Sugar = Sugar ?

First we went through this with calories.  Remember that story? A calorie is a calorie.  Maybe that works out for a device like a bomb calorimeter used in food analytical labs.  However human metabolism does not take place in a closed system.  There are so many moving parts that can heighten or reduce the extractable energy found in foods.  The individual’s endocrine system, the immune system’s response, the potential inflammatory component to many foods, and, maybe most importantly, the role of the micro-biome and how the bacteria respond to what we eat.

Sugars are made up of individual units called monosaccharides.  These vary from the more common and starchy root vegetable-based glucose to the less common and far more problematic fructose.  The research surrounding these two building blocks of sugar is clear: fructose is not well tolerated and creates more inflammation, more dysbiosis and subsequent endotoxemia, and more insulin resistance.  Almost all added or refined sugars are comprised of at least 50% fructose.  White sugar, brown sugar, cane sugar, evaporated cane juice…these are all 50% fructose.  It gets worse with sweeteners like corn syrup, agave, and fruit juice.  In these cases, fructose can make up as much as 65% of the sugar.  Paul Stanhope MD has published numerous papers quantifying just how damaging fructose is to human health.  The results from his trials are very damning to say the least.

Carrots, sweet potatoes, and potatoes on the other hand are almost entirely made up of glucose.  Not only is glucose much more compatible with our mitochondria and the bacteria in our GI, but these sources of carbohydrate are also much better at delivering the glucose very slowly.  Even a well-cooked sweet potato delivers glucose at a markedly slower pace than any of these refined sugars. Carrots, often maligned as a rich source of sugar, deliver their glucose at a rate of about 40% of that of refined sugars.

In summary, not only are the qualities of the sugars found in vegetables different (mostly glucose, very little fructose) but their delivery rates (often defined as their glycemic index or glycemic load) are substantially slower.  These attributes should help patients and their families understand that there is a substantial difference in how the human body responds to added sugars as opposed to the sugars found naturally within whole vegetables.

John Bagnulo MPH, PhD. - Director of Nutrition