Why—and how—you should steer clear of added sugars

Excess sugar in your diet contributes to obesity, diabetes, and heart disease.

The average American consumes a whopping 350 calories a day from added sugars, mostly guzzled down in liquid form. Sodas and energy and sports drinks account for more that a third of our daily intake of added sugar. But many processed and packaged foods also contain added sugars, which food manufacturers add to an array of products to make them taste better or last longer on store shelves. In addition to sugary desserts and candies, these foods include flavored yogurt, cereals, breads, and crackers, as well as salad dressings, spaghetti sauces, soups, ketchup, and other condiments.

But nutritionists caution against too much added sugar, which may lead to weight gain and other health problems, including diabetes and heart disease. Added sugars are a bigger concern than natural sugars, which occurs naturally in all foods that contain carbohydrates, including fruits and vegetables, grains, and dairy products. In addition to natural sugars, these whole foods contain other healthy nutrients, such as fiber, vitamins, and minerals.

The American Heart Association recommends keeping calories from added sugars under 100 calories a day (24 grams, or 6 teaspoons) for women and under 150 calories a day (36 grams, or 9 teaspoons) for men. But keeping track of how much added sugar you're getting from various foods is not so simple.

Manufacturers are required to provide the total amount of sugar in a serving but do not have to spell out how much of this sugar has been added and how much natural sugar is in the food. In 2016, the FDA approved a revamp of the Nutrition Facts label that would require food manufacturers to list added sugars in their products. The rule was originally slated to take effect in July 2018. But in June this year, the agency announced that it has postponed the implementation of the rule indefinitely.

In the meantime, you can spot added sugars on food labels with a bit of sleuthing. Added sugars must be included on the ingredients list, which is presented in descending order by weight. The trick is deciphering which ingredients are added sugars. They come in a variety of guises. Aside from the obvious ones—sugar, honey, molasses—added sugar can appear as

• agave nectar
• cane crystals
• corn sweetener
• crystalline fructose
• dextrose
• evaporated cane juice
• fructose
• high-fructose corn syrup
• invert sugar
• lactose
• maltose
• malt syrup, and more.

A wise approach is to avoid products that have any of these added sugars at or near the top of the list of ingredients—or ones that have several different types of sugar scattered throughout the list. If a product is chock-full of sugar, you would expect to see "sugar" listed first, or maybe second. But food makers can fudge the list by adding sweeteners that aren't technically called sugar—that term is applied only to table sugar, or sucrose—but that add to the sugar content all the same. The trick is that each sweetener is listed separately. The contribution of each added sugar may be small enough that it shows up fourth, fifth, or even further down the list. But add them up and you can get a surprising dose of added sugar.

– By Julie Corliss
Executive Editor, Harvard Heart Letter

You can learn more about added sugars and their effects on health in the Harvard Special Health Report, Reducing Sugar and Salt: Strategies for minimizing risks to your health.