No laddoos this Diwali for Hemant. A tech whiz who moved to Bangalore from California after the proceeds from writing a software program on industrial security and some fourteen patents ensured that he and his wife Sharon need not work for the rest of their lives, Hemant (name changed) started getting restless. He formed his own software company and corralled a few, but well paying, clients.
Sharon, who had worked as a junior programmer in the company Hemant had worked for was from Oregon, and her mother had taught her to whip up a mean strawberry soufflé. Hemant noticed his waistline expanding, even though he never missed his morning run.
The software genius, who worked out in his home gym thrice a week and did yoga with Sharon during the weekends couldn’t understand why he was putting on weight. He drank sparingly (except the Thursday night outs in one of Bangalore’s many pubs) and was careful about what and how much he ate. In two years, the 5’7” Hemant weighed 127 kilos. He couldn’t climb stairs without his knees hurting and his legs creaking. He was constantly tired and slept badly. He would get cramps in his stomach and legs. What started as mild headaches became full-blown migraines. He became irritable and cranky, and one day when he snapped at their two-year-old daughter for singing a nursery rhyme too loudly, Sharon suggested they see a doctor.
“Could be hypoglycaemia, but we should run some tests,” said the doctor. “You look as if you have a blood sugar problem.”
The tests proved the doctor right. Hypoglycaemia occurs due to excess insulin in the blood. It causes the heart to race, produces anxiety attacks and could even lead to permanent brain damage. Goodbye to strawberry soufflé. Sharon put Hemant on a protein rich diet and banned colas, canned juices, dried fruit, potatoes, corn, bananas, rice, pasta, honey and all desserts. No hakka noodles, no pasta. No more beer at the pub. Initially Hemant tripped out, but one day he woke up fresher than he had felt in over a year. He started dropping weight. The aches and pains reduced and Sharon went shopping for smaller sizes for Hemant—what he used to wear when they first met in, ironically in a cake shop. His diet included lots of vegetables, meats and some complex carbohydrates like peas, beans and grain. Sharon gave Hemant just one slice of an apple or four peels of oranges every four hours. Mixed nuts and cheese found a regular place in her recipes. Hemant admits the sugar cravings haven’t gone, and it needs an iron will to pass the bakery without flinching. But he is holding on.
Sugar is sucrose, a molecule composed of 12 atoms of carbon, 22 atoms of hydrogen, and 11 atoms of oxygen. Like all compounds made from these three elements, sugar is a carbohydrate. It’s found in most plants, but especially in sugarcane and beets. India, with 67 million confirmed diabetics and 30 million pre-diabetics, is the world’s biggest sugar guzzler. In a culture where sweets are an important part of any social occasion, the consumption of processed food like colas, chips and chocolates are going vertical yearly. The advent of fast foods and processed items haven’t helped. Pickles, chutneys, sauces and salty snacks contain indecent amounts of sugar. The Indian’s fondness for endless cups of tea has not diminished in spite of the advent of herbal teas, as the per capita consumption of sugar has risen from five per cent of global production to 13 per cent this decade. According to an IMACS report, this is growing at 2-3 per cent per annum. We consume one-third more sugar than entire Europe and 60 per cent more than China. Our yearly sugar intake is around 23 million tonnes. Punjab and Haryana are the largest consumers while Karnataka, at 23. 3 kilos per person, comes last. A Diabetes Foundation study in seven major metros found that 24 per cent of schoolchildren were overweight or obese, with the numbers highest in private schools. Fifty-three per cent ate chips at least once a week; 20 per cent munched on fries; 15 per cent gorged on pizzas and 36 per cent guzzled colas. India’s estimated `60 crore artificial sweetener industry is growing at 20 per cent annually. The government allows the use of artificial sweeteners in around 25 food items that include carbonated water, soft drink concentrate, sugary and sugar free confectionery, chewing gums, biscuits, breads, cakes, pastries and some sweets. Seventy to 80 per cent of the average Indian’s dietary energy comes from carbohydrates including sugars. These calories from sugar are termed ‘hollow calories’ as they lack proteins, vitamins and minerals. “For a healthy diet, reduce or ideally replace refined carbohydrates like sugar with whole grains and fibre,” advises Dr B B Gupta who treats an average of three diabetes patients a week at his Safdarjung clinic in New Delhi.
Kumar Raja (22) of Cuttack, Odisha is a typical example of how unregulated sugar intake can wreak havoc on the body. An engineering graduate, Raja landed a plum job with all the perks as soon as he left college. Very active in his student days, Raja found himself sleeping during the day as he started working as his hours in the IT firm he joined required him to work at night with clients based abroad. Unable to cope with the stress and with spare cash in hand, Raja found solace in aerated drinks, juices, chocolates, sugary cocktails, pastries, sweets and lots of fried spicy food. Four years into his job, he had ballooned by a staggering 17 kilos.
One day, his mother took him to Kanungo Institute of Diabetes Specialities (KIDS) in Bhubaneswar as he complained of extreme weakness and vertigo. It was found that his fasting blood sugar was 370 and 520 after taking food. There was no family history of diabetes but Raja was diagnosed with early onset Type-2 diabetes. He was hospitalised for seven days before being discharged with medication and lifestyle guidance with advice to avoid sweet foods and told to exercise regularly. Six months later, Raja is doing fine after shedding 12 kg.
Sugar is so addictive that recently French scientists in Bordeaux reported that cocaine-addicted rats chose sugar over the drug, leading to the conclusion that the intense stimulation of sweet receptors in sugar-rich diets generates reward signals in the brain causing self-control mechanisms to trip, thus leading to addiction.
It is a self-defeating vicious cycle: a sudden intake of sugar—a chocolate pastry for example—causes insulin levels to rise dramatically. The insulin rids the body of the sugar in the pastry, but blood sugar dips thanks to the high levels of the insulin left in the bloodstream, which leads to more intake of sugar heavy foods. This overload causes the liver to unload more bad cholesterol into the bloodstream, which the body cannot evacuate. The effect of fructose and excess sugar also has long lasting psychological effects. Says Dr Asif I Ahmed, Founder and Chief Psychiatrist, PsyCare and Head of Department of Psychiatry, Sharda University, “Mood change is only one reason from the psychological perspective why people get hooked to various substances. Addictive substances cause instant mood changes and instant gratification, which no human being can replicate.”
Dr M S Paul, Senior Consultant at the Department of Gastroenterology, Fortis Hospital in Vasant Kunj, Delhi remembers a 36-year-old woman who came to see him. At her age and 5 feet height her BMI (Body Mass Index) was 38, which is considered super obese; the optimum range is between 18 and 24. She loved sweets, specially bakery and halvai items. Because of her compulsive sweet tooth, she had not only gained a lot of weight, but also had contracted diabetes. She had to get a knee replacement because of her weight. Her BP was high and her kidneys were so badly affected that she was on the verge of dialysis. “That’s how bad the effects of excess sugar, especially fructose, which is present in many food items, is on the body,” says Dr Paul.
Fructose, the sweetest of all naturally occurring carbohydrates derived from plants is the main culprit. Studies say that its metabolic effects are similar to that of alcohol, depending only on the liver. Since the body doesn’t process ingested fructose completely, it could cause VLDL and triglycerides deposits to rise. The basic assumption behind diets and nutrition advice is that ‘What you eat = What you burn + What stays in your body.’ Ergo, eat less and do more to lose weight. Fructose has got a bad name for affecting appetite, boosting uric acid levels and causing fatty liver and obesity. The World Health Organisation has halved its recommended sugar intake for adults, from 10 per cent of total daily calories to 5 per cent—around 25 grams, or 6 teaspoons, per day for adults. This doesn’t include added sugars such as high-fructose corn syrup and ordinary table sugar in sodas, breads and processed foods. Meenakshi Nair was 15 when she got addicted to soft drinks, while growing up in Dubai. Her consumption steadily grew till there came a time when she was consuming five litres a day. By the time she was 24, her bones had become brittle. “She would break it often, because she had low calcium levels,” says Gayathri Asokan, a Kochi-based consultant nutritionist. “You remember the clip on YouTube which showed how cola made a tooth disintegrate. Meenakshi also has blood sugar variations and mood swings. Finally, she was overweight.”
Unfortunately, many young people are having health problems because of food imbalance. “They tend to consume too much of carbohydrates, and not enough proteins and fibre,” says Gayathri. “I gradually weaned Meenakshi off the cola and provided a nutritious diet.”
This includes having complex carbohydrate foods like idli, sambhar, pulses and vegetables. “I told her to avoid sweets and bread,” says Gayathri. Meenakshi was also told to have pulses, milk, fish and chicken.
Doctors advice that a balanced diet with moderate carbohydrates and with enough protein, fibre and water is needed daily. According to them, empty calorie drinks provide only carbohydrates but if we take lime juice instead it gives vitamin C and buttermilk provides enough protein.
Diabetolosists are worried about the increasing sugar intake of people. Thirty-year-old Rajesh, who works at a multi-national company in Hyderabad consulted Dr Prabhu Kumar Challagali, diabetologist at Care Hospital, with joint pains and a burning sensation in his limbs. He had also gained a lot of weight and developed a bit of a hunch, which his 6 feet of height couldn’t disguise. After having tested for high sugar levels, he was diagnosed as a diabetic. Dr Kumar put him on a basic drug, asked him to cut down on his sugar intake, keep a check on his diet and take a walk every day. He soon lost weight, the pain in his legs and became bright and alert. “There are plenty of cases where patients recovered by simply reducing the intake of sugar. After eating sweets, it is highly important to work out. For the amount of calories you are taking in, it is also important to burn them,” Dr Kumar adds.
Sweet and Sick
The effects of long term consumption of sugar is a natural encourager of diabetes: studies reveal that for every extra 150 calories gained from sugar by a person daily, the possibility of diabetes rises by 1.1 per cent. Added sugars generate excess insulin in the bloodstream, which abnormally accelerates the growth of the smooth muscle cells around each blood vessel, in turn causing tense artery walls that may generate high blood pressure, increasing the chances of a stroke or a heart attack. Type 3 diabetes was discovered by Brown University neuropathologist Dr Suzanne de la Monte who found that insulin resistance, high-fat diets, and Alzheimer’s are interlinked. She contended that Alzheimer’s is a metabolic disease caused by damage to the brain’s ability to employ glucose to produce energy. The link between sugar and obesity has been established—excess sugar consumption disconnects the body’s messages to the brain to fire up leptin hormones, which signal one to stop eating. A high-fructose diet fuels hunger, even when the person is overeating. An American Public Health Journal study that surveyed 9,000 people to study the link between depression and the consumption of sugary sweets and fast foods found that those who ate the most junk food developed a nearly 40 per cent greater risk of getting depression, because in people with insulin resistance, the brain releases lower levels of dopamine, which is responsible for generating the sense of well-being. For the cosmetically conscious, sugar in the bloodstream is deadly for the skin. It attaches to proteins to form molecules called advanced glycation end products (AGEs). These attack and damage nearby proteins, including the fibres in collagen and elastin, which keep skin firm and elastic. This causes it to wrinkle and sag. AGEs fuel the growth of fragile collagen and switches off the body’s natural antioxidant mechanisms, leaving the skin vulnerable to sun damage. So, instead of going under the knife, a sugar de-addiction could be the solution. Sugar also promotes the growth of yeast through fermentation. Hence yeast infections such as oral thrush are caused when the bacteria Candida, that exist naturally in the body— but controlled by the immune system— breaks out when blood sugar is high, in turn making saliva and urine its breeding grounds. Though researchers are yet to link cancer with sugar, it has been established that cancer cells feed on sugar in the body to grow and multiply.
Cracking down on sugar is politically inconvenient as it is India’s second largest agro-processing industry, employing around 2 million from rural areas. It contributes `1,700 crore a year to the Centre and states in excise duty and purchase tax on sugarcane. The sugar industry makes up around 0.7 per cent of India’s GDP. There are around 55 million sugarcane farmers—about 7.5 per cent of the rural population. Uttar Pradesh, Maharashtra, Karnataka, Gujarat, Tamil Nadu and Andhra accounts for more than 85 per cent of the country’s total sugar production with 60 per cent of the total production coming from UP and Maharashtra alone.
Sweet and Sour
Meanwhile, the anti-sugar movement is catching up internationally. London-based cardiologist Aseem Malhotra’s campaign ‘Action on Sugar’ is aimed at exposing the dangers in added sugar in foodstuffs. Social media campaigns are adding to the fizz—a video of a man pouring and drinking a glass of fat from a soda can has got more than 800,000 viewers. Robert Lustig, professor of paediatric endocrinology at the University of California is the leading light of the anti-sugar movement. Posted on YouTube in 2009, his anti-sugar talk has received 4.1million hits and is credited to have created the Anti-Sugar Movement—a campaign that seeks for sugar to be treated as a toxin like alcohol and tobacco.
Experts have calculated that reducing sugar in processed foods between 20 and 30 per cent over the next three to five years would remove 100 calories a day from diets, enough to halt or reverse the obesity epidemic.
In India, the picture is not all that sweet. An ASSOCHAM study on “Indian fast food market new destination: Tier-II & III cities” found that the Quick Service Restaurant (QSR) market touched around `50 billion from `35 bn last year. CRISIL says the QSR market will touch `70 billion by 2016 with pizzas, burgers and sandwiches accounting for over 83 per cent. The food processing industry accounts for over 32 per cent of the total Indian food industry. India’s `50 billion soft drink industry is growing at 6 to 7 per cent annually. Coca Cola will invest $5 billion in India by 2020. In a post liberalization society, where fast food, processed items and fizzy drinks are associated with prosperity and a Western lifestyle, the awareness of the dangers of sugar is growing surely, but slowly. Another ASSOCHAM study predicts that Indian non-carbonated drink market—fruit drinks, nectars and juices—could touch `54,000 crore by 2015 from `22,000 crore today. Indians who enjoy the delights of the sweet tooth are finding its bite deadly. Slowly.
With bureau inputs
Indians should have only five teaspoons of added sugar a day because they are in the diabetes high risk category
Orange juice in cartons
All the fibre has been squeezed out. Just eat the fruit
They deliver sugar but no nutritional value. For kids, stick to water and milk
Watch out for added sugar
It boosts insulin levels, tricking the liver to store energy in fat cells leading to the fatty liver syndrome
cookies and cakes
Use one third less sugar than the recipe says when baking
From Dr Robert Lustig: ‘Fat Chance: The Bitter Truth About Sugar’
Added sugar is 11 times more powerful in causing diabetes than general calories
To make low fat foods palatable, manufacturers use added sugar in it
GOOD AND BAD SUGAR
Glucose is the form of energy that sustains man. Every cell living thing on the Earth uses glucose for energy. Sucrose has been supplanted by fructose because it is cheaper to make.
Fructose in itself isn’t bad, but it’s the excess of it in food that is making people unhealthy. In vegetables and fruits, it is mixed in with vitamins, minerals and enzymes. 25 percent of people consume more than 130 grams of fructose a day. Low-fat diet foods are often highest in fructose. The body metabolises it differently from glucose, leaving it to the overworked liver.
Colas, white flour, white rice, bread, potatoes, pasta, chips, cheese spreads, ketchup, mayonnaise, cured meats, breakfast cereal, energy bars. Most processed foods contain sugar in various forms. Salad dressings and sauces may also contain sugar. There is hidden sugar in high fructose corn syrup, cane sugar, glucose, lactose, maltose, dextrose, malt syrup, molasses, agave nectar and brown rice syrup.
THE HIDDEN CULPRITS
Beet sugar because most of it is genetically modified
Rice syrup which is found in cereal bars and organic food because it introduces inorganic arsenic in the food
Brown sugar is just as bad as white
Buttered sugar found in cookies and icing and frosting on cakes combines the fat and cholesterol content of butter with sugar
Cane juice sugar found in baked goods is no different from refined sugar
Cane juice has high sugar content and is mostly swarming with bacteria
Cane sugar causes BP and cholesterol to rise adding to insulin resistance
Date sugar is less harmful than sugar but every 7 gram date holds 5 grams of sugar
Caramel is high in carbs and calories
Caster sugar used in baking and mixed drinks is only sugar in a finer form
Coconut sugar found in diabetic sweeteners is high in calories and low in nutrients
Corn sweetener found in cough syrups and antacids
Corn syrups and solids found in sodas, fast food and coffee creamers are high in carbs
Crystalline fructose found in ice cream and fruit flavours lead to high fat content in the blood and liver disease
Artificial sweeteners: Aspartame is found in foods labeled “diet” or “sugar free”. It accounts for more reports of adverse reactions, than all other foods and food additives combined. Aspartame is a neurotoxin and acarcinogen. Known to erode intelligence and affect short-term memory, the components of this toxic sweetener may lead to a wide variety of ailments including brain tumour, lymphoma, diabetes, multiple sclerosis, Parkinson’s, Alzheimer’s, fibromyalgia and chronic fatigue, emotional disorders like depression and anxiety attacks, dizziness, headaches, nausea, mental confusion, migraines and seizures.
High Fructose Corn Syrup (HFCS)
This highly refined artificial sweetener is found in almost all processed foods. It packs on the pounds faster than any other ingredient, increases your LDL (“bad”) cholesterol levels and contributes to diabetes and tissue damage.
Monosodium Glutamate (MSG/E621)
An amino acid used as a flavour enhancer in soups, salads, dressings, chips, frozen entrees and many restaurant dishes. It is an excitotoxin—a substance which overexcites cells to the point of damage or even causing death. Studies show that regular consumption may result in depression, disorientation, eye damage, fatigue, headaches and obesity. Found in Chinese food, chips, cookies, seasonings, most Campbell Soup products, frozen dinners, luncheon meats.