Sugar is intimately associated with diabetes. Even the original name for the disease — diabetes mellitus — means “sugar diabetes.” Phrases like “she has the sugar,” “he has sugar sickness” or “they have sugar trouble” are still used to describe this chronic disease in some places. Then, of course, there’s the routine checking of blood sugar levels for those of us who have diabetes.
It’s no wonder people assume that too much sugar causes diabetes and, consequently, that sweets are strictly forbidden for people who already have the disease. I even suspect some people with diabetes refuse to consult with a registered dietitian nutritionist like me simply because they think the sugarless, pleasure-less “diabetes diet” constitutes cruel and unusual punishment.
Of course, all of this is wrong.
[READ: Tips for Monitoring and Controlling Blood Sugar Levels.]
Sugar and Diabetes
First, too much sugar does not “cause” diabetes. Type 2 diabetes has a varied and complicated set of risk factors, including diet, weight and body composition. The risks for Type 1 diabetes (formerly called “juvenile” or “insulin-dependent” diabetes) seem unrelated to diet.
Second, there is no diabetes diet. People with diabetes can enjoy a wide range of foods to suit whatever their tastes — if they practice moderation with some food groups and manage their intake of carbohydrates.
Third, sugar is not forbidden. Sweets have important emotional and cultural benefits in our society, and sugar is a carbohydrate that may be included as part of a healthy, diabetes-friendly diet.
[SEE: Exercising Safely With Diabetes.]
How to Moderate Sugar Safely With Diabetes
For a person without diabetes, the American Heart Association recommends no more than 6 teaspoons (25 grams) of added sugar a day for women and 9 teaspoons (36 grams) for men. And the government’s Dietary Guidelines for Americans recommends no more than 12 teaspoons per day when following a 2,000-calorie diet. But the average American gets way more: around 22 teaspoons a day (88 grams).
Of course, for people with diabetes, calories and sugar are just part of the picture. Carbohydrates are just as important for people with diabetes.
Understand carbohydrate nutrition
Carbohydrates are the sugar, starch and fiber components of foods and have the most pronounced effect on blood sugar levels. They are, therefore, important to diabetes management.
Carbohydrates are found in:
— Fruits.
— Beans and lentils.
— Grains.
— Starchy vegetables.
— Milk and yogurt.
— Sweets.
Most carbohydrate-containing foods — those not filed under sweets — also provide important nutrients, antioxidants, vitamins and minerals, which makes these foods important to general health. Their nutritional value justifies the elevating effect on blood sugar for people with diabetes. Sugar, meanwhile, does not offer a justifiable nutritional deal.
[READ: The Best Low-Carb Vegetables]
Know portion sizes
Sugar itself isn’t worth eating for nutrition’s sake because the carbohydrate is so concentrated — and doesn’t offer any nutritional value. Only 1 tablespoon of sugar (or maple syrup or honey) has approximately the same carbohydrate content (so, the same blood sugar raising capacity) as 1 1/4 cup of strawberries, which also offers vitamin C, fiber, manganese and antioxidants.
Likewise, a tablespoon of sugar has about the same carb content as 1 cup of acorn squash, which also provides vitamins A and C, potassium and magnesium. A tablespoon of sugar also equals the carb content of a half-cup of lentils, which gives you fiber, folate, iron and phosphorus too.
Meanwhile, it takes a full 3 cups of raw, non-starchy vegetables — like broccoli, carrots, summer squash, asparagus and cucumber — to reach the amount of carbs in a single tablespoon of sugar.
Minimize added sugars
Make sure that eating sugar is a special experience not only by saving your sweets for truly special occasions, but also by minimizing foods that are loaded with added sugar but don’t have that “special experience” vibe. Foods like salad dressings, ketchup, sports drinks, sugary cereals and flavored yogurt aren’t worth the hit to your health the way a rich slice of chocolate cake on your anniversary is. Food labeling guidelines dictate that food manufacturers put “added sugar” on nutritional labels.
Question other sweeteners
Honey, agave and other syrups and nectars are all the rage as sweeteners, but their carbohydrate loads are essentially the same as sugar. It’s OK to have them instead of plain old cane sugar, but that moderation thing still applies.
Consider low-calorie sweeteners
Unlike honey, agave, sugar and syrups, low-calorie sweeteners add negligible calories and carbohydrates for the same level of sweetness. These sweeteners can act as sugar substitutes in virtually every way, including baked into that special anniversary cake. They also do not affect blood sugar levels and are a great way for people with diabetes to add sweetness to their diets.
A study published in February, 2023, revealed that consumption of a sugar substitute called erythritol was found to result in an increased rate of heart attack and stroke. Erythritol is a sugar alcohol that does not affect blood sugar levels and is used as an alternative sweetener or as a bulking agent in reduced sugar products.
It’s important to note that there were several limitations to this study, including that the participants already had a high prevalence of heart disease and the researchers did not look at the participants’ diet. These findings of increased risk for heart issues were an association, not a causation.
If you don’t feel comfortable using erythritol, there are many other low-calorie sweeteners that can be used.
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How Much Sugar Can You Eat If You Have Diabetes? originally appeared on usnews.com
