Rallying cries to quit sugar, especially when going through the menopause are loud and strong. So, what’s the deal? Should we battle to quit it, or is there something else worthy of our attention? It was great to chat this through in The Nourish Lounge so let’s dig into it here too.
It feels sensible to define what we mean by sugar, because if our intention is to quit it, we need to be clear on what it is that we’re trying to quit and messaging around sugar is confusing. So…
What is Sugar?
Simple sugar molecules are called monosaccharides and these join together to make chains of starches which are essentially cereals and grains. The body breaks down these chains through digestion into glucose. Glucose circulates in our bloodstream; it’s the main fuel that the body can use and convert to energy and it’s what our brain runs on.
Now if we think about fibrous carbohydrates, these are not just single chains; if you were to draw out these molecules, you’d see lots of branches off them. We don’t have the enzymes to break down these branches, which is why the fibre passes into our large bowel undigested and is the food for our trillions of bacteria instead.
Then we’ve got simple sugar molecules themselves being divided into two clear categories: naturally occurring sugars and free sugars. Examples of naturally occurring sugars are fructose that we find in fruit, lactose that we find in milk and dairy and sucrose of course itself is a naturally occurring sugar cane. Fructose is a monosaccharide, but others tend to be disaccharides, so they are made up of two sugar molecules. For example, lactose is made up of glucose and galactose and sucrose is made up of glucose and fructose.
Understanding Sugar in Fruit and Vegetables
Fructose naturally found within the cell walls of fruit and vegetables alongside other nutrients and fibre is not harmful to health. You do hear lots of scaremongering about fructose, but fructose that we eat within fruits and vegetables is metabolised by the liver perfectly normally. The problem arises when we start extracting fructose and turning it into high fructose corn syrup for example. High concentrations of fructose then added to food and drink becomes a free sugar and can cause problems for the liver contributing to fatty deposits, insulin resistance and poor metabolic function. That doesn’t occur when you eat melon or a bunch of grapes! Fundamentally fruit and veg intakes are associated with better health outcomes.
So, these disaccharides have to be broken down into monosaccharides to be absorbed. What’s really interesting about sucrose itself is we get this perception that if we eat sugar, it causes massive spikes in our blood glucose and loads of insulin to be released and that it’s all just a disaster. This isn’t strictly true; sucrose itself causes less of a spike than glucose because it has to be broken down into two individual molecules first. It’s about the context of how much sucrose we’re eating and that leads us on to the other category – added sugar.
Following the SACN report in 2015 added sugars were redefined as ‘free’ sugars. Free sugars essentially refer to any type of sugar added into food. It might be by us, sprinkling some on our cornflakes or adding it to our coffee or it might be done in a factory in which they’re adding all sorts of weird and wonderful types of sugar into our foods as part of the manufacturing process.
The sugar might be used as a preservative to extend shelf life, or it might be used to mask the taste of some other substance within that food that doesn’t really have a nice taste. Or it might just be added to aid palatability and of course, sugar goes really nicely with fat and salt as well. Sugar is associated with highly processed foods which are also high in fat and salt and may have other additives and flavour enhancers added to make them highly palatable.
How Does Sugar Affect Our Health?
Diet and nutrition survey data tells us that proportionally we are eating a lot of these free sugars compared to fibre and naturally occurring sugars and that they are associated with higher energy intakes. We can also see that sugar sweetened beverages seem to be particularly tricky and that’s because when we are drinking sugar, we don’t get the same appetite regulation kicking in. And what we can see in children and teenagers in particular is that the consumption of sugar sweetened beverages contributes to weight gain.
There is also an association between these high sugar beverages and increasing our risk of developing type two diabetes. So that’s not all sugar increasing our risk of diabetes, just these drinks.
It’s the very nature of a fizzy drink – the bubbles, the temperature that creates hyper palatability and enables our bodies to take on far larger amounts of sugar than we would if we were eating it. Warm, flat coke is not very appealing, but the ring pull of a cold can set off our reward centre in the brain and we dive in with pleasure.
Making Sense of Sugar Free Diet Messaging
When you look at diet plans that talk about quitting sugar, it gets really confusing because you’re then limiting foods that are considered healthy. No distinction is made between added sugar and naturally occurring sugar and as we’ve shown, these things are quite different.
Is Sugar-Free Even Free of Sugar?
You’ll hear loads of people say they’re going sugar free whilst simultaneously pouring the coconut blossom nectar, believing its natural sounding name must offer superiority health wise. This simply isn’t the case.
From your body’s perspective, whatever the source, it is all getting broken down into simple mono and disaccharides. Your body cares not whether the glucose has come from some fancy syrup or plain old white sugar – your body can’t distinguish the difference so this whole hierarchy of sugar is just pointless and means nothing from a biochemical perspective.
If I Quit Sugar, Will It Help My Menopause Weight Gain
Sugar per se, is not the problem. It is not going to increase your risk of developing diabetes. It is not going to automatically create more weight gain, but it clearly does contribute to higher energy intakes and sugar mixed within processed foods that are also high in fat and high in salt is not so good for health.
Diets that contain more whole foods are associated with better gut microbiomes and we know the value of gut health in menopause. We can see that higher fibre intakes are associated with lower sugar intakes and that higher fibre intakes are associated with reduced risks of disease, lower body weights, etc, etc. But it’s not sugar itself that’s the problem. It’s when it’s combined with those other components, which make higher quantities of it easier to eat.
Does Cutting Out Sugar Help Menopause?
We know that hormonal changes associated with the menopause make it harder for our body to clear glucose from our bloodstream after a meal. This could be in part due to our bodies being less sensitive to insulin as we go through the menopause transition and some of us may develop insulin resistance. There are many factors that influence this though, as we talk about in “Does Menopause Cause Insulin Resistance”.
Being clear on where we get our carbohydrates (fuel) from is helpful. We’ve seen already that this is less about sugar and more about what else our diet contains. Vowing to quit sugar often sets us off on a tricky path that is hard to stick to.
What Do We Really Mean When We Tell Ourselves to Quit Sugar?
If we dig deep and avoid sugar, what comes out of our diet?
And is this complete exclusion of all sugar, really achieving what we want it to achieve?
There are all sorts of claims that quitting sugar will improve mood, reduce anxiety, improve sleep and reduce our risk of diabetes. Quitting sugar itself won’t achieve these things, it’s about the overall context of your diet and the proportion of sugar within it.
So, perhaps rather than channelling all this energy into quitting it, we should actually ask with curiosity, proportionally, how much added sugar free sugar do I think I’m consuming? And is there any room in here for this to feel like it’s a slightly better balance? Is our pledge to quit it really our pledge to say I want to feel like I have more control?
“I feel like this thing in my diet is controlling me and I don’t like that feeling. I want to take the reins back. I want to quit it. I don’t want it to have a hold over me. I’m going to do whatever I can to win the battle against sugar”.
But what we’re really doing here is just creating a whole language around food which is really difficult for us to navigate. Because if we just want to live life and enjoy life, and we want to keep food as food, we’re never going to be able to do that when so much headspace is taken up with:
“Oh no, I’m not allowed to have that. Oh, no, I must not eat that. Oh no I’ve failed again, I always fail at everything”.
This language reinforces the belief we’re perhaps addicted to it. So,
Is Sugar Addictive?
We cannot be addicted to sugar as we cannot be addicted to something which is essential to life. What we do know is that sugar, when mixed with fat and/or salt, helps to create hyper palatability. And what that seems to do in our brains, is light up our reward centre, creating a similar sort of activity to what you would see with addictive substances.
What Causes Sugar Cravings?
What the research is starting to show is that the more of these foods we consume, the more of them we then need to get the same hit. So, it then starts to create this pattern of pulling us towards those foods and making us feel like we’re addicted. Our biology is geared to support over consumption and the food manufacturers are doing a really good job of making this super easy for us.
The other thing that really relates to sugar is under-fuelling. I’ve touched on this in How do you get rid of menopause belly fat. If you are reducing your carbohydrate intake in an attempt to lose weight you might be at risk of chronic under-fuelling. Sugary food in those instances is going to be even more appealing because your brain is recognizing that as being needed for survival.
That’s not your body being addicted to sugar or sugar being the root of all evil. It’s really your brain recognizing the need to get blood glucose levels up to prevent death. This will put cravings for sugar into overdrive.
Menopause Blood Sugar Fluctuations
There is also some evidence to suggest post-menopausal women have bigger dips and troughs in blood glucose, which may be a contributing factor to cravings for some women. Complete sugar avoidance without careful consideration of fuel needs generally is likely to make the situation worse though.
Changing the Conversation Around How to Quit Sugar
We need to stop buying into the fact that we’re addicted to this substance and that the only way we’re going to survive and improve our health is to quit sugar. It’s illogical and unhelpful.
So, to answer the question? I hope I’ve made clear that my standing point is no, we don’t need to quit sugar. But we do perhaps want to take a pause and with a slightly more compassionate nourishing lens, pull back and really have a look at the types of foods that we eat, why are we drawn to more sugary foods, and ask ourselves whether there could be something else going on behind the scenes?
How I Can Help You Improve Your Relationship With Sugar.
The Pause to Nourish Programme is a structured, self-paced little course that really enables you to look at your relationship with sugar. Understand the hormonal stuff and the links between our cravings for sugar and hormonal shifts during menopause. Participants take a nourishing journey to improved health. They move away from the diet voice and the judgement hammer smacking them over the head every single day. And they feel SO much better!
For more on the subject of weight management during menopause, you may like to read the article How Do You Get Rid of Menopause Belly Fat?