Hidden Sources of Sugar

As you probably know by now, sugar is one of my top villains when it comes to heart diseases and other degenerative health problems. But avoiding sugar is not always easy, especially when it comes to pre-packaged foods. Which foods are startlingly high sources of sugar (red light) and which get my seal of approval (green light)?

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“Sugar in the morning
“Sugar in the evening
“Sugar at suppertime
“Be my little sugar
“And love me all the time”

You may not be old enough to remember that 1957 No. 1 pop song hit “Sugartime” by the McGuire Sisters, but one thing for sure is that, decades later, Americans sure love their sugar. They consume egregious levels of sugar and sweeteners. Morning, evening, and night, just like the song. And it isn’t doing them much good. Just the opposite.

As a cardiologist I have long counseled my patients to cut down the sugar in their diet as much as possible. The main reason is that the sweets drive your blood sugar (glucose) level up, causing the body to respond with excess insulin, the pancreatic hormone that drives it back down. Over time, this roller coaster effect stokes insulin sensitivity (metabolic syndrome), diabetes, high blood pressure, arterial damage, inflammation, weight gain, and cardiovascular disease. That’s a high price to pay for yumminess!

According to a 2014 analysis in the journal JAMA Internal Medicine (Yang et. al), “most U.S. adults consume more added sugar than is recommended for a healthy diet,” leading to a “significant” increased risk of death from cardiovascular disease. In general, adults consume about 22 teaspoons of added sugars a day, more than three times the recommended amount for women and more than twice for men. The American Heart Association suggests no more than 6 teaspoons (100 calories) for women and 9 (150 calories) for men. There are 4 grams of sugar in a teaspoon.

One major factor driving these bad numbers is the consumption of sugars added to common foods and beverages. Natural sugar is found in fruits (fructose) and dairy (lactose), but that’s not the real big problem. Nor is the big problem so much the sugar that you add to a cup of coffee or to cereal, although too much of that habit isn’t a good idea. For many people, the challenge is the added, hidden sugars and sweeteners in processed food that they aren’t aware of unless they take the time to read the nutritional content labels on food packages. Such add-ons include white and brown sugar, honey, dextrose, malt syrup, and high fructose corn syrup.

High Sugar Foods to Avoid and Those with My Seal of Approval

You can cut down your intake of excess calories and sweeteners by taking the time − reading labels − and avoiding foods packed with added empty calories that your body absolutely doesn’t need. You have choices. Lots of them. Know when to recognize a red light and stop, when to proceed with caution, and when to give it a go:

  • Dates: Short yellow light. While dates are good sources of vitamins, minerals and fiber, they are also high in natural sugar. For the green light, limit yourself to 1 or 2 in a sitting
  • Ketchup, BBQ sauce and other tomato condiments: Long yellow light. Most commercially prepared ketchups and BBQ sauces are loaded with the sweet stuff. In general, a 2-tablespoon serving of BBQ sauce will give you 3 or more teaspoons of sugar; as for ketchup, it’s one-quarter sugar! My recommendation: Use these condiments sparingly, very sparingly.
  • Flavored yogurt: Red light. Low-fat yogurt typically contain 5 teaspoons of added sweeteners, plus artificial sweeteners. My recommendation: Choose full-fat, plain yogurt, or make your own. Yogurt has its own natural sweetness, from its natural lactose content, but if you still crave sweetness, add some berries, or mix in cinnamon, vanilla, unsweetened cocoa powder, or even a teaspoon or 2 of maple syrup (or up to 1 teaspoon of honey).
  • Nut mix: Short yellow light. Filled with healthy fats, protein and minerals, (unprocessed) nuts are some of the healthiest foods on the planet – a great choice for snacking! However, many nut mixes include candy, chocolate chips, or an abundance of dried fruit, which contains a good deal of sugar, albeit natural. To get a green light, make sure your nut mix is heavy on the nuts (I’m a big fan of almonds, walnuts and macadamia nuts) and light on the dried fruit; avoid dried papaya and pineapple, and go with raisins or dried cranberries. Add variety with pumkin or sunflower seeds, and forget the candy!
  • “Fruit snacks”: Red light! Processed fruit snacks are loaded with sugar (as much as 4 teaspoons per serving) plus artificial coloring and who-knows-what-else-that-your-body-doesn’t-need. My recommendation: Go with real fruit – it should always be your first choice instead of artificially sweetened substitutes. Another option is dried fruit, some of which taste sweeter than candy; be sure to limit your consumption of dried fruit, though, as the sugar in it can cause your insulin levels to spike.
  • Soft drinks: Red light. A 12-oz can of regular, carbonated soda contains 10-11 teaspoons of sugar. My recommendation: Avoid all sodas, including the diet varieties. They are liquid candy. Even tonic water, which has a bitter taste, contains as much sugar per serving as regular soda. Unflavored selzer water, by itself of with fresh lemon or lime juice or a splash of fruit juice is okay in my book.
  • Tomato / pasta sauce: Yellow light. Tomato sauce generally has more than 2 teaspoons of sugar for each ½ cup serving, not to mention high sodium content. For the green light: Shop carefully. Seek out brands with the lowest amount of sugar per serving. Organic sauces tend to be lower in sugar. Better yet, make your own sauce from fresh tomatoes.
  • Canned beans: Yellow light. Canned beans, especially baked beans, often contain added sugar. My recommendation: If you don’t want to cook beans from scratch, be sure to read labels. Some products are free of sweeteners.
  • Chocolate: Long yellow light. While milk and white chocolate varieties get the red light from me, I am a big fan of dark (70 percent or higher) chocolate because it contains healthy compounds. Be sure to limit yourself to 1 or 2 small pieces at a time: moderation is key.
  • Granola: Yellow light. Granolas often list sweeteners, such as dried cane syrup, brown rice syrup, and evaporated cane juice, among the first ingredients. They may contain more than 2 teaspoons per ½ cup serving. My recommendation: Look for brands with lower levels of sweeteners, often advertised as “high protein” or no-sugar added varieties. Avoid products with canola oil. If you are a culinary do-it-yourselfer, make your own granola (and use coconut oil).
  • Grapes: Green light. While grapes do contain some natural sugars, they are full of water, which makes them a better option than dried fruits. Grapes also contain lots of vitamins (especially C and K), as well as minerals and phytonutrients like resveratrol (in red grapes).
  • Fruits packaged in syrup: Very long yellow light. Fruits in cans, jars and plastic containers are usually loaded with sugar. As examples, most applesauces pack nearly 5 teaspoons of sugar per ½ cup serving. Canned peaches may have up to 3 teaspoons. My recommendation: Simple. Buy unsweetened versions and, if possible, rinse the fruit in a strainer before eating it. Best thing is to just eat the real thing found in the produce aisles.
  • Protein bars: Long yellow light. Protein or meal replacement bars can contain from 5 to 7 teaspoons of sweeteners (not to mention GMOs, unhealthy fats, and artificial additives). My recommendation: look for bars lower in sugar; unprocessed whole food varieties get my green light. If you are looking for protein, there are much better sources, even if you are on the go, such as hard boiled eggs, unsalted nuts, or a can of wild salmon.
  • Popular cereals: Yellow light. These can be real sugar traps, particularly the one intended for children. According to the Enviroinmental Working Group, an advocacy organization that educates the public on environmental issues affecting public health, some products are as much as half-sugar by weight. “Most parents say no to dessert for breakfast, but many children’s cereals have just as much sugar as a dessert – or more,” the organization said in a comprehensive 2011 review of children’s cereal products. My recommendation: Opt for cereals, preferably organic varieties, that are as low in sweeteners as possible. Getting children hooked on sweet stuff for breakfast will help create a sugar addiction and early onset diabetes, which is already at record level for youngsters. Add fresh fruit to sweeten them up. Good sources of fiber and nutrients, cooked cereals – especially steel cut oatmeal – offer a warming alternative. If time is an issue, instant oatmeal and whole grain products offer an alternative, but be sure to read labels; some are loaded with 3 teaspoons or so of sugar.
  • Sports drinks: Very long yellow light. Sports drinks offer a tasty replenishment for lost minerals (electrolytes) that occur from heat and heavy exercise, but most commerical varieties are are loaded with sweeteners. A 32-oz drink could  contain more than 12 teaspoons of sugar (in addition to artificial colors and flavors). I suggest diluting them with filtered water; what really gets my seal of approval, though, is coconut water or my Electrolyte Plus.

My Bottom Line on Sugar

Select no-sugar-added foods whenever you can. Your body will thank you for it!

References and Additional Resources:

© 2014 HeartMD Institute. All rights reserved.

Leave a Reply


  1. Richard

    on July 10, 2014 at 9:30 pm


    Concerning drinks that were mentioned, not only sugar kills but also the low Ph, especially carbonated drinks.
    As for the fruits in syrop, I would put up the red light, unless the dessert is diluted.
    I wonder why oats must be cooked. I always eat them raw with fruits or with hot pure cocoa and water. As I eat a lot of insoluble fiber, which is not OK, because it prevents the absorption of minerals,, I usually have oats in the morning only.

  2. Ida

    on July 11, 2014 at 1:40 pm


    Food labels always give sugar content in grams. How many grams of sugar are there in one teaspoon?

  3. Lisa

    on July 11, 2014 at 7:30 pm


    My husband makes a fabulous almond mix that contains sliced and whole almonds, lots of chopped fresh rosemary, sea salt, a bit of chili powder and olive oil — mix all together and bake until light golden brown. I’m not a big fan of nuts in general or almonds in particular, but I can eat spoons of this! It’s fantastic as a snack or on top of a salad. Great way to include nuts in your diet.

  4. Dana Allison

    on July 11, 2014 at 11:42 pm


    Why do people insist that sea salt is o.k.? NaCl is salt regardless of its source. Why are you against canola oil?

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