Is eating sugar-free worth it?

October 2, 2018

Swedish Nutrition Team

a woman preparing various vegetables in her kitchen

[6 MIN READ]

Most Americans eat too much sugar, which makes it a good idea to cut back.
Eating less sugar can cut the risk of diseases, including diabetes
Going sugar-free doesn’t necessarily mean cutting out all sugar from your diet — instead, focus on foods with processed sugars.
Visit a Swedish clinician to figure out the best way to reduce sugar in your diet.

Determining if eating sugar-free is worth it depends on your medical condition and the value of lifestyle tradeoffs you are willing to make for improved health and reduced risk of certain chronic health conditions.

There is little doubt that we need to cut back on the sweet stuff. Americans eat as much added sugar each year as the weight of an average golden retriever, or about 66 pounds. That translates into an average of 19.5 teaspoons every single day. The American Heart Association (AHA) recommends no more than six teaspoons for women and nine teaspoons for men, which means we are eating about two to three times more sugar than we should. It is no wonder why we are regularly questioning how much sugar we should eat, and whether we should do our best to do without.

Trying to eat completely sugar-free can be a difficult meal planning approach since most foods have sugar in them, including fruits and vegetables. The benefits of maintaining a low refined-sugar diet for those managing medical conditions like diabetes, high blood pressure, dementia and obesity are widely recognized. These benefits include healthy weight management and a reduced risk of diseases relating to the heart, brain, kidney and other vital organs, as well as reduced risk of developing diabetes.

Whether directed by a doctor or not, most of us have thought about cutting out or at least reducing sugar from our diet. Let’s look at the potential benefits of going sugar-free by focusing on defining the approach, challenges, and common goals of what people refer to as a ”zero sugar” diet.

What does eating sugar-free mean?

Eating sugar-free does not necessarily mean cutting out every food with sugar in it, because not all sugars are created equal in terms of your health. In the nutritional context, there is a big difference between natural sugars found in foods like fruits and vegetables (fructose) and refined sugars (glucose and dextrose) added to make processed foods sweeter.

For most people in good overall health, going sugar-free is a goal rather than a hard and fast rule. The goal typically centers around cutting out all refined sugar from your food choices or at least eliminating as much of it as possible. Eating sugar-free means choosing foods that have little to no processed sugar and moderating the consumption of foods that have natural sugars.

Is a low-sugar meal plan the same as a low glycemic index (low-GI) meal plan?

Not exactly, but they are related. The glycemic index is a widely accepted scale that ranks foods based on their effect on blood sugar levels. The theory behind the GI system is based on the time it takes for our bodies to break down carbs into sugars. Calories derived from refined sugars break down more quickly than carbs from foods like vegetables and whole grains. If you eat a lot of fast-acting carbs (“bad carbs”) it can make it harder to control your blood sugar. Eating more slow-acting carbs (“good carbs”) tends to help regulate a steadier blood glucose level and is widely considered to be the healthier way to eat.

Low glycemic index diet plans, or plans promoting a high mix of foods that keep blood sugar levels steady throughout the day, are the subject of research as to whether they are effective at reducing hemoglobin A1c levels. A1c levels are one of the most important measurements of how a person’s diabetes is being managed, alongside regular blood glucose tests.

If it were only as simple as choosing low-GI foods, it would make it so easy. Not all dietitians agree on strictly prescribing low-GI plans for all people, because not all high-GI foods are bad. For example, oatmeal has a higher GI than chocolate. More research is needed to form a prescriptive answer on adopting the low-GI meal plan approach across the spectrum of cases.

What about artificial sweeteners?

There is a fair amount of debate as it relates to whether it is acceptable to use artificial sweeteners — a common tactic people use who struggle to stay strictly sugar-free — because there are significant tradeoffs to consider. There are studies that indicate artificial sweeteners may generate a higher risk of glucose intolerance and promote gut bacteria changes that lead to increased fat storage. The FDA-approved artificial sweeteners on the market today are considered safe and can help you in some circumstances with weight management, as long as you consume them sparingly and pay close attention to not consuming extra calories.

Unless you have prediabetes or diabetes, it is best to avoid or minimize your intake of artificial sweeteners even if you are trying to achieve a low-sugar or low-GI diet. The downside to the broad use of artificial sweeteners is that sugar substitutes can change the way we taste food through overstimulation of sugar receptors, making healthy foods that are less sweet or unsweet seem less tasty than sweet treats with little nutritional value.

The reason some dieticians believe it is acceptable for some people with diabetic conditions to choose artificial sweeteners over sugar is that artificial sweeteners do not raise blood sugar levels like real sugars do. If you are managing prediabetes or diabetes, it is best to consult your endocrinologist and a registered dietician to understand which artificial sweeteners they recommend and in what amounts. Can artificial sweeteners be a part of an otherwise healthy diet? Yes, but depending on your health sensitivities and the amount you plan to consume, you should be knowledgeable about the potential tradeoffs to avoid taking two steps forward, and three steps back relative to your overall health.

Extreme sugar reduction efforts, are they worth it?

Yes, if you have sugar-sensitive health conditions like diabetes, insulin resistance, obesity, high blood pressure/hypertension, cardiovascular disease, high cholesterol or dementia. Not only are there significant health benefits to warrant the potential lifestyle tradeoffs you are considering, but your doctor may prescribe this dietary regimen as part of your treatment to help avoid further health complications. The answer to “Is it worth it?” is a resounding yes.

For everyone else, including people trying to better manage weight gain as they age, stave off potential genetic risks for pre-diabetes or even for those wanting more energy and to feel better in general, the question of worth really boils down to a quality-of-life question as it relates to short-term sacrifice for long-term benefit.

Why wouldn’t we want to take the best care of our bodies by working to restrict refined sugar as much as possible? It is hard to make a counterargument that doesn’t include some form of short-term thinking "live-for-today" rationale. Most health articles end with some form of "everything in moderation" sentiment, but in the case of refined sugar, it is clear: it should be minimized, not moderated. Natural sugars should be eaten in moderation, and only with a careful understanding of your health needs. And artificial sugars should be avoided unless you are a person with diabetes or prediabetes, in which case their consumption should be carefully monitored with your physician.

Watch this video on the importance of regular blood sugar monitoring:

Many people find dramatic sugar reduction a dietary bridge too far to cross. There are pros and cons to the nutritional approaches you could take: from the more extreme “sugar-free” plans to meal plans designed to feature low glycemic-index foods. While sugar can play a limited part in a balanced diet, reducing processed sugar as much as possible can have significant health benefits, especially for people with certain health conditions or medical histories.

Find a doctor

If you have questions about reducing sugar in your diet, contact Primary Care or Nutrition Care at Swedish. We can accommodate both in-person and virtual visits.

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