Where Sugar Lurks

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Mention the word “sugar” to someone who has diabetes, and chances are he’ll tell you that he either avoids it like the plague or at least makes some effort to limit his intake. Years ago, nutrition recommendations for people with diabetes were essentially to avoid sugar as much as possible, based on the thinking that sugar would send blood glucose levels through the roof.

Well, that notion was pretty much disproven, thanks to research that showed that sugar doesn’t act a whole lot differently than many other types of carbohydrate foods (like bread) when it comes to blood glucose control. The consensus became that it’s more the amount of carbohydrate than the type of carbohydrate that has the most impact on blood glucose.


And with that, guidelines were changed, guardedly stating that sugar, in moderation, could be part of a diabetes eating plan provided that it was used in place of other carbohydrate foods. As a dietitian, I spent a lot of time talking to my patients about how to fit sugar or sugary foods into a meal plan and was often met with skepticism and doubt. “Me, eat sugar?” tended to be the response. I also encountered (and still do) people who mistakenly believe that eating something sweet “caused” them to get diabetes.

Diabetes aside, we know that sugar isn’t exactly a paragon of nutrition. Most dietitians I know don’t advise their patients to eat more sugar. In fact, Americans, as a whole, tend to overdo it on the sugar: We tend to consume, on average, 22 teaspoons of sugar every day. That adds up to 350 calories. Much of the sugar that Americans take in comes from sugar-sweetened drinks, by the way.

One teaspoon of sugar contains 4 grams of carbohydrate and 16 calories

Downsides of sugar
Sugar is sweet but its effects on health, well, not so much. Here’s a rundown of what sugar can do in the body.

• Sugar may increase the risk of dying from heart disease, even if you’re not overweight.
• Sugar (in the form of high-fructose corn syrup) can lead to excess abdominal (belly) fat.
• Sugar can raise blood pressure.
• Sugar can lead to weight gain.
• Sugar can speed up the aging process, especially in the skin.
• Sugar can contribute to tooth decay.

How much sugar is safe to eat?
The reality is that we don’t have to avoid sugar altogether. Also, that would pretty much be impossible since sugar occurs naturally in some foods. The American Heart Association suggests that women limit sugar to no more than 100 calories per day (6 teaspoons, or 24 grams) and that men keep it to no more than 150 calories per day (9 teaspoons, or 36 grams). The World Health Organization proposes a tougher sanction on sugar: Keep sugar intake to less than 5% of daily calories (about half of what’s currently recommended).

Where is sugar hiding?
Most people know about the obvious sources of sugar in foods — cake, candy, cookies, soda, ice cream; pretty much anything that’s sweet. But sugar lurks in many other foods, even foods that don’t taste sweet or that we wouldn’t dream would containing anything sweet.

The Nutrition Facts label and the ingredient list on foods provide information about sugar, although currently, the label doesn’t distinguish between sugars that occur naturally in foods (like milk and fruit) and added sugars. Hopefully this will change if proposed revisions to the Nutrition Facts label are passed. In the meantime, if your goal is to limit your sugar intake, scan the ingredient list on packaged foods. Look for the following sources of sugar:

• White sugar
• Granulated sugar
• Brown sugar
• Cane sugar
• Invert sugar
• Turbinado sugar
• Evaporated can juice
• High-fructose corn syrup
• Corn syrup
• Maple syrup
• Honey
• Dextrin
• Molasses

If any of these sugars make up the first few ingredients on the list, or if you see several of these sugars in the listing, chances are, the food or beverage is high in sugar. You can also look at the grams of sugar on the label, remembering that every 4 grams of sugar translates into a teaspoon. Just keep in mind that milk or plain yogurt, for example, will appear to be high in sugar due to the lactose content.

Also, be on the lookout for unexpectedly higher-sugar foods such as the following (this is just a smattering of foods and not meant to be representative):

(Grams of sugar are per serving according to the manufacturer’s serving size)

• Kashi GOLEAN! Crunch cereal: 13 grams
• Fiber One Honey Clusters cereal: 9 grams
• Kellogg’s Raisin Bran cereal: 18 grams
• Kraft Barbecue Sauce, Original: 13 grams
• Cains Sweet Gherkins pickles: 8 grams
• Hidden Valley The Original Ranch Fat Free dressing: 3 grams
• Ken’s Steak House Lite Honey Mustard Dressing: 8 grams
• Campbell’s Classic Tomato Soup on the Go: 20 grams
• Progresso 99% Fat Free Minestrone soup: 4 grams
• Prego Traditional Italian Sauce: 10 grams
• Barilla Meat Sauce: 9 grams
• Chobani Greek Yogurt, Black Cherry: 17 grams
• Dannon Activia Peach Probiotic Yogurt: 17 grams
• Fiber One Honey Whole Wheat bread: 4 grams
• Thomas’ Cinnamon Raisin English Muffins: 8 grams
• Healthy Choice Sweet & Sour Chicken: 19 grams
• Lean Cuisine Spaghetti with Meat Sauce: 9 grams

Do you need to avoid these foods? No. But you may want to keep an eye on how much you eat and how often you eat them. Fat-free ranch dressing isn’t that high in sugar at first glance, but if you use more than the manufacturer’s serving size of 2 tablespoons, the sugar will quickly add up. It’s very hard to avoid sugar altogether, and you don’t have to. Just keep in mind the general goal (no more than 24 grams per day for women and 36 grams per day for men) and use that goal as your reference point when choosing your foods and beverages.

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