Sugar Smarts

Added sugars are everywhere—threatening our health in countless ways. Use these tips to limit your sugar intake.

by Matthew Kadey, MS, RD

Many foods you might never associate with being sweet contain an abundance of added sugar. It might surprise you to learn where it lurks—and how much you might be consuming.

In America, life is sweet all right: so sweet that for children and adults, respectively, added sugar—sugar that doesn’t occur naturally in food—accounted for 14% and 17% of calories consumed in 2009–2012 (Powell, Smith-Taillie & Popkin 2016). The federal government’s 2015–2020 Dietary Guidelines for Americans recommend that we get no more than 10% of our daily calories (about 50 grams, or 12 teaspoons) from added sugar. For a person eating a 2,000-calorie diet, that means fewer than 200 calories from added sugar (most adults eat about 308 sugary calories each day (Powell, Smith-Taillie & Popkin 2016), or about 60 pounds of sugar yearly). While the World Health Organization also suggests striving for a 10% limit, it stresses that 5% (about 25 grams) would be an even better goal (WHO 2015).

There is no way to sugarcoat it: The additive that tastes so good is a likely culprit in our obesity crisis and a range of health woes that go beyond diabetes and tooth decay. Researchers at the Centers for Disease Control and Prevention found that people who got 10%–24% of their calories from added sugar were 30% more likely to die from cardiovascular disease than those who ate less (Yang et al. 2014). Insulin resistance from excessive added sugar is a likely driver of heart disease (DiNicolantonio & O’Keefe 2017). An Oregon State University study discovered that a high-sugar diet can change gut bacteria in ways that might degrade cognitive function (Magnusson et al. 2015). Meanwhile, a recent study in the journal Nature Communications found that a high rate of sugar conversion by cancer cells may stimulate the growth of tumors (Peeters et al. 2017).

There’s strong evidence that our bodies respond to sugary calories differently than they do to other kinds of calories. Hence, the old saying “A calorie is a calorie” is a fallacy. What’s more, processed foods with lots of added sugar can cause blood-sugar spikes and subsequent crashes, says Jessica Murgueytio, RD, a clinical dietitian with Bethesda Medical Associates in Maryland. “[These swings] can make people feel lethargic and crave even more sugar, causing the cycle to continue,” she explains.

It doesn’t help that sugar lights up our brains’ dopamine centers, making us temporarily feel fantastic and ready for another hit. And Murgueytio adds that, at the end of the day, we’ve consumed a finite number of calories, so the kind of calories we choose matters. If we’re trying to lose weight—but consuming excess sugar calories—we’re probably crowding out calories from nutrient-dense foods.

Yes, each person is different and every diet should be tuned to specific needs. But in general, Murgueytio says, most people could benefit from a less-sugary diet. The pervasiveness of added sugar in our food supply makes it hard to scale back, but it’s not impossible.

These tactics can help you and your clients tame a too-sweet tooth:

Read Labels Closely

Sugar is everywhere, in unexpected places. About 75% of packaged foods on store shelves have sweeteners, according to a study in the Journal of the Academy of Nutrition and Dietetics (Ng, Slining & Popkin 2012). And people savvy enough to skip pastries, flavored yogurts, soda and other notorious sugar bombs might not realize that sugar is hiding in lots of supermarket foods that are generally healthier for us.

Whole-grain bread, jerky, frozen fruits, nut butter, granola bars, almond milk, deli meats, salad dressings and the tomato sauce you pour over your pasta all have extra sugar. “If these foods are the only sources of added sugar within the day, then it’s not too concerning,” says Maria Dalzot, RD, a sports dietitian and professional runner. “However, if the day’s intake includes additional sweets, then I would consider making the switch to options with no added sugars.”

New FDA rules starting in 2020 for large manufacturers and 2021 for smaller companies require Nutrition Facts labels to include a separate line showing how much sugar has been added to the food or drink (some companies have already updated their labels). This will make it easier to spot how much sugar occurs naturally (such as the lactose in yogurt) versus what has been pumped into the product.

Until then, Dalzot says, people can weed out some of the sweet stuff from their diets by judiciously examining ingredient lists for signs of sweeteners. “Once you know where sugar hides, you can start making changes.” Looking for labels such as “no added sugar” or “unsweetened” on items like almond milk and applesauce can also be helpful.

“Once you know where sugar hides, you can start making changes.” — Maria Dalzot, RD, sports dietitian

Learn Sugar Synonyms

When you read food labels, look for more than the word “sugar.” Added sugars hide behind aliases such as maltodextrin, evaporated cane juice, brown rice syrup, corn syrup, coconut nectar, barley malt, organic dried cane syrup, dextrose and maltose (basically any word ending in -ose). Manufacturers try to disguise sugar with other names that make it sound more wholesome (ahem, fruit juice concentrate). Don’t let fancy packaging and catch phrases like “natural” or even “organic” fool you. Be sure to flip over the package and examine the ingredient list, word for word, for signs of sugar in all its guises.

Avoid Sweet Soda and Drinks

Sweetened drinks are the biggest source of added-sugar calories in the standard American diet. A 2017 study in the journal Obesity Facts reviewed 30 non-industry-funded studies involving 244,651 subjects and found a strong link between sugar-sweetened beverage consumption and obesity among adults and children (EASO 2017).

And there’s more heartbreaking news for soda lovers: A review of 36 studies in the Journal of the Endocrine Society suggests that regularly quenching your thirst with sugar-sweetened beverages ups your chances of developing metabolic syndrome, a cluster of conditions such as abdominal obesity and elevated blood pressure that raises your risks of heart disease and diabetes (Deshpande, Mapanga & Essop 2017).

Even beverages considered “healthy”—like kombucha, flavored kefir, almond milk, green juices and enhanced waters—can put you in the sugar-intake danger zone. Since fruit juices lack the fiber found in whole fruits, slowing the digestion of natural sugars, most people should go easy on the OJ. “I recommend limiting juice to 4 ounces or less per day,” suggests Murgueytio.

“Free” Isn’t Free

Be especially wary of products like peanut butter, frozen yogurt and salad dressings advertised as “reduced-fat” or “fat-free.”

“When fat is removed from a product, sugar is usually added as a replacement to improve palatability,” Dalzot says. A serving of fat-free, fruit-flavored yogurt can typically have three times more sugar than a serving of 2% plain yogurt. Moral of the story? Opt for whole foods closer to their natural state, even if you get a few more fat calories.

Besides, fat is more satiating than sugar, so it’s easier to practice better portion control. “Psychologically speaking, the term ‘free’ on anything may make someone more likely to overdo it without fear of feeling guilt,” notes Dalzot.

Sweat First, Sweet Second

If Krispy Kreme is your guilty pleasure, the best time to satisfy a craving might be after a calorie-crushing workout. “Taking in sugar shortly after a hard workout can help you get a jump-start on the recovery process, as the sugar is efficiently used to restore muscle glycogen stores,” says Dalzot. As a stored carbohydrate, glycogen is a major source of energy during intense exercise. Hitting the gym is not a green light for overconsuming sweets, but it gives you a bit of wiggle room.

Prolonged endurance exercise (longer than 60–90 minutes) is another sweet opportunity, Dalzot says, because the body metabolizes sugar from items like gels and sports drinks for a quick source of easily digested energy. Just remember that no amount of training makes someone immune to the pitfalls of eating too much added sugar.

It’s All Sugar

Supposedly better-for-you sugars marketed as “more natural” don’t live up to the hype.

A study in The Journal of Nutrition found that when people ate the same amount (about 2 tablespoons) of honey, sucrose (i.e., white sugar) or much-maligned high-fructose corn syrup every day for 2 weeks, they experienced the same troubling metabolic changes, including increases in blood triglycerides and markers of inflammation—both risk factors for heart problems (Raatz, Johnson & Picklo 2015). Sure, coconut sugar (made by boiling down the sap of coconut palm trees) may have a smattering of nutrients like calcium, but levels are far too low to outweigh the health risks of eating too much sugar. And while maple syrup has antioxidants, you’d likely have to drown your pancakes in it to match the antioxidant levels in fruits and vegetables

In “less-processed” sugars like demerara and turbinado, the sugar crystals are larger, and some of the original molasses remains. Slightly less nefarious—but hardly nutritional saints. And agave has more fructose than high-fructose corn syrup, so it won’t do your liver any favors.

“At the end of the day, sugar is sugar,” says Murgueytio. “All forms of sugar should be minimized to promote improvements in health and body composition.”

Avoid Cravings

The next time you’re about to give into candy bar temptation, lace up your running shoes. Research shows that simply taking a brisk 15-minute walk can tame cravings for sugary snack foods (Ledochowski et al. 2015). “Exercise can temporarily suppress hunger hormones and alleviate cravings associated with boredom or stress,” says Dazlot.

Finally, consider staying fit with friends more often. A 2014 study by Norwegian scientists found that people with stronger social ties tended to drink fewer sugary beverages (Henriksen, Torsheim & Thuen 2014). Feelings of loneliness can bring on bouts of sugar lust.

REFERENCES

Azad, M.B., et al. 2017. Nonnutritive sweeteners and cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. Canadian Medical Association Journal, 189 (28), E929–39.

Deshpande, G., Mapanga, R.F., & Essop, M.F. 2017. Frequent sugar-sweetened beverage consumption and the onset of cardiometabolic diseases: Cause for concern? Journal of the Endocrine Society, 1 (11), 1372–85.

DiNicolantonio, J.J., & OKeefe J.H. 2017. Added sugars drive coronary heart disease via insulin resistance and hyperinsulinaemia: A new paradigm. Open Heart, 4 (2), e000729.

EASO (European Association for the Study of Obesity). 2017. Analysis of new studies including 250,000 people confirms sugar-sweetened drinks are linked to overweight and obesity in children and adults. ScienceDaily. Accessed Jan. 24, 2018: sciencedaily.com/releases/2017/12/171223134832.htm.

Henriksen, R.E., Torsheim, T., & Thuen, F. 2014. Loneliness, social integration and consumption of sugar-containing beverages: Testing the social baseline theory. PLOS ONE, 9 (8), e104421.

Ledochowski, L., et al. 2015. Acute effects of brisk walking on sugary snack cravings in overweight people, affect and responses to a manipulated stress situation and to a sugary snack cue: A crossover study. PLOS ONE, 10 (3), e0119278.

Magnusson, K.R., et al. 2015. Relationships between diet-related changes in the gut microbiome and cognitive flexibility. Neuroscience, 6 (300), 128–40.

Ng, S.W., Slining, M.M., & Popkin, B.M. 2012. Use of caloric and noncaloric sweeteners in US consumer packaged foods, 2005–2009. Journal of the Academy of Nutrition and Dietetics, 112 (11), 1828–34.

Peeters, K., et al. 2017. Fructose-1, 6-bisphosphate couples glycolytic flux to activation of Ras. Nature Communications, 8 (1), 922.

Powell, E.S., Smith-Taillie, L.P., & Popkin, B.M. 2016. Added sugars intake across the distribution of us children and adult consumers: 1977–2012. Journal of the Academy of Nutrition and Dietetics, 116 (10), 1543–50.

Raatz, S.K., Johnson, L.K., & Picklo, M.J. 2015. Consumption of honey, sucrose, and high-fructose corn syrup produces similar metabolic effects in glucose-tolerant and -intolerant individuals. Journal of Nutrition, 145 (10), 2265–72.

Sylvetsky, A.C., et al. 2017. Consumption of low-calorie sweeteners among children and adults in the United States. Journal of the Academy of Nutrition and Dietetics, 117 (3), 441–48.

Tey, S.L., et al. 2017. Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake. International Journal of Obesity, 41 (3), 450–57.

WHO (World Health Organization). 2015. WHO calls on countries to reduce sugars intake among adults and children. Accessed Jan. 24, 2018: who.int/mediacentre/news/releases/2015/sugar-guideline/en/.

Yang, Q. 2010. Gain weight by “going diet”? Artificial sweeteners and the neurobiology of sugar cravings. Yale Journal of Biology and Medicine, 83 (2), 101–08.

Yang, Q., et al. 2014. Added sugar intake and cardiovascular diseases mortality among US adults. (4), 516–24.

Meet our experts

AFM_Author_Kadey Matthew Kadey, MS, RD, is a James Beard Award-winning journalist, Canada-based dietitian, freelance nutrition writer and recipe developer. He has written for dozens of magazines including IDEA Fitness Journal, Runner’s World, Men’s Health, Shape, Vegetarian Times and Fitness.

The information provided is without warranty or guarantee and NASM disclaims any liability for decisions you make based on the information. Learn more