By Colleen D. Webb, MS, RDN, CLT
The average American eats about 17 teaspoons of added sugar per day, which is almost three times more sugar than experts recommend. For a frame of reference, one teaspoon is roughly one sugar packet or one cube of sugar.
I’d wager that the average person with inflammatory bowel disease (IBD) gets more than that. Plenty of my patients have kept food diaries showing over 25 teaspoons of added sugar per day. That’s 100 grams!
The World Health Organization recommends we limit our daily sugar intake to less than 25 grams per day or 6 teaspoons. That’s what I recommend to most of my patients, although many benefit from less.
Why People With IBD Are Apt To Eat More Sugar
Here are a few reasons I suspect people with IBD eat more sugar:
• You’re told to avoid fruits, vegetables, nuts and other high-fiber foods. This is one of the most common pieces of advice patients with Crohn’s and ulcerative colitis receive from healthcare providers. Unfortunately, rarely are you told to avoid cookies, cakes and other sugary foods. A better recommendation is to choose soft fruits, cooked vegetables, soups, smoothies, and nut butters vs whole nuts.
• You’re told to eat white foods. This is another popular recommendation people with IBD receive from providers. Most white foods are low fiber but high in sugar.
• You want to gain weight. Ice cream, cookies, pastries, and other sweets are quick sources of calories. Side note: rarely do my patients with IBD, particularly Crohn’s, gain weight from junk food. I suspect this might have to do with poor digestion, malabsorption, and an abnormal gut microbiota. See next point.
• You crave sugar. Lots of folks with IBD yearn for sugary foods. When they don’t get their sugar fix, they feel worse. I suspect that’s because your bad gut microbes love to ferment (feed on) sugar, and you crave what they crave.
Why Too Much Sugar Is Bad For Us & For IBD
Added sugar is making us sick. Growing scientific evidence links too much sugar to the following health conditions:
• Heart disease
• Liver disease (too much sugar is just as damaging to your liver as too much alcohol)
• Dysbiosis / Abnormal gut bacteria
• And more!
Plus, too much sugar, especially in the form of sugar-sweetened beverages worsens diarrhea, bowel urgency, abdominal pain, gas, bloating, and fatigue. Sugar-sweetened beverages include soda, lemonade, sweetened iced teas, Ensure and other nutritional supplements, Gatorade and other sports drinks. Don’t let health claims or the fact they’re served at hospitals fool you into thinking they’re good for you.
Research suggests that diets high in added sugars weaken the gut barrier, upset the gut microbiome and increase one’s risk of developing IBD and triggering IBD flares.
Beware Of Hidden Sources Of Added Sugar
“Added sugar” includes sugars and syrups added to foods during processing, preparation or at the table.
According to SugarScience, a reliable source for scientific evidence about sugar and its impact on health, there are at least 61 names for added sugar:
Agave nectar, Barbados sugar, Barley malt, Barley malt syrup, Beet sugar, Brown sugar, Buttered syrup, Cane juice, Cane juice crystals, Cane sugar, Caramel, Carob syrup, Castor sugar, Coconut palm sugar, Coconut sugar, Confectioner’s sugar, Corn sweetener, Corn syrup, Corn syrup solids, Date sugar, Dehydrated cane juice, Demerara sugar, Dextrin, Dextrose, Evaporated cane juice, Free-flowing brown sugars, Fructose, Fruit juice, Fruit juice concentrate, Glucose, Glucose solids, Golden sugar, Golden syrup, Grape sugar, HFCS (High-Fructose Corn Syrup), Honey, Icing sugar, Invert sugar, Malt syrup, Maltodextrin, Maltol, Maltose, Mannose, Maple syrup, Molasses, Muscovado, Palm sugar, Panocha, Powdered sugar, Raw sugar, Refiner’s syrup, Rice syrup, Saccharose, Sorghum Syrup, Sucrose, Sugar (granulated), Sweet Sorghum, Syrup, Treacle, Turbinado sugar, Yellow sugar
Added sugar is sweet and sneaky. Pastries, candy, and soda aren’t the only places it likes to hide. You can find it hiding in all kinds of foods we consider healthy, including:
• Granola bars
• Flavored yogurt
• Pasta sauce
• Salad dressing
• Barbeque sauce
• Teriyaki sauce
• Sports drinks
• Vitamin water
How To Eat Less Sugar With IBD
Keeping away from sugar is challenging but not impossible for people with IBD. Here are 5 tips for reducing your total sugar intake:
1. Choose ginger tea versus gingerale.
2. Ditch the sugary sports drinks, like Gatorade, and make your own oral rehydration solution. Combine 1/2 liter coconut water, 1/2 liter water, 1 Tbsp fresh lemon juice, dash of salt, and fresh fruit in a container. Replace half your day’s worth of water with this solution, and sip throughout the day. Discard after 24 hours.
3. Choose unsweetened varietes of packaged foods, such as oatmeal, yogurt and almond milk. Add 1 tsp raw honey or pure maple syrup if desired. One tsp is 4 grams of sugar.
4. Avoid Ensure and most other nutrition supplements. They’re sugar bombs. Use our custom smoothie guide to build your own nutrition supplements, or choose a less sugary pre-made option, like Orgain.
5. Flavor your coffee or tea with cinnamon instead of sugar.
Too much added sugar is bad for us and for IBD. Research links it to multiple health conditions, including Crohn’s disease and ulcerative colitis. A diet high in added sugar harms the gastrointestinal tract, disrupts the gut microbes, and worsens inflammation.
Overeating sugar is easy to do since it’s hiding in many of our favorite foods, but lots of sugar doesn’t belong in a healthy, healing diet. Neither do artificial sweeteners.
Check nutrition labels for total grams of added sugar and avoid food products with over five grams of added sugar per serving. Read ingredient lists and avoid products with more than one source of added sugar. Better yet, avoid packaged foods and stick to real food.
What are your favorite tips for satisfying a sweet tooth without too much sugar? We’d love to hear from you in the comments section below.
This article really resonates with me. I was diagnosed with TI Crohns and a stricture in 2016 and put on a low fibre diet. My main symptoms, after my initial flare was brought under control, were severe pain after eating ,and a continuous swing between diahorrea and constipation. So they put me on a low fibre diet. Theres only so much chicken and white rice a person can eat!! After four years of feeling miserable I decided to quit caffeine and refined sugar to see if it would improve my slowly declining mood. The withdrawl period (of about a week) was absolutely brutal, but after three months of consuming caffeine free teas , buying whole, natural foods, no added sugar, and doing my own cooking I feel so much better. Not just emotionally and energetically, but to my surprise all of my crohns symptoms have gone away. I can now tolerate most of the fruits and vegetables that caused me pain in the past and I can even manage a reasonable amount of wholewheat carbs. My sugar cravings have all but gone, and I find that I no longer need to snack between meals.
That’s wonderful! Thank you for sharing your experiences. We’re so glad that you’re feeling better and more energized with a healthy diet. I’ve worked with many patients who have also found that they can tolerate many fruits and veggies when they avoid/limit highly processed foods and excessive sugar.
All the best!