Why is added sugar worse for the body than carbohydrates?

Why Added Sugar Is Worse for the Body Than Complex Carbohydrates

Added sugars are more harmful to the body than complex carbohydrates because they directly stimulate hepatic de novo lipogenesis, promote visceral adiposity, and contribute to metabolic abnormalities without providing essential nutrients. 1

Understanding Different Types of Carbohydrates

Definitions and Classifications

• Simple carbohydrates (sugars): Monosaccharides (glucose, galactose, fructose) and disaccharides (sucrose, lactose, maltose) 1
• Complex carbohydrates: Glucose-containing polysaccharides such as starch 1
• Naturally occurring sugars: Integral parts of whole fruits, vegetables, and milk products 1
• Added sugars: Sugars and syrups added to foods during processing, preparation, or at the table 1

Metabolic Differences Between Added Sugars and Complex Carbohydrates

Rapid Absorption and Metabolic Impact

• Added sugars are rapidly absorbed, causing:

  • Postprandial hyperglycemia and hyperinsulinemia
  • Direct stimulation of hepatic de novo lipogenesis (fat creation in the liver)
  • Increased hepatic and visceral adiposity
  • Elevated uric acid production 1

• Complex carbohydrates from whole foods (fruits, legumes, vegetables, minimally processed whole grains):

  • Are digested more slowly due to fiber content
  • Provide essential nutrients
  • Have protective effects on cardiometabolic health 1

Fructose Component of Added Sugars

• Fructose (present in both high-fructose corn syrup and sucrose) has unique metabolic effects:
  • Limited influence on blood glucose but directly stimulates fat production
  • Promotes formation of Advanced Glycation End Products (AGEs) implicated in aging processes and vascular complications 2
  • Contributes to non-alcoholic fatty liver disease when consumed excessively 2

Health Consequences of Excessive Added Sugar Consumption

Cardiovascular and Metabolic Effects

• Excessive sugar consumption is linked to:
  • Metabolic abnormalities and adverse health conditions
  • Increased triglyceride levels
  • Greater cardiovascular disease risk factors
  • Obesity, especially in children consuming >10% energy from free sugars 1
  • Shortfalls of essential nutrients 1

Sugar-Sweetened Beverages

• Primary source of added sugars in Americans' diets 1
• Associated with:
  • Greater energy intake
  • Higher body weight
  • Lower intake of essential nutrients 1
  • Increased risk of obesity, diabetes, and cardiovascular disease 3

Current Consumption Patterns and Recommendations

Consumption Patterns

• Average intake of added sugars for Americans was 22.2 teaspoons per day (355 calories) in 2001-2004 1
• Between 1970 and 2005, average annual availability of sugars/added sugars increased by 19% 1
• Recent data (2023) shows US adults consume approximately 17.0 teaspoons of added sugars per day 4

Recommendations

• American Heart Association recommends limiting added sugars to:
  • No more than 100 calories per day (about 6 teaspoons) for most women
  • No more than 150 calories per day (about 9 teaspoons) for most men 1
• UK Scientific Advisory Committee on Nutrition recommends no more than 5% of food energy from free sugars 1

Common Pitfalls in Sugar Consumption

• Focusing only on high-fructose corn syrup while ignoring other added sugars
  • HFCS and sucrose have similar fructose-to-glucose ratios and comparable metabolic effects 2
• Replacing added sugars with refined complex carbohydrates
  • Both can be equally harmful to cardiometabolic health 1
• Overlooking added sugars in processed foods
  • Added sugars are ubiquitous in the food supply 1

Practical Approach to Reducing Added Sugar Impact

1. Prioritize whole food sources of carbohydrates (fruits, vegetables, legumes, minimally processed whole grains)
2. Limit sugar-sweetened beverages, which are the primary source of added sugars 1
3. Focus on overall carbohydrate quality rather than just targeting specific types of sweeteners 2
4. Be aware that both high-fructose corn syrup and natural sugar (sucrose) have similar metabolic effects 1

While some research suggests that added sugars within normal consumption ranges may not uniquely cause obesity, diabetes, or cardiovascular disease when substituted isoenergetically for other carbohydrates 5, 6, the preponderance of evidence from major health organizations supports limiting added sugar intake to reduce health risks.