Dangers of Added Sugars: Everything You Need to Know

This content originally appeared on diaTribe. Republished with permission.

By Susannah Chen

Added sugars quietly make an appearance in many foods you might not expect. This guide can help you identify which foods to look out for, the many different names for added sugar, and how to cut back.

From breakfast cereals to cookies and other sweets, added sugar plays a starring role in many foods in the standard American diet. But in addition to lending sweetness to baked goods and desserts, sugar quietly makes an appearance in a number of less obvious processed foods as well. This includes supermarket categories like canned goods, frozen meals and packaged snacks.

What is added sugar, and how does consuming it impact diabetes?

The FDA defines “added sugars” as sugars that are added during the processing and packaging of foods. These added sweeteners have a naturally high glycemic load, meaning that the glucose-raising effect is more significant than many other types of carbohydrates.

“Foods with added sugars are digested and absorbed rapidly, which causes blood sugar levels to spike,” said Luisa Sabogal, a registered dietitian and diabetes educator who works in a diabetes-focused private practice in Los Angeles.

In addition to immediate impacts on glucose levels, regularly consuming large amounts of added sugars can also negatively impact A1C and time in range. (Remember that if you have diabetes and require insulin, make sure to always have some form of glucose on hand to treat low blood sugar in the event of a hypoglycemic emergency.)

“Added sugars contribute calories to the diet, but no essential nutrients. This is why we often hear added sugars described as ‘empty calories,’” said Dr. Amy Morel L’Horset, an adjunct instructor of clinical nutrition at Rutgers School of Health Professions whose virtual practice, Prevention Dietitian LLC, focuses on nutrition counseling for women with prediabetes.

“For people with prediabetes or type 2 diabetes, their ability to efficiently move sugar from the bloodstream into the cells is often delayed due to insulin resistance. Keeping consumption of added sugar to small amounts is important for blood sugar management and overall health.”

Sources of added sugar and its many names

Cereal, condiments, canned soups, and salad dressings are among some of the common sources of added sugar. In particular, Morel L’Horset calls out nut butters, yogurts, and dressings with health-oriented labeling, such as reduced fat – “Often the ones labeled ‘low fat’ or ‘low sodium’ are higher in added sugar,” she said. Common sources of added sugar include:

Canned fruit
Condiments (e.g., barbecue sauce, ketchup, relish, mayonnaise, honey mustard)
Dried fruit
Energy, granola and protein bars
Flavored oatmeal
Flavored yogurt
Frozen dinners
Reduced-fat and reduced-sodium foods
Nut butter
Salad dressing (such as balsamic, sesame and poppyseed)
Tomato-based pizza and pasta sauces

Added sugar lurks in unsuspecting categories of supermarket items as well. This includes everything from savory foods to gummy vitamins and other health supplements. Less obvious sources of added sugar include:

Plant-based milk alternatives: Some sweetened, flavored versions of non-dairy milks contain as much or more sugar than a breakfast pastry.
Canned beans: Canned baked beans can have as much sugar as some desserts, but even unflavored beans may contain added sugars. One top supermarket brand includes 7 grams of added sugar in its canned dark red kidney beans, listing sugar, salt and dextrose (a corn-derived simple sugar) as the product’s third, fourth and fifth ingredients.
Protein powder: Despite a reputation for being heavy on protein and low on carbs, some brands of protein powder contain as much as 24g added sugar per serving.
Soy sauce: Certain varieties of soy sauce, such as Chinese dark soy sauce, Indonesian kecap manis and anything labeled “sweet soy sauce,” have a sweeter flavor profile and may contain added sugars.

While added sugars will always appear on a nutrition label’s ingredient list, they may go by less common names. Morel L’Horset suggests looking for ingredients listed besides “sugar” or “corn syrup” since the ingredient comes in many forms. Added sugar may appear on ingredient labels with the following names:

Anything labeled “sugar”: beet sugar, brown sugar, caster sugar, raw sugar, invert sugar, malt sugar, muscovado sugar, turbinado sugar, coconut sugar, date sugar, palm sugar
Sugarcane sweeteners: organic pure cane sugar, cane juice, evaporated or dehydrated cane juice, cane extract, cane crystals, brown sugar, caster sugar, demerara, turbinado, golden syrup, invert sugar, panela, rapadura, treacle, molasses
Fruit juices: fruit juice, fruit juice concentrate, grape must, grape juice concentrate, date juice concentrate
Syrups: maple syrup, date syrup, oat syrup, rice syrup, rice bran syrup, brown rice syrup, tapioca syrup, agave syrup, golden syrup, high fructose corn syrup, corn syrup, sorghum syrup, malted barley syrup, agave nectar, honey, raw honey, sorghum, sugar beet molasses
Malt products: maltose, maltodextrin, diastatic malt, malt sugar, malt syrup, barley malt, barley malt syrup, ethyl maltol, malt syrup, rice malt syrup, malt extract, molasses
Chemical names: glucose, sucrose, fructose, dextrose

Added sugars vs. naturally occurring sugar: what’s the difference?

Unlike added sugars, naturally occurring sugars are those found in foods such as whole fruits, vegetables (like carrots and corn), dairy products (like milk and yogurt), and 100 percent fruit and vegetable juice. In addition to being a source of sugar, they also may provide other benefits, such as fiber, protein, vitamins or minerals.

Image source: diaTribe

“Naturally occurring sugars are not as problematic, especially when obtained from whole food form [or foods that have not been processed],” Sabogal said, adding, “A small cup of fruit comes with fiber and water, which helps slow down digestion and absorption of the natural sugar present. Once paired with protein [such as meat, fish, tofu, nuts, or seeds], digestion is further slowed down, ultimately keeping blood sugar levels within range.”

Yet Sabogal says that it’s important to moderate intake of naturally occurring sugars as well, since these foods can still lead to elevated blood sugars. She recommends consuming protein in conjunction with sugar to help stabilize blood sugar levels.

When selecting foods, look for both added sugars as well as total sugars in the nutrition label, and take into consideration that many packaged foods contain both naturally occurring sugars as well as added sugars.

One source of naturally occurring sugar to watch out for is juice. “The naturally occurring sugar in fruit juice adds up quickly—it takes several pieces of fruit to make a glass of fruit juice—and we miss out on the fiber found in fresh and frozen forms of fruit,” Morel L’Horset explained.

Tips for avoiding or cutting back on sugar

In addition to prioritizing naturally occurring sugars in whole foods over added sugars in packaged foods, here are some additional suggestions for reducing or eliminating added sugars in your diet.

Start with one category if you’re overwhelmed. If reducing added sugars feels like a big undertaking, target one food category at a time. “Foods with added sugar that add up quickly include sugar-sweetened beverages such as regular soda, sweet teas, fruit punch and sugary coffee beverages,” Morel L’Horset said. “That is a great place to start.”

Identify unsweetened versions of your go-to foods. This might mean swapping Japanese shoyu for dark soy sauce, or searching for vinaigrettes that contain only olive oil, vinegar and spices. But Morel L’Horset warns that you shouldn’t assume sugar is lower in “health halo” foods. “Fat-free, gluten-free, all natural, refined sugar-free, organic: These terms do not mean they contain no added sugar,” she cautioned.

Prepare and cook your own meals. Not only does cutting back on ultra-processed foods help prevent weight gain, but making dishes from scratch also allows you to control how much of any ingredient goes into your food. For instance, consider buying unsweetened protein powder, then adding your own sweetening options such as fruit or stevia to a protein drink.

Reduce portion sizes. “Serving size and frequency of added sugar in the diet are the first places to consider,” Morel L’Horset added. If you have a favorite food that contains added sugar such as dessert, she suggests splitting it with a partner or friend.

Remember, don’t beat yourself up if you eat something high in sugar. “There will be times when a person with diabetes chooses to consume a food high in added sugar or has a day where several foods add up to overall high consumption of added sugar,” Morel L’Horset said. “When this happens, take a walk and then get back on track the next day.”

For more tips on cutting back on added sugars, see:

Six Tips: How to Cut Sugar and Processed Foods from Your Diet
Low-Cost, Low-Carb – 19 Diabetes Recipes that Fit the Bill

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