• What type of sugar is the “best” sugar? 
• Do some sugars create more blood sugar than others?
• Does sugar cause disease?
• How much sugar is too much sugar? 
• What about artificial sweeteners?

Our body sees dietary sugar / sweeteners for what they are – chemistry. When you eat white sugar (aka, granulated sugar), the body sees molecules of glucose and fructose which it in turn becomes blood glucose which turns into energy (glucose / fructose –> blood glucose –> energy).

• If energy isn’t needed, the body stashes the glucose away as glycogen for later use.
• If glycogen stores are full, it will turn it into lipid / body fat. 

Mind you this does NOT mean that sugar becomes fat on the body. This is the same process the body uses for any nutrient – including other carbohydrates like starch, protein, and fat. The body is not wasteful – it doesn’t just “throw” excess fuel away. 

You rarely find a bunch of monosaccharides naturally alone in our food supply (though you can get straight glucose from a lab). Rather, it’s more common that you’ll find certain foods are rich in monosaccharides (sweeteners, soda) and others contain combinations of mono and disaccharides (fruits, sweeteners, milk). 

However, in contrast to glucose, fructose enters glycolysis (energy production) at a step that bypasses the regulatory control normally exerted by phosphofructokinase. This, in theory, allows unimpeded conversion of excess fructose into cholesterol and triglycerides. 

All that being said, the research on whether or not excess fructose makes you gain more body fat and/or increases cholesterol relative to glucose is tough to decipher. Often experiments to establish either of these “facts” are a bit flawed and theoretical because…

1. They are usually a small sample size over a short period of time and
2. Involve giving participants very large doses of either fructose or glucose that are higher than what one would normally consume.

The research often demonstrates that eating a TON of EITHER glucose and fructose will result in fat gain and cholesterol, but fructose tends to be ever so slightly higher and the media (and marketers) have pounced on that – demonizing fructose. Here’s a decent explanation and example from Precision Nutrition in simple terms exploring one such study. 

One additional difference between glucose and fructose is how it affects the gastrointestinal system. For some clients with irritable bowel syndrome (IBS), high amounts of fructose cause the body to pull more water into the GI system causing more diarrhea. For those clients, I may opt for more low fructose, high glucose products whether as an athlete or every day life. 

Realizing the error of their ways, the GI can be translated into the glycemic load (GL). This takes into consideration the portion size AND the amount of carbohydrate in the food giving you a better understanding of how a food will affect blood sugar:  Glycemic Load (GL) = GI x Carb (g) / portion ÷ 100

Similarly, it’s broken into 3 categories

• High (>20)
• Moderate (11-19)
• Low (<10)

So if we go back to our examples: Watermelon has a GL of 7.21 (serving size of 1 cup). Carrots have a GL of 6 (serving size of 1/2 cup). The GL is considered additive for the entire meal – meaning if you 2 portions of watermelon and 2 portions of carrots, your GL for the meal is 14+12 or 26. 

My point in explaining all of this is that while many argue certain sweeteners have a lower GI than others often fail to take into account, the portion size used of each sweetener. Even if you look at the GL, you see the portion size varies greatly depending on the sweetener used. If you use the SAME portion for each sweetener (for example, 2 Tablespoons), you end up with very similar glycemic effects. 

That is why when someone asks me which is better, I honestly reply “portion for portion, they’re all the same. what matters is which satisfies you more, with less.” For example, while agave appears superior, I find most of my clients use 2-3x as much to get the same level of sweetness for their taste buds. So the effect on blood sugar is virtually identical. 

For example, check out a data snapshot from the CDC (below). It’s well documented in the public health literature that chronic disease states are  higher in lower income populations. Is there more disease just because they consume more sugar? Or perhaps it’s the chronic, toxic stress of living in impoverished circumstances…? Additionally, if they’re consuming more sugar, what does that mean for the REST of their food “choices?” 

I’m not saying sugar is completely benign and we should all eat a 100% sugar diet. But I am saying that health is about looking at the whole person – not just one nutrient (THIS BLOG post explains more). Cutting out sugar for someone who smokes, is inactive, and living in high stress (eg, working odd hours, multiple jobs, not sleeping enough) may help their health a bit, but the overall circumstance is what’s pretty harmful and making sugar a pretty important tool in their life. 

This post touched on SO many topics. Here’s the brief if I lost you along the way: 

• Sugar is a part of most foods – it refers to a carbohydrate with a simple chemistry. It’s not a demon. 
• Our bodies “see” all sugars as energy but how the body gets that energy is slightly different
• Portion for portion, the total amount of energy extracted from all sugars is virtually the same – there’s no “best” type
• There’s no great research to say how much sugar is too much, but if it’s making up a LARGE percentage of your total energy intake, it might be worth changing things around
• There’s no great research to say that consuming sugar will cause chronic disease. Chronic disease is likely more related to social factors
• Artificial sweeteners are controversial and a personal choice