Sugar, a Bliss or Bane for our Body! 

By: Dr. Bimal Chandra Mohapatra

Talking about sugar- it may not be a sugary topic to discuss! “तुम्हारे मुंह में घी शक्कर” (sugar and ghee be in your mouth- meaning what you said may come true)once upon used as a popular phrase of complement is now a scary proposition. Because now sugar is commonly perceived as a guilt-food item by health-conscious people. But let's face the reality about sugar.

Humans can not survive without sugar. Carbohydrates are our energy source and all carbohydrates are ultimately broken into sugars by the digestion process in the intestine for absorption to our bloodstream. The circulating sugar in the blood is the source of energy for every cell which is used inside the cell as biofuel by the powerhouse i.e the intracellular organelle called mitochondria. Thus it's evident that sugar is running our body-machine and is vital for our survival. Then why is sugar infamous as a bad food item and considered the root cause of many health conditions?

We all are familiar that the pink-coloured meat when heated during cooking turns gradually brown. This browning is due to the chemical reaction which is known as “glycation”. This is due to the sugar molecules combining with the protein. Similar to this “exogenous glycation” of meat during cooking there occurs “endogenous glycation” inside our cells when sugar (mainly glucose)molecules combine with protein molecules impacting the functions of vital proteins, nucleic acids, and lipids inside the cell ultimately resulting in cell aging characterised by increased size, dysfunction and losing power to divide. Glycation products are responsible for free radicals and oxidative stress in the body resulting in generalised inflammation which is the cause of most degenerative diseases. This glycation is a continuous physiological process that is responsible for our aging. It's a paradox that sugar is the source of our energy and indispensable for living and It is also the slow killer of our body by continuous glycation and aging of our cells. In this context, it is clear that the higher the level of sugar (primarily glucose) in blood there will be higher rate of glycation and quicker the aging process of our body. In a disease like diabetes with long-term high blood sugar levels, there is a higher rate of glycation and the products accumulated in excess have toxic effects causing serious conditions. Such conditions are classified as pathological glycation.

Glycation-induced biological products are known to be responsible for aging, degenerative disorders in the nervous system, diabetes and its complications, deposition of fat in arteries, kidney failure, immunological changes, retinal damage in the eye, skin aging, loss of elasticity, weakening of bones, and even development of some tumors. The inference is aging and death is delayed if the rate of glycation is slow.

Under normal physiological conditions, our body does have the mechanism to clear off the glycated products significantly. However, when a large quantity of sugar gets absorbed and causes a spike in blood sugar level the system gets overwhelmed and there occurs an accumulation of glycated products. To assess the average long-term blood sugar level “Glycosylated haemoglobin” (HbA1C) test is done. During each blood glucose spike, haemoglobin (protein part) gets glycosylated proportionate to the glucose spike. The lifespan of a RBC is 3 months. Thus measuring the HbA1C gives an average of all the spikes in the last 3 months as reflected by the amount of glycosylated hemoglobin, thus the overall picture of control of blood sugar. The key to minimise glycation is - while there must be a steady supply of sugar for the energy needs of our body the rate of input should not be high to cause big spikes in blood sugar.

To achieve this the following steps are important:

●    Taking as much quantity of carbohydrates as per energy needs:

Out of the total calories needed for an individual as per his age, gender, body weight, metabolic rate, activity level, and state of health, carbohydrates intake must be limited to roughly 50% ( 45-65%). Excess carbohydrates mean weight gain and high glycation.

●    Ensure intake of slowly  digested carbohydrates:

1. Choose the correct type:- Simple carbohydrates called sugars (table sugar, gud, honey, maple syrup, etc) get absorbed immediately within minutes and cause a sudden steep spike in blood sugar. Hence these should be strictly restricted if not (ideally) totally eliminated. The complex carbohydrates like starch coming from different grains are digested, broken down to sugars, and absorbed at different rates.Those from which the sugars released at the slowest rate (low glycemic index) are the best. Millets, Quinoa, and oats belong to this category. Hence make these part of the carb quota.

2. Include foods that slow down carbohydrate digestion/absorption - Avoid carbohydrate-heavy meals. Include protein and fat in each meal which slow down carbohydrate digestion and absorption. Fibres present in leafy green vegetables slow down this process. Eat some salads before starting to eat the main meal which forms a layer in the digestive tract preventing quick digestion of carbohydrates.

3. Besides daily routine exercise, do some activity like light strolling for some time after meals to utilise some of the sugars pouring into the blood to avoid a spike.

4. Some studies indicate taking a tablespoon of apple cider vinegar in a glass of water 15 minutes before food slows down the action of carbohydrate digesting enzyme thereby slowing down sugar release in the intestine.

In a nutshell, if we stop taking excess carbohydrates than required, stop taking simple sugars ( limited to taking only natural fruits in moderation), include complex carbohydrates like millet in our diet, and eat enough fibres we can prevent premature aging, metabolic diseases and remain fit.

(The Author is the Former Additional Dy.DG, Ministry of Health, Government of India)

(DISCLAIMER: This is an opinion piece. The views expressed are the author’s own and have nothing to do with OTV’s charter or views. OTV does not assume any responsibility or liability for the same.)