How healthy (or unhealthy) is sugar?

When people talk about “sugar”, they usually mean the white, granulated kind you find in the sugar bowl: table sugar, or sucrose to give it its scientific name. However, the term “sugar” actually refers to a whole group of sweet-tasting carbohydrates. Table sugar is made up of two sugar molecules: glucose (grape sugar) and fructose (fruit sugar). Manufacturers extract it from sugar beet or sugar cane, then purify it and allow it to crystallise. This results in refined sugar in its typical white form. Other types of sugar can’t be bought on their own – they occur naturally in fruit, vegetables and milk.

What are the different types of sugar?

Sugars differ in terms of the number of molecules that are bonded together. Experts classify them as either monosaccharides, disaccharides or polysaccharides:

• Monosaccharides consist of a single sugar molecule. This group includes glucose, fructose and galactose. Glucose and fructose occur in foods such as fruit and honey. Galactose is found in milk as a component of lactose (milk sugar).
• Disaccharides are two monosaccharides bonded together. Examples include sucrose, lactose and maltose (malt sugar). Sucrose is mainly found in sugary foods, lactose in dairy products and maltose in sprouted grains and malt products.
• Polysaccharides have at least three simple sugars bonded together. Shorter chains are referred to as oligosaccharides, while longer chains are known as polysaccharides. They include the starch in potatoes and pulses. These compounds don’t usually taste sweet.

A maximum of 50 grams of sugar per day – that’s the limit for adults recommended by Swiss specialists. That equates to around 12 to 13 sugar cubes weighing 4 grams each. This is based on a daily energy requirement of around 2000 kilocalories. If you use up less energy, the recommended amount is lower. According to the Federal Food Safety and Veterinary Office (FSVO), the average Swiss person consumes around 90 grams per day. That’s almost twice the recommended daily maximum amount. 

The recommendation focuses primarily on free sugars. These include all the sugars manufacturers add to their products, plus the sugar found in honey, syrups and fruit juices. Sugar in whole fruits, vegetables and milk is not classified in the same way. These foods also provide the body with vitamins, minerals and fibre. They slow down the digestive process, meaning sugar enters the bloodstream more gradually.

The effects of excess sugar aren’t immediately obvious – they develop over time. If you regularly consume large amounts of free sugars, you’re taking in more energy than your body uses on a day-to-day basis. Your body stores this surplus energy as fat, and over time, your metabolism is thrown out of balance. Frequent consumption of high levels of sugar is linked to the following health risks:

• Weight gain: a long-term energy surplus makes you more likely to become overweight or obese. Both increase the risk of further health complaints.
• Type 2 diabetes: the hormone insulin promotes the absorption of glucose from the blood into the body’s cells. A high-sugar diet, along with other factors, promotes insulin resistance. That means the cells respond less effectively to insulin. This metabolic disorder is often a precursor to type 2 diabetes. In many cases the first signs of diabetes only appear later on.
• Fatty liver disease: larger quantities of fructose are mainly processed by the liver. When our consumption of fructose is consistently high, fat production in the liver increases, which puts us at greater risk of developing fatty liver disease. The key factor here is the fructose found in soft drinks and sugary foods – not the kind you get from unprocessed fruit.
• Cardiovascular disease: excess body weight and changes in our metabolic values put strain on the heart and blood vessels. This increases the risk of developing cardiovascular disease over the long term.
• Tooth decay: sugar also leads to tooth decay.

The good news for anyone with a sweet tooth is that sugar alone does not usually cause these disorders. Exercise, body weight, genetic predisposition and overall diet also influence your personal level of risk. So having a slice of cake at Granny’s birthday party is unlikely to have consequences for your health. The amount of sugar you consume, how often you consume it and your habits in terms of diet and exercise play a much more important role in the long term.

What happens if you eat too much sugar in one sitting?

To start with, your blood sugar levels spike. The pancreas then responds by releasing large amounts of insulin, which transports the sugar into the cells. Blood sugar levels often then drop again as quickly as they rose. For some people, this fluctuation manifests itself as a sudden craving for food or a brief dip in energy levels. These reactions are possible signs of having consumed too much sugar in one sitting. They usually occur shortly after eating.

For healthy people, a single large dose of sugar is generally harmless. The body will naturally regulate blood sugar levels with the help of insulin. In diabetics, on the other hand, this insulin is either too weak or lacking entirely. Experts refer to sustained, significant elevation of blood sugar levels as “hyperglycaemia”. Colloquially, it is often known as a “sugar crash”. Symptoms include intense thirst, frequent urination, tiredness and nausea. Particularly sharp spikes in blood sugar levels can lead to a loss of consciousness, which requires immediate medical attention.

People are naturally drawn to sweet foods for reasons related to evolution. In fact, sweetness has a dual effect: it signals safety and acts as a reward. In nature, poisonous plants rarely taste sweet. So as far as our brains are concerned, sweet means safe. Then there’s the reward system. Sugar activates it, the brain releases the neurotransmitter dopamine, and for a moment everything feels good. And it’s precisely this feeling that sticks in our minds.

But of course, that pleasant feeling doesn’t last long. Soon you’re looking for your next sugary reward. The more you give in to these cravings, the more you reinforce the conditioning effect. Studies have shown that regular consumption of sweet and high-fat foods alters the way the reward system responds. Sweet foods become more appealing as a result, and we crave them all the more. This is why many people find it difficult to cut out sugar.

Some people experience these cravings as a form of addiction. However, there is no such thing as “sugar addiction” as a standalone medical diagnosis. It can still be problematic, however – for example, if you repeatedly lose control or when fixed habits involving sugary foods dominate your day-to-day life. If you do experience frequent binge-eating episodes or you are struggling to cope, see a specialist.

Not everything that contains sugar actually tastes sweet. Hidden sugar is everywhere, from ready meals and sauces to savoury snacks. It’s also in some products that are considered healthy: fruit yoghurt and ready-made muesli mixes account for a sizeable portion of the sugar that’s consumed in Switzerland. To keep track of how many grams of sugar you’re consuming per day, keep an eye on two pieces of information on the packaging:

The nutrition table: In the carbohydrates section, there will usually be a line that reads “of which sugars”. This includes all monosaccharides and disaccharides, meaning it also covers the natural sugars found in fruit and milk. However, it won’t tell you how much sugar was added during production.

The list of ingredients: The list of ingredients is more revealing. It shows exactly what types of sugar and sweetening agents the product contains. Sugar goes by many names – sucrose, glucose, fructose, dextrose, maltose, syrups, honey, molasses, fruit syrups, fruit concentrate and malt extract. The higher up the list a source of sugar is, the more of it the product contains. However, bear in mind that if the manufacturer spreads the sugar across several different types, each one moves further down the list, making the sugar content less noticeable even if it’s high overall. Caution is also advised where the label states “no added sugar”. Some manufacturers sweeten their products with ingredients such as oligofructose instead. This doesn’t appear under “of which sugars” in the nutrition table, but the body still digests it as a sugar.

Soft drinks: the overlooked sugar source

The biggest source of sugar is often overlooked: soft drinks contain particularly high amounts of free sugars. According to the FSVO, almost 40% of the added sugar in the average Swiss diet comes from drinks. For example, a standard serving of cola contains 10.6 grams of sugar per 100 millilitres. So a 330-millilitre can contains around 35 grams of sugar. That’s equivalent to around 70% of the recommended daily maximum amount – in just a few sips. What’s more, sugar enters the bloodstream particularly quickly in liquid form, causing blood sugar levels to rise rapidly. Even 100% fruit and vegetable juices such as beetroot and carrot juice still contain a lot of free sugar, even though they don’t have any added sugar.

“Light” and “zero” products contain little or no sugar, but they can encourage a taste for very sweet flavours. Many varieties also contain acids that attack tooth enamel. Furthermore, studies indicate a potential connection between sweeteners and cardiovascular diseases and changes in intestinal flora. No causal link has been proven, but sweeteners are by no means harmless. Sugar-free soft drinks are therefore not suitable as a day-to-day thirst-quencher.

Eating less sugar doesn’t mean giving up everything. For most people, it’s enough to change a few habits and replace heavily sweetened products with lighter alternatives. The following tips will help you reduce the amount of sugar in your diet:

• Get creative with your drinks: try adding some lemon, mint, berries or cucumber to your water. Unsweetened tea is also a great way to mix things up a bit.
• Dilute your fruit juice: mix one part fruit juice with two parts water. This simple cocktail contains less sugar per glass than undiluted juice.
• Sweeten your yoghurt yourself: buy natural yoghurt, add some fresh fruit such as berries, a grated apple or a ripe banana and no more than a teaspoon of honey. This delicious mix still contains less sugar than a ready-made fruit yoghurt.
• Make your own muesli: all you need is oats, a handful of nuts and a few pieces of fruit. If you do opt for a ready-made mix, be sure to check the sugar content in the nutrition table.
• Cook with fresh ingredients: make sure you cook with fresh, minimally processed ingredients wherever possible. This means you decide how much sugar goes into sauces, dressings and desserts.
• Add some spice: cinnamon, cardamom and orange zest are all great ways to add flavour while going easy on the sugar.
• Come up with clever combinations: have chocolate or sugary snacks together with fats, protein or fibre – for example, straight after lunch or with an apple in the afternoon. Sweet fruits such as grapes, bananas and cherries are also best eaten with a handful of nuts or some quark. This stops your blood sugar spiking, and the dip afterwards is also less pronounced.

You don’t have to go cold turkey. It’s easier to make the switch if you reduce your sugar intake gradually. Start with a familiar food or drink. Over time, your sense of taste will get used to the reduction in sweetness.

There’s no need to cut sugar out completely to ensure a balanced diet. You can still enjoy certain foods in moderation. On a day-to-day basis, make sure your meals consist mainly of protein-rich foods, starchy products, vegetables, salad and fruit. If in doubt, you can always consult the food pyramid published by the Swiss Society for Nutrition (SSN). It shows which foods should ideally be on your plate and in what quantities.