the same. No, they are not.

I'm not sure what question was asked of your endocrinologist but he's correct in terms of what we're teaching patients currently.

Most of the health professionals who took nutrition classes prior to 2010 did learn that fructose was a "better alternative" for diabetics, compared to table sugar. We were told to encourage fruit consumption instead of candy bars or "sugar snacks". That advice was never properly researched but it nevertheless was what was taught.

Research in the past decade does not support that one sugar is "better" than another. The body treats all simple and complex sugars the same: they all raise blood sugar levels although there is a difference in how quickly and for how long the blood sugar level is elevated. It is accurate to say that fruit is a better choice over candy because fruit provides other elements of a healthy diet - vitamins, fiber, etc - but in terms of sugar, fruit and candy are both going to raise your blood sugar quickly because they both have a high glycemic index.

What we're teaching patients now is to avoid simple sugars and foods that have added sugar. If you want to add sugar to food, use fructose instead of sucrose. That advice is based upon research done in the past decade.

Where some of the research has failed is that it has assumed that all of the subjects responded to sugars in the same way. That's not the case. Different people respond to sugar in different ways. That variability in how different people respond to sugars and carbohydrates skews the research. If you are one of those people who has type 2 diabetes or metabolic syndrome, your body does respond normally to sugar and you should avoid foods with a high glycemic index where possible.

High fructose corn solids and high fructose corn syrup is not the problem. The problem is all added sugars in processed foods. Whether soda is sweetened with HFCS or cane syrup isn't the point; the point is that you shouldn't drink soda if you have a problem with blood sugar levels.

What we do know is:

1. There's a lot of sugar being added to our food. During the 90s when the food industry was pushing "low-fat" food, they compensated for the bland taste of low-fat food by bumping up the sugar in the food.
2. Testing of prepared foods shows that the labeling on prepared foods is not always accurate. When the foods were tested in the lab, the sugar content varied from 85% to 125% of what was shown on the label.
3. Sodas and energy drinks are a substantial problem. A lot of the information about high fructose syrups being "bad" is coming from research about soft drinks. The problem is not that these drinks contain sugar. The problem is that people are drinking a lot of them.
4. For diabetics, fructose is still recommended over sucrose or glucose. This is based upon studies that show that fructose (which is not the same as high fructose syrup) resulted in a lower peak blood sugar level after meals compared to table sugar (sucrose). One of the reasons that fructose might be a better choice for diabetics is that fructose is perceived as being sweeter, so less fructose can be used to sweeten food. But again- the critical piece is that people with diabetes and metabolic syndrome should avoid all added sugars; no added sugar is always the best choice.

If you're one of those people who has an abnormal response to sugar and carbohydrates in that your fasting blood sugar level exceeds 100 mg/dL or 140 mg/dL two hours after a meal or if your A1C is > 5.6%, then you have to manage your sugar and carbohydrate intake. And probably the point that your endocrinologist is trying to get across is that trying to define some sugars as "good" and other sugars as "bad" misses the point. All forms of sugar are a problem for people who metabolize sugars abnormally.

 

[Telstra]

I don't know if there is any difference in terms of health between table sugar and sugar from really sweet plant such as sugar cane.
However, you would consumed much less if you eat sugar cane instead of table sugar.

 

[KaraBulut]

Cane sugar, beet sugar and table sugar are the same thing. They're all sucrose.

 

[Alistair]

Thanks for the information KaraBulut.

I've been using agave nectar in place of sugar. Is it a better option?

 

[KaraBulut]

I've been using agave nectar in place of sugar. Is it a better option?

The answer is "Yes" but with the caveat about whether you're someone who has problems with carbohydrate metabolism- e.g. diabetes or metabolic syndrome.

Agave nectar is fructose, so it falls into that NIH research that says that fructose elevates blood sugar but because it has a lower glycemic index, it doesn't elevate blood sugar as quickly or for as long as other sugars.

Also, because most people find fructose tastes "sweeter", you may find that your craving for sweet taste is satisfied with less fructose compared to table sugar. This is the catch though- a lot of what is labeled in the US as "agave nectar" is actually "agave syrup". Agave syrup is made by taking the nectar and boiling it down to remove water, so the syrup is very concentrated sugar- no different than cane syrup, maple syrup or high fructose syrup.

A teaspoon of agave syrup is 5 grams of sugar; a tablespoon is about 15 grams. A tablespoon of table sugar is about the same- 15 grams of carb. So, if you're using less agave syrup, you're getting less carb; however, if you're just replacing the same amount of table sugar with the syrup, it's really the same amount of carbohydrates.

However, for people who are diabetic, trying to avoid added sugars (including fructose) is the best option.

 

[mikey3000]

Great information. Thank you. I found another article detailing the differences of glucose vs fructose.

https://www.healthline.com/nutrition/why-is-fructose-bad-for-you#section1

Personally I follow the glycemic index of food but just cannot completely cut sugar out of my diet (if I had to have coffee without sugar, I'd blow a gasket), though I have virtually eliminated white bread, white rice, soda and sweets. I do enjoy a hunk of dark chocolate now and then.

 

[KaraBulut]

Great information. Thank you. I found another article detailing the differences of glucose vs fructose.

https://www.healthline.com/nutrition/why-is-fructose-bad-for-you#section1

Personally I follow the glycemic index of food but just cannot completely cut sugar out of my diet (if I had to have coffee without sugar, I'd blow a gasket), though I have virtually eliminated white bread, white rice, soda and sweets. I do enjoy a hunk of dark chocolate now and then.

And that is a smart way to handle it.

We used to tell patients to focus on blood sugar levels constantly and to maintain a strict diet. Now we have a little more insight into diabetes and the advice is more tailored to each patient's situation.

Exercise and weight control accomplishes a lot for patients with Type 2 diabetes, often to the point that they may reduce or eliminate the need for medication.

Moderation in diet and making better selections is a much more realistic strategy. And focusing more on keeping your A1C low over the long term is better than denying yourself reasonable treats that you enjoy.