A variety of doughnuts arranged diagonally with the words: "Sugar. The sweetness you can't live without!"

Sugar: The sweetness you can't live without!

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What is sugar?



From the dash in a morning coffee to the after-dinner dessert, sugar is a consistent companion throughout the day. Sugar, the sweet-tasting food additive, is a contentious substance despite being widely available and necessary for our survival.


In more formal terms, sugar is a subset of molecules known as carbohydrates. Carbohydrates are a dietary macronutrient like protein or fat. Sugar (and other carbohydrates) are as nutritionally dense as proteins with four calories per gram. Fat, on the other hand, is the densest macronutrient with nine calories per gram.


Carbohydrates are molecules which contain some combination of carbon, hydrogen, and oxygen atoms. The amount of these three atoms determines, in part, whether a carbohydrate is considered simple or complex. Simple carbohydrates contain fewer carbon, hydrogen, and oxygen atoms, while complex carbohydrates contain more.


During digestion, complex molecules in food are broken down into simpler ones the body can use for energy. One of these simpler molecules, glucose, is a carbohydrate with a single sugar molecule. Glucose is incredibly important; life, as we know it, doesn’t exist without the influence of glucose.



The glycemic index



A special measurement, called the glycemic index, indicates how quickly food is converted to glucose in our blood. Since pure glucose requires no additional processing, it’s used as a baseline in the glycemic index. Pure glucose has a score on the index of 100. Food that takes longer to convert into glucose will have a lower glycemic index. Foods that are highly refined are more easily converted to glucose and will have a higher glycemic index.


Somewhat surprisingly, white and wheat breads have a relatively high glycemic index (over 70). So, a diet which contains many refined foods, foods that are highly processed, is similar to a diet that contains many sugary foods. This similarity contributes to the incidence of the most common form of diabetes, type 2 diabetes, described in detail later in this article.


Fructose, which you may remember from the ingredient list of soft drinks (i.e., high fructose corn syrup), is another simple sugar. While high fructose corn syrup is a form of fructose that’s highly refined, fructose is also commonly found in foods which have not been processed like raw sweet potatoes and carrots.



Complex carbohydrates and sugars



When the simple sugars fructose and glucose are combined, a molecule called sucrose is formed. Since glucose and fructose are circular, like rings, sucrose looks like two rings joined together. Table sugar, the sugar we might add to our desserts or coffee, is just another name for sucrose. Lactose, a sugar found in milk, is the combination of glucose with a third simple sugar called galactose.


Like bricks in a wall, simple sugars combine into increasingly complex sugars. Now, if our body isn’t able to break down these complex sugars, they’re referred to as fiber. Since our body can’t break fiber down, we’re unable to utilize all the fructose found in foods that contain both (e.g., many types of fruit).


The process of creating fruit juice removes that dietary fiber and increases the amount of fructose we’re able to absorb. New research is revealing that fructose actually increases the nutrient uptake of our digestive system, which could contribute to increased obesity in Western diets.



Glycogen and why exercise might not lead to weight loss



When these complex molecules are digestible, they’re commonly starches (e.g., potatoes) or another interesting molecule called glycogen. Glycogen is complex, containing long chains of glucose molecules. This molecule, glycogen, is used as an energy store our bodies use over shorter periods of time, like during workouts. Fats are another way our body stores excess glucose which can later be used for energy.


While the process is more complex in practice, your body will essentially reach for easier-to-use forms of energy before accessing the forms that require further processing. This is one of the reasons why losing weight through exercise is difficult. 


We have excess energy available through the glucose in our blood and the glycogen stores in our muscles that our body will use before reaching into our fat stores. In ketogenic diets, carbohydrates are purposefully limited in order to cause the body to access a different type of fuel, ketones, created from fats rather than glycogen.



Diabetes and the complex relationship between glucose and insulin



The hormone insulin, produced in the pancreas, helps regulate the amount of glucose in the blood. When high concentrations of glucose are present, the pancreas increases the production of insulin which “tells” the body to store the excess glucose as glycogen or fat. A person with diabetes is unable to produce insulin (type 1 diabetes) or experiences resistance to insulin (type 2 diabetes), causing this conversion to occur irregularly.


People with diabetes need to continually monitor their blood sugar (the amount of glucose in the blood) and keep it in a healthy range. If a person with diabetes eats foods high on the glycemic index, blood sugar will rise and put them in danger of experiencing hyperglycemia, blood sugar levels that are too high. Since excess glucose isn’t being managed as efficiently in people with diabetes, blood sugar could also drop too low, a condition called hypoglycemia.


As glucose in the blood drops, the body starts to use fat for energy, a process called ketosis. Since the body’s glucose regulator, insulin, is less effective or not being produced, a person with diabetes is likely to reach this point sooner than a person without diabetes. If this occurs too quickly a person could experience diabetic ketoacidosis, a potentially lethal condition which requires immediate medical attention.


To complicate the picture further, insulin resistance may also contribute to an increase in the conversion of glucose to fat. This would lead to an increase in obesity for people with type 2 diabetes. Research suggests that fat cells are not just passive storage receptacles, rather, they produce hormones like other organs in the endocrine system. So, a person with type 2 diabetes is not only more likely to be obese, but the excess adipose tissue may contribute to additional insulin resistance as well.



Long-term health depends on a healthy diet



While cutting back on desserts might be a good step in the process of improving your diet, the truth is, unfortunately, more complicated. We need to consider a food’s glycemic index and how that affects the rest of your dietary habits. What’s more, you have to make sure you’re getting all the appropriate nutrients from your diet as well.


It’s easy to slip into less-than-healthy habits, especially as our lives get busy. Getting back on track might feel overwhelming given how many different diet options are available. Thankfully, you don’t have to figure it all out on your own.


With lab testing from Dr. Inman, you’re able to take a deeper look at your genetic makeup. With those details, you’ll get a better idea about conditions you’re more likely to face and can determine if there are steps you can take to avoid them.


If you have a family history of diabetes or a personal history of gestational diabetes, obesity, or hypoglycemia, then the testing can confirm if there are related conditions you may experience. Whether you pursue testing or not, annual check-ups and monitoring are important if you or family members have a history of these conditions.


Dr. Inman’s nutritional counseling focuses on helping you reach your health goals at a pace that works for you. She’ll help you make changes that will help you feel better, sooner. Her experience helps her understand which changes will have the biggest impact in the short-term.


As you start seeing improvements, you’ll gain confidence and be able to take the steps toward a healthy life you can maintain over the long-term. Book a nutritional counseling appointment today and work with Dr. Inman toward your happiest, healthiest life!