Is Sugar Killing You?

Featured Article, Healthy Recipes and Nutrition, Nutrition
on April 1, 2014
sugar addiction 2

Who doesn’t love sugar? Even crave it? It soothes us when we’re stressed. Makes us feel good after a long day at work. Helps us celebrate birthdays, weddings and Halloween. And even makes medicine palatable.

But some of us go too far on the sugar front. The Academy of Nutrition and Dietetics reports that on average American adults get nearly 15 percent of their daily energy—a.k.a. calories—from added sugar. And according to a 2009 statement from the American Heart Association (AHA), Americans down about 22 teaspoons, or 355 calories, of the sweet stuff every day.

Whether or not sugar is addictive is still up in the air. One thing is clear: “In some people, it may be habit forming,” says Laura A. Schmidt, Ph.D., M.P.H., a professor in the Institute for Health Policy Studies at the University of California San Francisco School of Medicine. And downing high doses of sugar for a long time triggers a chemical cascade in the reward center of the brain that may make you crave more. But that rush of pleasure comes at a price.

Study after study has shown that sugar wreaks havoc on our health. In fact, sugar causes all the conditions associated with metabolic syndrome—high blood pressure, overweight or obesity, fat around the waist, high triglycerides and high fasting blood sugar—which raises the risk for heart disease, diabetes and stroke, explains Schmidt, who is also co-director of the community engagement and health policy program for UCSF’s Clinical and Translational Sciences Institute.

Case in point: Women in the Nurses’ Health Study who went from one or fewer sugar-sweetened soft drinks per week to one or more per day during a four-year period and maintained that level for another four years gained on average nearly 18 pounds and had nearly a two-fold increased risk for Type 2 diabetes. A recent study in the journal JAMA Internal Medicine reported that eating lots of added sugar is bad for the heart. People who got 17 percent to 21 percent of their daily calories from added sugar had a 38 percent higher risk of dying from cardiovascular disease than people who got less than 10 percent of calories from sugar. People who got more than 21 percent of their calories from added sugar more than doubled their risk.

One type of added sugar—fructose—is especially harmful to health. Found in table sugar and high fructose corn syrup, this sugar is largely metabolized by the liver. Typically, fructose travels through blood to cells where it is used for energy. But if you repeatedly eat lots of fructose-sweetened foods or beverages, some fructose is stored as fat in your liver, raising your risk for “non-alcoholic fatty liver disease,” says Schmidt, who is also co-director of the community engagement and health policy program for UCSF’s Clinical and Translational Sciences Institute.

Fructose also interferes with a chemical called leptin that tells us to stop eating when we’re full, explains Schmidt. A steady diet of fructose causes insulin resistance, which occurs when the body doesn’t use insulin effectively and blood glucose levels rise, raising the risk of Type 2 diabetes. This, in turn, leads to leptin resistance—meaning the brain doesn’t hear the leptin signal, says Schmidt. The result: People eat more calories and exercise less. And that adds up to weight gain.

Overdoing the sugar may also up the risk of cancer and cognitive decline. And your dentist was right: Sugar is bad for teeth. A review found that 42 out of 50 studies on children and five out of five on adults showed a positive association between sugar and tooth decay.

So how much sugar is enough? The AHA recommends that men get no more than 150 calories from added sugar per day—about nine teaspoons—and women, no more than 100 calories—about six teaspoons. The World Health Organization (WHO) advises that sugar make up no more than 10 percent of total daily calories for the day. So if you consume 2000 calories, no more than 200 should come from sugar. But now WHO is considering lowering its sugar guideline to no more than 5 percent of calories—or 100 calories for someone who eats 2000 calories per day, bringing it in line with the AHA.

If you have a sweet tooth, cutting back on sugar may sound as impossible as climbing Mt. Everest. Not to worry. Here, easy strategies for scaling back on the sweet stuff.

Watch out for added sugar. Ingredients are listed on food labels in descending order by weight. So the higher up on the list an ingredient is, the more of it the food contains. In general, ingredients ending in “–ose” are sugars—think fructose, maltose, glucose, sucrose, dextrose. (Lactose, the sugar found in milk, is fine.) Watch out for corn syrup, corn sweetener, evaporated cane juice, too. Even agave nectar, molasses, honey, and maple syrup qualify as added sugar.

Know what you’re eating. Another reason to read food labels: Sugar isn’t just found in cakes and candies. It’s in pasta sauce, salad dressing, juice drinks, yogurt, packaged foods–even sports drinks, says Ximena Jimenez, R.D.N., a spokesperson for the Academy of Nutrition and Dietetics. She recommends choosing products with just five percent of the daily value from added sugar. Buy lower-in-sugar or sugar-free pasta sauces. Or make your own. Whisk up your own salad dressing, too. Sugar is included in the carbohydrate content on yogurt labels so stick to brands with no more 15 to 20 grams of carbs.

Watch the sweet beverages. Iced teas, juice drinks and soda are drowning in added sugar, making it easy to overdo the sweet stuff. Sugar-sweetened beverages now account for 37 percent of the added sugar Americans down. Soda is a major sugar culprit. One 12-ounce can of carbonated soda has about 133 calories—the equivalent of eight teaspoons—from added sugar. Drink two cans a day and you’ve downed 266 calories. Over the course of a week, that adds up to 1862 extra calories, and over time, to extra pounds. Brew your own sugar-free iced tea. If you can’t live without your OJ, buy 100 percent juice. And instead of soda, drink plain seltzer. For flavor, add a wedge of lemon or lime.

Don’t sweeten coffee or tea. Gradually reduce the amount of sugar you stir into your morning caffeine fix. “Instead of three teaspoons, add two,” advises Jimenez. Then, go from two teaspoons to one until you wean yourself off it. Or make a clean break. “Some people do very well going cold turkey,” says Jimenez.

Be careful with cereal. Buy cereal that has at least five grams of fiber and no more than 30 grams of carbohydrate per serving, advises Jimenez. These cereals typically contain less sugar. Another way to reduce the sugar content of your morning meal: Substitute unflavored oatmeal for cereal. “It takes five to 10 minutes to make if it’s rolled,” says Jimenez. To sweeten it, top with raisins or fruit. “You control what you put in the oatmeal,” says Jimenez.

Be wary of mixed drinks. Mixers like syrup, soda and juice up the sugar content of your favorite cocktail. Instead, ask for diet soda or 100 percent juice in your cocktail.

Cook from scratch. Added sugar is often used to preserve foods, so limit processed, canned and packaged foods. Buy fresh veggies and steam them. Broil a piece of fish or bake a chicken breast. Bake or mash your own potatoes. Eat fresh fruits for dessert—not canned fruits drenched in syrup.

Don’t fear fruit. While fruit does contain sugar, it’s naturally occurring. So, it doesn’t count towards your daily sugar allotment. Fruit also contains fiber, which will satisfy you and keep you from reaching for snacks with added sugar. Plus fruit is packed with good-for-the-body nutrients.

Make moderation your mantra. Deprive yourself of sweet treats and you’re likely to binge. “Eat only two to three bites of a sweet to satisfy your craving,” says Jimenez. And savor it. “ Make sure you eat slowly and mindfully,” adds Jimenez. “If you multi-task while you eat, you won’t enjoy the sweet.” And you may end up downing more than you want.