Beware of Polysaccharides
Beware of Polysaccharides

Sugar and Carbohydrates


I have been avoiding sugar now in my daily diet, which can be classified as moderate ketogenic, for about 2,5 years now, as I write these words in November 2017. Sugar or better sucrose, I have been taught is a di-saccharide, which consist of one molecule glucose and one molecule fructose. If you, like most people on this globe who live on a Western diet, burn mainly glucose for your energy, there is no problem with that, as long as you are healthy and insulin sensitive. With fructose there is more of a problem, the body cannot uptake fructose very well at all and your liver needs to go through a process of converting fructose into fat. A conversion process which is similar compared to dealing with ethanol i.e alcohol, which we all know is toxic and the liver always get rid of toxic stuff first. Consuming a whole lot of sugar (sucrose) therefore gives your liver the same type of heavy workload as folks that drink a whole lot of alcohol, without providing the brain the buzz therof people seem to be looking for. Refer for more detail to the magic video of Dr. Robert Lustig- Sugar- The bitter truth- link : HERE

So- the impact of sugar has been clear to me for some time now. What I always struggled with was starch or better the poly-saccharides, which are the primary content of things like wheatbread, pasta, rice, cookies, potatoes and roughly 80% of the processed foods you find in a supermarket. On Monday I found an article written by Zoe Harcombe in my mailbox, which greatly improved my understanding on this subject also. Starch (poly-saccharide=several sugars) is broken down by the body in glucose only mono-sacharrides. Fine- again- if you are insulin sensitive and can efficiently burn glucose- a disaster if you insulin-resistant. Uncomprehensible therefore that conventional medicine tell diabetics to put carbs in the diet of a Type 2 diabetic, since it obviously raises their blood sugar level tremendously, due to failing insulin sensitivity.  Criminal?

Anyway- Zoe´s article I borrowed - I am sure she wouldnt mind for once- and follows below


Sugar vs Carbohydrate – what’s the difference?

The story for this week was inspired by a tweet by someone with whom I’ve written a couple of academic papers: Dr James DiNicolantonio. James tweeted about his latest paper, published in BMJ Open Heart (Ref 1), but it was the graphic in the tweet that caught my eye. The graphic was a representation of the amount of sugar in a number of different foods, but with the sugar content represented as cubes of sugar.
The bottom left hand corner of the graphic reported the source as “Leo Delauncey/MailOnline”, but the picture had no label to describe exactly what was being illustrated. It made me wonder – is that added sugar, free sugars, or carbohydrate? What’s the difference anyway? This proved to be a really enlightening issue to explore.
We need to start with a quick description of carbohydrates (you will soon start to wonder what’s the difference between sugar and carbohydrates). Then we need to sort out sugar, added sugar, free sugars etc and then we will be able to answer the question: what are the sugar cubes supposed to represent and are they a fair reflection of the actual sugar content of each food shown?

What are carbohydrates?

 Carbohydrates can be divided into three categories: monosaccharides; disaccharides and polysaccharides. Saccharide comes from a Greek word meaning sugar. Mono means one; di means two and poly means many, so...
Monosaccharide means one sugar. The three most common monosaccharides are:
-  Glucose (found commonly in fruit and grains);
-  Fructose (found commonly in fruit);
-  Galactose (found commonly in milk).
Disaccharide means two sugars. The three most common disaccharides are:
-  Sucrose (one molecule of glucose and one of fructose) – what we know as table sugar;
-  Lactose (one molecule of glucose and one of galactose) – what we know as milk sugar;
-  Maltose (two molecules of glucose) – less well known as malt sugar.
Polysaccharide means many sugars. Polysaccharides come in digestible and indigestible forms. The digestible forms of polysaccharides are:
-  Glycogen. This is the form in which animals (including humans) store energy – in the liver and muscles in the body. Glycogen is made up of thousands of glucose molecules.
-  Starch. This is the form in which plants store energy – as in grains, pulses, potatoes and root vegetables. Starch is made up of thousands of glucose molecules.
The indigestible forms of polysaccharides are collectively called fibre. Fibre contains sugars linked by bonds, which cannot be broken down by human enzymes, and are therefore deemed indigestible. There are two forms of fibre:
1) Insoluble fibre (which does not dissolve in water). This includes cellulose, hemicellulose and lignin. Cellulose can be found in whole-wheat flour, bran, and vegetables. Hemicellulose can be found in bran and whole grains. Lignin is a woody fibre found in wheat bran and the seeds of fruits and vegetables;
2) Soluble fibre (which dissolves, or swells, in water). This includes pectins, mucilages, and gums. These substances are not broken down by human enzymes, but instead can be fermented by bacteria in the large intestine. Pectin can be found in apples, strawberries and carrots. (Because it absorbs water and forms a gel, it is often used in jams and jellies). Mucilages and gums are similar in structure. Sources of gums include oats, legumes (beans, peas), guar and barley.
The key fact to remember is that, during digestion, all carbohydrates need to be broken down into monosaccharides (simple sugars) to be absorbed. This means that all digestible carbohydrate either is, or breaks down into, sugar.
Let’s now turn to sugar itself.


At the simplest level, sugar in food can be seen as intrinsic (contained in the cell walls of a food) or extrinsic (outside the cell walls). However, it gets complicated straight away because milk sugar is deemed extrinsic. We thus end up with “intrinsic sugars” – glucose, fructose and, to a lesser extent, galactose – found in fruits and vegetables. We then have “extrinsic sugars”, which is divided into milk sugars and non-milk sugars. This leads to a term, which you may have seen: “Non-Milk Extrinsic Sugars” (NMES). NMES separate milk (seen as good) from external sugars (seen as bad).
“Added sugars” is one of the terms commonly seen in public health literature. Added sugars means anything added to the product by the manufacturer, cook or consumer. Added sugars include: sucrose (table sugar); fructose; glucose; (high fructose) corn syrup; and concentrated fruit juices (Ref 2).
The term “free sugars” was defined by the World Health Organisation (WHO), as part of the 2015 guidelines issued on sugar intake for children and adults.(Ref 3) Free sugars were defined as: “monosaccharides and disaccharides added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.” “Free sugars” exclude the sugars present in whole fruits and vegetables (intrinsic sugars) and “free sugars” exclude milk sugars. The WHO guidelines strongly recommended that adults and children should reduce intake of “free sugars” to less than 10% of total energy intake. It was advised (but less strongly recommended) that the intake of free sugars should be limited to 5% of total energy intake.
The difference between “non-milk extrinsic sugars” (NMES) and “free sugars” is that NMES include 50% of the fruit sugars from stewed, dried or canned fruit (this assumes that processing changes intrinsic sugars into extrinsic ones), but free sugars does not take processing effects into account (Ref 4).
In January 2017, Véronique Azaïs-Braesco et al published a very interesting article in Nutrition Journal (open view) entitled “A review of total & added sugar intakes and dietary sources in Europe.” (Ref 5) The paper opened by noting that there are many public health policies intended to limit the intake of sugar and yet sugar is not consistently defined, making it difficult to know what current intake is and what reductions might therefore be achieved. How true! One wonders if the confusion about even defining sugar is as helpful to manufacturers, as it is unhelpful to consumers.

The sugar cube graphic

There’s one final fact that we need to know before we work out what’s going on in the sugar cube graphic: there are four grams of sugar in one sugar cube. Remember that a sugar cube is sucrose – which is one molecule of glucose and one molecule of fructose – so each sugar cube is half glucose and half fructose.
We are now in a position to understand the sugar cube graphic.
The banana
The easiest way to check what the graphic shows is to take one of the most basic foods on the picture – a banana – and to see what the cubes represent. The nutritional breakdown of a banana can be found on the standard United States Department of Agriculture (USDA) all-foods database (Ref 6). If you look at one medium banana, the sugar content is given as 14.4g (grams) – that’s 3.5 cubes of sugar, which is what is shown in the graphic – bingo!
However, this is where the fun starts, because there are 27g of carbohydrate in that same medium banana. You know from the “What are carbohydrates?” section that total carbohydrate includes mono (one), di (two) and poly (many) saccharides (sugars). The 14.4g of sugar reported reflects the mono and disaccharides – the sucrose, glucose and fructose. The rest of the 27g – 12.6g – must be polysaccharides. The USDA listing reports that the medium banana has 3.1g of fibre and 6.3g of starch. (Ideally, fibre and starch together would have added to 12.6g, but, frustratingly, the numbers rarely add up on the USDA database – it is probably just not possible to measure all component parts sufficiently accurately).
If we take the non-digestible part of the banana (the 3.1g of fibre) and deduct it from the total carbohydrate, we get approximately 24g of digestible carbohydrate. This is sugar (fructose and glucose) and starch (glucose) in the case of the banana. Given that all digestible carbohydrate either is, or breaks down into, sugar, the medium banana has approximately 24g of sugar. The graphic is showing the simple sugars – it is not showing the simple sugar (glucose) that the starch breaks down into.
The biscuit
The Oreo cookie (Ref 7), on the graphic, is reported to have just one cube of sugar. One Oreo cookie is approximately 45 calories (less than half that of the medium banana). One Oreo cookie is reported to have 4.1g of sugar (as the 1 cube shows on the graphic), but 7.6g of carbohydrate, so what’s the rest?
The ingredients in Oreo are listed as: Wheat Flour; Sugar; Vegetable Oil (Palm); Fat Reduced Cocoa Powder 4.6%; Wheat Starch; Glucose-Fructose Syrup; Salt; Raising Agents (Potassium Hydrogen Carbonate; Sodium Hydrogen Carbonate; Ammonium Hydrogen Carbonate); Emulsifiers (Soya Lecithin, Sunflower Lecithin); Flavouring (Vanillin). Yuck! I expect that the 4.1g of sugar is the added sugar listed as “Sugar” and “Glucose-Fructose Syrup”. The “Wheat Flour” and “Wheat Starch” will be starch i.e. a substance that breaks down into glucose. The starch again is also sugar, but it wasn’t shown on the graphic.
The bagel
The bagel is interesting. A plain bagel (Ref 8) contains 92g of carbohydrate, of which 3g are reported as fibre and 5g are reported as sugar (that’s close enough to the 1.5g of sugar in the info graphic). If we deduct the non-digestible carbohydrate, fibre, from the total carbohydrate, we end up with 5g reported as sugar and 84g left. This, in a bagel, will be starch i.e. glucose i.e. sugar.
The info graphic thus represents “added sugars”, in the case of the biscuit and bagel, and intrinsic sugars, in the case of the banana. It could be argued that this is not comparing like with like. The WHO definition of “free sugars” (sugars to be restricted), would include the sugar in the biscuit and bagel and exclude the sugar in the banana. However, I think that the info graphic is fairer in this respect. The sugar cubes shown for the biscuit, bagel and banana represent the simple glucose and fructose sugars, before we get into starch. The body doesn’t know if sucrose came from a biscuit or a banana – it has to deal with that sucrose in the same way. In my view, the info graphic is right to compare the sucrose in a banana to the sucrose in junk food. Yes, the banana comes with some nutrients, but the sucrose bit is still just sucrose.
Many people think that fruit sugar is entirely fructose, which is not correct. Fruit contains glucose and fructose – in differing proportions. Apples, for example, have more fructose than glucose. Bananas have more glucose than fructose. Using a sugar cube to represent the sugar in fruit is not entirely accurate, but it’s OK as an approximation. To represent the sugar in a medium banana more accurately, a graphic should have 3.5 cubes of sucrose (14g) and 10g of glucose. To represent the bagel more accurately, a graphic should have 1.5 cubes of sucrose (5g) and 84g of glucose. (Because a sugar cube is 50/50 glucose/fructose, we need to be careful using a sugar cube to represent the sugar from starch, as starch sugar is just glucose.)
The final mind-blowing fact is that the body maintains a blood glucose level equivalent to just 4g of glucose (one cube, or teaspoon) at any one time. As soon as glucose enters the blood stream – from the banana or bagel – the body calls upon the pancreas to release insulin to turn this glucose into glycogen (the human form of stored glucose) to bring the blood glucose level back to normal (Ref 9). The fructose from the banana and the bagel (very little fructose in the bagel) goes to the liver to be metabolised, which is why we are seeing an increase in Non-Alcoholic-Fatty-Liver-Disease (NAFLD).
Maybe future graphics should represent the amount of glucose sugar in each product with a syringe (to illustrate that we are effectively injecting sugar into the blood stream and we may need to inject insulin one day to mop this up if our pancreas fails with the workload). The same graphic could represent the amount of fructose sugar in each product with a picture of a fatty liver (to remind people where fructose ends up).
Whatever these graphics do, they should fully represent the sugar present in food – not just the added sugars, extrinsic sugars, free sugars or whatever terminology is used to confuse us. Take total carbohydrate, deduct indigestible carbohydrate and the remainder – all digestible carbohydrate – is, or breaks down into, sugar.
Our governments tell us: “Base your meals on starchy foods.” This is an instruction to “Base your meals on sugar (glucose).” Specifically, we are told to have 55% of our diet in the form of carbohydrate. This is an instruction to have (fibre aside) 55% of our diet in the form of sugar. At the same time, we are advised to limit our intake of sugar to 5% of total energy intake. No wonder readers of this note find public health dietary guidelines to be insane!
Until next time
All the best - Zoë



Comments (1)

  1. fas

This is the first blog article that I have posted for over a year. In the preceding time I have learned a lot in matters health and root causes of disorders, but I never considered the time ripe for disclosure on this site, since the process of...

This is the first blog article that I have posted for over a year. In the preceding time I have learned a lot in matters health and root causes of disorders, but I never considered the time ripe for disclosure on this site, since the process of learning seemed to be never-ending. At one point however a start needs to be made and that will be this coming fall/winter season. Stay tuned for an update in "Fas´actions".

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