We hear all the time that sugar is bad for you. Recently, there has been more and more talk about added sugar and its negative impacts on your body. What is added sugar? How is it different from “regular” sugar? Why is it so bad for you? How can you avoid it?

The average American eats about 22 teaspoons of added sugars daily, which counts for more than 15% of total calories. This is mainly the result of there being added sugar in almost 70% of packaged foods, such as bread, health foods, snacks, yogurts, most breakfast foods, salad dressing, pasta, instant oatmeal, ketchup, and sauces. However, the main perpetrators are desserts, sodas, energy drinks, and sports drinks.

Very rarely do you come across something that doesn’t have added sugar because sweetness appeals to most people. So, sugar is added to processed foods to make them more appetizing. In addition, it’s added to foods to give them better texture and color, preserve foods (ex. jams and jellies), fuel fermentation (ex. bread), serve as a bulking agent, and balances the acidity of foods containing vinegar or tomatoes. Also, added sugars are often found in foods that contain solid fats, such as butter or margarine.

Even though it’s used frequently, what exactly is it?

Added sugar is any type of sugar that is added to a food at some point. This is different from natural sugar, which is inherently in the food, including those found in fruit, vegetables, or milk. This means that the sugars are added during the manufacturing process. There are several ways to tell if a sugar is added. The first is if the ingredient ends in “-ose”, such as glucose, fructose, sucrose, dextrose, and maltose. Another is if any ingredients have “sugar” in the name, like brown sugar or cane sugar, or have “syrup” in the name, including rice, maple, corn, or evaporated cane syrup.

Some forms of sugar are often purported to be healthier than others but really aren’t consist of honey, molasses, and agave. One that isn’t healthy, and surprising to most people, is ingredients with “fruit” in the name, such as fruit concentrates and fruit nectars. The main issue with added sugars is that they add calories without adding nutrients because adding sugar to foods and beverages makes them more calorie-dense, which makes it easier to consume extra calories without realizing it.

Sugar, whether natural or processed, is a type of simple carbohydrate your body uses for energy. According to the Food and Drug Administration (FDA), there are two main kinds of sugars on a molecular level, and most foods contain some of both. The first are monosaccharides, which are single sugar molecules, including fructose, galactose, and glucose. These are easily broken down by your body and go almost directly to your bloodstream.

The second type is disaccharides, which are two of these single sugar molecules linked together. For example, sucrose, or table sugar (glucose + fructose); lactose, or milk sugar (glucose + galactose); and maltose, or malt sugar (glucose + glucose). Since these take a little longer to break down into the single glucose molecules your body uses for energy, they raise your blood sugar slightly more slowly. Any sugar you eat, natural or added, is some combination of these molecules. Your body can’t tell the difference between them because they’re not any different in terms of their chemical structure.

Added sugars are usually made up of simple sugars, which means they’re digested immediately and rapidly absorbed into your body, resulting in a large spike in your blood sugar levels. This dramatic increase causes your pancreas to produce more insulin. If your pancreas can’t keep up with the demand, your blood sugar levels continue to rise. If this happens on a frequent basis, it can lead to problems with insulin secretion and eventually to diabetes.

Sugar also increases inflammation throughout your body and raises triglycerides (a type of fat found in the blood). Both of these can lead to weight gain that results in obesity and elevates your risk for heart disease/stroke. This is why many scientists believe added sugar is a main offender in the obesity epidemic.

Another effect of sugar is that it boosts dopamine levels in the brain, which is responsible for providing you with that feel-good sensation, or high. This is why the more sugar you eat, the more your brain tells you you want it. Eating lots of added sugar creates changes in the brain similar to those found in people who are addicted to cocaine and alcohol, and some people experience the same type of cravings/withdrawal symptoms.

A particular concern with added sugar is that foods laden with them are often less nutritious than other foods, so your body misses out on important nutrients, vitamins, and minerals. Bacteria, like us, need sugar to survive, so eating lots of sugary food encourages bacteria to grow in your mouth and increases the chances of tooth decay. Sugar turns on the aging programs in your body, which means the more you eat, the faster you age. As a result, it’s being looked at as a possible cause of Alzheimer’s disease. An additional concern is that too much added sugar in your diet damages your liver, similar to the way that alcohol does. Since the increase in added sugar consumption across the country, almost 33% of adults and 13% of children have nonalcoholic fatty liver disease, which is a condition directly linked to added sugar consumption.

“Sugar belly” is the term used when your waist is bigger than your hips and comes from your liver repeatedly detecting more fructose (often found in processed foods) than your body can use. To be able to process this extra fructose, your liver breaks it down into fat globules. These fat globules are sent via your bloodstream to the area around your internal organs and midsection. Fructose is concentrated in high doses from corn, beets, and sugar cane, in which much or all of the fiber and nutrients have been removed. Without the fiber to slow it down, your body receives a huge influx of fructose.

Fructose also dulls your body’s reaction to the brain hormone leptin, which is your body’s natural appetite suppressant. If you eat large amounts of added sugar, you can develop leptin resistance, where your brain stops getting the message to stop eating, so you overeat. To make it worse, leptin resistance will make you feel sluggish, making it difficult to be active, thus contributing to further weight gain. The leptin resistance phenomena enabled our ancestors to survive long periods of time when there was a limited food supply by encouraging them to overeat during times of plenty and enabling them to conserve more calories as fat. However, nowadays, this is no longer a concern.

On the other hand, foods consisting of only naturally occurring sugars are usually full of other good stuff, like fiber (in fruit), protein (in dairy products), and vitamins/minerals (in both fruit and dairy products). These other nutrients affect how your body reacts to the sugar in that food. So, it’s far easier to get more nutritional value and harder to consume excessive amounts of sugar from foods with only or mostly natural sugars because of the nutritional value in the rest of the food, not the nature of the sugar itself.

You’ve probably heard a great deal about high-fructose corn syrup (HFCS) and how bad it is, but according to the FDA, it simply means that it has a higher ratio of fructose to glucose than regular corn syrup and is similar to sucrose, or table sugar. It’s commonly used in large amounts as added sugar in many packaged goods. However, there isn’t no evidence that HFCS is worse for you than any other form of sugar. The issue lies in the amount of it in food products, no matter the type of added sugar.

It’s important to note that sugar substitutes made in a lab, like saccharin and sucralose, or derived from nature, such as stevia or monk fruit, are classified by the FDA as high-intensity sweeteners, which are totally different in their chemical structure from sugar and effects they have on your body. Similar to added sugars, they’re added to foods and beverages to give them a sweet taste, but they don’t alter the sugar or overall nutritional content. Since they’re not composed of sugar molecules, they contain zero or very few calories. Sugar alcohols, like sorbitol or xylitol, are the same in that they taste sweet, like sugar, but they’re not actually sugar.

Obviously, sugar, especially added sugar, should only be consumed in small amounts. Per data from 2003-2010, Americans above the age of 6 consumed about 14% of total daily calories from added sugars. According to the Healthy People 2020 objectives and the 2015-2020 Dietary Guidelines for Americans, we should keep our intake of added sugars to less than 10% of our total daily calories, which is about 12 teaspoons or 48 grams. So, if you’re following a 2,000 daily calorie diet, no more than 200 calories should come from added sugars.

The World Health Organization’s (WHO) recommendation is that no more than 10% of an adult’s calories, ideally less than 5%, come from any form of sugar. The American Heart Association advises stricter limits, including no added sugar for children younger than age 2, no more than 100 calories (6 teaspoons or 24 grams) from added sugar a day for children older than age 2 and most women, and no more than 150 calories (9 teaspoons or 36 grams) from added sugar a day for most men.

To put these numbers into perspective, 1 teaspoon of sugar is equal to about 4 grams and has about 16 calories. This means that a 12-ounce can of regular soda has about 160 calories or about 10 teaspoons or 40 grams of sugar. This is equal to the amount of sugar in 1 orange + 16 strawberries + 2 plums.

To help consumers better understand what types of sugars they’re ingesting, a new law went into effect on January 1, 2020. The FDA first announced the new labels in 2016, and after several delays, they’ve finally debuted. This law stipulates that food manufacturers with over $10 million in annual sales are required to put the amount of added sugar on the nutrition facts label; however, small companies have until next year to comply.

The Nutrition Facts Labels are great for comparing similar items because all the label information is based on the serving size listed on the nutrition panel, which includes calories as well as nutrients. It’s essential to note that ingredients are listed in descending order by weight. So, if you see sugar listed among the first few ingredients, the product is likely to be high in added sugars. It can be confusing to try to decipher the amount of added sugars on nutrition labels because it’s listed in grams, which is an abstract term for most people.

An easy way to remember this is to think of the “rule of 4.” For example, divide the number of grams by 4 to convert grams of sugar to teaspoons. So, 16 grams of sugar equals 4 teaspoons. If you want to convert grams of sugar to calories, multiply the number of grams by 4, which means that 16 grams of sugar equals 64 calories.

According to researchers, the new labels have the potential to improve public health and reduce healthcare costs. They estimate that over the next of 20 years, it’ll cause a shift in the nation’s diet to prevent over 300,000 new cases of cardiovascular disease and about 27,000 deaths from cardiovascular disease. In addition, it should prevent nearly 600,000 cases and over 16,000 deaths from type 2 diabetes. Also, during the same years, the country could save $31 billion in healthcare costs.

The reason for all of these dramatic improvements is that the assumption is since companies are required to list how much added sugar is in their products, they’ll put less of it in the products. The researchers might not be wrong with this calculation because in 2003 when food labels were mandated to include information about trans fats, food manufacturers changed their products to decrease the amount of trans fats in their products. So, they’re likely to do the same thing with added sugar. One study estimates that the amount of added sugar in 7.5 – 9% of food products would go down by an average of 25% each year over the course of the first four years after labeling rules go into effect.

You can reduce the amount of added sugar you take in in several ways. One of the big ones is swapping out sugary drinks for plain water, calorie-free drinks, or low-fat milk. If you want to drink fruit juice, just make sure it’s 100% fruit juice, not juice drinks that have added sugars. Better still, eat the fruit rather than drink the juice; this way, you’ll also get the fiber. These can also be a great option for dessert instead of cakes, cookies, pies, ice cream, and other sweets. Also, limit dessert to only once a week, especially anything with added sugar. If you’re buying canned fruit packed, make sure it’s in water or juice, not syrup.

For breakfast, skip sugary and frosted cereals and choose the reduced-sugar varieties of syrups, jams, jellies, and preserves. When choosing a snack, select something nutrient-rich, like vegetables, fruits, low-fat cheese, whole-grain crackers, and low-fat, low-calorie yogurt. It’s a good idea to sweeten foods yourself because you’ll probably add less sugar than a manufacturer would.

The good news is that reducing the amount of added sugar in your diet isn’t about deprivation, counting calories, or cutting fat. Instead, you’ll replace the less desirable foods with foods that taste even better. Be warned that during the first five days of no added sugar, you will probably have intense cravings for sweets, especially in the evening, but these will fade, and you’ll start to feel more energetic, more focused, and less irritable. Keep in mind that it takes up to three weeks of no added sugar to get your brain’s dopamine system back to normal. One way to help you cut sugar is to look at the total grams of sugar in the food, no matter the source, and reduce how much you take in each day.

In order to live a long, healthy life, you need to move more and eat better by getting fewer of your calories from added sugars. Reducing it to minimal amounts is key if you can’t completely cut it out. This is why checking the label to see how much sugar is in your food is helpful. Take the time to learn how to read and understand food labels because you’re more likely to make better decisions when it comes to selecting what to eat if you do. Added sugars don’t have to control your life, and by taking the necessary step of looking at the label, you’ll be able to select what’s best for you.