Written by Dr. Nicole Avena
Dr. Avena is a professor, research neuroscientist, and author on food & addiction. She has done extensive research on sugar and the effects it can have on health. She is the author of Sugarless: A 7 Step Plan to Uncover Hidden Sugars, Curb Your Cravings and Conquer Your Addiction.
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The terms “sugar” and “added sugar” are discussed with great frequency in the media, among health professionals, and even in grocery stores, but what do these terms mean? Are the differences even important? Yes, and by understanding these differences you are setting yourself up to know how to support your optimal health. Let’s begin with the basics…
What is Sugar and Where Does it Come From?
Sugar is a compound that is naturally occurring in a variety of the foods that we eat: fruits, whole grains, nuts, vegetables, dairy, etc. Sugar is part of the carbohydrate family, and there are two types of carbohydrates: simple and complex.
What are Simple Carbohydrates?
Simple carbohydrates are made up of only one to two glucose molecules, which helps our bodies digest and absorb them very quickly. This can result in quick bursts of energy and elevated blood sugar levels. Although glucose often gets a bad reputation, it is our body's preferred source of fuel as it can be used immediately by the body for energy. We just don’t want too much!
What are Complex Carbohydrates?
As opposed to simple carbohydrates, complex carbohydrates are longer and larger chains of polysaccharides, which means they take more effort and energy for the body to digest, absorb, and utilize. This results in a slow and longer lasting release of energy, and a steady rise in blood sugar levels. Examples of complex carbohydrates include oats, beans, brown rice, quinoa, apples, strawberries, and bananas.
In short, whenever we hear of the term “sugar,” we are actually referring to a carbohydrate, whether that be simple or complex.
Naturally Occurring Sugar vs. Added Sugar
Now that we understand sugar better, let’s dive into what is meant by “added sugar.” Added sugars are not naturally occurring in food and are primarily made up of simple sugars. They are added to foods for a purpose; often to extend a food’s shelf life, or enhance the flavor or texture. Baked goods, candies, and chocolate usually come to mind when you think of foods with added sugar, but high amounts of added sugar is also lurking in so many of the foods that are often touted as part of a healthy diet, such as cereal, granola bars, smoothies, bread, condiments, and sports drinks. Some simple sugars can also be naturally occurring food, however, these foods also contain vitamins, minerals, and fiber.
How to Spot Added Sugar in Foods
Due to advancements in the science and technology of food manufacturing, more and more sugar has begun to emerge within our food supply. Now with over 250 names for added sugars, it can be difficult to identify them on an ingredient list. Some of the more common names include: high fructose corn syrup, invert sugar, dextrin, barley, rice syrup, molasses, and malt. In general, it is best practice to look for names that end in “ose” or ingredients that include the word “syrup” or “juice.” However, note that allulose is different–it is a rare sugar that is not metabolized by the body in the same way as traditional sugars. It is absorbed in the small intestine but is not significantly metabolized, so it has minimal impact on blood glucose and insulin levels, so this is an "ose" that is OK!
It is mandated by the FDA for food manufacturers to include how much added sugar is found in a product, so the nutrition label can help you see whether or not added sugar is present in a food item, and if so, how much. This information can be found below the “total sugar” section of the nutrition labels, labeled as “added sugars".
Natural Sugar and Health
Now that we are able to understand the difference between “sugar” and “added sugar,” let’s discuss how they can positively and negatively impact our health. Much of this depends on the food source the sugar is coming from. For example, the natural sugars that are found in plant foods can help with blood sugar management because they are mostly complex carbohydrates, which means instead of spiking your blood sugar, they slowly elevate your blood sugar. Complex carbohydrates give us the most bang for our buck as they provide our body with steady energy, help us reduce our risk for health complications, and nourish the body with vitamins, minerals, and fiber.
Added Sugar and Health
Alternatively, added sugars are made up of only simple sugars and lack other nutritious components, so health complications can result when we consume excessive amounts of them.
Because these simple carbohydrates are digested and absorbed quickly, this results in quick energy and a spike in blood sugar levels and insulin. Following this, blood sugar and insulin levels can drop, which can result in hunger. The more we eat foods high in added sugars, the more spikes and drops can occur, which can lead to complications and even insulin resistance over time.
Diets high in added sugar have also been linked to weight gain and obesity due to excessive caloric intake. Additionally, excess added sugar consumption can result in increased cardiovascular complications and elevated blood pressure. It has also been linked to increased risk of developing diabetes, insulin resistance, cancer, fatty liver disease, and stroke.
Balancing Your Sugar Intake
Excessive consumption of added sugar, whether that be from sweets, soda, or salad dressing, may feel good in the moment, but over time this way of eating can cause severe negative health implications. In order to maintain health and longevity, it is important to actively avoid added sugar in the diet. In fact, the American Heart Association recommends that men consume no more than 36 grams of sugar per day, and 25 grams per day for women.
Once you start to realize how much added sugar is found within our food supply, it can be really eye opening. Beginning to avoid added sugar definitely does not come without challenges; however, ditching added sugars and incorporating more whole foods into your diet can make all the difference and positively impact your overall health status.
And remember, you don’t have to do it all overnight! The best success comes in making small changes in your diet and routine. Swapping out one sugary snack, or one can of soda, can be a great start and motivate you to make even more healthy changes. Always remember that progress is the goal–not perfection! One step in the right direction, or one healthy choice made, is a success!