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Be Well

Not So Sweet News

by John Swartzberg, M.D.  

I like chocolate as much as anyone, but because of its sugar content I try to limit myself to a small square or two. Americans eat too much sugar, which has been a major player in the obesity epidemic. There are many types of sugar, yet nutritionally speaking, sugar is sugar. What matters most are the context and quantities. Sugars naturally in foods—such as lactose in milk and fructose in fruit—are okay, since they’re accompanied by vitamins, minerals and other healthful substances. The real problem is the sugar (sucrose or high-fructose corn syrup) liberally added to so many foods—not only to sweets like candies and cookies, but also to staples like pasta sauces, ketchup, canned baked beans and breakfast cereals. Sugar, like salt, is everywhere.

One frustrating thing about nutrition labels is that they don’t differentiate between naturally occurring and added sugars. The line for “sugars” in the Nutrition Facts box, under “total carbohydrates,” lumps them together. For many foods, that’s pretty useless. How would you know that 16 of the 43 grams of sugar in commercial sweetened applesauce has been added? Or that half the 26 grams of sugar in your healthy-looking 6-ounce low-fat fruit yogurt has been added—often largely in the form of fructose syrup.

The government’s Dietary Guidelines advise limiting added sugar, but don’t provide specifics. More helpful are the recommendations from the American Heart Association: Most women should consume no more than 25 grams (about 6 teaspoons and 100 calories) of added sugar a day; most men, no more than 37.5 grams (about 9 teaspoons and 150 calories).

It’s easy to exceed these limits, and most Americans do. On average, we consume about 90 grams (22 teaspoons) of added sugar a day—providing 360 calories—more than one-third from soft drinks. One 16-ounce bottle of soda has about 44 grams (11 teaspoons) of added sugar, which is why Mayor Michael Bloomberg of New York City has been right to target super-sized servings of such beverages.

For years the Food and Drug Administration (FDA) has been talking about improving food labels, including a simplified system of front-of-package nutrition information. The Institute of Medicine, which Congress requested to study the topic, has recommended that added sugar be one of the criteria on such labeling. Doing an end run around the government, the food industry recently introduced its own voluntary Facts Up Front, which does not include added sugar. The industry has long resisted labeling of added sugar, and so far it still seems to have the upper hand. At best, it will take years for the FDA to develop new labeling.

To tell if sugar has been added to packaged foods, check the ingredients list for any form of sugar. The more sugars listed, and the higher they are on the list, the more total sugar. Sucrose (table sugar) and high fructose corn syrup are the most common forms, but watch out also for brown, raw or invert sugar, as well as honey, molasses, agave nectar, evaporated cane juice and fruit juice concentrate, which sound healthier but are just other forms of empty sugar calories.