Everything You Ever Wanted to Know About Sugar

Sharon Salomon

Seems everyone's got an opinion about sugar. It's a safe bet that many people have resolved to give it up this year, because they think sugar negatively impacts their health. The relationship of sugar to health is an emotionally charged issue, with people taking sides for or against it with little, if any, scientific support for their beliefs.

"Sugar has an undeserved bad reputation. This may be due, in part, to the fact that sugar is often used in combination with other ingredients, such as fat, which are known to have adverse health effects," says Richard Surwit, Ph.D., professor of psychiatry at Duke University Medical Center (Durham, North Carolina). Since confusion abounds on the subject of sugar, EN answers your most pressing questions about this sweet stuff.

Q: What is sugar anyway?

A: White granulated table sugar, also known as sucrose, is the most common form of sugar. But it's not the only kind of sugar; other forms of added caloric sweeteners include corn sweeteners (high fructose corn syrup or HFCS, glucose syrup, and dextrose), honey, lactose, maltose and maple syrup. The method of transforming plant or raw sugar (from cane or beets) into table sugar is called refinement, which involves washing, crystallizing, clarifying and filtering raw sugar to remove plant matter and molasses to create the final product, white sugar. No chemicals are used or added during this process.

Q: Can reading a food label ferret out sugar?

A: "Sugars" on the food label refers to all caloric sweeteners in a food, even those that you might not think of as sugar. This term includes any naturally-occurring sugars that are found in vegetables, grains, fruits or dairy products, as well as other added sweeteners, such as those mentioned above, including corn syrup, high fructose corn syrup, lactose, dextrose, maltose, invert sugar and fructose. Lisa Raum, R.D., a consultant dietitian in Virginia, explains that since "sugars" on a label is a combination of naturally-occurring and added sugars, there is no way to tell how much of each is in the food. She recommends reading through the ingredient list to find out what sugars have been added.

Q: How much sugar do Americans really eat?

A: Sugar hidden in foods and beverages can add up. According to the U.S. Department of Agriculture, the U.S. is the largest consumer of sugars and caloric sweeteners in the world. Data from the National Health and Nutrition Examination Survey 2001-2004 (the most recent data available), states the average intake for all Americans is a whopping 22.2 teaspoons per day vs. recommended sugar intake by the American Heart Association (AHA) is no more than six teaspoons per day for women, nine teaspoons for men.

Q: Are we consuming too much sugar?

A: The American Heart Association (AHA) thinks so. AHA's position is that added sugars contribute zero nutrients and extra calories that can lead to weight gain and obesity. The guidelines above are for added sugars and sweeteners, not those found naturally in whole foods. It's difficult to calculate how many teaspoons of added sugar you're getting in two chocolate chip cookies or a serving of spaghetti sauce. So, the best advice is to eat as few processed foods as possible and focus on whole, fresh foods.

Q: Does sugar cause obesity?

A: It's commonly believed that obesity is a function of high energy (or calorie) intake without adequate energy output. In other words, eating too much and exercising too little. But the causes of obesity are more complex than that. A statistical analysis of population dietary surveys from 1989-2002 published in August 2007 in Food and Chemical Toxicology determined that obesity is a multi-factorial problem with lifestyle, behavior and environment having a more dominant role in obesity prevalence than individual foods.

Q: Is sugar addictive?

A: Scientists believe that the preference humans seem to have for sweets is probably a long-cultivated, protective mechanism against poisonous substances, since many poisons taste bitter while many safe, nutritious foods, like fruit, taste sweet. But does that mean humans have a natural tendency to crave sweets?

According to a paper published in Neuroscience and Biobehavioral Reviews in the first issue of 2008, sugar is a substance that releases opioids and dopamine; thus it might be expected to have addictive potential. However, true addictions involve cravings, tolerance and withdrawal. People do not often crave pure sugar, but rather a sweet food, like candy or cookies. The nature of tolerance implies that a person needs more and more sugar to satisfy the craving, and withdrawal indicates that if the craving is not satisfied, the person will experience actual physical symptoms.

While some people, especially women, report symptoms of craving and withdrawal for sugar and sweetened foods, science does not yet support that sugar is addictive.

Q: Does sugar cause diabetes?

A: The official word from the American Diabetes Association is that sugar does not cause diabetes. However, consuming too many sweetened foods can contribute to overweight and obesity, and being overweight can increase the risk for developing diabetes. People with diabetes monitor their sugar intake to help manage their blood sugar.

Q: Does sugar cause hyperactivity?

A: Ask any schoolteacher how her class behaves after the students eat birthday cake and you'll probably hear a recurring theme that sugar causes hyperactivity. And many adults report difficulty sleeping after eating sweets. There's plenty of anecdotal evidence to persuade people that sugar and hyperactivity or disruption of sleep go together, but there is scant scientific evidence to support that notion.

Marion Nestle, M.P.H., Ph.D., professor of nutrition at New York University, explains that the relationship between sugar and hyperactivity is more situational. She adds, "One would expect a kid to be giddy at a party, whether sugary foods were served or not." Another consideration is that sugar is usually found as an ingredient in a food that contains many other ingredients; thus it is possible that other components in foods can cause potential reactions in behavior.

Q: Does sugar feed cancer cells?

A: Sugar -- in the form of glucose -- feeds all the cells of your body, including cancer cells. But there is some truth behind the idea that a high-sugar diet isn't good for cancer prevention. The link between sugar and cancer seems to be related to higher levels of insulin, which can be the result of dietary factors, body weight issues and/or metabolic problems, according to a study published in Cancer Causes Control in December, 2002.

"Insulin can accelerate the growth of cancer cells," explains Sharon Hollinden, M.S., R.D., a dietitian at the Center for Cancer Care, Torrington, Connecticut. In order to moderate insulin levels, Hollinden encourages cancer patients -- just as she would anyone else -- to limit added sugars.

THE BOTTOM LINE ON SUGAR

It seems that the optimal way to deal with sugar is to limit foods with added sugars, but to continue to enjoy them in moderation instead of banning them altogether. For many, the decision about how much sugar to eat every day will rest on personal experience, instead of scientific evidence. And since your body can do quite well without eating added sugar, there's no concern if you choose to eliminate it.

SUGAR LINGO

All these are names for sugars; look for them on labels:

Dextrose

Corn Syrup

High-Frustose Corn Syrup

Maltodextrin

Fruit Juice Concentrates

Malt Syrup

Molasses

Invert Sugar

Honey

Sorghum

Cane Sugar

SKIMMING SUGAR FROM YOUR DIET

1. Choose mostly whole, fresh foods

2. Reduce soft drinks and sweetened beverages

3. Limit processed foods such as crackers, cookies, sweetened breakfast cereals, and condiments like catsup

4. Read ingredient labels and learn the names for added sugars

5. Switch from regular jelly to "all-fruit" spreads

6. "Sweeten" foods with fresh fruits. For example, add mashed banana to oatmeal instead of sugar.

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Health & Nutrition - Everything You Ever Wanted to Know About Sugar