Sugar frequently gets a bad rap, but it shouldn’t in every case. Here is how added, natural, and artificial sugars differ in how they affect your health.
There is plenty of evidence a high-sugar diet can come with damaging health risks. For example, excess sugar has been linked to an increased risk of high cholesterol, high blood pressure, inflammation, reduced “good” cholesterol, obesity, insulin resistance, type 2 diabetes, heart disease, and nonalcoholic fatty liver disease. One study found cutting back on sugar could save you money as the disorders are associated with increased medical bills.
But none of this suggests all sugar is bad. However, the sugars in a soda can aren’t the same as those in a cup of fresh berries.
Added vs. Natural Sugar: What’s the Difference?
Natural sugars are found in unprocessed, whole foods, including fructose in berries or bananas or lactose in a glass of skim milk, says a clinical dietitian based in Fairfield, Connecticut, Vanessa Mazzella, MS, RDN.
“Foods with natural sugars tend to be low in calories and sodium and high in water content and many important vitamins and minerals,” explained Mazzella.
The fiber in fruit slows down how rapidly your body digests it, so you don’t get the same spike in sugar after eating a donut, says Mazzella. The lactose in milk comes with a healthy serving of protein that provides prolonged energy, so you feel full longer than after a sugar-packed soda.
Additional sugars, including soda and donuts, are the ones to be more concerned about; added sugar is any sugar that is added to food — either by you, a food manufacturer, or a chef — before you put it in your mouth, notes the U.S. Department of Agriculture (USDA).
Added sugars include high-fructose corn syrup that lurks in some bread and ketchup and the agave or honey you might add to a mug of coffee or a smoothie. Because of the additional sugars, like fiber and protein, our bodies digest them quicker, which can cause a fast increase in blood glucose (sugar). Over time, having consistently high blood glucose contributes to health problems, including type 2 diabetes, obesity, and heart disease, according to research.
What excess sugar does to your health
Research has shown that high amounts of added and refined sugars in sweets, snack foods, and sodas contribute to weight gain and obesity development in the U.S., as they tend to be calorie-dense with no nutritional benefits, said Mazzella. These sugars can cause rapid increases in blood sugar, increasing the risk of insulin resistance and, finally, type 2 diabetes.
Excess sugar may also increase the risk of developing nonalcoholic fatty liver disease, along with increased triglyceride levels, contributing to cardiovascular disease. The American Heart Association (AHA) has linked high amounts of added sugars with heightened rates of heart disease and obesity.
To avoid risks, the Dietary Guidelines for Americans 2020-2025 recommends limiting additional sugar to less than 10 percent of daily calorie intake.
According to the AHA, women should consume no more than six teaspoons of additional sugar daily, and men should limit their added sugar to 9 teaspoons or less. Suppose you add two teaspoons of sugar to your daily coffees, eat granola or cereal containing added sugar, and drizzle store-bought salad dressing on your salad. In that case, you may be near or at your daily added-sugar limit by lunchtime, even without having any dessert or candy.
How can you spot added sugars in processed foods?
Added sugars hide in foods you might not expect, like baby food, processed frozen foods, cereal, dried fruit, granola, salad dressings, instant oatmeal, barbecue sauces, ketchup, pasta sauces, protein bars, flavored yogurt, and more. They are also found in organic foods and other foods at your local health food store.
The excellent news is that totaling added sugars in packaged foods is now easy since the Nutrition Facts label must list “added sugars” below where it says “total sugars,” per U.S. Food and Drug Administration (FDA) regulations.
How does sugar appear on the list of ingredients?
Sugar goes by several different names — over 60 if we are talking about what is listed on nutrition labels. Here are some of them:
• Corn sweetener
• Brown sugar
• Dextrose
• Corn syrup
• Rice syrup
• Barley malt
• Maltose
• Fructose sweetener
• Glucose
• Honey
• Fruit juice concentrates
• High-fructose corn syrup
• Lactose
• Invert sugar
• Malt syrup
• Maple syrup
• Molasses
• Raw sugar
• Pancake syrup
• Sucrose
• Trehalose
• Turbinado sugar
To identify added sugar, look for words ending with “-ose,” and phrases that contain “malt” or “syrup.”
Keep in mind: Ingredients on packaged food labels are listed in descending order in terms of weight, so when you see these names at the top of lists of ingredients, the product contains plenty of sugar.
Can you overdo naturally occurring sugars?
Some credit weight loss success to eliminating all sugars (even naturally occurring ones). However, sugars found in dairy and fruit are part of a healthy diet and should not be on the “naughty” foods list.
“Like any component of a diet, you can overdo it on sugar, even if it’s naturally occurring,” Mazzella says. However, most can stay healthy when it comes to natural sugars if they focus on choosing whole foods over processed ones — try slices of fresh fruit on a peanut butter sandwich instead of jam or jelly, likely adding extra sugar, and focus on consuming a well-balanced diet.
The Dietary Guidelines for Americans recommends two cups of fruit and, at minimum, 2.5 cups of vegetables per day for adults. Adults should also get two to three servings of dairy — one cup of low-fat or non-fat milk, a cup of low-fat yogurt, or 1.5 ounces of natural cheese — all count as one serving.
With that being said, dairy isn’t necessarily a required element for a healthy diet and might be one area where people reduce their intake further to reduce sugar. If you drink nut or soy milk, choose unsweetened versions to keep the added sugars low.
Remember that dairy can be a crucial source of calcium — a mineral responsible for keeping your skeleton strong — notes the National Institute of Health’s Office of Dietary Supplements (ODS).
If you are avoiding dairy, opt for plant-based calcium sources, like kale, chia seeds, and tofu. According to the ODS, you can also get some calcium in fortified foods like cereal and orange juice.
The less sugar you have in your diet, the sweeter foods will naturally taste, says Mazzella. Taste buds will adjust when you eliminate or reduce added sugars, and you may find specific sugary beverages and foods will taste too sweet. This will make it easier to cut back on food with sugar.
No two bodies are the same. Consider your overall physical activity level and lifestyle when making dietary choices, adds Mazzella. For more active individuals, more servings of fruit can be a healthy way to add necessary calories. Working with a registered nutritionist dietician can help you adjust your diet, including sugar intake, when necessary. Keep in mind any underlying medical conditions. For example, a person with diabetes must monitor their carb intake more closely. While allowed, fruit must be eaten in moderation, as pointed out by the American Diabetes Association (ADA).
What about sugar substitutes and artificial sweeteners?
Before you tear open a packet of artificial sweetener, instead of spooning sugar into your tea or coffee, take a pause. While artificial sweeteners are generally considered harmless, Mazzella explains that the scientific community does not agree about their safety.
Sugar substitutes can be categorized as “natural,” like monk fruit extract and stevia, or “synthetic,” including saccharin, aspartame, neotame, acesulfame, and sucralose as FDA-approved artificial sweeteners, notes research.
Although people often choose artificial sweeteners to lose weight and reduce calorie intake, research found artificial sweeteners may stimulate your appetite and enhance sugar cravings.
Simply replacing sugary beverages with diet versions may not give you the positive health outcomes you want to achieve. One observational study found the consumption of dirt soda was associated with a 36 percent greater risk of metabolic syndrome and a 67 percent higher risk of type 2 diabetes.
Simultaneously, some research on stevia suggests it might play a role in protecting against some cancers. Separately, one study suggested that stevia might improve some biochemical parameters, including fasting blood sugar, in people with chronic kidney disease.
A review of 35 observational studies found using sugar substitutes rarely resulted in beneficial health outcomes. Some participants lost weight, while others improved fasting blood sugar numbers. However, their body mass index (BMI) improvements were insignificant.
So, what’s the bottom line? Unless a physician recommends switching to sugar substitutes for health reasons, you are better off cutting sugar out entirely or reducing it in a recipe. Add as little sugar to your tea or coffee if you really want a little sugar in your tea or coffee.
