Contributed by Dr. Steven T. Devor – Director of Performance Physiology for MIT and OhioHealth, and Associate Professor of Exercise Physiology, Department of Human Sciences, and Department of Physiology and Cell Biology, The Ohio State University
In early March of 2014 the World Health Organization (WHO) released new guidelines that recommend an individuals daily intake of sugar should exceed no more than 5% of overall daily caloric intake. The previous recommendation from the WHO was released in 2002 and at that time it advised that no more than 10% of total daily calories come from sugar. Cutting the recommended sugar intake in half is a large reduction, but I believe this action is necessary.
The WHO guidelines follow the results of a recent benchmark study indicating that consuming too much added sugar in processed and packaged food increases your risk of death from heart disease. Other research has clearly linked a high intake of added sugars to a number of adverse health conditions, including obesity, type 2 diabetes, high blood pressure, and risk factors for heart disease and stroke. Health and wellness recommendations from major health organizations do not happen without a tremendous amount of research and deliberation. And following more than two years of intensive review of the literature the WHO determined that dropping the recommended daily sugar intake to 5% would reduce the risk to Americans health. Further, the recommendation on severely limiting additional sugar intake from the American Heart Association is consistent with the new WHO guidelines.
The recommendation includes sugar that is added to any food, and includes fruit juices with additional sugar added and fruit concentrates. Added sugars also include table sugar, brown sugar, all varieties of syrups, honey, confectioners glaze, dried cane extract, dextrose, high-fructose corn syrup, agave nectar, molasses, and other calorie containing sweeteners found in prepared and processed foods and beverages. The recommendation does not include sugars that occur naturally in fruit, fruit juice, and milk and dairy products.
A large percentage of the sugars we consume today are found in processed and packaged foods that most people would not define as a treat or as sweets. For example one tablespoon of ketchup contains approximately one teaspoon of sugar. And additional sugar is often added to frozen pizza, many bread products, soups, yogurt, breakfast cereals, mayonnaise, and even many energy bars. Research indicates that nearly 75% of all processed and packaged foods and beverages contain added sugar or some form of additional sweetener. Many food manufacturers began adding additional sugar to their products when consumers became increasingly concerned about the amount of fat in their food. Manufacturers responded with hundreds of low-fat items, but often substituted sugar or other sweeteners to help maintain the palatability of the product.
In order to determine the number of calories from sugar contained in a product simply multiply the grams of sugar by four. For example, a product containing 20 grams of sugar will have 80 calories per serving from sugar, and if you consume 2,000 calories a day that equates to 4% of your daily calories. For an adult at a normal body mass index (BMI), consuming 5% of daily calories from sugar would equate to approximately 25 grams of sugar (i.e., six teaspoons) per day. Keep in mind that is less than what is typically found in a single 12-ounce can of regular (non-diet) soda, which contains approximately 40 grams of sugar.
So how does the sugar intake recommendation from the WHO fit with the recommendation endurance athletes have to consume a carbohydrate electrolyte beverage (e.g., Gatorade, Gatorade Endurance, Powerade, GuBrew, et cetera) during long training runs and races. First I believe it is very important to understand that those of us who walk or run half marathons and full marathons are not average Americans. And the WHO guidelines regarding added sugar intake are written for the American population as a whole.
My advice on this topic is the same as it has always been. When you are performing long distance endurance exercise, your body performs most optimally when it has an adequate supply of carbohydrate and electrolytes. When you are doing your long distance aerobic exercise, the carbohydrate you consume in a performance beverage is almost immediately utilized as a fuel source to power your skeletal muscle contractions. If your endurance exercise is going to last for longer than 60 minutes, you should consume the recommended amount of a carbohydrate electrolyte beverage. If your endurance exercise is going to last for less than 60 minutes, all you need is plain water.
But I want to be clear, even for those of us that do a lot of endurance exercise your body only requires the carbohydrate electrolyte performance beverage when you are actually doing your running. You do not need it the entire rest of the day, and you should not consume it then. Eliminate processed and packaged food and beverage products with added sugar at all costs the rest of the day. When you are not engaged in long distance endurance exercise much of the added sugar you eat is stored, and it also results in sharp spikes to your blood glucose. Neither of those outcomes are desirable from a health perspective.
Finally, I believe the new WHO guidelines can serve as a strong reminder that the onus is on the consumer to read and scrutinize nutrition labels. Educate yourself about your food choices, read the labels carefully. Quality food choices can have medicinal properties, as the ancient Greek physician Hippocrates said, “Let food be thy medicine, and medicine be thy food”. You only get one body and what food and beverage products you put into it every day truly matters.