Diabetes, sugar and heart disease are inextricably linked. To reduce the risk of heart disease you need to control your diabetes. This in turn means reducing your intake of sugar. But what is the maximum amount of sugar you should ingest daily to minimise your risk of heart disease?
Heart disease is one of the most common complications of diabetes. Indeed, most diabetics who fail to control their blood glucose levels are killed by heart disease.
In addition, if you are diabetic then there is an 85 percent chance that you also suffer from high cholesterol and blood pressure levels, and this increases the risk of heart disease. If you smoke, you up the risk even further.
In order to beat diabetes and avoid heart disease you need—besides giving up smoking, reducing your cholesterol and getting your blood pressure under control—to reduce the amount of glucose your digestive system produces by limiting the amount of sugar you ingest.
But how much sugar should you ingest on a daily basis? What are the limits?
Calories from added sugar
The number of calories each of us requires on a daily basis depends on our age, height, gender and level of activity. On average, however, a healthy adult needs 2,000 calories a day and a child 1,200 calories.
Natural foodstuffs, such as fruits and vegetables, contain sugar. But it seems that this is not enough for most of us. Sugar is added by diners, chefs and food processors. How much of this added sugar do we need?
Not much. In fact, this added sugar is a major problem with our modern Western diet.
In March 2014, the Journal of the American Medical Association published findings from the National Health and Nutrition Examination Survey of 31,147 adults which ran for 22 years from 1988 to 2010.
These findings show that people who get 17 to 21 percent of their calories as added sugar have a 38 percent greater risk of death from heart disease compared to persons who get only 8 percent of their calories from added sugar.
And the risk triples for adults who get 25 percent or more of their calories from added sugar.
The message is pretty obvious.
Calories in sugar
A gram of sugar contains four calories. Eight percent of an intake of 2,000 calories a day is 160 calories or 40 grams (160/4). Thus to minimise your risk of heart disease, you need to limit your intake of added sugar to 40 grams a day.
If, instead, you ingest 340 to 420 calories (85 to 105g) a day as added sugar you have a 38 percent higher chance of developing diseases of the heart. And if you take in 500 calories (125g) a day as added sugar you triple your risk.
It’s simple really. You can minimise your risk of cardiovascular disease by ensuring that you do not ingest more than 8 percent of you daily calorie requirements from added sugar. For the average person, that’s 40g a day of added sugar maximum.
But how can you ensure that the added sugar within your diet does not exceed that maximum?
The simple answer: with great difficulty.
The sugar in our food
Food labelling regulations require the quantity of sugar in a manufactured foodstuff to be shown on the label. So minimising your intake of sugar sounds like a cinch—until you dander down to your local supermarket!
Take cereals for example. A 100g of normal breakfast cereals contains 35g of sugar on average. A reasonably-sized bowl of cereal for breakfast will contain at least 200g, ie 70g of sugar which is well over the 40g limit that minimises your risk of heart disease. And it’s still only breakfast time!
Cruise the aisles and read the labels. I have found small tubs of yoghurts that contain 15g of sugar, more than one-third of the daily limit. Sauces, it seems, are loaded with sugar, 44% in the case of a particular sweet chilli sauce.
Next time you are in a supermarket, spend 10 minutes reading labels closely. Then let me know how you can stick to the upper limit of 40g of added sugar a day—without severely restricting your consumption of processed foods.
WHO recommendations on sugar
For the last ten years, the UN’s World Health Organisation has been recommending that a maximum of 10 percent of our daily calories should come from added sugar. For the average adult on 2,000 calories a day, this comes to an upper limit of 50g of added sugar.
The recommended average intake of calories for a child is about 1,200 calories a day. Thus, the WHO’s recommended upper limit for a child is 30g a day of added sugar. Go back to the supermarket and check out some more labels.
One can of a sugary drink such as a coke or orangeade exceeds the upper limit of 30g a day for a child, which is not too surprising.
But did you know that the sugar in a single-portion tub of yoghurt and a glass of orange juice together can exceed the child’s daily limit? Yet compared to a fizzy drink, most of us would, as parents, consider this combination to be a healthier choice.
Throw in beans on toast for tea (7g of sugar) and a jam sandwich (15g plus) along with the yoghurt and orange juice on a regular basis and your child is well on the road to heart disease in later life.
But even these limits (10 percent of daily calories from added sugar) are now considered too high.
In March 2014, the WHO issued revised recommendations, stating that 5 percent is the more ideal amount of daily calories that should come from added sugar.
This means that, on average, adults should consume no more than 25g of added sugar a day, while children should be limited to 15g a day.
Given the nutritional content of most foodstuffs sold in most supermarkets in the Western world, staying within these limits is almost impossible—unless you give up processed foods entirely.
What to do about added sugar in our foodstuffs?
Sugar is added to the stuff we eat by manufacturers and cooks. Then we, the consumers, often add more sugar before we eat.
Remember when you used to sprinkle a good spoonful of sugar on your Corn Flakes before adding the full-fat milk?
Reducing the amount of sugar we eat will require drastic changes in how our food is produced and how we consume it.
Manufacturers add sugar (and fat) during processing in order to enhance flavours. This needs to change, even if manufacturers object.
Surely society’s ingenious food scientists can come up with tasty foods that do not rely on sugar and fat to be attractive to consumers? Given the right incentives, I’m sure they could.
That incentive can come from legislation forcing them to comply with scientific common sense. The threat of losing a market can be a great incentive for innovation.
In addition, consumers need to learn how to read labels and how to resist being manipulated by advertising. This will require a publicity drive by governments.
Consumers also need to receive advice that is specific. Phrases such as ‘sugar needs to be limited’ are virtually useless and need to be replaced or expanded with specific recommendations on the maximum amounts people should consume on a daily basis and how to calculate these for food groups.
The good news is that all our tastes and preferences in food (with the exception of mother’s milk) are acquired. These tastes can be de-acquired easily enough, as anyone who has switched to a plant-focused diet, like the one I am using to beat my diabetes, will know.
So reducing the added sugars in our food will not present a drastic problem and our taste buds will soon adapt and appreciate the new sensations of taste—provided we know how to assess the sugar in our food.