“Enough, no more. ‘Tis not so sweet now as it was before.” —William Shakespeare, Twelfth Night
My mother used to fling this quote at us when we were indulging in too
much of a good thing.
Sugars are a natural part of fruits, vegetables, dairy products and grains, and are used to provide energy for our bodies. Unless we’re diabetic or have specific health issues, dietitians, doctors and nutritionists have no problem with our eating these intrinsic sugars.
“I don’t concern myself at all about the sugars in fruit,” says Seattle nutrition educator Cynthia Lair, author of Feeding the Whole Family. “Fruit is a whole food containing fiber and many nutrients that keep the sugars from having a dramatic effect.”
The problem is added sugars, consumed when we ladle sugar into our tea or coffee, drink sodas and sugar-sweetened drinks, indulge in candies or desserts, or ingest high-fructose corn syrup or other sweeteners hidden in most canned or packaged foods.
All this adds up to a whopping 22.2 teaspoons of added sugar a day for the average American, according to the 2001-04 National Health and Nutrition Examination Survey, conducted through the Centers for Disease Control and Prevention. That’s 355 calories. The average is 34.3 teaspoons a day, or 549 calories, for 14- to 18-year olds.
In contrast, the United States Department of Agriculture (USDA), providers of the Food Pyramid, has a discretionary calorie allowance of about 3 teaspoons of added solid fats, 5 teaspoons of sugar or one alcoholic drink for a person who takes in 1,800 calories a day. In its August 2009 recommendations on “Dietary Sugars Intake and Cardiovascular Health,” the American Heart Association (AHA) put the level of added sugars for women at 6 teaspoons, or about 100 calories, a day. Six teaspoons of sugar by volume is about 25 grams in weight. (A regular, 12-ounce can of soda has almost 10 teaspoons or 39 grams of sugar.)
According to the USDA, the major sources of added sugars in the American diet are:
What’s so bad about extra sugar?
In agreeing with the 5- to 6-teaspoon-a-day limit, Cristen Harris, Ph.D., a Seattle dietitian and professor at Bastyr University, outlines some of the harmful effects.
The biggest problem is sugar’s contribution to obesity, which is a risk factor for a host of conditions from cardiovascular disease to type 2 diabetes to many types of cancer. Sodas and sweetened drinks are implicated. “When people drink their calories, they don’t feel full and they don’t reduce the calories they take in later; they end up being add-on calories,” Harris says.
Any concentration of sweetener stimulates the body to release more insulin to process the sugar. This results in a low blood sugar level, making the person hungry and tired and wanting more sugar, Harris explains. This effect is still being studied, but has been implicated in the onset of type 2 diabetes.
The natural sugar fructose (found in honey, fruits and some root vegetables) is chemically overconcentrated in some sweeteners, including high-fructose corn syrup and agave syrup. “Fructose is implicated in higher levels of triglycerides and bad cholesterol in the blood, regardless of obesity,” Harris explains. Fructose-heavy sweeteners also contribute to the accumulation of deep abdominal fat, the most dangerous kind.
The second major problem with added sugars is that they displace high-nutrient foods that protect us from disease, Harris summarizes.
Lair describes a series of food decisions that result in this displacement. “We often get up in the morning and unconsciously choose empty calories like sugar and white flour,” she says. “If I have a cup of coffee, orange juice, a donut or a white bagel, I’ve got nothing to sustain me. By 10:30 a.m., I feel tired and poorly, so I look for a jump-start and grab a sugary granola bar or a Frappuccino to keep going. The sugar high and low repeats. If I don’t stop and feed my body a nutrient-rich lunch, I’ll be starving and moody by dinnertime — which can lead to more poor food choices.”
Not only does sugar displace nutritious calories, it may also deplete the body of nutrients. Lair refers to theories and studies showing that sugars and refined flours create an acidic condition in the body. The body strives to create balance. To alkalize the system, it draws minerals from the bones and teeth — leading to a link between sugar consumption and osteoporosis. In addition, the body uses up zinc, chromium, calcium and B-vitamins to generate the extra insulin needed to process excess sugar.
While not directly linking sugar with heart disease, the American Heart Association reviewed 114 studies and reports to make its new recommendations on dietary sugars. In addition to the contribution to obesity and bad cholesterol, there are possible links to high blood pressure and overall inflammation in the body and to loss of micronutrients that are beneficial to the heart.
The American Cancer Society updated its guidelines on nutrition in 2006, stating that “by promoting obesity and elevating insulin levels, high sugar intake may indirectly increase cancer risk.” Specifically, being overweight increases the risk of breast, colon, uterine, esophageal and kidney cancers. A new study finds a strong link between drinking soda and increased incidence of pancreatic cancer.
The American Diabetes Association is less specific about added sugars, lumping them with simple carbohydrates (ones without much fiber that break down quickly) and overall calories from snack food and desserts that contribute to weight gain and insulin resistance.
The American Dental Association recommends reducing sugars because they can contribute to bacteria and plaque, leading to cavities. In addition, poor nutrient levels affect the health of teeth and gums.
Sugar by any other name…
Yes, it will taste as sweet. And yes, any kind of sugar will have the same added calories and same effect on health.
There are lots of names for sugar, which can make it difficult to identify it correctly on food labels. Sugars are simple carbohydrates that include glucose, galactose, fructose, dextrose, lactose (found in milk) and maltose (found in malt). Many sugars are a combination of glucose and fructose. Sugar from sugar canes or beets (sucrose) is about half glucose and half fructose, as is honey, maple syrup and molasses. High-fructose corn syrup is about 55 percent fructose, and agave syrup — which is highly processed and not recommended by Lair or Harris — is 84 percent fructose.
In addition to the names listed above, you’ll find added sugars described as sugar, brown sugar, raw sugar, corn sweetener, syrup, corn syrup, malt syrup, fruit juice concentrate, invert sugar, evaporated cane juice or suconut (from coconut sap). Sucanat, popular in health-food stores, is a non-refined cane sugar that retains its natural molasses content.
“No sweeteners are any different in the body; it’s the same calorie to calorie,” Harris says. She prefers less processed, more naturally occurring forms of sugar, such as brown sugar, molasses or honey, which have a little nutritional value. Lair also prefers to use better quality, less refined sugars — ones she could make in her own kitchen. Sucanat, molasses, honey and maple syrup have more flavor, adding more than just sweetness to recipes, she says.
Except for sodas and all-sugar drinks, it may be difficult for us to tell which calories are intrinsic to the food and which are added. More than a decade ago, the nonprofit Center for Science in the Public Interest asked the federal Food and Drug Administration to require food labels to declare how much sugar is added to foods and drinks and to set a maximum recommended daily intake. So far, these pleas have fallen on deaf ears.
Lair recommends eating whole foods — with only one or a few ingredients — and looking at the ingredient list on canned or packaged foods to see which have the most total sugars. If a form of sugar is listed high on the ingredient list, it contains more added sweetener in proportion to other nutrients. Many low-fat versions of prepared foods have more sugar than the regular versions, according to the USDA. (See a list of which kinds foods have the most added sugars at www.ars.usda.gov; type “added sugars” into the search box.)
“The most important thing about sugar is the amount you eat compared to
other more nutritious foods,” Lair says. “We don’t
want to say, ‘No, I can never have birthday cake or a piece of
pie.’ It’s OK to say ‘Yes’ to dessert, but
put it in its right perspective. Put a priority on feeding yourself
well for the majority of each day, and let the cookie be an occasional
SIX WAYS TO CUT DOWN ON SUGAR
It’s not easy to limit our intake of added sugars because we’re born with a predisposition to like sweet things. Although there’s lots of controversy over whether sugar can be addictive, it does seem to stimulate a reward system in the brain, Bastyr Professor Cristen Harris explains. Some people have more of a genetic predisposition to like sweets, and obese people may be more sensitive to the stimulation of the reward centers. In its report on sugars, the AHA noted that sucrose goes directly to the “pleasure center” of the brain and alters levels of dopamine and natural opioids.
Nevertheless, Harris says, if we get into a habit of consuming fewer sweets, we experience fewer sugar highs and lows and lose some of the craving and taste for sugar.
Here are some practical suggestions from Harris and nutrition educator Cynthia Lair:
TALKS ON SUGAR AND DIET
“SUGAR-FREE LIVING” with Dr. Cristen Harris
Saturday, May 15, 10 to 11 a.m., at the Bastyr Center for Natural Health, 3670 Stone Way N. The lecture is part of the series, “Living Naturally: Conversations on Health and Happiness with Bastyr Experts.” It is free and open to the public.
“SWEETIE PIE, HONEYBUNCH: BAKING WITH SWEETENERS” Demonstrations with Cynthia Lair
Tuesday, June 22, 6:30 to 9 p.m., at the Green Lake PCC, 7504 Aurora Ave. N., Seattle; Tuesday, June 29, 6:30 to 9 p.m., at the Issaquah PCC, 1810 12th Ave. N.W., Issaquah; Saturday, July 10, 10 a.m. to 12:30 p.m. at the Bastyr campus, 14500 Juanita Drive N.E., Kenmore; and Tuesday, July 20, 6:30 to 9 p.m., at the Edmonds PCC, 9803 Edmonds Way, Edmonds. Cost is $35 for PCC members; $40 for nonmembers. Call 206-545-7112 or visit www.PCCcooks.com to register. Find out more about Lair’s philosophy and recipes by viewing her online cooking show at www.cookusinterruptus.com.
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