Everywhere we go, we hear about sugar these days. It’s just like ‘low fat’ in the 1990’s and we are left wondering what to believe, what to eat, and what to make of these ever-changing recommendations!
I still remember scouring food labels in the 90s and trying desperately to find the winning ticket; ‘fat free’ (i.e. <0.5g of fat per serving). Every time I went to the grocery store a new ‘fat free’ food popped up. The problem is, in an attempt to create foods like this, most manufacturers added sugar. Now, this was heaven for someone like me; suddenly I was able to eat ‘healthy’ and still eat cookies). I should have known better…. if it seems too good to be true, it usually is, and this certainly holds true when it comes to nutrition.
Please humour me for a few paragraphs as I give you some of the stats around sugar- if it’s not your cup of tea, feel free to skip ahead to the practical suggestions for reducing sugar in your diet.
Here goes, the SCIENCE. There’s a growing body of literature which suggests that the level of free (or added) sugar in the diet is related to dental cavities, weight gain/obesity, Type 2 Diabetes (T2D), cardiovascular disease (CVD), even death from CVD. Whether the latter is indirect (i.e. solely related to weight gain) or direct (via mechanisms such as inflammation or liver metabolism) is still up for debate. Regardless, it’s clear that reducing the amount of free sugar in your diet is a good move!
The term ‘free sugar’ means any sugars added to food or drinks, or found naturally in honey, syrups and unsweetened fruit juices (and yes, this includes the sugar from ‘juicing’). This DOES NOT include the sugars naturally found in milk and whole fruit. Whole fruit not only provide a plethora of other benefits to ‘counter’ the sugar (such as fiber, vitamins, minerals, phytochemicals…), but the sugar is also held within the fibrous cell wall thus is not so rapidly absorbed thereby eliciting a lesser impact on blood glucose.
Free sugars can be in the forms of monosaccharides such as glucose, galactose and fructose or combined into disaccharides such as sucrose (glucose and fructose) or lactose (glucose and galactose). If you are looking for free sugars in a food label they can be listed as: sucrose, glucose, fructose, maltose, fruit juice, molasses, hydrolysed starch, corn syrup, honey, agave sugar, rice malt syrup, malt syrup, maple syrup, nectars, maltodextrin, dextrose (among others!). Sneaky eh?!
Guidelines around the world are now reflecting the growing belief that ‘less is more’ when it comes to sugar intake. The World Health Organization (WHO) has suggested free sugar constitute less than 10% of total calories for adults and children. The 2015 Dietary Guidelines are recommending the same whereas the UK Scientific Advisory Committee on Nutrition has suggested less than 5% of total calories from free sugars for ages 2 and up.
The UK has recently announced a ‘sugar tax’ on sugar sweetened beverages (SSBs) expected to raise £520m (that’s about $749m) in funds towards children’s obesity prevention programs. The US has recently revamped nutritional labeling to more clearly show the amount of sugar added to foods.
Some believe that sugar in the form of fructose is particularly bad. It is metabolized almost entirely in the liver in an insulin-independent manner whereas glucose tends to bypass the liver and be metabolised in tissues around the body in an insulin-dependent manner. There is evidence that high fructose diets lead to an increase in liver fat, gout, insulin resistance, and increase blood lipids. Adding fuel to the fire is the data on sugar sweetened beverages (SSBs). SSBs are the largest source of calories and free sugars in adults and children in the US hence have been heavily targeted as a point for intervention (ex. sugar tax in the UK). SSBs are generally made of High Fructose Corn Syrup (HFCS) which is about 55% fructose, 45% glucose. Some have suggested it’s the fructose component of SSB which is responsible for the growing problem we are facing with obesity and metabolic disease. However, the WHO (and other related guidelines) have not felt there is enough evidence to warrant specific recommendation around types of sugars. Their message is simply reduce [ALL] sugars!
So, what does this all mean? Well, for the average 2,000 calorie diet, you should only be eating about 50g of added sugar (25g if you want to stay below 5%). ONE can of soda is 35g of sugar. A hefty bowl of Crunchy Nut Cornflakes and you are through your sugar quota for the day before 8am. Generally, the more processed food is, the more sugar (and salt) gets added.
The only way to stay within these guidelines is to be diligent and read food labels to make sure sugar is not high up on the ingredient list. Until the new nutrition labeling comes into effect (see link above), free sugars are not separated from naturally occurring sugars (it just says sugar) so you have to examine the ingredients (see list above) to see if any has been added. Also, if there is no fruit or milk in the product (which have natural sugars), the sugar has likely been added. HINTS: look for food with less than 5g of sugar per 100g serving (less than 5%). If something is labeled ‘sugar-free’ it means less than 0.5g of sugar per serving. Also, don’t be fooled by ‘reduced sugar’ which just means 25% less than the original version of the product (therefore may still be quite high!).
Cook healthy, unprocessed food and you will find you can dramatically reduce the amount of sugar in your diet. Meals do not need to be complex if you are short on time (or if you have an 18-month old wrapped around your legs while you are trying to cook like I do!). Focus on whole foods which have had minimal (to no) processing; lean meats, vegetables and fruits. This means avoiding store-made sauces and condiments and certainly avoiding cookies, cakes and chocolate. If you are grocery shopping, try only shopping on the outside aisles of the store; the processed stuff tends to accumulate in the middle. Often removing temptation is enough to facilitate big changes.
If you simply can’t live without a sweet-fix, consider using low calorie sweeteners (in moderation). These include aspartame (Equal), saccharin (Sweet ‘n’ Low), sucralose (Splenda) and the new naturally derived sweetener, stevia (Truvia). While these sweeteners have all been deemed safe, there is some data suggesting that consumption of artificial sweeteners may, in fact, lead to overconsumption of foods later so its best these be kept to a minimum.
If you are used to a lot of ‘sweet’ you may be tempted to load up on these artificial sweeteners however, I suggest trying to stop adding sugar entirely- you will be surprised how quickly you will get used to the food/drink. I gave up adding sweeteners to my coffee when I was pregnant with my first child and now couldn’t imagine drinking sweet coffee again!
So, my challenge to you is to count your sugar for one day…you WILL be surprised how quickly it adds up! On day 2, try to reduce it. Every little bit helps and just being mindful of your habits will help you start taking steps to a healthier you. Good luck and let me know how it goes!
- Bray GA. Energy and Fructose From Beverages Sweetened With Sugar or High-Fructose Corn Syrup Pose a Health Risk for Some People. Nutr. 4: 220–225, 2013.
- Hu FB. Resolved: there is sufficient scientiﬁc evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obesity Review. 2013.
- LT Morenga et al. Dietary sugars and bodyweight: systematic review and meta-analyses of randomised controlled trials and cohort studies. 2013; 346.
- JB Moore and BA Fielding. Sugar and Metabolic Health: is there still a debate?
- Yang et al. Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. JAMA Intern Med. 2014;174(4):516-524.
Written by Dr. Tara Coletta, PhD
Tara's research focused on obesity and metabolism. She studied exercise science (MS, UMass Amherst) before earning a PhD in nutritional biochemistry (Tufts University). Wellness remains an integral part of Tara’s life as she works to balance being a mother of three.