Alternatives to Sugar?

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White sugar is the commonest sweetener used in our daily life. From morning coffees to evening tea, sugar plays a very crucial role in our cuisine. But the sweet lifestyle is also the main reason for increase in obesity, diabetes and other health problems among us.

"brown sugar is not healthier than white sugar, as the mineral content is very little to have any beneficial effect"

Sugar is made out of sugar beet, a type of plant which contains a thick syrup that’s converted to sugar. Refinery processes remove molasses (a dark brown by product) and the thick dark syrup is converted to white sugar. If the molasses is left in the mixture, then brown sugars are made.  

Brown Sugar VS White Sugar

The difference between White Sugar and Brown Sugar is the refinery process involved as mentioned. Brown sugar has some molasses left, while white sugar is well refined.

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In terms of nutrient content, brown sugar has more minerals compared to white sugar. Thanks to molasses it has iron, magnesium and other mineral whereas white sugar has none. Calorie value of both types of sugar are the same. So, one teaspoon of white sugar gives same amount of energy as white sugar, and increases blood sugar level equally.

Essentially, brown sugar is not healthier than white sugar, as the mineral content is very little to have any beneficial effect.

Alternatives to sugar

Honey

Is honey a healthier alternative to sugar?

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The short answer is no. 

Honey contains sugar too. Before the creation of sugar from sugar beets or sugarcane, honey was used as sweeteners. The calorie value of honey is almost similar to sugar, if not more depending on the manufacturing process. But honey also contains many vitamins especially Vitamin B and minerals such as calcium.

"The calorie value of honey is almost similar to sugar, if not more depending on the manufacturing process"

So, adding honey instead of sugar might give the additional benefits of vitamins and minerals but it does not make much difference in terms of calorie and the rise in blood sugar level. 

Thus honey is not a good alternative for people with diabetes or those who want to prevent diabetes.

Artificial sugar

Artificial sugars such as saccharin and aspartame (Equal brand) are commonly used as sugar alternatives. How does it work?

Artificial sugars are not absorbed in our gut, thus it carries zero calorie. It does not cause an increase in blood sugar level.

Aspartame has been heavily used until studies suggested the linkage between artificial sugars and cancers, especially bladder cancer and blood cancers such as leukemia. Association of bladder cancer in rats with saccharin (a type of artificial sugar) was first reported in 1978 by Reuber MD. 

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He reported that high dose of saccharin leads to bladder cancer in rats. In response to this, the US Congress mandated that saccharin carries a hazard label stating it’s possibly hazardous for consumption at that time.

But many other studies fail to prove the same among humans. It was found that rats respond to chemicals in the urine differently than human, so humans have no risk of bladder cancer when saccharin is consumed.

What about Aspartame? 

Heavy artificial sweetener use (>1680 mg per day) leads to an increased relative risk of 1.3 for bladder cancer in humans

Aspartame is the common artificial sugar used in brands like Equal. Aspartame has been linked with blood cancers previously but many subsequent studies have failed proof that claim.  A review on artificial sugars in Annals of Oncology concluded that there is no risk of cancer by using Aspartame or Saccharin as artificial sugar. 

But the author also warned that “Heavy artificial sweetener use (>1680 mg per day) leads to an increased relative risk of 1.3 for bladder cancer in humans” but no specific artificial sweetener can be identified as the culprit. For comparison, one packet of Equal brand artificial sugar contains 1000mg of sugar. FDA recommends us not to take more than 40mg/kg of aspartame.

According to American Cancer Society, after looking at several strong researches, people who drink aspartame containing beverages did not have increased risk of cancers.

So, the studies are controversial. Most say it’s harmless, some say it’s harmful.

But are they beneficial? Not many scientists agree that it is. For example, Swithers SE in Appetite journal argue that artificial sugar is not the answer to reducing the prevalence of obesity among children. 

He claims that artificial sweeteners will lead to overeating as people won’t be worried about adverse effects of sweetened food or beverage anymore.  A team of scientists recently discovered that artificial sweeteners can actually lead to diabetes by causing changes to the bacteria that live in our digestive tracts. 

This is supported by Taylor Feehley from University of Chicago, who wrote a commentary piece on this issue. She mentions that “artificial sugar consumption correlated with disease markers linked to obesity, such as elevated fasting blood-glucose levels and impaired glucose tolerance”. Both are related to diabetes mellitus.

In conclusion, there is no evidence based healthier alternatives to sugar. Honey and brown sugar are often called as natural sweeteners and people assume it’s healthier than white sugar. It is not. Artificial sweeteners on the other hand do provide zero calorie sweetness but it’s safety is very controversial, till today.

The best method would be to reduce the amount of sugar in our food and be mindful of what we consume. We must keep in mind high carbohydrate diet also be converted to sugar in our body. So, even if we go sugar-free, we still need to keep in mind on how much carbohydrate we consume per day.

For further reading

1.       FDA Article on Artificial sweeteners

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm397711.htm

2.       Review on Annals of Oncology on artificial sweeteners

http://annonc.oxfordjournals.org/content/15/10/1460.full

3.       Artificial Sweeteners linked to change in gut microbiota

http://www.ncbi.nlm.nih.gov/pubmed/25231862

4.       Artificial Sugars and Childhood obesity

http://www.ncbi.nlm.nih.gov/pubmed/25828597

5.       American Cancer Society on Aspartame

http://www.cancer.org/cancer/cancercauses/othercarcinogens/athome/aspartame

6.       Commentary on artificial sweetener

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449731/

Anti-oxidants

What are anti-oxidants? 

Anti-oxidants work against oxidants, or more correctly Reactive Oxygen Species(ROS). 

As we know oxygen is vital for us. But in our body, oxygen molecules can turn into ROS and damage our cells.  ROS is a group of reactive molecules that contain oxygen, and is unstable. Thus to achieve stability it tends to react with our cells, protein, enzymes and other molecules. These reactions often cause damage to our cells, and this damage is called “oxidative stress”. 

Oxidative stress means our body has no sufficient anti-oxidant to fight off the reactive oxygen species. Thus we have damages occurring to our DNA, proteins and other cells.  

It’s widely believed that consuming a large amount of anti-oxidants will reduce the oxidative stress. 

How true is this? 

Food that are rich in Vitamin A, E and beta-carotene are often cited as anti-oxidant food.  

Vitamin A and E are fat soluble vitamin, and is found in very high levels in fruits such as oranges and pineapples. Additionally, many among us take supplements in form of tablets to ensure the take sufficient vitamins every day.  

Anti-oxidants and heart 

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Heart issues are a main concern now in developed countries. We are seeing an increasing trend of obesity and heart problems often accompany it. Selenium gained popularity as anti-oxidant with the capability to reduce atherosclerosis (hardening or blood vessels in the heart with fat). 

Selenium is a trace element found in many food. Tuna especially has 92 mcg per serving of selenium. Many other dairy products and cereal have high amount of selenium as well.  

Is selenium effective in preventing heart disease?  

A group of researchers from Cochrane collaboration pooled 12 researches that were done on this topic. After carefully looking at all the studies done on this issue, they concluded that selenium has no benefits in reducing heart diseases. But interestingly, selenium is reported to increase the risk of getting diabetes mellitus. But the risk is not strong enough for us to have any firm conclusion.  

But, we can safely conclude that as of now, Selenium has no benefits nor risk in regards to cardiovascular health. The authors of the research paper concluded that it’s not necessary for a well-nourished adult to take Selenium for heart protection.  

Vitamin E is also a fairy popular anti-oxidants taken by many. Another study done by a group of scientists from UCLA, pooled a total of 84 researches done on effect of Vitamin E on cardiovascular health. Again they concluded that Vitamin E supplementation does not protect us from heart problems.  

Anti-oxidants and Cancer 

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Vitamin A is found in food like fish oil, milk and egg. Does it help in cancer prevention? One group of scientists looked into the claim of Vitamin A being a protective agent against bladder cancer. They concluded that eventhough the researches are showing Vitamin A to be protective against bladder cancer, no consensus can be reached in regard to how much Vitamin A is needed and what’s the best way to take it.  

Furthermore, do we all have to take Vitamin A to prevent bladder cancer? Who are the ones with high risk? Without answering these questions, taking Vitamin A daily might not be very beneficial. Not much studies have been reported for other types of cancers.  

In conclusion, taking supplements for its antioxidant activity has not been proven effective in preventing illness especially heart diseases and cancer. But daily requirement of vitamins in the form of food should be taken regularly as a general health measure.  

For further reading:  

1. Selenium – Health Info 

https://ods.od.nih.gov/factsheets/Selenium-Consumer/ 

2. Vitamin A – Health Info 

https://ods.od.nih.gov/factsheets/VitaminA-Consumer/ 

3. Vitamin A and Bladder Cancer 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030017/ 

4. Vitamin E and cardiovascular health 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1492195/ 

5. Selenium and cardiovascular health 

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009671.pub2/abstract

Benefits of OatMeal

Oatmeal comes from Oat plant (Avena sativa). It’s heavily advertised as the meal of fitness and we have seen many brands adding oats to their food in order to appear healthier. How much of oatmeal we need to consume per day to achieve the benefits stated? Is there any evidence behind the health claims of oatmeal?   

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1. Does eating oatmeal reduce cholesterol level?

The short answer is yes. There are three types of cholesterol level that we are concerned about. LDL, HDL and Triglyceride. LDL & Triglyceride also known as the “bad” cholesterol are the ones responsible for accelerated hardening of our blood vessels (atherosclerosis). With the hardening of blood vessels, there is a higher chance of getting stroke or heart attack.

HDL on the other hand, is the “good” cholesterol. It helps in preventing the hardening.

So, the aim is to increase HDL and reduce LDL along with Triglyceride. Many claim that oatmeal is capable of doing that. A research by Thongoun et al proved that eating oats everyday for 4 weeks, reduced the total cholesterol level by 5%, and LDL by 10%. That sounds promising. Patients included in the study were all those with high cholesterol level, thus it’s more applicable for those with the problem.

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Researchers from Cochrane Heart group looked at 10 studies done on this matter, and made scientific calculations on how beneficial oatmeal really is in reducing cholesterol level. These sort of “calculation” is known as meta analysis, and it’s regarded as the highest level of evidence.

They concluded that people who eat oatmeal   had lower level of total cholesterol and LDL cholesterol. But they cautioned that “many of the studies done on this matter were short term, of poor quality and doesn’t have sufficient power. Most of the trials were funded by companies with commercial interests in wholegrains.”

Another group of scientists from Chengdu, China specifically looked at how oatmeal helps in people with diabetes mellitus. They included 16 articles on studies that looked at oatmeal’s ability to reduce cholesterol and blood sugar level in people with diabetes mellitus. They discovered that oatmeal consumption is able to reduce blood sugar level, total cholesterol, LDL cholesterol as well as slightly reducing Triglyceride.

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2. Oatmeal and colon cancer

Oatmeal helps in reducing constipation, simply because it’s an soluble fibre.  It is not well absorbed by our body, so it stays longer in the colon. In colon it absorbs water and makes the stool heavier,thus helping in preventing constipation. But is there evidence that soluble fibre prevents colon cancer?

Oatmeal and other wholegrain food have shown some benefits in patients with colon problems as well. A paper published by British nutritionists looked at 28 articles on benefits of oatmeal in colon patients. The group of scientists concluded that there is no evidence to suggest that oatmeal and other wholegrain meals can prevent colon cancer or reduce symptoms in other bowel disorders.

How to prepare oatmeal to benefit maximum from it?

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Researchers from China looked into the best method of oats preparation. After studying the effect of oatmeal, they concluded that boiling oatmeal makes the oat better at reducing blood cholesterol level compared to brewing. There are many ways to prepare oatmeal, some prefer to add fruits, or milk for flavor and additional nutrients. 

In conclusion, small scale studies with short follow up time do show some benefits for oatmeal in reducing cholesterol level and preventing colon cancer. However there is no strong evidence to suggest oatmeal being useful in reducing cholesterol level and preventing colon cancer. Hopefully more researches in future will show strong evidence.

For further reading:

1.       Oatmeal & Bowel Diseases

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9362077&fileId=S0007114514002293

2.       Oatmeal and Cholesterol reduction

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005051.pub2/ful

3.       Oatmeal preparation

http://www.ncbi.nlm.nih.gov/pubmed/26498197

4.       Oatmeal in Type 2 Diabetes Mellitus

http://www.mdpi.com/2072-6643/7/12/5536

Fibre in Food- What's good about it?

What is fibre?

Fibre is an indigestible form of carbohydrate that is found in both plants and nuts. Some are soluble making it possible to be absorbed into our body system after consuming it, while others are not. It is found in many plants and nuts in varying amount.

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There are two types of fibre. Soluble, and insoluble fibre.

Soluble fibre is found in many beans and some fruits. It’s called soluble because it dissolves in water and forms a gel like material in the intestine. This gel like material binds to fatty acid and bile acid, thus reducing blood cholesterol level. Soluble fbres help in reducing rate of digestion. When the digestion process is slowed, it reduces spikes in blood glucose level. 

This helps in regulating body sugar level which is beneficial for people with diabetes and prevent high sugar level in others.

Several studies have backed this effects of soluble fibres. This positive effect of preventing the rapid rise of blood sugar has been shown by many research studies. Recently, a group of scientists from Warwick Medical School looked at 23 scientific studies done on the effects of fibres on blood cholesterol level as well as blood pressure. 

"aiming for 30g of soluble fibre per day has been proven to reduce blood cholesterol level and help in blood sugar control"

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They concluded that increasing dietary fibres improves blood cholesterol as well as surprisingly reducing diastolic blood pressure.  Diastolic blood pressure is the denominator of the blood pressure reading, and it’s best kept below 90mmHg to prevent the heart from pumping too hard.

What is the role of Insoluble Fibre?

while this form of fibre does not dissolve to be taken into the blood stream it has benefits on stool formation. One consumed it works in the large bowel by absorbing water and contributing to ‘bulking the stools’. This relieves constipation.

Where do we get fibres from?

Best method of getting the fibre is by eating the food rich in fibre. Recommended fibre intake by the US Department of Health is 14g per 1000 calorie. This roughly translates to about 28 to 35g of fibre intake per day, depending on your calorie intake.

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So which food has the highest amount of fibre? Navy beans contain the highest amount of fibre. According to US Department of Health, cooked navy beans have 9.6g of soluble and insoluble fibre in half cup. 

Apart from fibre, navy beans are also filled with Vitamin C, Vitamin E and Iron. Chickpeas are also rich in fibres. It contains 8.1g of fibre in ½ cup.

Locally available fruits such as papaya and durian are rich in fibre too. Banana contains 3.1g of fibre in each. Papaya has 2.1g of fibre, and durian has approximately 1g of fibre in each of its seeds.

As we know , soluble fibre is more effective in controlling blood cholesterol level along with reducing blood sugar. Among fruits, passion fruit has the highest amount of soluble fibre with 6.5g of fibre per 125ml juice. Avocado contains 2.1 g of fibre in half fruit.

In conclusion, aiming for 30g of soluble fibre per day has been proven to reduce blood cholesterol level and help in blood sugar control. Let’s choose fibre rich food to be added in our diet and live a healthy life!

For Further Reading

US Dietary Guidelines 2015 –http://health.gov/dietaryguidelines/2015/

Food Sources rich in soluble fibre, by Dietitians of Canada - 

http://www.dietitians.ca/Downloads/Factsheets/Food-Sources-of-Soluble-Fibre.aspx

Systemic review on dietary fibre’s effect on cardiovascular health http://www.ncbi.nlm.nih.gov/pubmed/26758499