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Understanding the Basics of Sugar

Sugar is a broad term for simple carbohydrates or monosaccharides. Along with proteins and fats, carbohydrates are one of the three major food groups or macronutrients which the body needs in large amounts. But sugar is not a macronutrient. Eating too much sugar can lead to serious health problems. It’s also important to pay attention to how much sugar you are eating as well as the types of sugar you are consuming. 

Types of Sugars

Natural Sugar vs. Added Sugar

Naturally occurring sugar is found in whole foods such as fruits, vegetables, dairy, and whole grains. Several types of sugars occur naturally in foods, including sucrose, fructose, glucose, galactose, maltose, and lactose. 

Added sugars are processed sugars that are added to foods and beverages during processing or preparation, such as table sugar added to coffee or cereal and processed foods such as a candy bar or sugar-sweetened fruit juice. 

Food manufacturers add sugar to many foods such as candy bars, baked goods (cookies, cakes), breads, dairy products such as flavored yogurt, sugary drinks including soft drinks and energy drinks, and condiments such as ketchup, tomato sauce, and pasta sauce.

Added sugars can be made by processing natural sugars. For example, white sugar (sucrose), brown sugar (sucrose, fructose, and glucose), and honey (fructose, glucose, and other sugars). In addition, added sugar can be a chemically manufactured sweetener such as high-fructose corn syrup.

Brown Sugar vs. White Sugar

All sugar is made by extracting sugar juice from sugar cane or sugar beet plants. Sugar made exclusively from sugar cane plants is called cane sugar. From here, different types of sugars are made by adjusting the manufacturing processes. Sugars can, therefore, be classified by:

• Color: White sugar or brown sugar, which is made by mixing molasses back into white sugar

• Crystal size: Granulated, powdered, or superfine sugar

Refined Sugar vs. Unrefined Sugar

Refined sugar is used to add flavor and sweetness to processed foods. It is also used as a preservative in jellies and jams and a fermenting agent in breads and pickles. The body metabolizes refined sugar quickly. Eating refined sugars therefore leads to a spike in blood glucose levels. 

Unrefined sugar retains more of the natural nutrients, such as iron, calcium, and magnesium. Examples of unrefined sugar include honey, maple syrup, jaggery, agave, panela, panocha, and turbinado sugar. 

Natural Sweeteners vs. Artificial Sweeteners

Natural sweeteners include honey, agave nectar, and maple syrup. While they are healthier compared to processed sugar or refined sugar, natural sweeteners are still considered added sugar and are processed by the body in the same way.

Artificial sweeteners are sugar substitutes and are regulated by the FDA as food additives. They are made from chemicals or plant-based sources in a laboratory and have a sweet taste but don’t contain sugar. 

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Health Effects: How Bad is Sugar For Your Body?

Cardiovascular Health

Studies have found that eating too much added sugar is linked to high blood pressure and a higher risk of death from heart disease. One study done over a 15-year period found people who got about one-fifth of their calories from added sugar had a nearly 40% greater risk of death from cardiovascular disease compared to those who got about one-tenth of their calories from added sugar.

Weight Gain

Each gram of sugar contains about 4 calories. Eating too much sugar can, therefore, lead to consuming too many calories, which can lead to weight gain and obesity. 

Moreover, packaged foods with added sugar have no nutritional value. In other words, they contain empty calories that provide energy without any nutrient value.

In addition, when you eat sweet stuff, you are likely replacing healthier food choices. So, it’s not only that you’re eating added sugars in processed foods, but also that you’re missing out on healthy, nutritious foods.

Dental Health

Dental caries and tooth decay occur when acid in the mouth attacks the teeth, causing cavities to form in the tooth enamel. This acid is produced by bacteria in the plaque, a thin, sticky film that forms over teeth. Sugar in foods and beverages interacts with these mouth bacteria to produce the damaging acid that dissolves tooth enamel and causes tooth decay, which can progress to tooth abscesses.

Studies show that sugars in food and drinks play a major role in the development of tooth decay. Public health experts recommend limiting sugar intake to 5%-10% of daily energy intake to minimize the risk of dental caries. 

Liver Disease

When you consume sugar, your body breaks it down into glucose. It uses some of the glucose immediately for energy and saves the rest for later in the form of fat. The liver is one of the organs in the body where excess fat is stored. Over time, a high-sugar diet can lead to liver cells being gradually replaced by fat cells. This condition is called non-alcoholic fatty liver disease (NAFLD). In the early stages, NAFLD is not harmful, but in the advanced stages, it can lead to severe damage to the liver, including cirrhosis and a higher risk of diabetes, heart attack, and stroke.

Other Negative Health Effects of Sugar

• Eating large amounts of sugar added to foods and drinks can lead to weight gain, obesity, increased body fat, and metabolic syndrome, which are risk factors for type 2 diabetes. Long-term high-sugar diets can lead to insulin resistance, where cells in your body stop responding to insulin hormones properly, leading to increased blood sugar levels and diabetes.

• Research indicates that dietary sugar plays a key role in low-grade chronic inflammation and autoimmune diseases.

• Sugar itself is not carcinogenic (it does not cause cancer). However, consuming too much added sugar can lead to obesity, which is a risk factor for many types of cancers.

• Eating sugary foods leads to a spike in blood glucose and insulin levels. This can lead to increased oil production, inflammation, and androgen secretion — all of which can contribute to acne.

• Excessive consumption of sugary foods and drinks has been linked to an increased risk of memory problems, cognitive impairment, and mood disorders like depression and anxiety.

Sugar Addiction

Studies have found that certain foods can trigger the same reward circuits in the brain as cocaine and gambling. Eating too much added sugar triggers the pleasure centers in your brain, causing it to bypass the normal biological triggers for hunger. This causes you to crave sugary foods and beverages even when you are full and have plenty of calories in your system.

Consumption of excess sugar in sugary beverages is especially harmful. Research suggests that calories obtained from beverages are less satisfying than calories obtained from solid foods. Liquid calories can trick your body into turning off its appetite regulation system. This can cause you to crave sugar and add more calories to your diet.

Does Sugar Have Any Benefits?

Sugar as an Energy Source

Sugar isn’t all bad. In fact, you should not cut sugar out completely because your body needs it for energy. When you eat carbohydrates, the body processes them and turns them into glucose (sugar) and releases it into the bloodstream. The cells in your body take up the glucose from the bloodstream and use it as a fuel for energy. Therefore, removing carbohydrates and natural sources of sugar from your diet can lead to health problems. 

As mentioned, simple sugars are broken down quickly in the body for immediate energy. It’s also important to know that while simple carbohydrates (white flour, white bread, white rice, and pasta) don't contain added sugar, they also are broken down quickly by the body and can cause blood sugar spikes. 

Complex carbohydrates (whole grains, brown rice, vegetables) are therefore preferable as they provide a more steady source of energy. Talk to your primary care doctor if you want to learn more about which types of carbs are better for you and how much you should consume. Dietitians are also a good resource for nutrients, diets, and recipes that work best for your health while satisfying your preferences.   

Read more: Are Carbs Bad for You? What to Know

Benefits of Natural Sugars

Consuming natural sugars is healthy because plant-based sources of sugar also contain many important nutrients such as vitamins, minerals, antioxidants, fiber, and lean proteins. The body digests these foods slowly, and they don’t cause spikes in blood sugar levels. 

Recommended Daily Intake of Sugar for Different Age Groups

According to the National Cancer Institute, the average American adult consumes 24 teaspoons (about 100 grams) of added sugar per day, which is about 400 calories.

Other studies suggest that the average person in the United States consumes about 17 teaspoons or 72 grams of added sugar a day, which also is far more than the recommended amount. 

How Much Sugar is Safe Per Day?

The American Heart Association recommends:

• No more than 6 teaspoons (24 grams) of added sugar per day (100 calories) for adult women 

• No more than 9 teaspoons (36 grams) of added sugar per day (150 calories) for adult men 

• No more than 6 teaspoons (24 grams) of added sugar per day (100 calories) for children between 2 and 18 years of age, and no more than 8 ounces of sugary beverages per week

• Children below 2 years of age should not consume any added sugars

The Dietary Guidelines for Americans 2020-2025 recommend that adults and children over 2 years of age limit the intake of added sugars to less than 10% of their total daily calories. For example, if you are on a 2,000-calorie diet, you should obtain no more than 200 calories from added sugars (about 12 teaspoons of total sugars from foods and beverages with added sugars). Children younger than 2 years should not eat any added sugar at all. 

Is It Better to Never Eat Sugar?

Pros and Cons of a Sugar-Free Diet

A sugar-free diet or no-sugar diet limits or eliminates added sugar. A more extreme version also restricts foods with naturally occurring sugar, such as whole fruit and other foods, but this is not recommended as these foods are part of a healthy, balanced diet. 

The advantages of a sugar-free diet include improved health, weight loss, and a lower risk of chronic health conditions such as diabetes and heart disease. The disadvantages of a no-sugar diet are that it can be challenging and time-consuming to follow.

Myths and Facts About Sugar Elimination

• Myth: You should completely avoid sweet fruits if you are trying to cut off sugar

• Fact: Whole foods that naturally contain sugar should not be off-limits when you’re trying to cut back on eating sugar. This means you can still enjoy sweet fruits such as bananas, oranges, and pineapples.

• Myth: Fruit juices are healthy to drink since they are not soda. 

• Fact: Beverages such as iced tea, lemonade, sports drinks, energy drinks, and fruit juices often contain added sugar. Healthy beverage choices for sugar elimination include water and (in moderation) 100% fruit juices with no added sugar, diet sodas, and unsweetened tea or coffee.

• Myth: If you are trying to cut down on sugar, all you need to do is to eat less cookies and candies. 

• Fact: Besides the obvious sources of added sugar (cookies, cakes, candy bars, jams, jellies, sweetened breakfast cereals), make sure you are not eating more sugar in foods such as smoothies, dressings, sauces, condiments, dried fruit, and even gummy vitamins.

Tips to Reduce Sugar Consumption

Identifying Hidden Sugars in Food

Here are some tips on avoiding hidden sugars in foods and beverages:

• Read the nutrition label for sugar content. Remember, added sugar can be hidden in savory foods. Hidden sugars can also be found in foods that contain honey or other natural sugars. 

• Read the ingredients list on packaged foods carefully. Look for words such as:

  • Sugar (raw sugar, cane sugar, brown sugar)

  • Syrup (corn syrup, rice syrup)

  • Juice (cane juice)

  • Words ending in “ose” such as sucrose, fructose, maltose, dextrose

• Read the "Carbohydrate (of which sugars)" section of nutrition labels. Less than 5 grams of sugar per 100 grams of carbohydrates is considered low, while more than 22.5 grams of sugar per 100 grams of carbohydrates is considered high. 

• Eat home-cooked meals made with whole foods. This is often the easiest and best way to eat less sugar.

Healthier Alternatives and Sugar Substitutes

Sugar substitutes such as artificial sweeteners have fewer calories compared to sugar or no calories at all. Keep in mind that they also don’t contain nutrients such as vitamins, minerals, fiber, and antioxidants. However, sugar substitutes can help you control your calorie intake.

Food labels that contain artificial sweeteners may say “diet,” “sugar-free,” “keto-friendly,” “no-calorie,” or “low carb.” Artificial sweeteners include aspartame, saccharin, acesulfame potassium (Ace-K), advantame, neotame, and sucralose.

Other types of sugar substitutes include sugar alcohols (isomalt, erythritol, lactitol, sorbitol, maltitol, and xylitol) and plant-derived novel sweeteners (monk fruit, allulose, stevia, tagatose).