Sugar is a component that makes people think of joy and disdain at the same moment. It is a basic of diets from throughout the globe, although worldwide its uses and preference vary. Humans are hard wired to love it, as it is a substantial component of human breast milk. Further, as the basic currency of energy in the bloodstream and the body, its physiological importance is undisputed. Yet, abnormalities of its clearance from the bloodstream and its use create problems. Thus, the ingestion of too much sugar has been alleged as a cause of chronic diseases from obesity, metabolic syndrome to diabetes, and cardiovascular disease.
There is concern that the increased intake of sugars coupled with a decrease in overall caloric needs has increased the percent of calories coming from sugars and has made it much more difficult to meet nutrient needs. In addition, there is major debate regarding possible health consequences of sugar consumption especially in light of the fact that 21st century humans ingest more sugar than they did in the 1800s. Some charge that sugar is one reason for current high rates of obesity seen today, even though more recent data show that if this were true obesity should decrease. Although per capita consumption of beet and cane sugar has increased from 45 g/d to approximately 50 g/d since 2004, the daily consumption of high-fructose corn syrup (HFCS) has declined from about 45 g/d to nearly 33 g/d for a net caloric decrease of 27 kcal/d over the decade (USDA/ERS 2015a).
As there is so much controversy, myth, and misunderstanding in both the popular press and within the scientific community, the need for an authoritative, science-based, up-to-date, and analytically illuminating critique about the importance of sugars in foods, not just for taste, but for safety and structure became critical. Equally important was a similar in depth assessment of the role of sugar on human health and disease. This need prompted both a survey of the existing scientific and medical literature and a critical investigation of written positions and recommendations regarding sugars by government bodies and health organizations, as well as popular contentions about these loved and maligned macronutrients.
To fully address the many aspects of sugar, this comprehensive review starts with a discussion of the history of sugar cultivation and consumption. This is followed by an assessment of the chemical characteristics and properties of the mono- and disaccharides including information on their sweetening power. Then the manufacture, composition, caloric value, functionality, and consumption patterns of each class of sugars is systematically presented.
The discussion flows into an examination of the biochemistry, digestion, metabolism, and physiology of sugars from macro to cellular level in normal healthy individuals. This sets a stage for transitioning to disordered metabolism and pathophysiology of sugars and human disease. Consideration is given to the way in which dietary sugars play, or do not play, a role in overnutrition, caloric over-sufficiency, and micronutrient insufficiency and associated comorbidities including metabolic syndrome, type 2 diabetes, cardiovascular disease, and stroke.
Next, the emerging and hotly debated issue of sugar “addiction” is critically examined and an evidenced-based, carefully argued medical science perspective is presented. The phenomenon of withdrawal is suggested as a proxy for frank addiction and as a means of differentiating cravings for certain macronutrients from true substance dependence and addiction.
The controversy associated with public policy ramifications of strategies such as taxation of sugar-sweetened beverages and other foods is introduced and discussed. Finally, gaps in current research are identified.
hopefully that is the part of it that you ment
sorry it is so long
