When I arrived at Queen Elizabeth College in 1979, it was seven years after Professor John Yudkin, a former professor of nutrition at the same college, had published his seminal book Pure, White and Deadly. His theory that sugar was evil and the root cause of many modern-day health problems including obesity, cardiovascular disease and diabetes had already fallen out of favour with the nutrition community and fat was the new bad boy on the block. In order to produce low-fat foods, manufacturers had to replace fat with something else and all too often that was sugar. Some 43 years later it seems we have now come full circle: fat is OK but sugar is back in the crosshairs. Is sugar really as evil as the headlines would have us believe? It’s true that sugar contains empty calories which can contribute to obesity and it is, without doubt, bad news for our teeth. Add to this the fact that most of us eat somewhat more than we should (and some of us eat a hell of a lot more than we should) and it might seem hard to defend sugar — but, curiously, that’s often what I find myself doing these days.
Are all sugars equal?
You don’t need to have a degree in nutrition to know that there is a huge difference between the sugar that you might spoon into your tea or coffee or sprinkle over your breakfast cereal and the natural sugars in a banana or a glass of 100 per cent pure orange juice. So why do so many of the reports that I’ve read in newspapers in recent months suggest that they are exactly the same thing, and that sugar in all forms needs to be banished from our diet? Part of the problem is that issues around nutrition are never black and white: one of the first things I was taught at university is that there is no such thing as healthy and unhealthy foods, only healthy and unhealthy diets. Although in terms of their chemical structure sugars are a homogenous group, from a nutritional point of view not all sugars are equal. It’s also important to remember that we eat food, not nutrients: looking at one nutrient, in this case sugars, without considering what else a food brings to the diet is a mistake. In taking this approach there’s a real danger of throwing the baby out with the bathwater.
One of the food groups that I feel has been unfairly vilified in this recent witch hunt against sugar is fruit juice. Contrary to what many people believe, 100 per cent fruit juice contains no added sugar, only the sugar that is naturally present in the fruit from which it is made — but what it also contains is a host of other nutrients which can make a positive contribution to the diet and particularly so for certain population groups like young people and the elderly. A small glass of pure orange juice is an excellent source of vitamin C and while it’s true that vitamin C deficiency isn’t a common problem in the UK, low iron stores are, especially in certain groups like young children and women. A report on iron and health published by the Scientific Advisory Committee on Nutrition revealed that between 25 and 34 per cent of UK children between the ages of 18 months and four-and-a-half years had evidence of low iron stores in their bodies, and the same was true of 24 per cent of 15- to 18-year-old girls, 16 per cent of girls between ten and 24 years and 13 per cent of women aged between 35 and 49. Iron from foods such as cereals, nuts and eggs is not very well absorbed by the body — studies suggest that only between 5 and 15 per cent of iron present in foods such as these is absorbed into the body — but vitamin C can enhance the absorption of iron from these foods, so having a small glass of fruit juice with a bowl of cereal or a piece of toast at breakfast offers a nutritional benefit over and above the vitamin C it contains. In addition to vitamin C, orange juice is a source of folate, a B vitamin which is important for a healthy immune system and is particularly important or women in the first few months of pregnancy. It also provides the mineral potassium, which will help maintain a normal blood pressure, and a whole host of phytochemicals including the flavonoid hesperidin which emerging research suggests may play role in helping to prevent cardiovascular disease. Let’s not forget that a small glass of pure fruit juice will count as one of the recommended five a day — and hand on heart, how many of us can honestly say we reach our five a day?
The many faces of sugar
There’s no doubt that many people are confused about sugar, particularly when it comes to the subject of what counts as sugar. Many books, magazines and blogs written by celebrities and self-styled nutrition gurus talk about the dangers associated with sugar and provide us with handy tips to help us eliminate it from our diet — while at the same time assuring us that we can have our cake and eat it if we replace sugar with honey or something like agave syrup, which they say are natural and better for us. The truth is that both honey and agave syrup are just sugar in a different form, and what does ‘natural’ mean anyway? Opium, which is derived from poppies, is natural but that doesn’t mean that it is healthy. Agave syrup, which is often claimed to be better for us because it’s ‘less refined’, is extracted from the leaves of the agave cactus is much the same way that sugar is extracted from sugar beet or sugar cane.
How much is too much?
A recently published report from the World Health Organisation recommends that free sugars should account for no more than 10 per cent of our energy intake, and recommends reducing sugars to no more than 5 per cent of energy if possible. ‘Free sugar’ means any sugar that is added to foods by the manufacturer, cook or consumer, plus that naturally present in honey, syrups and fruit juices. It does not include sugar naturally present in milk or whole fruit and vegetables. Unfortunately, determining how much free sugar a food contains is tricky because food labels only give information about total sugar, so it is impossible to tell how much free sugar a food contains. Foods like plain yogurt which contain natural sugar in the form of lactose, which falls outside of the category of free sugars, can still have an amber traffic light on the front of pack. The bottom line is that we all know deep down that too much sugar is not good for us, but fortunately it doesn’t have to be an all-or-nothing approach. If we focus our efforts on cutting back on empty calorie sugars, such as that added to tea and coffee, and keep foods such as cakes, biscuits and confectionery as treats rather than a regular part of our diet, and if food manufacturers play their part by reducing sugar in foods packaged foods, life can, indeed, be sweet.