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DOI: 10.21276/sjm.2016.1.2.2
29
Review Article
Saudi Journal of Medicine ISSN 2518-3389 (Print)
Scholars Middle East Publishers ISSN 2518-3397 (Online)
Dubai, United Arab Emirates
Website: http://scholarsmepub.com/
Effect of sugar intake towards human health
Varucha Misra1*, A.K. Shrivastava2, S.P. Shukla3, Mohammad Israil Ansari 4
1,2,3ICAR-Indian Institute of Sugarcane Research, Lucknow-226 002, U.P, India
1,4Amity University, Lucknow Campus, U.P, India
*Corresponding Author:
Varucha Misra
Email: misra.varucha@gmail.com
Abstract: Sugars belong to glycan/carbohydrate group of chemicals. Realisation of their sweetness was earlier as
compared to its use as an energy source and an important dietary component. Although sugar is vital for defraying many
physiological functions of our body properly, “Sweet tooth” or “Craving for sugar” is of common occurrence in children.
Of late, we have realised that an excess consumption of sugar is harmful leading to various elements affecting our health,
more so in children and women. So one should not only be careful while consuming excess amount of sugar (more than
the recommended) in one’s diet, but rather advertently avoid it.
Keywords: essential, excess consumption, harmful, health, nutrition, sugar.
INTRODUCTION
Sugars are polyhydroxy aldehydes/ketones
belonging to glycans/carbohydrate group. By providing
energy currency, ATP and some other beneficial
physiological activities of the body, the carbohydrates
have earned the sake of macronutrients which are found
in several foods and beverages. The main function of
carbohydrates is to offer energy to the body for its
functioning and physical activities, utilizing glucose as
its source. This instant energy is fulfilled by intake of
sugars. Besides this, a therapy used for overcoming
chronic back pain termed as Prolotherapy indulges
sugar (glucose or dextrose) in injections for relieving
pain [1]. In addition to, many drugs consists of glycans
(type of sugar) as an essential ingredient. Drugs such as
heparin (used for treatment and prevention of blood
clots in veins, arteries or lungs), erythropoietin, some
anti-flu drugs and drugs treating against cancer contain
glycans [2]. Even though there are many uses of sugar
but yet the fight of sugar being a friend or a foe,
irresolvable, continues to be. In certain aspects, sugar is
considered to be a foe, yet its complete absence in our
diet will affect our health to a great extent. Thus, this
review highlights the effect of sugar intake (beneficial
or harmful) on human health.
Role of sugar in body and effect of its intake on
human health
Our body would cease to function properly if
there is no sugar intake. Naturally occurring sugars
causes huge profits in our diet like, sugars found in
fruits, lactose, milk sugar, etc. However, the sugars
called as “added sugars”, viz., sugars added during
processing of food, beverages and other preparations
are harmful to our body [3] while the “essential sugars”
are the carbohydrates required by the body in up-taking
nutrients from its source. Basically, the latter, its
nutrients are recognized as glyconutrients obtained from
fruits and vegetables [4]. Intake of the fruit sugars does
not harm our body, as besides fructose it also contains
fibers as well as some other nutrients. The fructose
provides our body with a quick energy while fibers
counterbalances the fructose effects, leading to long
lasting energy to body. Sugars in dairy foods are also
beneficial for our body as they provide us with other
nutrients too. Certain complex carbohydrates like whole
grains and starchy vegetables also contain some healthy
sugars and other nutrient fibers [5].
Some common types of sugar that we
generally consume in our diet and their effects on our
body health are given below –
Glucose-Consumption of glucose stimulate pancreas to
secrete insulin. This increase in insulin signals by brain
which instructs to stop eating as we had enough of it.
There are many processes going in our body after
consuming glucose but one that occurs in the liver
produces very low density lipoproteins (VLDL) that
causes cardiovascular disease in our body. However,
about 1 out of 24 calories of the glucose we consume is
processed in the liver and gets converted into VLDL
[6].
Sucrose and high fructose corn syrups (HFCS) –
Both sucrose and HFCS contain a large amount of
fructose (50% in sucrose and 55% in the HFCS). Intake
of these sugars is harmful to our body because fructose
Varucha Misra et al.; Saudi J. Med.; Vol-1, Iss-2(Jul-Sep, 2016):29-36
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is metabolized only by liver that means a large amount
of VLDL is produced along with fats. Also, intake of
these sugars cannot be controlled by brain as brain
resists leptin (a protein for energy intake regulation and
to check the efficacy of metabolism). This does not
mean that intake of these sugars is always harmful. In
case of athletes, intake of HFCS leads to accumulation
of glycogen in their liver which is used later in their
exercises or athlete activities. This vouches that intake
of HFCS is beneficial to persons performing higher
physical activity and requiring instant energy [6].
Fucose- It is exclusively found in large amounts in
human breast milk, sea kelp, Brewer’s yeast and even in
some of the mushrooms. L-fucose (6-deoxy-L-
galactose), a monosaccharide, is found in N- and O-
linked glycans and glycolipids produced by mammalian
cells. These are important in blood transfusion,
selection–mediated leukocyte-endothelium adhesion,
host microbe interaction and ontogenic events. An
alteration in their expression is associated with
pathological conditions like cancer and artherosclerosis
[7]. Intake of this sugar encourages long term memory,
prevents respiratory infections and growth of tumors.
Besides, they also act as powerful modulators for
immune system [8]. Glycoproteins and glycolipids
associated with this sugar are vital for toning immune
system as well as controlling inflammation [9]. This
sugar execute antibodies function as well as that of
major histocompatibility complexs (MHCs), platelets,
interaction of egg-sperm or connective tissue health,
exchange of substance across and building up of tissues.
It also performs some hormonal functions like follicle
stimulating hormone while the latter perform cellular
membrane functioning in exchange of substance as well
as interactions between the cells such as tissues build–
up [10]. Lack of this sugar is associated with
rheumatoid arthritis. In patients suffering from ailments
like cystis fibrosis, diabetes, hepatic disorders, low
levels of fucose are observed. Fucose is also important
in extruding herpes virus from body [11].
Administering, this sugar also reduces wrinkles by
thickening the skin and their hydration.
Brown algae and some sea weeds (mozuku,
kambu, bladder wrack, wakam, hijiki) as well as
animals like sea cucumber contains fucoridan
polysaccharides which are used in some dietary
supplements [12].
Galactosamine- These are found in shark cartilage and
crustacean shells and also in some red algae
(Phaeophyceae). Although it is least essential, but helps
intercellular communication. Administering these
sugars help in regulating immune system and
inflammation. It is also necessary for proper health of
joints. Its low levels are associated with cardio vascular
diseases [13].
Glucosamine- This glyconutrient is helpful in
maintaining health of the joints. Being precursor of
cartilage, it helps in managing osteoarthritis problems
and is. In shark cartilage and crustaceans shells found as
galactosamine. Administer when in our body some of it
gets oxidized while the remaining ones are converted
into glycoproteins and glycolipids [13].
Galactose- This sugar which is found in milk is
composed of lactose- a disaccharide in combination
with glucose (nearly 5% solids in dairy products). This
sugar is also present in variety of fruits, vegetables and
also in some herbs [13]. Galactose helps in speedy
healing up of injuries, aids in absorption of calcium and
improve their memory power [14].
Mannose- Mannose is an integral component of our
immune system. Lack of this sugar leads to
inflammation and some diseases. As compared to
glucose it is absorbed in the body at a relatively slower
rate. After absorption it directly enters bloodstream. It is
found in Aloe Vera, sea kelp, beans, capsicum, cabbage,
eggplant, tomatoes, turnips, currants some mushrooms
and Aloe Vera, the latter being main source of it [13].
Neuraminic acid or N-acetyl–neuramic acid (or
NANA) - A unique sugar found in colestrum, is the first
ever food a mammalian gets after his/her birth from
his/her mother. This sugar is vital constituent of
gangliosides present in grey matter of brain. The
Follicle stimulating hormone (FSH) needed for
ovulation also contains it. Besides, this sugar also
distinguishes mammals from animals groups of other
animals [15].
Xylose- Xylose, an aldo-pentose, found in embryo of
most edible plants and is known for preventing
digestive tract cancers. It is found in a number of fruits
and vegetables, and to name few are Aloe Vera,
blackberries, broccoli, eggplant, green beans, guava,
pears, peas, raspberries, sea kelp and spinach [13].
Sugar metabolism in the body
Every cell in our body requires energy for its
physiological activities and this is accomplished by
enzyme catalyzed oxidation of the sugar. The flow of
sugars in our body takes place as follows:
Glucose (sugars) small intestine
blood stream Insulin liver and other tissues
Sugar molecules after reaching the cells in
liver and tissues of our body could be metaboilsed by
HSK pathway (glycolysis) and TCA cycle and various
intermediates to synthesize a number of molecules that
help various metabolic activities and storage [16]. After
being processed by the digestive system and subsequent
metabolism, the sugar gets converted into glycoproteins
and glycolipids. In animal cells, cell membrane is
Varucha Misra et al.; Saudi J. Med.; Vol-1, Iss-2(Jul-Sep, 2016):29-36
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composed of glycoproteins and glycolipids, sugars and
fats. Both of these (glycolipids and glycoproteins) form
tiny antennae on cell wall, which serve as a
communication between cells and also absorb and
process nutrients, enzymes, hormones and various other
chemicals required for the activity of our heart, healing
in skin, taking cure of bacterial infections,
arteriosclerosis, Alzheimer’s and Parkinson’s diseases
[13].
Glycans are linear or intricate or branched
chains of sugars moieties occurring in our body,
composed of few to dozens of sugar molecules. The
study of structure, biosynthesis and biology of
saccharides is called as glycobiology while the
systematic study of all glycans structures of a cell or
gangilion is known as glycomics. Glycans regulate the
proper folding of proteins ensuring their proper
functioning. Glycans also serve as ZIP codes, to direct
the newly synthesized proteins to proper place of their
use in the body. Some of them also act as anchors to
attach viruses on cell surfaces signaling to immune
system and ensuring proper brain functioning [17].
As soon as we consume sugar, the primary
function is to provide us with energy for our brain and
nervous system that regulate performance of daily
activities [18]. Besides, there are several other
necessary reasons for us to consume of sugar in our
diet. Some of these are-
Metabolizing fats: Thus preventing use of proteins
for energy in our body which are otherwise
required as structural constituents.
Reservoir source of energy: Glucose can be stored
in liver in form of glycogen which act as reservoir
of energy. This energy is used up by the body
during exercise or when glucose is not available as
energy source. Their reservoirs also maintain our
blood sugar level stable.
Energy source for brain and muscles- An adult
brain uses about 140 g of glucose/day, viz viz., half
of the total dietary carbohydrate consumed for its
functioning. Studies have shown that sugar
sweetened beverage or carbohydrate meal are
associated with enhancing mental ability such as,
improved memorizing power, reaction times,
attention span and arithmetic ability. Also, it
encourages cognitive effects and even reduces
fatigue [19, 20]. Driving test using automobile
stimulators have indicated that for a long distance
(about 120 km) test, persons undertaking test after
consuming sugars committed less error than the
ones having water alone [21].
In addition to, intake of sugar activates two
hormones/neurotransmitters of the brain and
serotonin (feel good hormone) and beta -endorphin
which serve as pain reliever and overcoming
anxiety.
Maintain body temperature [22].
Production of myelin- It is a sheath around axon of
a neuron and insulating it for proper functioning of
nervous system. It is composed of 70-85% lipids
(glycolipid, galactocerebroside) and 15-30%
protein. Myelin formation requires glucose as well
as its derivative, glucosamine [22].
Transportation of monocytes- Monocytes are the
largest known leucocytes (WBCs) and an essential
part of the immune system. Intake of sugars helps
in their transportation [22].
Muscle formation- Muscle is a connective tissue of
the animals, filaments of which contain actin and
myosin. These slide past over one another; provide
contraction, maintains posture, movement,
locomotion as well as function of the interior
organs. Glucose and its derivative glucosamine are
essential for formation of muscle [22] as well as
keeping our muscles lean [18].
Skin formation- Skin is the outer protective and
sensory (for touch, heat etc.), covering of our body.
Collagen and elastin, the two main constituents of
the skin, require glucose as well as glucosamine for
its formation. A lack of sugar in our body causes
our skin to age early or speeds up ageing [22].
Fucose, by stimulating elastin formation,
deposition and maintaining density of fibres
improves skin elasticity [23].
Fig-1: Symptoms associated with low or no intake of sugar in diet.
Varucha Misra et al.; Saudi J. Med.; Vol-1, Iss-2(Jul-Sep, 2016):29-36
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Lack of sugars in the diet leads to low blood
sugar level which cause a number of problems like
restlessness, distracted, feeling hungry and weakness.
Some other observed symptoms include chills, lack of
coordination, sweating and clammy skin. Persons on
low sugar diet for longer time also experience blurred
vision, headache, confusion and difficulty in performing
even simple tasks. They may experience nightmares and
crying (while sleeping) [24] (Fig. 1).
Contrary to the common myth that consuming
sugars in our diets causes diabetes the fact is otherwise.
Although diabetes is occasionally related to increase in
blood sugar levels yet it has no association with sugar,
per se. A recent study in Sri Lanka, however, has shown
a correlation between per capita sugar consumption and
prevalence of diabetes mellitus in various countries.
The countries consuming relatively more of sugars were
relatively more prone to this metabolic disorder. The
correlation was found to be rather more in the Asian
countries (r= 0.660, p<0.001) as well as South East-
Africa (r=0.916, p <0.001). In Asian countries, Central
Asian countries (r=0.968, <0.001) exhibited relatively
higher correlation in comparison to the South Asian
countries (0.684, p<0.050) [25]. Homeostatic
mechanism maintains the normal range of blood sugar
levels in the human body. Any disturbance in this as
well as malfunctioning or failure of pancreas could lead
to increase in blood sugar levels. The pancreas of the
person having a pedigree of diabetes is less efficient. If
the pancreas produces less of insulin due to its
malfunction then the person suffers from diabetes (DM
type I) but if cells of body does not respond for insulin
production then the person suffers from diabetes (DM
type II). Besides, in women, in family way not having
otherwise detected for diabetes, if insulin is not
produced in requisite amount then the women suffers
with diabetes of gestational type [26]. Thus, in such
patients this process gets aggravated with intake of
more of sweets and more fats containing eatables.
However, people with normal health conditions may not
suffer with these by consumption of sweets and fat-rich
foods [27].
It is well known that excess of everything is
bad and so is true for the sugars as well. Higher
consumption of sugars leads to several health problems
or accelerate and may give rise to many diseases (Fig.
2). Sugar intake is solely not responsible for its harmful
affect on human health but improper functioning of
glands and organs are equally important.
Following are some of the recognised important
health related foes associated with higher dietary sugar
intake:
Suppression of immune system [28].
Defence against bacterial infection- By
impairing functions of WBCs is impaired [29].
Disturbed mineral and vitamin balance in the
body [30].
Chromium deficiency [31].
Disturbs role of calcium, magnesium in body
[31].
Macular degeneration of eyes [32].
Ageing- Sugar molecules enter into the blood
along with proteins and produce some harmful
molecules, AGEs (Advanced glycogen end
products) which damage elastin and collagen,
making the skin fragile and affect its firmness.
AGEs also neutralise the anti-oxidative
enzymes protecting the skin from harmful sun
rays and ultimately our skin ages [33].
Causes inflammation [28].
Lack of Matching Insulin activity [28].
Sucrose intolerance- It is sucrase enzyme that
metabolises sucrose in the body; and when it is
not produced in small intestine in sufficient
quantities, sucrose intolerance occurs. As per
Wikipedia, the latter could be visualised by
abdominal cramps and bloating, diarrhea and
constipation, hypoglycemia and headache,
poor growth, viral infection in the upper
respiratory tract, anxiety, etc. The people of
Alaska are more prone to sucrose intolerance.
It is also called as congenital sucrose-
isomaltase deficiency or even as sucrose
isomaltase deficiency [34]. Some other
intolerances met with sugars are fructose
intolerance (due to deficiency of fructose
carrier in enterocytes), trehalose intolerance
(due to lack of enzyme trehalase), lactose
intolerance (when a person is not able to
digest milk sugar (lactose), due to lactase
enzyme non-availability) and glucose-
galactose intolerance (a rare disorder, where
only fructose is digestible) [35]. It may be
sometimes called as sugar malabsorption.
Sucrose allergy due to the malfunctioning of
the immune system.
Sugar sensitivity- Due to unstable blood sugar
levels, low levels Serotonin- a feel good
hormone, and beta-endorphin- the reliever for
pain and anxiety [36].
Increase levels of triglycerides elevating
cholesterol levels leading to cardiovascular
diseases [37].
Damage to the structure of DNA: There is a
positive relationship between sugar
consumption and oxidative damage to the
DNA [38]. A study conducted on 5309 healthy
adults ranging between 20-65 years, whose
diets consisted of sugar sweetened beverages,
revealed that length of the telomeres (the
protective DNA caps at the end of a
chromosome) reduced [38].
Increase in uric acid (hyperuricaemia) in body
causing increased blood pressure, probability
of heart attacks and CVDs [39].
Varucha Misra et al.; Saudi J. Med.; Vol-1, Iss-2(Jul-Sep, 2016):29-36
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Association of excess sugar consumption with
other diseases like cancer [40-46], obesity [47-49],
Tooth decay or dental caries [51-54], Arthritis
(rheumatoid arthritis, gout and osteoarthritis) [55],
cardiovascular diseases [56], encourages yeast infection
(Candida albicans) [57], association with memory loss
and brain functioning [58-59], atherosclerosis [60],
cataract and myopia (short-sightedness) [62], etc.
Fig-2: An overall affect of intake of normal and other sugars and glycans in human body
Consumption of excess sugars causes some
diseases in men or women; and in children, as a group, excess intake of sugars also causes some diseases (Fig.
3).
Fig-3: Overall negative effects of excess sugar intake in women, children and men: Women are more affected by
excess consumption followed by children and men.
For men, American Heart Association (AHA)
has recommended average consumption of sugar to be
150 calories per day which is equivalent to 37.5 g or 9
tsf [63]. Increase in this amount may lead to exclusive
problems in men like increases estradiol level, decrease
in testosterone level and affects their sex life [64].
For women, AHA recommends an average
consumption of sugar to be 100 calories per day which
is equivalent to 25 g or 6 tsf [63], however, higher
consumption of sugars will be affecting their health
(Fig. 3) with frequent occurrence of ailments like breast
cancer, higher breast density in women who have not
attained menopausal state [65]. High intake of sugars,
both in pre-menopausal as well as post-menopausal
Varucha Misra et al.; Saudi J. Med.; Vol-1, Iss-2(Jul-Sep, 2016):29-36
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women lead to higher breast density [66]. Excess of
sugar intake in women, in family way, causes toxaemia
and even influences production and strength of muscle
of their offsprings. Lactating women also exhibit a
similar response to excess sugar intake. It may also
increase neural tube defects in embryos; and more so in
adolescent mothers. It also affects pre-menstrual
syndrome (PMS), a hormonal imbalance associated
with women craving for sugar [67]. The latter worsens
the situation in women with Polycystic Ovary
Syndrome (PCOS) due to a rise in insulin level. The
latter may stimulate the androgen receptors and blocks
egg release form the follicle, and symptoms of hair
growth on face, arms, legs, head and acne are observed
[68]. Excess consumption of sugar in pre-diabetic and
diabetic women even causes brain decay [69] and
pancreatic cancer [70]. Unlike men, excess
consumption of sugar affects sex life in women and
produces excess testosterone which results in decline of
sex hormone binding globulin (SHBG) gene. Low
activity of latter would result in infertility, polycystic
ovaries, uterine cancer and more frequency of CVDs
[71].
A child having no craving for sugar is rare as
high intake of sugars (and their products), is common in
this age group. It increases the negative effects like
Juvenile delinquency [69], hypersensitivity, anxiety,
incapability of concentration, increases in adrenalin
level, decreased learning capacity and less of drinking
of milk [54] (Fig. 3). The recommended intakes of
sugars for children in different age groups are given in
the table 1.
Table 1: Recommended sugar consumption in various categories of children
Category
Calories requirement /day
Sugar intake/day
Pre-schoolers
1,200 - 1,400
16 g (4 tsp)
4-8 years of age
1,600
12 g (3 tsp)
Pre-teens and teens
1,800-2,000
20-32 g (5-8 tsp)
(Source: Modified from http://www.bjcschooloutreach.org/Nutrition/Featured-Content/Adding-it-Up-How-Much-Sugar-
Should-Youth-Consume, 07.08.2015)
The negative aspect of excess consumption of
sugars does not end here. The innumerable undesirable
effects of excess consumption of sugar as well as how
we may overcome these, have been amply highlighted
in many of the recently published books like Lick the
Sugar Habit (1988) by Nancy Appleton and Suicide by
Sugar: A Startling Look at Our #1 National Addiction
(2009) by Nancy Appleton and G.N.Jacobs; Sweet
Poison- Why Sugar Makes us Fat (2009), The Sweet
Poison- Quit Plan (2013) both by David Gillespie, Get
the Sugar Out: 501 Simple Ways to Cut the Sugar Out
of Any Diet (2008) by Ann Louise Gittleman, I Quit
Sugar for Life by Sarah Wilson (2014), and for
children, Beat Sugar Addiction Now! For Kids by Jacob
Teitelbaum and Deborah Kenndy (2012), and there are
some more in the list. A blog on “The 141 reasons sugar
ruins your body” by Nancy Appleton has also appeared
[72].
CONCLUSION
Sugar is one of the important ingredients in
food products in today’s life. Although consumption of
sugar activates the “feel good hormone” of the brain but
on other side it can even make you addicted towards it.
No matter how sweet does the sugar tastes, it has some
negative effects on human beings, especially its excess
consumption which overweighs its positive effects on
our health. Even in non-diabetic persons, excess intake
of sugars is certainly harmful, more so for the women.
So, one should not only be careful while consuming
excess amount of sugar (more than the recommended)
in one’s diet, but rather advertently avoid it. It is
important for the further studies on sugar consumption
in humans.
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