• Bari Stricoff, MSc, RDN

A Sensible Approach to Minimizing Added Sugars and Associated Health Risks

Updated: Feb 23, 2018



I attended a Webinar hosted by Siggis (the yogurt company) titled “Behind the Label: A Look at Added Sugar”. The presentation was given by 2 Dietitians, both extremely informative and great speakers. The presentation was focused around Added Sugars in regards to the new FDA approved food label, consumer perceptions of added sugars and the health risks associated with excess consumption. Below I will summarize the information provided and give my final opinion/recommendation.


New Food Label:

As of January 2020, food labels must be explicit about total sugar (grams) and how many of those come from added sugars. This movement was fostered by the new Dietary Guidelines for Americans (DGAs) recommendation, but also fuelled by consumer’s interest in added sugars. In fact, an estimated 22% of Americans are said to restrict their sugar intake, while 37% of consumers are looking for reduced sugar options. Hopefully these new food labels will not only help those health-conscious consumers, but also enforce the new Dietary Guidelines!



The new food label has also made some changes to enhance consumer’s understanding of the nutrition facts. The serving size and calories per serving have been enlarged and bolded - so consumers can make more informed decisions. As stated before, “sugars” have been switched to “total sugars” with an explicit amount of added sugars listed, as well as their % daily value.


New Guidelines:

The new DGAs (2015-2020) recommend limiting calories from added sugars to no more than 10% per day. For an average American consuming 2,000 calories, this means 200 calories (12 tsp) from added sugars! Currently only 42% of Americans above the age of 2 meet this new recommendation.


The new DGAs were inspired by research from the American Heart Association (AHA) that actually recommends a stronger cut on added sugars. The AHA suggests a limit of no more than 100 calories/day (6 tsp or 24g) form added sugars for most women and no more than 150 calories/day (9 tsp or 36g) from added sugars for most men.


What is an added sugar?

Added sugars are “sugars and syrups that are added to foods or beverages when they are processed or prepared. This does not include naturally occurring sugars such as those in milk and fruits” (discussed later). There are a lot of misconceptions regarding added sugars, as consumers often mistake added sugars for refined sugar and unnatural sugars. Yes, added sugars include things like “brown rice syrup” and “high fructose corn syrup”– but added sugars also include that 100% pure maple syrup or coconut sugar added to your “clean” raw balls… In this definition, added sugars DO NOT include sugar from whole foods, 100% juice concentrate, dried fruit or purees.


However, foods containing high percentages of added sugars include soft drinks, energy drinks, sports drinks, cereals, cookies, cakes, candies, pies, pastries, donuts, fruit drinks, and ice cream! No surprise that these food items fall into the added sugar category.


Risks Associated with Added Sugars

The AHA states that cutting back on added sugar will aid in slowing both the obesity and heart disease epidemics. Added sugars have been linked to weight gain, obesity, cardiovascular disease, type 2 diabetes and even some cancers. Most of the research has been tied to the adverse effects of sugar-laden drinks, however new research also looks at added sugars from the whole diet.


The Farmington Heart Study linked sugar intake to cardio-metabolic risks via visceral adipose tissue. In other words, excess sugar intake has been linked to cause an excess of fat that is centrally stored in the mid-section - picture it wrapping around your organs. Visceral fat has shown to be “insulin-resistant” and increases the risk of Type 2 Diabetes and cardiovascular disease.


Research using the NHANES data estimated that the total added sugar intake is about 16% of the average diet (6% higher than the recommendation). The data also shows correlations between added sugar and lipid levels. For example, as added sugars increase… HDL (good cholesterol) decreases, Triglycerides increase and dyslipidemia (altered lipid profile) increases.


Current evidence also suggest that added sugar consumption increases systemic inflammation, which is also a risk factor for chronic disease. For example, those that consume >21% of calories from added sugar are at more risk of mortality from heart disease


Thus, high intakes of added sugar have adverse effects on health independent of body weight. This means, normal weight individuals who consume high levels of added sugars are at more risk than overweight individuals adhering to the added sugar guidelines.


Natural vs. Added Sugar:

The two most common forms of natural sugar that cause confusion with my clients and the general population are fructose (from fruit) and lactose (from dairy). In both fruit and dairy, beyond the natural sugars, both food groups contain several beneficial properties. For example, whole fruit contains fiber which helps slow the release of sugar into the blood stream and increase satiation, as well as promote a healthy gut. Dairy, specifically, contains high levels of vitamin D, calcium and potassium – all of which American’s tend to lack in their diet.


However, sugars such as agave, honey, maple syrup, cane sugar, coconut sugar, date sugar, or any other “clean” form of sugar, is still considered added sugar. Regardless of how your body responds to them or their glycemic index, they are still considered added sugar – which, per the DGA and AHA, should be limited to <10% of daily calories.


Recommendation:

Trying to control everything about your diet is next to impossible – and if you succeed – it is 100% NOT FUN! However, we can all make a few swaps or extra efforts to avoid added sugars in our diets. Some recommendations include:


· Swapping fruit for dessert compared to cakes or ice cream (frozen grapes are incredible)

· Always try to opt for the “unsweetened” versions of packaged foods (just make sure they aren’t laden with extra chemicals)

· Swap your sodas for seltzer

· Reduce your portions of added sugar (1 tsp of sugar in coffee, as opposed to 2)


With all that being said, don’t go cutting out fruit and dairy from your diet! There has never been a study that linked adverse health effects with fruit consumption! Additionally, multiple studies suggest the inclusion of dairy in your diet helps promote weight loss and weight stabilization!


One of the most important takeaways from the presentation was “try to only add sugar to otherwise healthy foods”! Added sugar has no health benefits, so making sure you add them to foods that do, will be key. At the end of the day, your body cannot decipher the “brown sugar” from the “coconut sugar” from the “white sugar”, so when you do add sugar to foods, make sure you are still getting some nutritional benefit! For example, adding honey to oats or Greek yogurt is still okay, but just drinking a bottle of soda is what we are trying to avoid!


As always, feel free to leave any questions or comments, or email them to me if they are more specific! Also, references available from the data in this post upon request!

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