On supermarket shelves, restaurant menus and in many homes, there has been an increasing shift towards healthier food options. And nowhere is this more evident than with refined white sugar. Long considered an evil villain in the fight against obesity and its twin scourge diabetes refined sugar is being usurped in favour of other options perceived to be healthier.
In Malaysia, this trend has been gaining momentum, especially as people are waking up to the reality that Malaysia is the fattest country in South-East Asia, with nearly half of the population either overweight or obese.
In the Malaysian Adults Nutrition Survey 2014, sugar ranked second in foods consumed daily among the Malaysian adult population living in both rural and urban areas. Based on the survey, average sugar and condensed milk intake daily was 75.5 g, which grossly exceeds the World Health Organisations (WHO) recommendation of 50g of sugar (12 teaspoons) a day.
While sugar is not the sole contributor of the obesity epidemic, there is a strong connection between sugar consumption and weight increase.
In light of this, there has been a considerable shift in the means and methods of incorporating sugar into diets, with consumers, food producers and eateries rising to the task of making healthier options.
Most notably, this has manifested in the increased use of sugar substitutes like honey, agave nectar, stevia, molasses, palm sugar, maple syrup and artificial sweeteners like Sweet N Low. The end products can take many forms from artisanal granola sweetened with honey, cakes made with dates or molasses and carbonated drinks enhanced with stevia instead of sugar.
Many of these products are marketed as being healthier, and various websites and online articles substantiate these claims by pontificating about the virtues of different sugar substitutes. Over time, this, coupled with refined sugars bad reputation, has led to the widespread belief that sugar substitutes are somehow healthier than sugar itself.
Yes, there is a trend for individuals to choose sugar substitutes in the hope that these substitutes would dampen the effect of excessive sugar intake. Obesity and the increasing prevalence of diabetes in the country clearly are the driving force for individuals to seek healthier substitutes in their diet, as processed sugar has been termed the culprit leading to obesity and diabetes, says Asst Prof Dr Satvinder Kaur, the head of the nutrition with wellness programme at USCI University.
Are sugar substitutes better ?
According to Satvinder, in terms of calorie intake, there is very little difference between consuming refined white sugar (a disaccharide known as sucrose that is made from glucose and fructose and which contains 398 calories in 100g) and consuming substitutes like honey, palm sugar or maple syrup.
Satvinder believes that people should be looking at reducing their sugar intake.
One teaspoon of any form of sugar provides approximately 20 calories. So calorie-wise, it does not differ greatly from each other, thus using it as a healthier substitute may be misleading. As for metabolism, our body metabolises glucose, fructose and galactose (which are all the simplest form of sugar) differently. While glucose requires the hormone insulin for metabolism, fructose is metabolised in the liver. As such, although the balance of glucose and fructose in refined sugar and sugar substitutes differs, the metabolism of table sugar and other sugar substitutes may not vary greatly as all share similar end products (glucose and fructose) which are absorbed in the body, she says.
For people looking to reduce calorie intake, zero-calorie artificial sweeteners may be the way to go, although these sweeteners themselves have come under increased scrutiny, especially as a recent study (commissioned by WHO) and published in the British Medical Journal indicated that artificial sweeteners were no healthier than refined sugar.
Satvinder also cautions against over-consumption of sugar substitutes as the effects of consuming too much can be as harmful or worse than consuming refined sugar.
Citing honey as an example, she says, Honey mainly consists of fructose and clinical studies have shown that excess fructose is often the culprit behind metabolic syndrome and weight gain, so high consumption would translate to obesity and metabolic irregularities.
Despite honey having health benefits through antioxidant properties, intake should still be in the recommended amount as over-consumption would result in more harm than benefits, she says.
Ultimately, reducing sugar consumption should be the ultimate goal.
Sugar substitutes should not be characterised as an alternative without also looking into the amount consumed. Often the amount of sugar consumed leads to higher rates of obesity and diabetes rather than the type of sugar consumed per se. Using less sugar is the way to tackle issues related to obesity and diabetes. This is because foods that have high sugar are normally energy-dense foods that contain little nutrients, she says.