Added Sugar: Finding the Sweet Spot

By Danielle O’Keefe and Dr. Alexandra Kazaks, PhD, RDN, guest contributors

This article was originally published in May 2020

Comparing an apple to a donut

Are the natural sugars in your Pacific Northwest Honeycrisp apple better for your health than the cane sugar added to an apple scone? Should all added sugars be avoided? If such concerns have been weighing on your mind, you’re not alone.

Questions about added sugars versus naturally occurring sugars may be coming up more frequently because of recent changes to nutrition fact labels on food products. Older labels on food products reflected total sugars in the product, but new labels distinguish between total and added sugars. As part of a Food and Drug Administration (FDA) move to help consumers make more informed choices, most foods were required to include that separate listing for added sugar content by Jan. 1, 2020, and all must meet that requirement by July 1, 2021 (FDA, 2018) (see 2020 Brings Big Changes to Nutrition Label). In jarred marinara sauce, for instance, the labels let consumers distinguish between natural sugars from tomatoes and the extra sugar added to many commercial brands.

Now that the numbers are available, here’s some information to figure out what it means for you:

Sugar gets a lot of negative hype, but it is important for human health. It’s a type of simple carbohydrate produced by plants that tastes sweet and serves as a key source of energy for humans. The fruits and vegetables we eat, along with dairy, naturally contain sugars.

Sugar is classified as “added” when it’s used as an ingredient in food processing or preparation, encompassing every sweetener from high fructose corn syrup in soda production (banned at PCC since 2007) to the honey you add to your homemade golden milk.

In many cases, the sugars added in food processing are the very same ones found naturally in fruits and vegetables and are all used by our body for energy. The main reason experts make a distinction between the two is because one comes with other nutrients and one doesn’t. Both fresh blackberries and a sweetened kombucha drink may contain fructose, for example, but only the sugars in the blackberries come with vitamins A, C, E and multiple B vitamins. Adding maple syrup or honey to kombucha balances its tartness, not necessarily its nutritional profile.

Health experts don’t yet fully agree about the health implications of eating one form of sugar over another, but they do agree that there are health implications of eating excessive amounts.

Consuming large amounts of added sugars long term matters because eating high amounts of it can have deleterious health consequences. In the short term eating sugary foods spikes blood sugar: You’ve probably experienced the energy you feel after eating a large amount of sugar and the subsequent crash in energy you feel later. Less commonly recognized are the potential costs of long-term spikes and crashes in blood sugar. These include inflammation, insulin resistance and high blood triglycerides, which all contribute to the risk of developing chronic diseases like diabetes mellitus and non-alcoholic fatty liver disease.

Eating sugars from whole foods like fruits and vegetables can deftly sidestep the problem of such extreme fluctuations in blood sugar. Although eating sugars in whole foods still increases our blood sugar levels, the sugar in whole foods exists in amounts our bodies are better equipped to handle and the fiber content slows the rate at which it enters our bloodstream so there isn’t such a drastic spike in blood sugar. Eating fat and protein along with sugar, such as pairing an apple with peanut butter, additionally slows the rate sugar enters the bloodstream.

Food manufacturers have multiple reasons to add sugars to food, not the least of which is to make them delectable. In this way, added sugars grant us immense enjoyment of our food, which, in moderation, has benefits of its own. Overly restricting added sugars from our diet often leads to over-indulgence later. Balance between health and happiness, then, is the secret to being a mindful consumer of sugar.

Many ways exist to cut back on added sugars without feeling deprived if you’re concerned that your diet contains excess. Start by looking at food labels for “added sugars.” It’s easy to see the source when sugar is listed as an ingredient, but less obvious contributors include agave nectar, malt sugar, maple syrup, honey, corn sweetener, corn syrup, evaporated cane juice, fruit juice concentrate, or words ending in -ose such as fructose, dextrose, lactose, maltose and sucrose. Plant milks, salad dressings and condiments are surprising sources of added sugars and can often be swapped for an equally appealing but lower sugar alternative product. Other swaps include sweetening plain yogurt or breakfast cereal with real fruit instead of buying flavored varieties, with the added benefit of increasing nutritional content. Try flavoring foods with spices like ginger, nutmeg, turmeric or cardamom. Cinnamon, in particular, adds a slightly sweet flavor to foods and drinks without increasing the sugar content. When you do eat foods with added sugar, you can minimize the impact on your blood sugar by eating it as part of a meal that includes fat, protein and fiber.

Whole food and added sources of sugar both bring us energy and joy. Whole foods possess the added benefit of nutrients, but they both have a place in our diets. The key is to be an informed, mindful consumer. And, overall, that’s a pretty sweet deal.


Danielle O'Keefe

Look for regular Sound Consumer articles over the next year from Danielle O’Keefe, a student in the Master of Science in Nutrition and Master of Arts in Counseling Psychology dual degree program at Bastyr University. Dr. Alexandra Kazaks, PhD, RDN, is an associate professor in the Department of Nutrition and Exercise Science.

A pioneer in natural medicine, Bastyr University is a nonprofit, private university that is at the forefront of developing leaders in natural health arts and sciences for the 21st century. Bastyr offers graduate and undergraduate degrees in science-based natural medicine that integrates mind, body, spirit and nature. The University is also a leader in conducting cutting-edge research in complementary and alternative medicine and in offering affordable natural healthcare services in its local communities.

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