Sugar & Health Risks for Lupus Warriors: Not So Sweet

Cutting sugar, especially processed sugars and carbohydrates, from your diet can be a challenge. But, it can lead to health benefits and fewer lupus flares.

What would you cut first to decrease the amount of sugar you eat? Avoiding cookies, candies, and cakes is a good start. But sugar has found its way into many unlikely foods, and not all of them are sweet. Would you believe that pickles, tomato sauce, and beef jerky have sugar in them? They do! Sugar is used as a flavoring and as a preservative in many foods.

The United States uses nearly three times as much sugar as some other countries. Take for example a traditional Japanese doughnut (read more here on how to travel with lupus). You will find that despite being brightly colored and sweet looking, these doughnuts taste bitter to the American palate. 

According to a 2009 report by the American Heart Association, or AHA, the average American eats about 22.2 teaspoons of sugar a day. This is far greater than the recommended daily intake of 6 teaspoons for women and 9 teaspoons for men. To put this in context, the average can of soda contains 8 teaspoons.

Being vigilant about consumption and reading labels is worth the effort since cutting back on sugar can really help people with lupus.  

What does sugar do in the body?

Excessive amounts of sugar causes problems in the body, but it isn’t all bad. In fact, we need it to survive. 

Sugar and carbohydrates are a source of glucose, which our cells use as fuel. Glucose is what keeps our brain thinking, our heart pumping, our lungs breathing, and our body moving. It’s not just us, though – plants produce sugars and bacteria eat sugars. Fat is also a source of glucose since it is how both plants and animals store glucose for later use. Complex sugars, fats, and even protein can be transformed into glucose — but it takes a while, which gives the body time to handle it properly. Fructose and processed sugars are transformed quickly and taste sweeter.

The sweet taste of sugar has a historical antecedent. Back in the days of hunting and gathering, it could mean life or death. It usually came in the form of fruits, which had other vitamins and nutrients that made them integral to our health. Unfortunately, we now live surrounded by easily-accessible sources of sugar, fat, and carbohydrates that provide energy and little else. In fact, according to the journal Nature, consumption of sugar nearly tripled worldwide since 1960. While a little bit of sugar is not a problem, a lot can cause health risks over time.

When your body has a lot of this energy at its disposal, it stores it away as fat. This can lead to health problems including obesity. The body also feeds the microbiome, the ecosystem of bacteria, viruses, yeasts, and other microorganisms that live in your mouth and gut. Glucose affects both the types and amounts of the microorganisms in the body, which in turn affects the immune system, digestion, and acidity levels in the mouth. You can read more about the gut microbiome and lupus here. 

High sugar and refined grain diets are linked to many major health problems, including diabetes, heart disease, memory problems, tooth decay, and obesity. 

What are the health risks of sugar?

When you think about health risks and sugar, you probably think about obesity, diabetes, and cavities. Sugar rushes and crashes might also be on your mind. Unstable energy levels do not go well with lupus fatigue and pain. 

You would be right on all of those counts. Sugar consumption is linked to oral health and metabolic health. But those aren’t the only concerns. It is can also be linked to problems with memory and cognition, heart disease, and liver damage. Some of these effects may be due to an increased level of inflammation, the immune response that causes the symptoms of all forms of lupus.

Heart Disease

In studies in human males given additional sugar in the form of sugar-sweetened beverages, their blood tests showed increased cardiovascular risk markers such as LDL cholesterol and High-sensitivity c-reactive protein (or hs-CRP). Hs-CRP is a protein associated with inflammation that has been linked to heart disease. It is made in the liver in response to inflammation and high levels are a risk factor for both cardiovascular disease and lupus flares.

Tooth Decay

Sugar feeds microbes living in the mouth and can lead to tooth decay and gum disease. People with lupus are susceptible to tooth decay and other oral health issues, more so if you are also battling Sjogren’s syndrome. Tooth decay and oral health can affect the entire body, causing inflammation and even serious infections.

You can read more about tooth decay and lupus here.

Obesity

The link between sugar and obesity is well-documented. When the body has excessive sugar, it stores it away as fat.  

Sugar also dampens the hunger signal, which makes you feel more satisfied after eating sugar. (This is why dessert is often served at the end of a meal, by the way). However, sugar also reduces the signaling and production of dopamine, a chemical involved in mood, pleasure, and feelings of fullness. This means that more food needs to be eaten to trigger those receptors and feel full, resulting in overeating.

Sugar, alongside salt, can also encourage weight gain through fluid retention. Certain steroid medications already cause fluid retention and swelling, and sugar can exacerbate this swelling, which can be uncomfortable.

Weight gain and obesity are linked to several other medical conditions, including high cholesterol, hypertension, heart disease, and type-2 Diabetes. Being overweight is linked to inflammation, so it can contribute to lupus symptoms. Managing weight is difficult, especially with many lupus medications, but cutting out sugar can help.

Diabetes

Sugar does not cause diabetes, but it does increase the risks, especially when weight gain is involved. Consuming processed sugar also leads to high blood glucose levels followed by low blood glucose levels as the body secretes insulin. These fluctuations in energy – the typical sugar “rush” and “crash” can exacerbate diabetes and lupus symptoms such as fatigue and pain.

Cognitive Problems

Sugar consumption may have effects on the brain. Rats consuming saturated fatty acids and sugar did not perform well on tests that required them to use their memory and recognize specific places. In humans, sugar is known to be linked to depression and low moods.

These effects could contribute to poor mood and the brain fog symptoms of lupus.

Inflammation

In studies on rats, high sugar and high fat diets were associated with weight gain and memory problems. Rats that were  given sugar-supplemented chow also showed molecules associated with inflammation in their blood and patterns of gene expression associated with inflammation. The researchers generally feel that these are connected – sugar may be causing inflammation, which leads to the other symptoms. 

This idea is further supported by studies in monkeys and humans. When given additional sugar, both primates had proteins in their blood that are associated with inflammation.

A 2018 review noted several studies that linked sugar to fatty liver disease and implied that this occurred because sugar intake triggered inflammation. Liver damage is known to contribute to inflammation, creating a feedback loop that could make symptoms worse.

 While there are few studies looking at lupus and sugar specifically, increased inflammation could lead to increased symptoms and could potentially cause flares.

Is sugar bad for people with lupus?

People with lupus should watch out for sugar in their diets and should be keeping a close eye on what they eat. Your diet and your lupus are closely tied together. Food can cause flares but also provides the vitamins that you need to heal. Medications can affect how your body processes many foods. In particular, steroids can make it harder to manage weight.

Steroid medications are a common treatment for lupus, but they also change how food affects your body. Many patients report weight gain while on steroids. And, they are more sensitive to even “normal” levels of carbohydrates and sugar in their diet. 

A low fat, low carb, low sugar diet is a good option for people on steroid medications to help control weight. This can include fruit, which will give you enough sugar for energy along with vitamins and fiber, which can also help with lupus. You can read more about fiber and lupus here. 

Sugar is also involved with inflammation and can worsen symptoms and cause flares. Spikes in blood glucose caused by consuming sugar, and the drop in blood glucose that follows due to insulin, can also cause flares along with other metabolic problems. So yes, sugar is bad news for Lupus warriors. 

Now, how do you get the sugar out of your diet?

How do I cut sugar from my diet?

Reducing your sugar intake is not easy. Sugar sneaks into a lot of foods and can come under many names.

First, keep fruit in mind. Eating fruit is good for you, and it is probably the best way to get your daily recommended sugar. However, it is still a lot of sugar, so sticking to low-sugar fruits is a good plan. If you like sweeter fruits, then try not to eat too much added sugar. 

Avoid sugary drinks such as fruit juices, sodas, and other sweet beverages. This is because sugared drinks bathe your mouth in sugar and encourage the growth of bacteria. The sugar also hits your body harder when you drink it as opposed to eating it, so avoid these drinks if possible.

Read labels on everything – you’ll be amazed at where sugar can end up. This Medical News Today article goes into all of the ingredients that add sugar, and even some of the other names that added sugar can be listed under to avoid scrutiny. Check anything you buy to make sure that you know where your sugar is coming from, and eat home-cooked low-sugar meals when you can. 

When cooking or having food cooked for you, reduce any sugar in the recipe by about a third. This will help keep sugar levels down, and you may find that the food actually tastes better without the sugar. If you need flavor, replace sugar with extracts or spices that add flavoring, such as vanilla, cinnamon, allspice, nutmeg, cloves, or whatever suits your fancy. 

And, of course, avoid sweet carbohydrates such as cakes and cookies.

Interestingly enough, sweet potato, despite being sweet, is actually a low-sugar food. If you can eat sweet potato, try it instead of a baked pastry for dessert. You might be amazed.

What about artificial sweeteners?

Artificial sweeteners are sugar substitutes. They have a sweet taste like sugar, sometimes sweeter, but are not processed by the body into glucose. Artificial sweeteners are not bad, necessarily, but many of them have a bad reputation and the health risks are poorly understood. 

Artificial sweeteners also can encourage overeating by tricking the brain. Because they taste sweet, the brain signals the body to produce insulin as you eat the food to get ready for the influx of sugar. Since that sugar doesn’t arrive, and the only sugars present are a modest amount found in the rest of the food, blood glucose levels drop. The brain senses this and signals the body again that there is an energy deficit that must be remedied with food immediately. This leads to more calories ingested which can, paradoxically, make diet foods more fattening.