What’s the Problem with Added Sugar?

Assuming that I am not the only nutrition blog that you’ve ever read, you have undoubtedly heard a few things about added sugar. Some of the advice in the blogosphere can be a little extreme. Are you really going to avoid all added sugar? No dessert ever!? Ummm no. Are you going to inquire about the ingredients of every meal you ever order? Oh, please don’t!

Despite our reluctance to swear off added sugar, I think it’s worth knowing a little bit about why it is not good for your health to eat a lot of added sugar. And it is helpful to know where to look for hidden sugars in foods that you might not expect. It’s everywhere! So much so that the average American adult consumes about 17 teaspoons of added sugar every day! (1) That seems crazy.  But do you know how much added sugar you had today? I bet it is more than you realize. Even if you feel like you don’t have a sweet tooth, you’re probably consuming more sugar than you think.

What Does Added Sugar Mean?

Sugar occurs naturally in any food that has carbohydrates. That means that fruits, vegetables, grains, and dairy all contain naturally-occurring sugars. After all, carbohydrates are just sugars linked together.  Consuming whole foods with natural sugar is typically fine.  They are also full of fiber that balances out the sugar, and many of the sugars come in more complex forms that take longer to break down—that is a good thing for your blood sugar.  In fact, a high intake of fruits, vegetables, and whole grains can actually reduce your risk of chronic diseases like diabetes and heart disease. (2–4)

On the other hand, added sugar is sugar that food manufacturers add to food and beverage products to improve their flavor. It’s the sugar that does not naturally occur in food. It includes high-fructose corn syrup, which is ubiquitous in packaged food. But it also includes agave, fruit juice concentrate, honey, raw sugar, and brown rice syrup—things that may sound “healthy” but are still just sugar.

Why Lots of Added Sugar Isn’t Good for You

Like most things, the poison is in the dose.  A little added sugar is not a big deal.  But consuming too much added sugar is linked to an increased risk of chronic diseases like type 2 diabetes, non-alcoholic fatty liver disease, and heart disease. (5-6) I am not going to dive too deep into the biochemistry of what happens when you get a lot of sugar in your blood at once (you can read more on that here ). But at a high level, there are a few issues.    

One of the problems with added sugar is that it adds calories without giving your body any essential nutrients. Many of those extra calories don’t make you feel full either. Think about how much added sugar, and therefore calories, you’ll find in lemonade or coke or Vitamin Water.  And do you feel any less hungry after drinking it?  Nope.  It’s just sneaky added calories. 

But the real concerns about added sugar run a lot deeper than calories.   The problems have to do with what added sugar does to your blood glucose levels.  When you consume added sugars, all those sugars enter your bloodstream superfast.  Think about the difference between a bottle of ocean spray cranberry juice and eating an equivalent amount of sugar worth of cranberries.  One, you probably would give up before you ate all those cranberries.  But more importantly, it would take a long time to eat them, digest them, and then absorb the sugars.  All that extra time holds the key to avoiding a blood glucose spike.  That bottle of ocean spray is hitting your belly and your bloodstream like a tidal wave.  Your body needs to maintain glucose levels in a very strict range.  When blood glucose gets too high, it can damage blood vessels throughout your body and can cause long-lasting effects to your entire immune system triggering chronic inflammation.  Basically high blood glucose is no bueno.

So your body fights hard to get rid of the flood of sugar into your blood as quickly as possible.  It does this through rapid production and release of insulin into the bloodstream.   The insulin helps get rid of all that sugar by opening sugar doors to cells all over your body so the sugar flows into the cells and out of the blood.  But your body acts so quickly and sometimes overshoots its insulin production, so you end up getting rid of too much sugar from your blood.  Et voila, a sugar crash!  Or that afternoon slump. 

What happens after a sugar crash? Or when you need something to get you past 3pm?  You’re hungry again.  And you are hungry for sugar because that is what your body is low in.  So, the cycle continues. How exhausting.

Still not convinced? Here are some other reasons you might want to limit added sugars:

• High levels of added sugars increase your blood lipids (aka triglycerides) (7) 

• Added sugar, especially fructose, contributes to visceral adiposity, which is the fat around your belly that increases your risk of chronic diseases (8)

• Added sugar has been linked to disruptions in the gut microbiome (9)

• Added sugar may also increase the risk of depression (10)

Foods High in Added Sugar

The primary sources of added sugar in the American diet are sugary beverages, desserts, and sweet snacks. But added sugar can be sneaky, too! It hides out in some of your favorite “healthy” snacks. So, the next time you’re at the grocery store, keep an eye out for these products, which are often laden with sugar:

• Granola and Granola Bars

• Pasta Sauce

• Flavored Yogurt

• Instant Oatmeal

• Peanut Butter

• Breakfast Cereal

• Ketchup

• Canned Fruits or Fruit Snacks

• Trail Mix

• Sports Drinks

• Kombucha

Cutting Back on Added Sugar

If you’re looking for ways to cut some added sugar out of your diet, there are a few things you can start doing right now.

Choose Water: Almost half of the added sugar in an American’s diet comes from sugary beverages like soda and juice.11  To cut those out, grab a sparkling water instead. Water has no calories, and there is a variety of flavored, unsweetened waters that make drinking healthy more fun!

Swap for Fruit: Instead of snacking on a granola bar that is filled with added sugars, opt for a piece of fresh fruit. It will satisfy your sweet tooth without that sugar crash later.

Start Small: You don’t have to completely cut sugar out of your life. If you usually take your coffee with two sugar packets, cut it down to one. If you regularly drink sugary drinks throughout the day, try to drink one less per day.

I tend to believe (and I think the science supports) that a super restrictive diet is counterproductive to most long-term health goals. And I don’t recommend cutting out anything from your diet unless you are having some terrible reaction to it. But there is a lot of value in cutting back on added sugars, incrementally, and in a way that does not suck the joy out of eating experiences for you! It is also one of the few dietary changes that you see pretty quick results with — no more sugar crashes, afternoon slumps, or crazy sweet tooth cravings. If you are interested in talking about ways to cut back on your added sugar, let’s chat!

References

1.         CDC. Know Your Limit for Added Sugars. Centers for Disease Control and Prevention. Published November 28, 2021.

2.         Crawford B, Sandler D, Merchant A, Steck S, Park YM. Dietary Patterns, Socioeconomic Status, and Risk of Type 2 Diabetes in the Sister Study. Current Developments in Nutrition. 2022;6(Supplement_1):7. doi:10.1093/cdn/nzac047.007

3.         Hu EA, Coresh J, Anderson CAM, et al. Adherence to Healthy Dietary Patterns and Risk of CKD Progression and All-Cause Mortality: Findings From the CRIC (Chronic Renal Insufficiency Cohort) Study. Am J Kidney Dis. 2021;77(2):235-244. doi:10.1053/j.ajkd.2020.04.019

4.         Chiuve SE, Fung TT, Rimm EB, et al. Alternative Dietary Indices Both Strongly Predict Risk of Chronic Disease123. J Nutr. 2012;142(6):1009-1018. doi:10.3945/jn.111.157222

5.         Vreman RA, Goodell AJ, Rodriguez LA, Porco TC, Lustig RH, Kahn JG. Health and economic benefits of reducing sugar intake in the USA, including effects via non-alcoholic fatty liver disease: a microsimulation model. BMJ Open. 2017;7(8):e013543. doi:10.1136/bmjopen-2016-013543

6.         Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. JAMA Internal Medicine. 2014;174(4):516-524. doi:10.1001/jamainternmed.2013.13563

7.         Duan MJ, Dekker LH, Carrero JJ, Navis G. Blood lipids-related dietary patterns derived from reduced rank regression are associated with incident type 2 diabetes. Clinical Nutrition. 2021;40(7):4712-4719. doi:10.1016/j.clnu.2021.04.046

8.         Faruque S, Tong J, Lacmanovic V, Agbonghae C, Minaya DM, Czaja K. The Dose Makes the Poison: Sugar and Obesity in the United States – a Review. Pol J Food Nutr Sci. 2019;69(3):219-233. doi:10.31883/pjfns/110735

9.         Ramne S, Brunkwall L, Ericson U, et al. Gut microbiota composition in relation to intake of added sugar, sugar-sweetened beverages and artificially sweetened beverages in the Malmö Offspring Study. Eur J Nutr. 2021;60(4):2087-2097. doi:10.1007/s00394-020-02392-0

10.       Reis DJ, Ilardi SS, Namekata MS, Wing EK, Fowler CH. The depressogenic potential of added dietary sugars. Medical Hypotheses. 2020;134:109421. doi:10.1016/j.mehy.2019.109421

11.       CDC. Sugar Sweetened Beverage Intake. Centers for Disease Control and Prevention. Published April 11, 2022.