How to spot hidden sugars

Affecting almost five million South Africans, diabetes ranks as our second leading cause of death, according to Statistics South Africa. There is no cure for it – and while it can be successfully managed, it’s far better to avoid getting it in the first place. 

At present, no one knows how to prevent type 1 diabetes, where your pancreas produces little or no insulin to get blood glucose to your body’s cells for energy. But type 2 diabetes (affecting about 90% of people with diabetes) has been linked to lifestyle factors including excessive and unhealthy body fat, especially a diet high in calories and processed foods, which often include hidden sugars. 

With this condition, your body does produce insulin, but not enough for your needs, and your cells aren’t able to respond to it as they should, says Michael Brown, consultant diabetes specialist nurse at the Centre for Diabetes and Endocrinology in Johannesburg. 

You can lower your risk of developing type 2 diabetes by losing as little as 5% of your body weight – that’s only 3kg, if you weigh 60kg – and by exercising for 30 minutes a day, says Cape Town endocrinologist Dr Wayne May. 

There’s no need to buy special, often expensive, foods suitable for diabetes – simply follow a balanced healthy eating plan with emphasis on portion control, says Cape Town dietitian Gabi Steenkamp, who has a special interest in treating diabetes. Focus on vegetables and fruit, controlled portions of wholegrain foods, moderate helpings of protein and a little healthy fat. 

“If you mostly eat sensibly, you can still indulge in the odd sweet treat after your balanced meal,” she says. “Have three jellybeans or a square of good quality chocolate.” 

The Food-Based Dietary Guidelines for South Africa encourage sparing use of sugar and drinks high in sugar. The World Health Organization advises getting no more than 5–10% of your total daily energy intake from “free sugar” (the type you add as opposed to the kind naturally occurring in produce). That’s about 25–50g, or just 6 to 12 teaspoons of sugar – about half our national average. 

Learn to read labels 

There are numerous sweet alternatives on the market today. However, the ones known as sugar alcohols (xylitol, sorbitol and maltitol) may cause cramps, wind or diarrhoea if you consume more than about four teaspoons per meal or in a drink, particularly if you have a sensitive stomach. 

It can be better to retrain a sweet tooth by cutting down on sugar over a week or two. But even if you do this, you may unknowingly be consuming sugars, as they’re widely used in foods and beverages. They have many useful functions beyond improving taste: as a raising agent in bread and cakes; a preservative; and to hold water in fruit, which helps retain its colour. 

Sugar also adds body to yoghurt and helps balance acidity in things like salad dressing and tomato sauce. The solution is to read the back label and check the ingredient list for words that signify different forms of sugar – glucose, fructose, maltose, maltodextrin, fruit sugar, de-flavoured fruit juice, fruit juice concentrate and more. 

“The higher they are listed in the label, the greater the quantity used,” says Steenkamp. 

The next time you reach for a commercial muffin for breakfast, think carefully: most muffins contain 5–20g of sugar, almost half of the recommended daily sugars. And most flavoured yoghurts contain added sugar. 

However, the total sugar value listed in the nutritional analysis table includes both the added AND the inherent sugars (lactose, in the case of dairy products), Steenkamp says. “That’s why plain, natural yoghurt contains between 3–6g sugar per 100g. This is the naturally occurring lactose in dairy products. So a fruit flavoured yoghurt containing 8.7g sugar per 100g will contain 3g inherent lactose and 4.7g sugar from the fruit pulp and added sugar.” 

Rather have plain yoghurt and add a handful of fresh berries, or sliced apple or whatever fruit is in season, she says. “Pair it with a slice of wholemeal toast with a poached egg, and you’re ready for the day.” 

As for that glass of orange juice: many store-bought fruit juices have more sugar than soft drinks, to counter the acidity – the average 330ml cola packs about nine teaspoons of added sugar, and fruit juices, 10. Instead of drinking fruit juice, eat a fruit whole, Steenkamp suggests. “It has fibre to keep you feeling full, curbs your appetite and keeps your system regular, as well as packing in healthy natural nutrients.” 

Most packaged foods, packet soups, sauces and condiments are loaded with sugar, she adds, especially supposedly “healthy” low fat ones, which tend to use sugar to compensate for lack of flavour. The likes of sweet chilli sauce, jam, chocolate spread and even honey should only be for occasional treats. 

Watching your consumption of sugars is important to manage weight and stay healthy, as excess unhealthy body fat is a growing problem in South Africa, and raises the risk of coronary heart disease, stroke, metabolic syndrome and fatty liver diseases as well as diabetes. 

But it’s particularly important if you’re at high risk of diabetes – which you are if you have a family history of it in first-degree relatives, or have blood pressure or cholesterol problems, a history of cardiovascular disease, a tendency to pack fat around your waist, are over 40, or are a woman who had big babies (4kg or more). 

The typical “classical” symptoms of uncontrolled or undiagnosed diabetes (a constant urge to pass large amounts of urine, extreme thirst and tiredness, and inexplicable rapid weight loss) are often initially absent in people who develop type 2 diabetes, says Brown. 

“They can take up to 10 years or more to emerge. By that time, a significant number of people will have a largely irreversible complication of uncontrolled diabetes affecting their heart and blood vessels, eyes, kidneys, nerves, skin or sexual organs,” he says. 

This makes it vital to speak to your health provider or pharmacist about having a fasting laboratory blood glucose test every year from age 45, if you are at high risk, and every three years if you are at low risk. The key is to address the problem early. For information and support, call Diabetes SA on 021 425 4440 or visit diabetessa.org.za 

Click here to book a diabetes screening at a Clicks Clinic

Also read: The effects of stress on diabetes

IMAGE CREDIT: Getty Images

* Reliance on any information provided on this Website is solely at your own risk.
The content of this Website is provided as a service to you for educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing symptoms or need medical advice, you should seek the advice of your healthcare professional.