Did you make a New Year’s resolution to eat well or lose
weight? Have you decided to cut down on the added sugar in your life? Reducing the
amount of added sugars you consume is one way to enhance the quality of the
food you eat, eliminate some unwanted calories and work toward improving your
overall health. Making the decision to cut down on added sugars is simpler than
actually doing it. Let’s be honest; sugar tastes good.
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| Brown Sugar By Moe Rubenzahl (Moe Rubenzahl) GFDL (http://www.gnu.org/copyleft/fdl.html) via Wikimedia Commons |
How much added sugar do Americans consume?
According to the Center for Disease Control, adults and
children in the United States
are consuming more than the recommended amount of added sugar. About 13% of the
calories adults 20 and older eat come from added sugars, according to the National
Health and Nutrition Examination Survey (NHANES) data collected from 2005-2010.
NHANES data from 2005-2008 revealed that children age 2 through
19 get about 16% of their calories each day from added sugars
The current Dietary Guidelines for Americans states that
no more than 5% to 15% of total calories each day come from a combination of added sugars and solid
(saturated) fats (CDC data briefs). The American
Heart Association specifically recommends that women consume no more than 100
calories per day from added sugars (6 teaspoons) and men consume no more than 150 calories per day from added sugars (9
teaspoons) (AHA page). If that seems
like a lot of sugar, consider that a typical 12-oz regular (not diet) cola
contains 150 calories and about 10 teaspoons of sugar (Harvard School of Public Health-Added Sugar).
Resources
What is added sugar and why is it used?
Added sugars are
sugars that are introduced to foods and drinks during preparation or processing. Added sugars are not an inherent
part of a food or beverage. Examples include adding a packet of sugar to
a cup of coffee, sugar coated breakfast cereals, products like energy bars
sweetened with nectar, honey, or syrups of any
kind. Added sugars contribute calories (4 kilocalories per gram) and that is
why added sugars are considered nutritive sweeteners. The term “nutritive
sweetener” is deceptive because regardless of the source of its origin, added sugars contribute empty calories.
Sugars are added to enhance flavor, texture, color, reduce acidity, preserve
fruits, and provide energy for fermentation. Sugar is also added as a bulking
agent.
Do added sugars affect health?
You can’t get
something for nothing
Added
sugars increase the calorie content of the foods and drinks you consume. They
come with a cost of 4 kcals/gram. If you regularly consume more calories than
you need you increase the likelihood you will gain weight. A can of
regular soda contains about 150 calories. If you drink 1 can of regular soda
every day of the year and do not make room for that in your eating plan it can lead to as much
as 10-15 lbs. of weight gained over the course of the year.
Sugary
drinks provide calories and may immediately satisfy hunger or craving. Sugar added foods and drinks provide
empty calories that are quickly digested and absorbed. The sugar gets into your
bloodstream quickly and is delivered to your cells and tissues. Dietary
components like complex carbohydrates, protein, and unsaturated fats help you
digest and absorb food more slowly than added sugars. They allow you to feel full longer and provide your body with the fuel you need at a steadier pace.
You get unwanted fat
and displace other nutrients
Foods that contain a lot of added sugar are more likely to
be higher in saturated fat. Not only do you get additional calories from sugar,
you also get additional calories from fat. Calories you may not need or want
and that you may not realize are in the product. When people consume foods and
drinks that are high in sugar, it is often at the expense of other more
nutritious food items that provide vitamins, minerals, protein, fiber,
phytochemicals, and some unsaturated fat.
Triglycerides
Triglycerides are a type of fat found circulating in the
blood and in fat cells. A diet that contains a lot of added sugars is
associated with higher blood triglycerides. High blood triglycerides are
associated with an increased risk of heart disease. When you consume more
sugars than you need, some will get stored as glycogen in the liver and muscle while the rest will get converted into fat and be incorporated into
triglycerides.
Oral health / tooth
decay
Microorganisms love to feed on sugar. When you eat more
added sugar, microorganisms have more fuel. More fuel means they grow and prosper at the expense of your teeth (tooth decay). Oral hygiene is important
to promote dental health.
Bray, G. A.,
& Popkin, B. M. (2014). Dietary sugar and body weight: have we reached a
crisis in the epidemic of obesity and diabetes?: health be damned! Pour on the
sugar. Diabetes Care, 37(4), 950-956.
doi: 10.2337/dc13-2085
The many faces of added sugars
Ingredients on food labels are always listed by weight from highest to lowest. If sugar is listed in the
first three ingredients, you know two things: 1) it is an added sugar and 2) there probably is a lot of it in the
food or beverage. Currently, you have to read the ingredient list to find if
the sugars in your food and drinks are added or not. In order to figure that
out, you have to know what to look for. This list includes the most common
types of added sugar you might encounter:
White sugar
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Brown sugar
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Raw sugar
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Corn syrup
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Corn syrup solids
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Dextrin
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High fructose corn syrup
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Malt syrup
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Maple
syrup
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Pancake syrup
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Fructose sweetener
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Liquid fructose
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Fructose
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Honey
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Molasses
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Anhydrous dextrose
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Crystal dextrose
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Dextrose
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Nectar (all kinds, like agave)
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Fruit
juice concentrate
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Invert
sugar
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Malt sugar
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Glucose
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Maltose
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Sucrose
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Syrup (all
kinds, like brown rice)
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Cane sugar
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Cane crystals
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Evaporated cane juice
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Nutrition Facts Panel
As of January 2015,
deciphering the added sugar content in food products
remains an exhausting and
often confusing task. Naturally occurring and added sugars are included
together under a single category of “sugars” on the Nutrition Facts panel
(figure 1). The food represented in the Nutrition Facts panel (figure 1) contains
37 grams of carbohydrate, 4 grams of dietary fiber, and 1 gram of “sugars.” In
order to figure out if the sugars are added sugars or sugars that are
inherently part of the food (like lactose – milk sugar – that is a natural part
of milk) you would have to read the
“ingredients” list and hunt for the sugars. To do that, you have to be able to
recognize names of added sugars.
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| Figure 1. Nutrition Facts Panel Used Now (1/2015) |
In August of 2014, the Food and Drug Administration proposed changes to
the food label.
The goal is to make food labels easier to read and to update
the labels to reflect the most current knowledge about diet and health. One of
the changes, if the label is put into practice, will be to display “added
sugars” as its own category. This would make reading and using the Nutrition
Facts panel much easier. Figure 2 shows a version of the proposed revised label
(it is still a draft and is not in use) from the FDA’s website. You can see in
figure 2 that there are no added sugars in this product and so the 1 gram of
sugars come from naturally occurring sugars that are an inherent part of the food.
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| Figure 2. PROPOSED Changes to Nutrition Facts Panel |
Are some nutritive sweeteners (added sugars) healthier than others?
When it comes to reducing the risk of cardiovascular disease
and body weight, it is the amount of sugar you eat rather than the source of
the sugar that seems to matter most. A
healthy human body metabolizes nutritive sweeteners of all kinds the same way (American Heart Association,
Mayo Clinic - Added Sugar,
Harvard School of Public Health - Added Sugar,
Mayo Clinic - Artificial Sweeteners).
If your diet regularly contains excess added nutritive sweeteners beyond your
caloric needs, you increase the likelihood that you will gain weight and,
possibly, increase your risk of heart disease. A 2014 literature review and
systematic (meta) analysis found that drinking sugar-sweetened beverages was
associated with increased blood pressure (Malik, Akram, Shetty, Malik, & Yanchou Njike, 2014).
Honey has been used in different cultures and traditions to
treat many conditions but the efficacy of it remains unclear. The Mayo Clinic
reviewed research about honey and health. They ranked the evidence using an A, B,
C, D, F grading system (Mayo Clinic - Honey).
In general, honey received Cs for all areas reviewed which the Mayo Clinic
defines as “unclear evidence for this use.” At this time, there are no medical recommendations to
support the use of honey to treat any medical conditions
Different sugars contain different plant chemicals
(phytochemicals). For example, in 2011, over 26 phytochemicals were identified
in maple syrup (Li & Seeram, 2011). The potential role and
impact of these phytochemicals on the human body is currently in the early
phases of research and understanding (Gonzalez-Sarrias, Li, & Seeram, 2012).
Maple syrup is not a recommended treatment for any condition.
In 2014, a mouse study was published that tested whether or
not agave nectar elicited different responses in mice compared to mice fed similar amounts of sucrose (table sugar) in terms of weight gain, blood glucose control and whether or not they developed high cholesterol. The research revealed that mice that ate agave nectar instead
of sucrose gained less weight and had better glucose control than their
sucrose-fed counterparts (Hooshmand et al., 2014). This was a small mouse
study, so more research is needed to find out if similar effects are found in
other species of mice, other rodent models, and (most importantly) in humans. Agave nectar is not recommended to prevent obesity, insulin resistance, or improve blood glucose control.
At this time, no
research supports the use of any type of sweetener over any other. The
recommendation from the American Heart Association, the United States
Department of Agriculture and the Department of Health and Human Services is to
limit added sugars.
Final Thoughts
Reducing the amount of added sugars you consume is a healthy lifestyle choice. Research continues to indicate too
much added sugar in the diet contributes to weight gain, elevated blood pressure, and an increased risk of heart disease. Reducing added sugar in your diet in small ways
can have a positive effect on your overall health.
In the future, I look forward to learning more about how gut microorganisms
impact the nutrient metabolism, nutrient utilization, and other functions of their human hosts. This is a new area of research. A
paper was published at the end of November 2014 in PLoS One that reported
results of a study that looked at how microorganisms obtained from obese and
lean people differed and how they could assess that difference based on how the
cultured microorganisms metabolized different nutrients, including
carbohydrates (sugars) (Aguirre, Jonkers, Troost, Roeselers, & Venema, 2014).
Aguirre, M., Jonkers, D. M., Troost, F. J.,
Roeselers, G., & Venema, K. (2014). In vitro characterization of the impact
of different substrates on metabolite production, energy extraction and
composition of gut microbiota from lean and obese subjects. PLoS One, 9(11), e113864. doi:
10.1371/journal.pone.0113864
Bray, G. A.,
& Popkin, B. M. (2014). Dietary sugar and body weight: have we reached a
crisis in the epidemic of obesity and diabetes?: health be damned! Pour on the
sugar. Diabetes Care, 37(4), 950-956.
doi: 10.2337/dc13-2085
Gonzalez-Sarrias,
A., Li, L., & Seeram, N. P. (2012). Effects of maple (Acer) plant part
extracts on proliferation, apoptosis and cell cycle arrest of human tumorigenic
and non-tumorigenic colon cells. Phytother
Res, 26(7), 995-1002. doi: 10.1002/ptr.3677
Hooshmand, S.,
Holloway, B., Nemoseck, T., Cole, S., Petrisko, Y., Hong, M. Y., & Kern, M.
(2014). Effects of agave nectar versus sucrose on weight gain, adiposity, blood
glucose, insulin, and lipid responses in mice. J Med Food, 17(9), 1017-1021. doi: 10.1089/jmf.2013.0162
Li, L., & Seeram,
N. P. (2011). Further investigation into maple syrup yields 3 new lignans, a
new phenylpropanoid, and 26 other phytochemicals. J Agric Food Chem, 59(14), 7708-7716. doi: 10.1021/jf2011613
Malik,
A. H., Akram, Y., Shetty, S., Malik, S. S., & Yanchou Njike, V. (2014).
Impact of sugar-sweetened beverages on blood pressure. Am J Cardiol, 113(9), 1574-1580. doi: 10.1016/j.amjcard.2014.01.437
