Added Sugars: The Facts about Caloric Sweeteners – Tufts

Fruits and vegetables have intrinsic sugars naturally contained within their cell walls, along with nourishing vitamins, minerals, and phytochemicals. They also have fiber that slows the release of sugars into the bloodstream and tends to limit how much one can consume at one sitting. “The health effects of sugar depend more on the dose and speed of ingestion and less on the source and type,” says Mozaffarian, “Our bodies evolved to metabolize small amounts of slowly digested sugars, such as those in a piece of fruit. When we consume added sugars, we are often getting a high dose of rapidly digested refined sugar.” This is the case even for so-called “natural” sugars. “There tends to be a misconception that if the sugar is isolated from a ‘natural’ source it does not count,” says Alice H. Lichtenstein, DSc, senior scientist at Tufts’ Human Nutrition Research Center on Aging and executive editor of Tufts Health & Nutrition Letter. “That simply is not the case. Added sugar is added sugar, even if it comes in the form of concentrated organic fruit juice. There is no getting around that fact.”

Sugar by any other name

Added sugars appear on ingredient lists by many names, but the body metabolizes them all in essentially the same way. On Nutrition Facts label ingredient lists, added sugars include the following:

  • any ingredient with the word “sugar,” such as white granulated sugar, coconut sugar, brown sugar, beet sugar, raw sugar, or sugar cane juice
  • any ingredient with the word “nectar,” such as agave nectar, peach nectar, or fruit nectar
  • any ingredient with the word “syrup,” such as corn syrup, high fructose corn syrup, carob syrup, maple syrup, brown rice syrup, or malt syrup
  • any ingredient containing a word ending in “-ose,” including sucrose, dextrose, glucose, fructose, maltose, lactose, galactose, saccharose, and mannose
  • cane juice/evaporated cane juice/cane juice crystals
  • caramel
  • corn sweetener/evaporated corn sweetener
  • fruit juice/fruit juice concentrate
  • honey
  • molasses
  • muscovado
  • panela (raspadora)
  • sweet sorghum
  • treacle

Health Impact of Added Sugars: Studies indicate that added sugars are associated with a number of adverse health concerns. “Natural sugars in fruits, vegetables, dairy, and grains are not associated with negative health outcomes,” says Lichtenstein, “but sugars that are removed from these natural sources, concentrated, and added to beverages and foods in processing are.” Sugary drinks and foods contribute directly to dental caries (cavities), and the caloric nature of many sweet treats may lead to weight gain. Being overweight or obese is, in itself, a risk factor for a number of chronic health conditions, including cardiovascular disease, type 2 diabetes and some cancers, but intake of added sugars may impact health even when weight is in the so-called “normal” range. “There is strong evidence that added sugar intake is a risk factor for type 2 diabetes,” says Lichtenstein. Strong evidence also indicates higher intake of added sugars is associated with increased cardiovascular disease risk in children and moderate evidence indicates an association with increased risk of high blood pressure, stroke, and coronary heart disease in adults. In a 2014 study in JAMA Internal Medicine, people who consumed more added sugars had a much higher risk of death from cardiovascular disease (CVD). Subjects who consumed ten percent to 25 percent of their calories from added sugars were 30 percent more likely to die from CVD than those for whom added sugars contributed less than ten percent of calories.

Take Charge!

All added sugars are associated with negative health effects. Try these tips to cut back:

-Cut back on all forms of added sugars, don’t just switch from foods with high fructose corn syrup to those with added apple juice concentrate, for example.

-Make water your beverage of choice (milk and unsweetened coffee, tea, and herbal teas are also good choices)

-Gradually cut back on any sugar added to coffee and tea (and watch out for the excessive sugars often added to commercially-prepared coffee and tea drinks)

-Make sweets and desserts a treat not a daily event

-Check Nutrition Facts labels for added sugars (dividing the grams listed by four will give an approximate number of teaspoons)

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