By Julie Engebretson, Associate Editor

I shouldn’t.

How many of us have muttered these words while hovering over a box of Krispy Kreme doughnuts or an Entenmann’s strudel?

Our culture seems to have divided sweet treats, and all foods, for that matter, into two categories: good and bad. Carrots = good. Carrot cake = bad. Brown rice = good. Rice pudding = bad. Cookies, candy, crumb cakes and sweets in general seem to top the list of bad foods; things that should be avoided at all costs. But this oversimplified model isn’t necessarily the reality, nor does it encourage a very healthy attitude toward food. Although doughnuts and strudels should be avoided, it’s important to know why. Simply labeling sugar or sugary foods as bad doesn’t present the whole story.

Sugar: Simple vs. Complex

Let’s revise the good vs. bad dichotomy just a bit and instead look at sugars as simple vs. complex. Chemically, simple sugars are one, two or at most three units of sugar linked together in single molecules. Complex sugars – most often referred to as complex carbohydrates, and sometimes as “starches” – are hundreds or thousands of sugar molecules linked together. Generally, the simpler the sugar is, the sweeter it tastes, such as honey, table sugar or the high-fructose corn syrup in sodas. A complex carbohydrate, such as potatoes, tomatoes or whole grain breads and cereals, may not be sweet, but these foods are pleasant to the taste.

Think of all sugar as existing in some stage of refinement: The simplest sugars have already been so heavily refined that the body has to work less in order to convert them into glucose, or blood sugar, once ingested. Complex sugars are the least refined and take longer for the body to break down. It would be easy to assume that less work for the body is better, but the refining process of simple sugars before they even touch your tongue has stripped away most if not all vitamins, minerals, nutrients and fiber, leaving a “food” of almost no nutritional value. The most complex sugars or complex carbohydrates are the least refined, retaining all original nutrients for the body.

Whether a sugar is simple or complex makes a difference not only in terms of its level of refinement or nutritional value, but also in terms of its journey through the body. By now we know it requires less work for the body to break down simple sugars than complex sugars, but that fact merits even closer scrutiny.

One very important characteristic of sugar is how quickly it enters the bloodstream and triggers the insulin response after digestion. Those highly refined, simple sugars in icings, candy and fudge are quickly broken down and enter the bloodstream, causing blood sugar levels to rise almost instantaneously. This, in turn, prompts the pancreas to release insulin – the hormone needed to carry these sugars to the cells of the body. High amounts of insulin help the sugar to be used rapidly, but then blood sugar levels take a dive and the body hits what is known as a sugar low, or hypoglycemia. Just as the hormone insulin is released when the blood sugar level was quickly raised, other stress hormones are summoned as the blood sugar plummets. These stress hormones attempt to restore blood sugar levels to normal, taxing the liver for stored sugar. This rollercoaster process can be taxing on anyone’s body, but is most demanding on individuals with sugar-sensitivity, often causing mood swings and drastic behavioral changes.

Studies indicate that these spikes in blood sugar and subsequent stress on the pancreas to produce insulin eventually can cause the pancreas to, in essence, wear out. A resulting inability to produce enough insulin results in diabetes. Reckless sugar consumption may account, at least in part, for the estimated 1.5 million new cases of diabetes diagnosed in U.S. adults in 2005.

Complex sugars, which, again, are far less refined than simple sugars, make the body work a little bit to disassemble these molecules and convert them into blood sugar. The effect is like that of a time-released capsule: The slowly converted glucose enters the bloodstream at an even pace, providing constant energy without any rollercoaster rides or mood swings.

Excess Sugar = Excess Calories

Aside from tempting diabetes, an excess of simple sugars in the diet adds countless extra calories accompanied by little or no nutrition. For a person trying to lose weight, avoiding additional caloric intake is one thing, but a lack of daily nutrition welcomes a slew of other health problems for anyone. For instance, a non-diet soda may contain 150 calories, which doesn’t seem like much, but for a person who is trying to limit their daily calorie intake to 2,000 calories per day, by drinking this soda, has already consumed nearly 10 percent of their daily allotment of calories. Those calories are accompanied by absolutely zero nutrition – in essence, they are empty calories.

In a 2003 report, the World Health Organization and the Food and Agriculture Organization indicated that sugar should comprise less than 10 percent of total daily calories – that’s one soda per day, based on a 2,000-calorie diet. It’s up to the remaining 90 percent of your calorie allotment to supply the vitamins, minerals and nutrients you need. And if you throw in another soda, or perhaps a small slice of coffee cake, a larger and larger percentage of your remaining calories for that day need to be super-nutritive. That’s a lot of pressure to track down and consume healthier foods in the middle of your busy day.

And let’s be honest, there aren’t many Americans who limit their caloric intake so strictly. A more likely scenario is that the sodas and cake are only added to their daily intake, without regard for excess. With that scenario the reality, fat storage and weight gain are imminent. Apparently, that’s the case: A whopping (no pun intended) two-thirds of all U.S. adults are considered overweight or obese, according to the National Center for Health Statistics.

If you’re thinking to yourself, but the sweets I eat are low-fat or even nonfat, check the nutrition labels. Many of the snack cakes and cookies hitting the market these days wave the nonfat banner, but are overloaded with sugar to make up for the difference in taste. Use common sense, a nutrition label featuring a high amount of sugar and calories, but severely low amounts of vitamins, minerals, fiber and protein, should be a red flag. Studies show that excess sugar in the American diet suppresses immunity, reduces the ability of white blood cells to kill germs, can alter attention span and behavior, and promotes heart disease.

It is important to appreciate the sheer volume of sugar we ingest every year, not just in sodas, candy and cookies, but in all of our foods. Estimated annual sugar consumption for the average American usually hovers around 115 pounds! Just think about that for a minute: If you’re a 179-pound adult (the average weight for a U.S. adult as of 2006), you consume approximately 66 percent of your body weight in sugar every year.

Kick the Habit

According to Dr. Barry Sears, author of The Zone Diet, sweets can have an effect on the body similar to an addictive drug. Sugar releases endorphins or “feel-good” hormones that provide a high. But every peak has a trough and that’s when cravings take hold. The good news is, there are other ways to stimulate the release of endorphins and other well-being hormones, and even keep them steady all day long.

By following the five guidelines listed below, you and your patients can reduce your intake of simple sugars and thus reduce your risk of diabetes and obesity. By replacing your consumption of simple sugars with complex sugars, you will feel better and take the stress off your body. This will lead to a longer, healthier life.

5 Ways to Kick the Sugar Habit

1 Exercise regularly. As if there aren’t enough reasons to exercise, 20 minutes a day of rigorous physical activity brings just the rush of endorphins you’re craving. In fact, when you feel a craving coming on, immediately step outside for a brisk walk or quickly hop on the treadmill. Pretty soon, you’ll crave the workout instead of the doughnut.

2 Graze on healthy snacks throughout the day. The traditional three-meal-a-day diet hasn’t done much for sugar addicts. The full feeling after a meal turns to hunger in a matter of three or four hours, leaving you susceptible to sugar cravings. Make healthy snacks accessible all throughout the day and use them to keep your stomach sated (not full!).

3 Drink water. Lots of water. A craving is often a sign of plain dehydration, not a cry for food. So, carry a bottle of water or iced herbal tea with you to combat those sugar attacks.

4 Cut back on caffeine. Plain and simple, caffeine can cause a drop in blood sugar levels. Switch to herbal tea if possible.

5 Grab a piece of all-natural fruit. If the above tips aren’t taming that sweet tooth completely, don’t quit! Keep up the good work, and reward yourself with a piece of fruit, such as a pear, apple or orange. Fructose sugars don’t send blood sugar levels on a rollercoaster ride, and the fiber in the fruit will fill you up.