Nicole Avena Ph.D.

Food Junkie

The New Dietary Guidelines Highlight Limiting Sugar

Find out some of the top sources of hidden sugar

Posted Jan 28, 2016

In March 2015 the WHO called on all countries to reduce daily intake of free sugars to 10% of their total energy intake and went even further with a “conditional” recommendation of reducing free sugar to less than 5% of total energy intake. Since excess sugar consumption is associated with increased risk of developing dental carries, diabetes, metabolic syndrome, heart disease, dyslipidemia and hypertension 1-3 it was a recommendation that many nations around the world took notice of.

Almost 1 year later, with the release of the 2015-2020 Dietary Guidelines, the United States Department of Agriculture (USDA) and the Department of Health and Human Services decided to follow the WHO’s lead and recommended a cap on the amount of calories coming from sugar people should consume. According to the new guidelines, people should reduce their added sugar intake to <10% of their total calories. This recommendation came from national data and food pattern modeling which showed for most calorie levels, if people exceeded 10% of calories from sugar, while trying to stay within their calorie limits, they will not be able to meet their nutrient needs and food group requirements. Basically, if a person consumes more than 10% of calories from sugar, they most likely are surpassing their calorie level or missing out on vital nutrients and food groups4.

The average adult consumes 22 teaspoons of sugar per day- that's about 350 calories solely from sugar. It's not hard to reach that amount when about 75% of all food and beverages have some form of added sugar in it. Although people are decreasing the amount of sugar-sweetened beverages (SSB) they consume, 47% of added sugars in the diet still come from beverages. The good news is some beverage and food companies are trying to reduce the sugar content in their products. Some candy companies have been working to reformulate their candy bars and have decreased the portion sizes so the sugar content per package would be less. Further, even the sugar content of medical food is changing, as Europe just approved artificial sweetener to be used in place of sugar in certain medical foods for children ages 1-3.

However, many food and drinks still have way too much added sugar and evidence points to sugar as the most addictive macronutrient. Unfortunately, sugar is hiding in many of the foods and condiments that we eat on a daily basis. There are over 60 different names it can go by, so be sure to read the ingredients label.

Some sneaky names for sugar include: syrup, malt, agave nectar, caramel, beet sugar, honey, molasses and apple juice from concentrate. Also, look out for words ending in “OSE” such as dextrose, fructose, lactose, glucose and maltose.

In addition, many foods and beverages contain “hidden” sources of sugar. These are products you may be consuming on a daily basis that you didn't realize were sabotaging your healthy eating and making you surpass the new dietary guideline recommendations!

Below are a few examples of foods and drinks you may have not realized were actually loaded with sugar:

1) Yogurt:  Dairy naturally contains sugar in the form of lactose (for example- 1 cup of milk naturally contains 12 grams of sugar). The same holds true for plain yogurt. However, once you opt for a flavored yogurt, especially the ones with added “fruit,” you can expect the sugar content to skyrocket. One container of low fat flavored yogurt (typically shy of a full cup) may have up to 25 grams of sugar- that's almost 6 packets of sugar! This doesn't mean you have to avoid all yogurts, it just means you have to read the label. Moreover, look out for “low fat” varieties, which may have even more sugar in order to increase the palatability. If you don’t enjoy the plain varieties, try adding your own fresh or frozen fruit to sweeten it up. An even better option is the slightly tart, high protein Greek or Icelandic yogurts. Due to the straining process, some of the sugar is removed making it a smart choice for part of healthy meal or snack.

PDpics/pixabay
Source: PDpics/pixabay

2) Juices and Sports Drinks: According to the new guidelines, 1/3 of the recommended amount of fruit people consume comes in the form of juice. Further, in children between the ages of 1-3, 47% of their “fruit” servings are derived from juice. Although 100% fruit juice is not classified as a SSB, it still contains a lot of sugar. For example, 8 oz of the 3 most popular juices- Orange, Apple and Grape provide 21grams, 24 grams and 36 grams, respectively. So just because sugar is not “added” during production, does not mean it’s not there. Don't be fooled by “fresh squeezed” juices- they still contain the same amount of sugar.

Conversely, sports and fruit drinks are considered SSB and together make up almost 15% of the SSB that people consume. A bottle of some popular sport drinks contain 33 grams of sugar- that's like dumping a little more than 8 packets of sugar into a bottle of water! Opt for water instead if you need to re-hydrate.

3) Salad dressings, BBQ sauce and Ketchup: Many condiments contain a lot of added sugar. The usual serving size for salad dressing is 2 tablespoons (the size of a ping pong ball), which may have up to 12 grams of sugar depending on the variety. For example, French dressing has about 10 grams of sugar per serving, and many people “drizzle” more than that amount on a salad. BBQ sauce is another condiment packed with sugar, just 1 tablespoon (the size of the tip of your thumb) provide a whopping 7 grams of sugar. Ketchup is not much better, coming in at 4 grams per tablespoon.

4) Pasta sauce: Besides the excessive sodium, some people don't realize ½ cup of jarred pasta sauce contains about 11 grams of sugar. Tomatoes naturally contain sugar, however many commercial brands add sugar or high fructose corn syrup to make it taste better. It is something to be aware of when adding sauce to pizza or pasta, which are already high in refined carbohydrates.

stocksnap/pixabay
Source: stocksnap/pixabay

5) Cereals: Although breakfast is said to be the most important meal of the day, starting out your day with a bowl full of sugar is not recommended. While there are obvious offenders, like cereals with chocolate or marshmallows added in, ones marketed as “healthy” may have a lot more sugar than you think. For example, bran and muesli are excellent sources of fiber and a “go-to” for people starting a diet. However, not all are created equal. For example, just 1 cup of a popular bran cereal with raisins contains 18 grams of sugar, and this is before the milk is added. Also watch out for some corn flake cereals, ones “lightly sweetened” with honey, or with “dried fruit.” Lastly, always be mindful of the serving size (usually ¾ cup), which is a lot less than many people think when pouring it into a bowl.

6) Low fat or fat free versions of “junk food”: If your trying to save calories on muffins and cakes, choosing the low fat version of the same food may sound like a good option. But, when food companies take out one ingredient, they usually have to replace it with something else so it still tastes good- so they add more sugar. Think fat free ice cream, low fat muffins and “diet” cookies. Although the calories maybe slightly lower per serving (fat provides 9 calories per gram, sugar provides 4 calories per gram), these foods are still highly processed and not good for your waistline.

7) Meal replacement bars: Some protein bars actually have more sugar than a candy bar, especially the ones with “yogurt or chocolate” coating. It’s not to say all meal replacement bars are bad choices, but some of the most popular bars contain over 20 grams of sugar each. If you see cane sugar, corn syrup solids or molasses in the ingredients, these are all just fancier ways of saying sugar and aren’t part of a healthy meal.

With the new Dietary Guidelines urging people to cut back on their sugar, understanding which foods and beverages contain large amount of sugar is vital. While decreasing your sugar intake is a great way to improve your health, you need to know what to look for first. Remember- always read the nutrition label as well as the ingredients so you won’t be tricked into consuming foods with hidden sugars.

References:

1.            Dhurandhar NV, Thomas D. The link between dietary sugar intake and cardiovascular disease mortality: an unresolved question. JAMA. 2015;313(9):959-960.

2.            Malik VS, Popkin BM, Bray GA, Despres JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33(11):2477-2483.

3.            Te Morenga LA, Howatson AJ, Jones RM, Mann J. Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. Am. J. Clin. Nutr. 2014;100(1):65-79.

4.            U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/.

Appreciation is extended to Kristen Criscitelli for drafting this post

Dr. Nicole Avena is a research neuroscientist, author and expert in the fields of nutrition, diet and addiction. She received a Ph.D. in Neuroscience and Psychology from Princeton University, followed by a postdoctoral fellowship in molecular biology at The Rockefeller University in New York City. She has published over 70 scholarly journal articles, as well as several book chapters and books, on topics related to food, addiction, obesity and eating disorders. She also edited the books, Animal Models of Eating Disorders (2012) and Hedonic Eating (2015), coauthored the popular book of food and addiction called Why Diets Fail (Ten Speed Press), and recently finished her new book, What to Eat When You're Pregnant. Her research achievements have been honored by awards from several groups including the New York Academy of Sciences, the American Psychological Association, the National Institute on Drug Abuse, and her research has been funded by the National Institutes of Health (NIH) and National Eating Disorders Association.

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