Monday, March 31, 2014

Sugar ... how much is OK?

     The journey from Bangalore to Mysore in Karnataka is one of the most scenic in the country. Particularly attractive are the seemingly endless fields of sugar cane, especially when they are in bloom. Having made this trip hundreds of times, my enjoyment of this sight ceased once I started studying nutrition. I realized that while beautiful and lush greenery is soothing to the soul, the crop I was admiring was not only water wasteful and chemical intensive, it was essentially going to become a 'food' that contributes to our population's ill health!

      All the debate about white sugar has been resolved – yes, excessive sugar intake over a long period of time really does cause Diabetes, Heart Disease, Cancer and Asthma in addition to creating a body environment that promotes other diseases as well. Most scientists, nutritionists and medical professionals now agree that sugar should rightly be classified as a 'toxic' substance.

      There is a war being waged against sugary foods around the world and beginning in India too. Parents especially want laws passed to make it mandatory for food manufacturers to reduce the sugar present in their products to a minimum level. They want clearer food ingredient labels as well to help people distinguish if a product is high in hidden sugars. Also, the sale of sugary foods is being limited in school zones there. Soon governments all over will be taking actions – but will these really resolve the problem? Let's come back to this point in a bit.

      Here in India too, we're not only talking about white, refined sugar – with a bakery or sweet shop on the corner of virtually every street, the problem lies in first identifying unhealthy sugary foods:

- Indian sweets and desserts of all types

- Jams, jellies, marmalades and even ketchup / tomato sauce

- Biscuits (especially those with cream filling) and cookies

- Cakes, muffins, pastries, desser,ts, waffles, pancakes, doughnuts, bread-based sweets like croissants,  etc.

- Ice cream, ice candies, flavoured yoghurts, smoothies, srikhands, chocolates, mints, chewing / bubble gum, hard boiled candy, etc.

- Processed fruit juices, fruit juice concentrates, reconstituting juice powders, dehydrated fruit pulp snacks, even fresh fruit juice or milkshakes from a vendor, etc.

- Carbonated (soft) drinks, flavoured sodas, sports drinks, 'energizing' drinks, flavoured milk or soymilk, etc.

- Sugary breakfast cereals including muesli, energy / nutrition bars, etc.


      Kids are most susceptible to excessive sugar intake....look at the list above, some food or the other may make it into your child's mouth on a daily if not weekly basis.

      The impact of sugar containing foods on children's systems is much worse...They consume sugary foods at the expense of healthy ones leading to dental caries and tooth decay, behavioural problems related to sudden sugar highs and lows, irritability and tantrums. Obesity, insulin resistance and type 2 diabetes can result from prolonged excessive consumption. Temporary disturbances like drowsiness and headaches can be seen after a child's sugar binge.

     Children don't need sugar, even in milk! Least of all for energy. Sugar and sugary foods cause a sudden increase in blood sugar levels which is followed by a just-as-sudden drop in glucose levels and this see-saw effect is responsible for most of the above consequences. Parents should ensure their child gets enough steady supply of calories from the COMPLEX CARBOHYDRATES in whole grains, pulses and sprouts in their diet. Even sugar from fruits and dry fruits is preferable to processed sugar sources. Refined carbs like white rice and maida products are no good. They affect the body similarly to sugar.

     There is evidence that excessive sugar intake during pregnancy too affects your infant's taste preferences so avoid sugary foods and sugar consumption during this time. While you're at it, reduce your sugar needs during breastfeeding as well. Though traditional practices may dictate lots of high calorie sweet foods at these sensitive stages, do your best to avoid them and educate the elder women in the family.

     There is no such thing as a 'sweet tooth' – these are only cravings caused by the brain's pleasure centre becoming excessively stimulated, setting up repeated cravings for sweet foods. Sugar is dangerous because of it's addictive nature!

  The good news is, as you include more whole grain cereals and pulses, consciously cut out the hidden sources of sugar listed above and eat fruits when a craving hits, consistently, you will retrain your brain and body to create a healthy metabolism again.

     Demerara (brown) sugar, honey, jaggery and palm sugar, while preferable since they haven't undergone as much processing as the refined white variety, still should only be enjoyed in limited quantities since they too impact blood glucose levels.

     Artificial sweeteners and foods containing them should be avoided by children at all costs. Their livers are much more sensitive to the chemicals present in these. Not only that, children (and adults) who routinely use artificial sweeteners or consume products containing these may develop a dislike for less sweet or non-sweet, healthy, filling, and highly nutritious foods while consuming more artificially flavoured foods with less nutritional value. The brain's ability to correlate sweetness and calorie perception is also affected.

   Even Diabetics don't really benefit from using such sugar substitutes. The responsible thing to do is to reduce your need for the sweet taste altogether! Sweets and snacks promoted as Diabetic friendly are most often high in fat instead – thereby completely unhealthy in any case.

       So how much is OK? Assuming you are limiting other sugary foods in the diet, your child and family members can consume a maximum of 2 to 3 teaspoons (10 to 15 g) of any type of sugar per day. This is however just the maximum allowance – you can avoid sugar completely and it will be even safer for all of you!

       Ideally stick to natural foods which are much healthier but if you must choose processed foods, look at the food ingredient labels. Sweeteners can be nutritive (calorie providing) or non-nutritive (contain negligible calories)... 


Nutritive sweeteners -  contain calories so are not really any use for the health conscious.

 Processed

  Table sugar / sucrose, Confectioner's/powdered sugar, High Fructose Corn syrup, Dextrose, Invert sugar, etc.

 Unprocessed

  Brown sugar, Fructose or "fruit sugar", Glucose, Honey, Lactose  / milk sugar, Maltose or "malt sugar", Mannitol, Molasses, Raw sugar, Xylitol, Sorbitol, etc.

Non-Nutritive Sweetenerscontain chemicals which have to be dealt with by the liver, therefore not really any healthier than refined sugar..

Aspartame, Acesulfame K, Neotame, Saccharin, Sucralose,etc.

The Salt Shake-up


      Anyone who has high blood pressure must decrease their salt intake drastically. Everyone knows that. What is not really understood is that it is because of our high intake of salt from a young age that we are at risk for heart disease in later years. In fact, as a nation, we average about 9 g of salt per day! Indian medical professionals and nutritionists consider the maximum safe allowance for adults to be 5g.  Studies have also linked high childhood salt intake to risk of developing osteoporosis, respiratory disorders, kidney issues and even stomach cancer in young adulthood.





Age Group

Maximum Allowance of Sodium (mg)

Grams of Salt

3-6yrs

1000mg

2.5g

7- 18yrs

1600mg

4 g

Adult

2000mg

5 g



Source: National Institute of Nutrition, 2010


Note - 5 g of salt is equivalent to 1 small teaspoon.

         - 1 g of salt contains 0.4 g of Sodium

     Sodium is an essential mineral. It is required for regulation of blood pressure, maintenance of water and acid-base balancing mechanisms, controls temperature, transmits neural impulses at a cellular level and plays a vital role in absorption of nutrients and molecules across cell membranes.

         
Symptoms of Sodium / Salt overload in children:

….stomach discomfort, nausea, vomiting, cramps and diarrhoea (which lead to dehydration)

….high blood pressure!

….seizures (especially in infants and toddlers)

….increased thirst and water retention (puffiness of skin)


Severe salt overload can lead to brain swelling, kidney damage and even heart failure.


     3 things you need to remember  
a) Maximum allowance is just that - an upper limit beyond which consumption adversely affects health. The actual requirement for every age is just half this maximum number. 

b) Children below 2 years should not be fed any added salt including from processed foods below! You may think their food is bland but they don't. Feel free to introduce other natural flavours and spices. 

c) Salt is just one source of Sodium, there are other hidden sources in our food.....


-  Biscuits, breads and other baked foods, sports drinks and carbonated beverages.

-  Processed foods - instant soups and noodles, snack foods, ready-to-eat foods, batter pre-mixes (dosa / idli / cake), breakfast cereals, muffins, ice creams, sweet yoghurts,etc.

-  Pappads, pickles, chutneys, sauces, mayonnaise, salad dressings, cheese and butter.

-  Fast foods like  pizzas, burgers, fried chicken, salads, subs, manchurians and chaats

-  Restaurant foods right from masala dosa to paneer butter masala and naan.


     [Food additives such as monosodium glutamate (MSG), baking soda and powder, disodium phosphate, sodium alginate, sodium benzoate, sodium hydroxide, sodium nitrite, sodium propionate and sodium sulphite - all increase the sodium content of foods to which they are added] 


     There are different varieties of salts – kala namak, sea salt, himalayan rock salt, moon salt, etc.... just check to see whether they contain Iodine or not. Salt is virtually our biggest supplier of this other critical mineral.


     To sum up, while salt does impart flavour, we should realize that food just tastes different with less – it is not 'bland' or 'tasteless'. There is flavour - the natural flavour of the food! You can even use more herbs, spices, lemon juice and other flavourings while cooking to tickle the taste buds. The big secret is that our actual physical daily requirement of salt is so low that even if you leave out salt altogether, you will still glean enough sodium from the natural foods you consume!


     You can calculate your daily salt intake using the calculator at the link below....and bring it down to a reasonable level for your family's long term health.