How to spot — and avoid — added sugar

It's not just in sweetened drinks. Sugar is added to cereal, pasta sauce, and even crackers.

We all know that too much sugar is bad for health, but even the detectives among us may not realize how often sugar shows up on the dining table. "It's the added sugar that's problematic. Not the natural sugar in fruit, which has fiber to slow absorption, but added sugar—such as honey, molasses, and corn syrup," says Debbie Krivitsky, a registered dietitian at Harvard-affiliated Massachusetts General Hospital.

Why it's bad for you

Sugar is added to many types of foods, and eating too much of the sweet stuff—even when it seems to come from a natural source—is a risk for weight gain, heart disease, diabetes, high blood pressure, cancer, and even dementia. A diet heavy in added sugar is linked to a risk of dying from heart disease even if you're not overweight, according to a study that was published earlier this year in JAMA Internal Medicine.

Why does added sugar cause so much trouble? It's digested immediately and rapidly absorbed, and this causes an upswing in your blood sugar levels. "That challenges your pancreas to pump out more insulin. If the pancreas can't keep up with that demand, blood sugar levels rise, which can lead to more problems with insulin secretion, and ultimately to diabetes," says Dr. David M. Nathan, a Harvard Medical School professor and the director of the Diabetes Center and Clinical Research Center at Massachusetts General Hospital.

Sugar also raises inflammation throughout the body, increases triglycerides (a type of fat found in the blood), and boosts the levels of dopamine in the brain. "Dopamine gives you a high, and that's why the more sugar you eat, the more you think you want," says Krivitsky.

Where it's hiding

Added sugar is obviously in candy, cake, soda, and fruit drinks. But it's also in foods that aren't considered sweets, including salad dressings, crackers, yogurt, bread, spaghetti sauce, barbecue sauce, ketchup, and breakfast cereals.

You can find added sugar by looking at the ingredients in a product. Look for words ending in "ose," such as fructose, dextrose, and maltose, and look for syrups and juices (see "The many names of added sugars").

You won't find added sugars on the Nutrition Facts label, since the listing for sugar includes both natural and added sugars. Proposed new labels aim to change this. But you can see how many grams of sugar are in a product.

What you should do

The American Heart Association (AHA) recommends that women limit added sugar intake to 24 grams (the equivalent of 6 teaspoons) per day, and total sugar (natural and added) to about 48 grams per day. It recommends that men limit added sugars to 36 grams (the equivalent of 9 teaspoons) per day, and total sugar to about 72 grams per day. When eating prepared foods, check the Nutrition Facts labels. They list the total grams of sugar (natural and added) in a serving.

If that's too complicated, Krivitsky recommends that you look for places in your diet where you can cut back on added sugar. "Are you eating a lot of cereals with added sugar? Maybe you like juices. Start eliminating those types of foods, and increase your intake of fiber," says Krivitsky.

One last tip: sweeten foods yourself. You'll probably add less sugar than a manufacturer would.