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 sugary foods 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!
How Much Sugar Is Too Much Sugar?
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.
Is Your Diet Full of Sugary Foods?
You can cut down your intake of sugary foods by taking the time − reading labels − and avoiding foods packed with added empty calories. Shop smartly, especially when it comes to these foods:
- Ketchup, BBQ sauce and other tomato condiments: 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: 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 pure maple syrup (or up to 1 teaspoon of raw honey).
- “Fruit snacks”: 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 or eat it with nuts, though. Too much dried fruit without healthy fats and proteins can cause your insulin levels to spike; practice moderation.
- Soft drinks: 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: Tomato sauce generally has more than 2 teaspoons of sugar for each ½ cup serving, not to mention high sodium content. 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: Some canned beans – like baked beans – contain added sugar. My recommendation: If you don’t want to cook beans from scratch, be sure to read labels. Many products are free of sweeteners.
- Chocolate: While milk and white chocolate varieties get the “it’s just not worth it” thumbs down 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 a few small pieces at a time: moderation is key.
- Fruits packaged in syrup: 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: 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: 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.
- Juice drinks and sports drinks: Whichever way you slice it, fruit drinks are liquid candy. It’s a shame this is what so many kids hydrate with. Always choose real fruit juice over the lesser quality “drink” options. Real fruit juice does contains a good amount of natural sugar, so you also want to practice moderation with it. I suggest diluting it – by at least 1/2 – with filtered water. Same thing goes for sports drinks. While they offer a tasty replenishment for lost minerals (electrolytes) that occur from heat and heavy exercise, many commercial sports drinks are very sugary. A 32-oz drink could contain more than 12 teaspoons of sugar (in addition to artificial colors and flavors). Better beverage solutions include coconut water or my Electrolyte Plus.
My Bottom Line on Sugar
Try to eat a diet of unprocessed foods. When you can’t avoid choosing processed foods, select no-sugar-added varieties whenever you can. Your body will thank you for it!
References and Additional Resources:
- Yang Q, Zhang Z, et. al. Added Sugar Intake and Cardiovascular Diseases Mortality Among U.S. Adults. JAMA Intern Med. 2014;174(4):516-524. [Abstract.]
- American Heart Association. Frequently Asked Questions About Sugar. AHA.org, accessed July 9, 2014.
- Environmental Working Group. Sugar In Children’s Cereals: Popular Brands Pack More Sugar than Snack Cakes and Cookies. Foodpolitics.com, accessed July 9, 2014.
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