This week we will be discussing sugar, different types of sugars, and the effects of sugar on the menopause.

What are Sugars?

Sugars are a type of carbohydrate and can be either natural or refined. Natural sugars are normally found in whole foods, such as strawberries, milk, and sweetcorn. Refined sugars are created when natural sugars are extracted from foods, like sugar cane or sugar beets, and are usually added to processed foods, such as fizzy drinks and chocolate bars.

There are 6 main types of sugar known as glucose, fructose, galactose, sucrose, lactose, and maltose. Glucose, fructose, and galactose are monosaccharides, or simple sugar. Monosaccharides are sugar building blocks that combine to form disaccharides, such as sucrose, lactose, and maltose. These combinations include:

• Sucrose = one glucose molecule + one fructose molecule.
• Lactose = one glucose molecule + one galactose molecule.
• Maltose = two glucose molecules.

These sugars are found in a number of different foods:

• Glucose – plant-based foods such as spinach, broccoli, corn, kale, oats, and beans.
• Fructose – found in fruits and some vegetables.
• Lactose – galactose is not found naturally but combines with glucose to become lactose, a dairy sugar.
• Maltose – a by-product of natural sugars fermenting, often found in alcoholic products.
• Sucrose – table sugar, brown sugar, honey, and maple syrup.

Sugar Guidelines

The NHS Eatwell Guide shows how much of what we eat should come from each food group, with the aim of maintaining a healthy, balanced diet.

In terms of natural sugars, we should aim to eat at least 5 portions of a variety of fruits and vegetables each day, choosing from fresh, frozen, tinned, dried, or juiced. However, fruit juices and smoothies should be limited to around 150ml a day.

For refined sugars, the Eatwell Guide suggests that foods including chocolate, cakes, biscuits, and soft drinks should be eaten less often and in smaller amounts [1]. Using food labelling, foods with 22.5g or more of total sugar per 100g are considered to be high in sugar. Foods with 5g or less of total sugar per 100g are low in sugar [2].

Research on Sugar in our diets

Regarding the health impacts of excess sugar intake there are a number of studies viewing this. One study found that the incidence of metabolic disorders, such as obesity, non-alcoholic fatty liver disease, cardiovascular disease, and diabetes, has increased due to chronic overconsumption of refined sugars [3].

In terms of natural vs refined sugar there is mixed research. One study found that in rats that were fed a high-fat high-sucrose diet for 8 weeks, compared to those fed natural sweeteners such as agave and maple syrup, that liver inflammation and insulin resistance was attenuated in those fed natural sweeteners compared to sucrose. Suggesting that natural sweeteners are a less harmful alternative to sucrose in the context of obesity [4].

Another study looked at the replacement of refined sugar by natural sweeteners. It found that natural sugars, such as those found in fruits and vegetables, were preferred as they have a high nutritional value, which can aid in offsetting the negative effects of refined sugar [5]. 

Does sugar intake impact menopause symptoms?

There are several studies regarding the effects of high sugar diets on menopausal symptoms. One viewed 6040 menopausal women at 3-year intervals over a total of 9 years. Dietary intakes were assessed at each stage of the study as well as menopausal symptoms of night sweats and hot flushes. 

Six dietary patterns were identified including cooked vegetables, fruit, Mediterranean style, meat and processed meat, dairy, and high fat and sugar. The results of the study consumption of fruit or Mediterranean-style diet decreased reporting of hot flushes and night sweats. Whereas a high-fat and -sugar diet increased the risk of these symptoms [6].

Another study viewed menopausal symptom intensity and food consumption by degree of food processing. They used data based on dietary intake, menopausal symptom intensity, and quality of life. The results showed that higher intakes of sugar-sweetened beverages were associated with poorer memory and concentration, and greater intensity of somatic symptoms. Additionally, higher intake of ultra-processed foods was associated with more intense vasomotor symptoms [7]. 

How do I manage sugar cravings?

It is not uncommon for menopausal women to report increased sugar cravings. There are two principal rewarding aspects of sugar consumption: nutrition and taste.  The reward of the sweet taste, however, activates a different pathway in our brain than the caloric input [8]. When we eat foods with high amounts of sugar, the area of the brain that triggers dopamine release is activated.  This is also known as the brain’s reward system [9]. Cravings can occur when these reward systems get over-activated. 

Your response to sugar cravings can be considered in the context of hunger.  There are 4 types of hunger:

• Physical 
• Emotional 
• Taste 
• Practical

Understanding what is happening when these sugar cravings  strike can help to determine the best response. For example, a sugar craving due to an emotional trigger is different to a physical trigger which may be more easily rectified. If for example, you have skipped a meal, your blood sugar levels and energy levels will have dipped which is leading to you craving a high sugar containing food. Looking for patterns and trends in when your sugar cravings can occur, can help to put plans in place to minimise the impact of the craving.

However, don’t forget food is more than just nutrition and in small quantities, these foods such as chocolate, may be satisfying other parts of our body such as pleasure. 

Reducing Refined Sugar Intake

There are numerous ways in which you can reduce your refined sugar intake, here are some ideas:

• Switch sugary breakfast cereals for those with no added sugar or try wholemeal toast or plain yoghurt with fruit instead.
• Try adding fruit to your breakfast instead of sugar to sweeten naturally.
• Watch out for added sugar in ready-made soups, sauces, and ready meals.
• Switch sugary snacks for those lower in sugar, such as fruit, nuts, rice cakes, and lower-sugar yoghurts.
• If you are craving a sugary snack, try to make a lower-sugar swap, for example try dark chocolate or a lower-sugar hot chocolate instead of chocolate, or malt loaf instead of cake.
• A lot of added sugar can be found in fizzy drinks, try swapping to water or sugar-free drinks instead.
• If you enjoy something sweet after a meal, try less sugary desserts such as fruit, plain yoghurt, or lower-sugar rice pudding.

Summary

In summary, research suggests that a higher intake of sugar causes a greater intensity of menopausal symptoms. There is mixed research regarding if the type of sugar affects this outcome, however, studies generally agree that natural sugars and sweeteners are preferred over refined sugars. Additionally, sugars from fruit are encouraged as part of a healthy, balanced diet as they offer additional health benefits due to their high nutritional content.