There's something lurking in your kitchen. It's hiding in your cabinets, in your fridge, and even on the counter. And it's trying to kill you. It's sugar.
While it sounds dramatic, it is true: If more than 21 percent of your daily calories come from added sugars, your risk of early death is doubled compared to people who have just 10 percent of calories coming from added sugars. That's according to research published in the Journal of the American Medical Association Internal Medicine.
"A lot of people connect weight with sugar. They connect diabetes with sugar. But they forget that when we follow a diet that's high in added sugar, it also shows that our triglyceride levels are going to increase, bad (LDL) cholesterol can go up [and] our blood pressure can go up," says Natalie Filippone, R.D., a dietitian with Sodexo. In a 2010 study, people who had the added sugar equivalent of 2.5 sodas per day had higher blood pressure than people who had less sugar, even if they all had the same amount of salt. Many Americans don't realize these risks though, Filippone says. "Getting that information out to people, as dietitians, that's what we're working so hard to do."
It's not just heart health, either. While more research is still needed, when French scientists conducted an observational study the diets of more than 100,000 people, they found that an increase in added fructose equivalent to 100 of extra
"Some studies show that a high consumption of high-sugar beverages and foods are also associated with an increased risk of inflammation and oxidative stress," says Brittany Modell, R.D., founder of Brittany Modell Nutrition and Wellness. Oxidative stress, or an excess of free radicals in the body, can contribute to heart disease, diabetes, cancer risk, diseases like Parkinson's and Alzheimer's, and even aging. Scientists also theorize that this could be part of why added sugars can affect our mental health: In one three-year study, scientists found that women who ate the most added sugar were at a 23 percent higher risk for clinical depression than those who ate the least added sugar.
It's clear that whether you care about losing—or gaining—weight or not, your intake of added sugars matters. Now specifically makes sugar "added"?
Added Sugar vs. Natural Sugar
Natural sugars occur naturally in foods and make them sweet—like the fructose in an apple or the lactose in a glass of milk.
"Even though they have sugar in them, when we have something like milk or a piece of fruit, we're getting other nutrients: calcium, vitamin C, vitamin D," explains Rachel Driscoll, R.D., an outpatient dietitian with Bristol Health in Connecticut. Basically, natural sugars bring important friends along with them in the form of nutrients we need. And certain nutrients they come with, like fiber and fat, can help slow down your digestion of the natural sugars, so your blood sugar doesn't spike as much as it would with added sugars, Driscoll says.
Added sugars, on the other hand, don't come with those helpful friends. "It's essentially a form of pure carbohydrate. You're getting extra sugar that isn't providing you any nutrition at all," she says.
And that "extra" is becoming a larger part of our diet every year. In 2016, researchers found that ultra-processed foods make up more than half of all calories in the average U.S. diet, contributing nearly 90 percent of all added sugars. These additives are in almost everything we eat—they're found in almost 75 percent of all packaged foods.
Soon, they'll be easier to spot: In 2021, nutrition labels will be required by law to list "Added Sugars" as their own line. For now, though, they can hide in the ingredients list as things that aren't called sugar at all.
"There are more than 50 names for sugar that can be found on a food label," says Driscoll. Many people have become aware that words that end in "ose"—glucose, fructose, dextrose, sucrose—are sugars, but others still trip up clients, she explains. Names like cane juice, brown rice syrup and "nectars" may seem natural, but if they're listed on their own as an ingredient, they've been added to your food.
Until the "added sugar" designation comes to the nutrition facts label, Driscoll says, look at the first three ingredients and avoid foods where an added sugar, by any name, shows up in these spots.
How much added sugar should I eat?
The American Heart Association recommends a limit of 100 calories, or 6 teaspoons, of added sugars per day for women, and 150 calories, or 9 teaspoons, per day for men.
But most labels don't list sugar in teaspoons, nor do they outline how many calories of sugar are in the item. These labels list them in grams. And counting grams of sugar all day may not be feasible or sustainable with most people's lifestyles.
"I tend to recommend that if you're looking at a product [label], aim for less than five to 10 grams of added sugar per serving," Driscoll says. The AHA recommendations come out to about 25 daily grams for women, and less than 36 for men.
Filippone tries to keep her patients' focus off numbers and on occasions: "Let's say, in the morning, you had a donut," she says. "The rest of the day, try to avoid or minimize sweets. Just don't have it at every meal. If you're aware of each item you're eating [and whether it has added sugar,] chances are you won't overdo it."
How can I reduce my added sugar intake?
We all know that donuts and other sweets are loaded with sugar, but all three dietitians interviewed say it's reducing sugars we don't realize are present that can make a difference in overall intake. For Modell, that means checking the labels of foods we think of as "healthy," like peanut butter and dried fruits. Many of these foods have sugar added—dried cranberries, for instance, have "sugar" listed as their second ingredient, and have 29 grams of sugar in the quarter-cup you might add to a salad.
Driscoll has a two-fold approach to reducing sugar that applies to any sugary drink or added-sugar food you're consuming regularly. First, give your taste buds time to adjust by reducing your intake gradually.
"If you're drinking 10 cans of soda per day, it's [probably] not realistic to cut it out completely all at once," she says. "If you're adding three tablespoons of sugar to your coffee, start by going down to 2.5. [Over time,] you'll get used to the flavor, but you're also reducing the sugar and letting your body get used to it."
Driscoll's second strategy: Replace the added sugar with something that makes food tastier, but also that your body needs. For coffee, she says, that's often adding a low-sugar protein powder. Protein not only builds and supports lean muscle, but it also makes food more filling because it digests slowly so you feel fuller longer.
It's a simple strategy—eat less sugar gradually, add more of what your body needs—but these simple swaps add up to something much bigger in the long-run: a longer, healthier life.