Sugar, we are told, is not good for our bodies. The challenge, then, is to find a way of satisfying our sweet tooth while avoiding the harmful effects of both natural and artificial sweeteners. By Michael Lim

AFTER an exercise workout, you may not think twice before reaching out for your favourite ice-cooled sugar-sweetened drink to savour its refreshing taste and quench your thirst.

However, drinking this can of sugar-sweetened beverage may mean putting back the calories that have been burnt up during the exercise – calories from the up to 10 teaspoons of sugar in some drinks.

According to the International Study of Macro/Micronutrients and Blood Pressure, regular consumption of sugar-sweetened beverages or juices is associated with higher blood pressure and increased weight. Other studies have also shown that reducing consumption of sugar-sweetened beverages can reduce blood pressure and lower weight, strengthening the evidence linking sugar consumption with blood pressure elevation.

Many of us have a sweet tooth and would find it difficult to get by without any sugar in our diet. The challenge is to continue to be able to enjoy the desired sweetness in the taste of food and yet avoid the detrimental effects of glucose.

Fruit sugar

Fructose, fruit sugar, has been touted as a better alternative to glucose. Most sugar-sweetened beverages currently use sucrose (which has glucose and fructose joined together) or high-fructose corn syrup (HFCS).

HFCS is a corn syrup that has been processed to convert some of its sugar into fruit sugar (fructose) to produce a sweet taste. In the United States, HFCS is very commonly used in processed foods and beverages. The most widely used HFCS in soft drinks has approximately 55 per cent fructose and 42 per cent glucose.

While all cells in the body can use glucose, fructose can only be metabolised by the liver cell. High fructose intake can result in increased production and build up of triglycerides (a type of fat) in the liver, causing fatty liver and liver damage, and it can also cause insulin resistance, predisposing one to diabetes mellitus.

Robert H Lustig, a professor of pediatrics and an obesity specialist at the University of California, San Francisco, cautions that the increase in fructose intake is worrisome, as it appears to parallel increases in obesity, diabetes, and non-alcoholic fatty liver disease that now affects up to one-third of Americans. As a result, there is increasing concern about the extensive use of HFCS in foods.


Many diabetics are mistaken in thinking that by taking honey as a sugar substitute, they can continue to savour the desired sweetness without compromising blood sugar control. In truth, honey contains mainly fructose and glucose, and hence frequent consumption of honey will adversely affect the diabetic sugar control. Worse still, some honey sold in supermarkets either contain HFCS or utilised HFCS in their production.

Artificial sweeteners

Those seeking the taste of sweetness without the risk of increasing their waistline look upon artificial sweeteners as a panacea. In the US, the Food and Drug Administration (FDA) has approved five artificial sweeteners ( acesulfame, aspartame, neotame, saccharin, and sucralose) and one plant-derived non-caloric sweetener (stevia). Their popularity stems from the fact that they can be hundreds of times sweeter than natural sugar but do not contain calories.

Artificial sweeteners are preferred by diabetics and those who want to enjoy the sweet taste without adding calories and weight. However, there is a concern that taking artificial sweeteners routinely may result in desensitising the person to sweetness and make healthy food such as fruits and vegetables less appetising. Trials are currently being conducted to understand the relationship of artificial sweeteners to weight gain (or loss) and other health outcomes.

Breakfast bread and cereals

Can simple sugars be substituted with complex sugars? Breakfast for most routinely consists of starches such as potatoes, or processed carbohydrates such as white bread, white rice or low fibre breakfast cereals. Contrary to common perception, these foods may be unhealthy. Processing removes the beneficial components such as dietary fibre, vitamins, essential minerals and fatty acids and alters the food’s natural structure. In addition, it usually adds unhealthy components such as trans fats, sodium and sugars. The common use of HFCS or sucrose in these foods means that the body will be loaded with fructose, resulting in increased triglycerides and liver damage. Healthier carbohydrate choices will include whole grains which are associated with lower blood pressure and cholesterol.

Everything in moderation

There is evidence to suggest that overconsumption of sugars is associated with elevated blood pressure, weight gain, diabetes, insulin resistance and fatty liver, but this does not mean that we should all stop taking sugar. While some like Dr Lustig would have us believe that sugar is toxic, what is probably closer to the truth is that excessive consumption of sugar is detrimental and sugar consumption should be judiciously moderated.

Sugar consumption through the intake of unprocessed complex carbohydrates is probably best, but that means constantly denying ourselves the pleasure of our local favourite foods and desserts. Still, as the saying goes, no pain, no gain.