Hey guys,
I got a high powered blender recently and it’s helped a lot with getting enough food in that isn’t junk when calories get above 4000. I have however been putting sugar in them because it’s very cheap, bumps up the calories without adding a lot of volume to the smoothie and doesn’t cause any bloating.
My question is in the context of somebody ticking all the usual dietary boxes (sat fat under 10%, plenty of fibre, fruits and veg, correct amount of calories etc), would it be detrimental to treat sugar as a carb supplement purely to add some calories on top of a health promoting diet?
I guess I could use some other form of carb but would it make much difference? All the other options I can think of would be much more expensive or harder to digest.
Thank you for your time and everything you guys do around here 
Short answer: we don’t really know.
Long answer: Dietary patterns wit added sugar generally correlates with excess Calories, high sodium intake, low fiber intake, and so on. Outside of that, there does seem to be a risk of micronutrient deficiency when added sugar gets to be higher than ~ 10-15% of added Calories, but again, this isn’t a slam dunk.
I don’t know that it would make a difference to sub out sugar for another carbohydrate source, though that would be my preference based in a speculative benefit from reduced sugar intake.
I’ve wondered the same thing as Memento. In the absence of strong evidence, how would you reason about mechanisms that might make sugar good or bad?
By my limited understanding, sugar can make food hyper-palatable and lead to over-eating, so if you stay at a healthy weight, you can avoid that problem. But sugar also “spikes”[1] insulin and maybe it could lead to some insulin resistance even in low-ish doses. What do you think? Are there likely mechanisms that could make sugar intake harmful for an otherwise healthy person?
[1] I know you talked on the podcast recently about how you don’t like this term but hopefully you get what I’m saying.
As a general rule, I think mechanisms offer little confidence in currently unknown predicted clinical outcomes. I think sugar’s most nefarious potential has to do with added Calories. Next, it could displace foods with the necessary micronutrient content. Barring those, I don’t think any of the mechanisms attributed to sugar are particularly worrisome. The insulin example you reference for example, only looks scary in the absence of comparison. All meals increase insulin release in a level proportional to energy, carbohydrate, and protein intake. I would not predict a sugar-free diet to necessarily have lower insulin levels compared to a diet similar in carbohydrates, energy, and protein. A lower carbohydrate does not always reduce insulin needs either.
To be clear, I think limiting foods with added sugars is a good idea and I think the amount of added sugar in the diet should be addressed. I suspect it is more likely than not that relatively high consumption of foods with added sugars will produce unwanted weight gain and - depending on fortification- potential micronutrient deficiencies I do not feel the same way about naturally occurring sugar.
As a final note, I think it’s difficult to discuss single nutrients when it comes to health trajectory. The dietary pattern matters FAR more and that would be easier to discuss IMO.
I detail my current thoughts on a dietary pattern that supports health and performance here: