What Is The Story With Sugar? Getting Fresh On Fruit…

Courtesy of Dr. Kirsty Fairburn

Ever the pragmatist I observe the sugar story with much interest. There are many interpretations of the ‘no sugar’ movement, and different ways in which members of the community decide to manage their sugar intake. I am glad that sugar is getting attention, and we do need to be taking note of where it finds its way into our food supply, and how.

Lately I have been somewhat concerned to hear of a few instances where fruit consumption is discouraged due to it’s sugar content. I am not convinced that this is necessary, particularly for fresh raw fruit.

The form in which sugars enter your diet is really important. In the case of fruit, the sugar is naturally occurring. The fiber that forms the fruit cell wall helps slow down the digestion and absorbtion of the sugars present.  Importantly, that sugar source comes packaged with lots of other really valuable nutrients like fiber, folate, vitamin C and other vitamins and minerals.  Dietary fiber intake is a major issue for many countries, including the USA1. Americans are encouraged to consume more fruit and vegetables because these foods contribute the nutrients that the Dietary Guidelines Advisory Committee identify that Americans are at risk of underconsuming for optimal health, including fiber, vitamins A and C, potassium, folate and magnesium1. NHANES data found that that American’s consumed just 16g dietary fiber per day2,3, compared to a recommended Adequate Intake of 25g (females) and 38g (males) a day4.  Eating enough dietary fiber has been shown time and again to protect our bowel health, and reduce the risk of cardiovascular disease and diabetes by improving blood fat and glucose levels3,4.  Given their wide-ranging health benefits, we should be aiming to bump up our fiber intake by eating a lot more fruit and vegetables, and replace refined starches and carbohydrates with wholegrain versions. That simple change would have a significant impact on our health.

Contrast that 16g/day of fiber with the mean intake of 73g of added sugars consumed by Americans 2 years and over in the NHANES 2013-2014 data4, and it is easy to see that the kinds of carbohydrates we eat are a bit out of whack. Almost half of the added sugars consumed (47% of them) came from beverages like sodas, fruit drinks, sweetened tea and coffee, energy drinks, alcoholic beverages and flavoured waters. Other significant added sugar sources were cakes, pies, cookies, brownies, doughnuts, sweet rolls, pastries and dairy desserts like ice-cream3. This is why the microscope has been firmly placed over sugar, sweets and sugar-sweetened beverages. Sweets and sugar sweetened beverages are also aggressively marketed to our children. Those foods contribute little other nutrients to our diet, and should not feature in our diets as much as they do.

To see fruit victimised as a source of sugar at the expense of the fiber and other nutrients fruit contains bothers me. Admittedly, dried fruit has a higher sugar content by weight, because the water has been dehydrated out of it. You could eat a few more dried apricots than you could fresh apricots (although I know which I prefer!). Fruit juices are often a law unto themselves. With my cynic’s hat on, one of my personal favourite taglines from front-of-pack labelling is the old ‘Made from real fruit’ line. Where? And exactly how much ‘real fruit’ is left in the product? It is quite likely that somewhere down a lengthy production line, a piece of real fruit featured in some form. Hunt for that ‘real fruit’ in the ingredients list. Maybe it will be there way down towards the end of the list as a fruit extract, or fruit leather, or a concentrated fruit juice, or not at all! The ‘made from real fruit’ claim certainly does not make the food you are looking at healthy!

Dried fruit, freeze-dried fruit, fruit leathers, fruit juices, fruit balls and other fruit based products are prolific. Depending on the amount of processing involved, some of these fruit products will have other nutrients with them – others won’t. When deciding whether, and how much, of these products you consume, consider whether the fiber is still present as the fruit cell wall, and how many pieces of fruit you are going to be eating. Equate it to whole pieces of raw fruit – would you really sit down and eat 10 pieces of that fruit in one go? Stick to raw equivalent portion sizes, or add small quantities to other nourishing meals like breakfast, lunch or dinner for a little lift, and you will likely be okay. Sit down and finish a packet and there is a good chance you have eaten more than you need. And hope that your gut forgives you – especially in the case of apricots and prunes!

Sugar also features naturally in other nutrient-dense foods like milk and some vegetables. When you are comparing foods at the supermarket next, look at the Nutrition Facts label in tandem with the Ingredients list. The Nutrition Facts will tell you how much sugar is in that food, and the FDA is phasing in requirements to separate out the sugars added in processing from the total sugars present in the food (which includes sugars naturally occurring in the food also). Check that the serve size quoted on the Nutrition Facts label is realistic too, some foods suggest a serve size that is half, or a third, of the size or volume of product container you are buying.

A natural muesli with some sultanas will have a higher sugar content due to the sultanas, so read the Ingredients list too. The Ingredients are listed from the largest quantity first down to the smallest quantity. The further down that list any sucrose or high-fructose corn syrup or maltodextrin is, the better.  The table enclosed lists the different names for sugars that could feature as added sugars in the Ingredients list. If you see none of these in that ingredients list, or they are way down the end of that list, maybe it’s okay to choose that product.

This exercise can be applied to all kinds of foods in the supermarket, from yoghurts and dairy foods to muesli bars and sauces and almost everything in between. You are generally pretty safe with the fresh fruit and vegetables though. Love your body back by eating more of those!

Table 1: Different names for added sugars to spot on Ingredients Lists…

Dr. Kirsty Fairbairn

Advanced Sports Dietitian, www.invigoratenutrition.com

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References:

1 Scientific Report of the 2015 Dietary Guidelines Advisory Committee, Part D, Chapter 1: Food, Nutrient intakes and Health: Current Status and Trends.

2 Hoy MK and Goldman JD. Fiber intake of the U.S. population: What We Eat In America, NHANES 2009-2010. Food Surveys Research Group Dietary Data Brief No 12, September 2014.

3 US Department of Health and Human Services and US Department of Agriculture. 2015-2020 Dietary Guidelines for Americans, 8th Edition. December 2015.

4 Institute of Medicine Food and Nutrition Board. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids. Panel on Macronutrients, Panel on the Definition of Dietary Fiber, Subcommittee on Upper Reference Levels of Nutrients, Subcomittee on Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluatino of Dietary Reference Intakes, National Academies Press 2005.

5 Bowman SA, Clemens JC, Martin CL et al. Added Sugar Intake of Americans: What We Eat in America, NHANES 2013-2014. Food Surveys Research Group Dietary Data Brief No. 18, May 2017.