With Easter weekend bringing in its usual assortment of Easter chocolate, sweets and cakes, the internet has been awash with comments and real concerns over the effect that the additional sugar may have on one’s health. The very first thing that I feel is important to share, is that a single weekend of eating outside of your usual habits is unlikely to have any real impact on your overall health. Three days is less than 1% of a year, and even less significant in the context of your whole life.
The myth that sugar causes diabetes is a pervasive one. In type 1 diabetes, the body doesn’t produce insulin (or if it does, it only produces very little). This is an autoimmune disease caused by the immune system attacking cells in the pancreas involved in producing insulin. It isn’t caused by any food or diet. Type 2 diabetes (T2DM) is characterised by a resistance to insulin. It is diagnosed by HbA1c levels (a marker of average blood sugar levels over several weeks) rise above 48 mol/mol. T2DM can occur for a variety of reasons, with some people being more genetically predisposed to develop it. Lifestyle can also play a factor, and this can include diet. Because of T2DM having high blood sugar levels, it was thought that high dietary intake of sugar could cause diabetes. However, the reality is a bit more complex.
I work in a diabetes support programme, and many patients I speak to are confused as to how they have T2DM as they don’t drink sweetened coffee or fizzy drinks, or eat lots of chocolate and sweets. Carbohydrate, the macronutrient that foods such as wholegrains, pulses, fruits and vegetables include also play a role. Carbohydrates are made up of lots of smaller structures and when these are broken down, you are left with sugar molecules. This includes the sugar glucose, which we find in our blood. With insulin resistance, the body is less able to manage blood glucose levels.
Diet and exercise can also play a role on our blood glucose levels. Diet directly influences how much glucose goes in to our bloodstream, and exercise uses up glucose, as our muscles need it to work. A diet that brings lots of glucose into our blood, and limited activity levels mean that blood sugar levels can rise. To combat higher blood glucose levels, our pancreas beta cells have to make more insulin. Over a longer time, this can cause damage to the beta cells, making it harder for them to produce insulin effectively. The body then finds it even harder to manage blood glucose levels, even if diet and exercise levels change.
So although sugary foods and drinks can play a role in the development of T2DM, they are only one part of the picture. Additionally, the point at which T2DM occurs varies between people. Some people are genetically more likely to develop T2DM, whereas someone else might never develop it, even if they are engaging in behaviours that increase the risk of T2DM. And this doesn’t mean all carbohydrates are bad. Carbohydrates high in fibre are generally associated with positive blood glucose outcomes, as digestion is slowed by fibre. Building meals with proteins and healthy fats can also help to slow absorption of glucose, even with lower fibre carbohydrates.
Diabetes is a chronic and complex condition, and a large part of developing it is out of your control. Whilst I absolutely encourage a varied, balanced diet as a Nutritionist, part of a good diet includes enjoyment. So eat your Easter eggs in peace (if you have any left!) and no, it won’t give you diabetes.
Still concerned about sugar? Read here to learn if unrefined sugar is really a better choice.