Sugar Sugar Alcohols

Artificial Sweeteners and your Health

Chelsee Shortt cshortt@mountvernon.k12.ia.us

@educateexercise

About Me ● Struggles ● Ah Ha moment ● Influences

○ Gary Taubes- Why we get fat and what to do about it ○ Robert Lustig- Sugar the bitter sweet truth ○ Dallas and David Hartwig- Whole 9

■ It Starts with Food ○ Fed Up Documentary with Katie Couric

Purpose Statement ● How sugar/sugar alcohols affect the body ● Where sugar/sugar alcohols can be found ● How much is too much ● How is this impacting childhood obesity ● Why we should address this issue as health

advocators.

Carbohydrates Monosaccharides: Glucose, Galactose, Fructose Disaccharides: Lactose, Maltose, Sucrose Polysaccharides: Starches Fiber

Southgate, 1995

Carbohydrate Metabolism Stomach: Salivary Amylase Intestines: Pancreatic Amylase, Brush border enzymes

Glucose/Galactose: Absorbed through villi into bloodstream (Sodium transport) Fructose: Transports to Liver to break down into glucose and triglyceride

Blood sugar rises, Insulin responds, glucose gets utilized throughout body, stored in muscles/liver as glycogen or stored as fat

The role of Insulin Insulin:

● Growth Hormone ● Controlled by the pancreas ● Signals to muscle and fat tissue to uptake

glucose in the bloodstream

Insulin Resistance Insulin is not effective in signaling the uptake of blood sugar. More insulin is needed to do the work.

(Reaven, 2005)

Sugar Sucrose: Glucose/Fructose Fructose: Breaks down in liver as glucose and triglyceride, uric acid and free radical byproduct

Study:

Moderate Amounts of Fructose Consumption impairs Insulin Sensitivity in Healthy Young Men

Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease

Sugar on the food label corn sweetener, corn syrup, dextrose, fructose, fruit juice concentrates, glucose, high-fructose corn syrup, invert sugar, lactose, maltose, malt syrup, raw sugar, sucrose, sugar syrup, cane crystals, cane sugar, crystalline fructose, evaporated cane juice, corn syrup solids, malt syrup, honey, agave, maple syrup

Sugar Alcohols Sugar alcohols are digested in the large intestine, mainly by the bacteria in the intestine. This can cause bloating, GI discomfort, or a laxative effect. They do have a caloric value ranging from 1.5-3 calories per gram (Sugar 4 calories per gram)

Sugar Alcohol on Food Labels Mannitol-pineapples, olives, asparagus, sweet potatoes and carrots, 50-70 times sweeter Sorbitol-Fruits and vegetables, 50 times sweeter Xylitol-straw, corncobs, fruit, vegetables, cereals, mushrooms and some cereals, same sweetness as sugar Lactitol-Found in dairy, 30-40 times sweeter Isomalt- Found in hard candies, 45-65 times sweeter Maltitol- Hard candy, gum, desserts 75 times sweeter Erythritol- Stevia 200 times sweeter Hydrogenated starch hydrolysates (HSH)- Hydrolysis of Corn 40-90 times sweeter

Artificial Sweeteners Aspartame (Equal) and Saccharin (Sweet & Low) Do not raise the blood sugar Cognitive sweetened response stimulates hunger hormones to consume

Artificial Sweeteners: A systematic review of metabolic effects in youth

What is Healthy Fasting Blood Sugar of 70-100 mg/dl (Milligrams per deciliter)

AMA Recommendations for added sugar: Women 100 Calories (6 teaspoons) Men 150 calories (9 teaspoons)

1 teaspoon of sugar=4 grams

What are we eating? Average American consumes 20 teaspoons of Sugar a day BEWARE! Sugar is EVERYWHERE! Be a conscious consumer

Breakfast

Fat Free Strawberry Greek Yogurt: 2 tsp ½ Cherry Bagel: 1 tsp

Lunch Peanut Butter/Celery: 1 tsp Subway Turkey Sub: 2 tsp

Why should we care? Excess Sugar or sweetener in diet is linked to ● Obesity ● Diabetes Type 2 ● Addiction (sweeteners) ● Cancer (sweeteners) ● Cardiovascular Disease

So Much Research... For every sugar beverage a young person has each day their BMI correlates to the added sugar intake Chronic Stress, Combined with a High-Fat/High-Sugar Diet, Shifts Sympathetic Signaling toward Neuropeptide Y and Leads to Obesity and the Metabolic Syndrome Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake

Most research is done on sugary beverages but desserts can be just as bad

How can educators help Good News! Consumption of sugary beverages are on the decline Increase Insulin Sensitivity in Children Change Eating Behaviors and Habits Eliminate added sugars from diet Carbs vs Fat

References 1. Southgate, D. A. (1995). Digestion and metabolism of sugars. The American journal of clinical nutrition, 62(1), 203S-210S. http://ajcn.

nutrition.org/content/62/1/203S.full.pdf 2. Aeberli, I., Hochuli, M., Gerber, P. A., Sze, L., Murer, S. B., Tappy, L., ... & Berneis, K. (2013). Moderate Amounts of Fructose

Consumption Impair Insulin Sensitivity in Healthy Young Men A randomized controlled trial. Diabetes Care,36(1), 150-156. http://care. diabetesjournals.org/content/36/1/150.short

3. Utzschneider, K. M., & Kahn, S. E. (2006). The role of insulin resistance in nonalcoholic fatty liver disease. The Journal of Clinical Endocrinology & Metabolism, 91(12), 4753-4761. http://press.endocrine.org/doi/full/10.1210/jc.2006-0587

4. Reaven, G. M. (2005). The insulin resistance syndrome: definition and dietary approaches to treatment. Annu. Rev. Nutr., 25, 391-406. 5. American Diabetes Association. (2014). Standards of medical care in diabetes--2014. Diabetes care, 37, S14. http://care.

diabetesjournals.org/content/37/Supplement_1/S14.long 6. http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Sugar-101_UCM_306024_Article.jsp 7. Beaugerie, L., Flourié, B., Marteau, P., Pellier, P., Franchisseur, C., & Rambaud, J. C. (1990). Digestion and absorption in the human

intestine of three sugar alcohols. Gastroenterology, 99(3)), 717-23. 8. Ellwood, K. C. (1995). Methods available to estimate the energy values of sugar alcohols. The American journal of clinical nutrition, 62

(5), 1169S-1174S. http://ajcn.nutrition.org/content/62/5/1169S.long 9. http://www.ynhh.org/about-us/sugar_alcohol.aspx

10. Yang, Q. (2010). Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings: Neuroscience 2010. The Yale journal of biology and medicine, 83(2), 101.

11. Guthrie, J. F., & Morton, J. F. (2000). Food sources of added sweeteners in the diets of Americans. Journal of the American Dietetic Association, 100(1), 43-51.

12. Welsh, J. A., Sharma, A. J., Grellinger, L., & Vos, M. B. (2011). Consumption of added sugars is decreasing in the United States. The American journal of clinical nutrition, 94(3), 726-734.