Some people will swear that everything sugary — including fruit — is bad for you and should be avoided. Others pick one sugar, like high fructose corn syrup, and give it specifically a bad rap. Still others insist that sugar in its natural form, like honey or fruit, is fine, but white sugar and manufactured sugars are the real evil. Others insist that a calorie is just a calorie, and it makes no difference where that calorie comes from. And, what about no-calorie fake sugars? Are they okay? There is so much information out there, and it’s confusing. Today, we talk with Dr. Ashley Guild, an internist with TriStar Medical Group, about how she helps patients navigate the confusing topic of sugar, and how exactly is affects our health.

Sugar is found in many hidden places, including cereal, yogurt, condiments and more.

Eating in a healthy manner, and helping her patients eat in a healthy manner, including what to eat to lose weight, is a passion of Dr. Guild’s, so talking about sugar was a conversation that could easily have become one much longer. I say this because if you have more questions, talk to your doctor and do your research. Sugar just may be playing a larger role in your health and weight than you think.

StyleBlueprint: Is a sugar addiction a true thing?

Dr. Guild: Addiction is a broad topic. With groups like Obesity Anonymous, Overeaters Anonymous and Food Addicts Anonymous, I guess you could say the desire to eat sugar could also be an addition. Hormones in your brain get activated with sugar, and in that regard, it can cause your brain to say, “I like that, I want more.” There is some connection as the place that sugar activates inside your brain is the same place that opiates activate. For people with more addictive personalities, they could be more susceptible to this craving. And, just like other things, to feed the sugar addiction, you’ll need more and more sugar to satisfy it. But activating that part of the brain, for food, this is unique to sugar. As far as it being addictive, that’s dependent on the person … someone’s problem might be salt, and certain people are more susceptible to sugar, while for others it is alcohol or cigarettes … then some can go cold turkey after smoking 50 years.

It’s like having a 5mg pain medication that helps the pain, but eventually it might not help the pain and you’ll need more. You first start eating something sugary, and it only takes a little to satisfy. Then, you keep wanting more. I do think it is a true thing. As obesity becomes more prevalent in our society, how food affects the brain will continue to be studied more, and we’ll have more to reference.

SB: What about a little piece of chocolate after dinner? Or a small bowl of ice cream?

Dr. Guild: Yes, and then each night you want that sugary thing, right? It’s because we are training the brain that to be satisfied, and that our meal is over, we need that sugar. Sugar becomes the trigger to say, “I’m now satisfied.”

SB: So how do you advise your patients to eat sugar?

Dr. Guild: For patients trying to lose weight, I tell them no carbs! No sugar carbs. As doctors, we see the worst of the worst. I say none because having a happy medium is hard for so many patients. Knowing that they’ll eat some, I advise them to eat none.

SB: Can sugar cause or heighten your risk of diseases such as arthritis, osteoporosis, heart disease and cancer?

Dr. Guild: In a roundabout way, yes. Obviously obesity is an issue, and with that comes increasing calories, which increases your risk for diabetes, which therefore increases your risk for heart disease and stroke. For arthritis, I don’t know for sure, but there is evidence for sugar increasing inflammation. This is the body’s reaction to stress and exposure — inflammation. Arthritis is inflammation of the joints. There is some evidence that sugar can lead to inflammation, which in turn can lead to arthritis. Does this happen in all people? No. Diabetics aren’t all arthritic, but all have high sugar.

For osteoporosis, sugar consumption can indirectly lead to osteoporosis as if you are eating sugar, you aren’t making healthier dietary issues. So, from this standpoint, you maybe aren’t eating enough protein, and your muscles need protein to be strong. Stronger muscles lead to stronger bones. As far as sugar intake increasing your risk of heart disease, absolutely. It’s one of the most studied connections. Now as far as cancer is concerned? I have no clue. Personally, I think there could be a connection there. Having diabetes does not mean you will have pancreatic cancer, but there are a large number of pancreatic cancer patients who have diabetes. This is a huge topic that is being studied right now. In 20 years, are we going to figure out that sugar is like cigarettes were 50 years ago? We don’t know. There are a lot of studies about all of this right now.

SB: I’ve read that sugar is an anti-nutrient, depleting our bodies of minerals and digestive enzymes. Is this true?

Dr. Guild: I guess you could say that, but because if you are eating a lot of carbs, you are not eating the good stuff. When a negative balance of the bad stuff (sugar) replaces the good stuff, you aren’t getting what your body needs in order to function properly. There is no good thing that sugar does in the body.

SB: Are artificial sugars better for you?

Dr. Guild: Your body reacts to artificial sweeteners the same way. It all appears to your body the same. Your body’s reaction to sugar is to bring the sugar level down by releasing insulin. High levels of insulin running around causes more fat storage. Sweeteners cause a chain reaction that leads to fat build up and fat storage. These fake sugars are not without consequence; the chemicals and additives, while not sugar, still can be harmful to your body.

SB: Is there a difference between eating a bowl of strawberries or eating that same amount of strawberries in a smoothie? Basically, is there a difference between whole fruit and pureed fruit?

Dr. Guild: Yes, there is a difference. When you are chewing the whole food, your body has to break it down and that takes energy and calories. When the fruit is pureed, the act of breaking it down is done for you, which is not as good for you. Without the whole fruit, you are just getting the fruit in its sugar form.

SB: Then, what about fresh squeezed juices?

Dr. Guild: Hey, I drink fresh juices also. There is a lot of nutrition in them, but you can get a false sense of security. No, it’s not all bad, but it does affect sugar level. Choose more vegetable than fruit, but if I were to say only drink vegetable juices, that might not be palatable for most people, and there are a lot of vitamins and nutrients there. Try to limit the amount of fruit in the juice, but keep enough to have it taste good!

SB: Are there common foods with hidden sugars that we should be aware of?

Dr. Guild: Yes! There are so many hidden sugars. Most people think of sugar as what we see in the packets. But, there are many other forms. High fructose corn syrup is one of the more highly consumed sugars — don’t even put it to your lips! Other sugars include fructose (fruit), lactose (cheese) and sucrose (in packaged foods and candy). I tell my patients that if it’s in a package, stay away as there are too many preservatives and sugars.

Lots of condiments have sugars, like ketchup and salad dressings. A lot of yogurts have sugar. Pasta, potatoes, potato chips, bread — they all have sugar in them. Fruit juices? Hidden sugars. Energy drinks? Tons of sugars. Frozen coffee drinks? Lots of sugar. Cereal and most breakfast foods also have hidden sugars.

I’ll have patients keep a food diary, and they are working so hard and show me that they are only eating 1,200 calories a day, but they aren’t losing weight. But, the yogurt they are having every day for breakfast is filled with sugar, and just that can throw you off.

SB: Do your hormones affect your sugar cravings? Do they affect the way you digest sugar?

Dr. Guild: I don’t know if it’s completely true, but every woman who has gone through PMS wants chocolate! Does it create a comfort feeling? Well, if it activates part of your brain that makes you happy, and that makes you feel better, then hormones affected your cravings. But, this answer is more experience-based.

SB: If you are having a sugar craving, is there one food over another that can satisfy that craving, besides sugar, more effectively than another?

Dr. Guild: Fruit is a good option and your best go-to if you are craving sugar. But if you are craving sugar because you are hungry, you likely need protein, as protein calories will sustain you longer.

Thank you, Dr. Guild! We’ll discuss protein more another day … but, hopefully this helped clear up any confusion on sugar. No, not all calories are created equally, and when it comes to sugar, it’s hidden in many of our foods. Thus, even if we think we’re not eating a lot, we’re likely getting more than we need or want.

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