Overview of Sugar Part 2 – Effects, Recommendations & Lowering Strategies

Americans’ intake of sugar is way too high and it has no real value in the diet. We use sugar for energy which is the extent of what it’s good for. Too much sugar leads to very serious health effects including obesity, type 2 diabetes and heart disease. Though dietary sugar serves little purpose in the body, we can still eat some without facing negative health effects. (Sugar Part 1 – Definition & Sources)

Effects of too Much Sugar

Obesity. A high sugar intake is associated with increased obesity in many different populations. Obesity also leads to its own health problems such as heart disease, stroke and some forms of cancer. While sugar alone may not lead to some of these health issues, developing obesity as a result of high sugar intake leaves you susceptible to a plethora of additional health concerns.

• One study looked into the effects increased sugar consumption had on obesity and diabetes in India. It found increased sugar consumption coupled with decreased physical activity led to insulin resistance, abdominal adiposity (fat storage), hyperglycemia, and atherosclerosis. The study projected a rapid increase in obesity in the next decade if sugar intake (particularly from sugar sweetened beverages) was not reduced¹.
• Another study looked into the effects of salt intake and sugar sweetened beverage consumption on obesity risk in Australian children aged 2-16 years. It found salt intake was positively associated with sugar sweetened beverage consumption (more salt = more sweet drinks); each additional 1 gram of salt per day was associated with 17 extra grams of sugar sweetened beverage per day. Those who consumed more than one serving of a sweetened beverage were 26% more likely to be obese or overweight².
• Yet another study examined whether sugar sweetened beverage consumption in infants predicted obesity at age six. It found obesity prevalence was twice as high in six year old children who consumed sweetened beverages in their infancy than those who did not consume them³.
• There are plenty of studies tying sugar intake to obesity^{4, 5, 6}.

Type 2 Diabetes. Type 2 diabetes is a condition affecting how the body metabolizes sugar; sometimes the body resists the effects of insulin (a glucose regulating hormone) and other times, the body does not produce enough⁷. Many studies have shown sugar intake to increase the chances of developing type 2 diabetes.

• One review study found 1-2 servings of sweetened beverages per day was associated with a 26% greater risk of developing type 2 diabetes. Based on all the studies the authors reviewed, they concluded, “the evidence that decreasing SSBs [sugar sweetened beverages] will decrease the risk of obesity and related diseases such as T2D [type 2 diabetes] is compelling⁵.”
• Another review study looked into the effects of fruit juice intake on type 2 diabetes risk. They found sugar sweetened fruit juice was significantly associated with type 2 diabetes risk. They also found 100% fruit juice was not associated with an increased type 2 diabetes risk⁸. If you love fruit juice, stick with 100% juice products instead of those which add sugar into the juice.

Heart Disease.

• One study looked into the effects dietary sugar intake had on cardiovascular mortality among adults in the United States. The researchers concluded a significant relationship between sugar consumption and cardiovascular mortality⁹.

Daily Sugar Recommendations

Americans consume too much sugar; 13% of total caloric intake in adults comes from added sugar¹⁰. In a 2,500 calorie diet, this equates to 81 grams of added sugar per day. The 2015-2020 Dietary Guidelines for Americans recommends consuming no more than 10% of daily calories from added sugar¹¹. For example:

• 2,000 calorie diet
  • 10% = 200 calories from added sugar or 50 grams of added sugar per day
• 2,500 calorie diet
  • 10% = 250 calories from added sugar or 62.5 grams of added sugar per day
• 3,000 calorie diet
  • 10% = 300 calories from added sugar or 75 grams of added sugar per day

The American Heart Association’s recommendations are more strict. They recommend women get no more than 100 calories or 25 grams of added sugar per day while men limit their intake to 150 calories or 37.5 grams per day¹².

The recommendations deal with added, not natural sugars. Typically, foods high in added sugars are to blame for high intakes. Nutrition labels do not currently (though they will soon) differentiate between added and natural sugar. It is important to look at the ingredient list and decide whether sugar is an added ingredient. The ingredients on a nutrition label are listed in order of how much is found in a food. Ingredients at the top of the list are found in greater quantities than ingredients at the bottom of the list.

Ways to Decrease Sugar Intake

Sugar intake is high due to processed foods which rely on sugar as their main ingredient. The focus of any lowering strategy should be to avoid foods high in added sugar. Remember, foods high in natural sugars such as fruits and vegetables improve health. You do not want to eliminate these foods even though they are high in sugar.

There are a few ways to begin reducing sugar intake:

Sugar Sweetened Beverages. Sugary beverages such as sodas, sweet tea, fruit juice and energy drinks are a major source of dietary sugar. Eliminating or drastically reducing reliance on these products goes a long way in reducing overall sugar intake. Replace sugary drinks with water or sugar-free alternatives. If you are not able to completely eliminate these drinks, reduce intake levels gradually over a period of time. Try one soda per day instead of two or three.

Replace Junk Food with Healthier Options. Junk foods such as cookies, doughnuts, muffins, cakes and candy are high in sugar. Replacing these food products with healthier options lowers sugar intake. Again, rather than making drastic changes overnight, start off reducing reliance on these items instead of completely eliminating them right away.

Fruit Juices. Fruit juice is marketed as a healthy alternative to soda. The truth is these beverages are as high in sugar as other drinks known to be unhealthy. If you must drink fruit juice, ensure it is 100% juice without any added sugars. Eating whole fruit is almost always a healthier option.

Nutrition Labels. Every product has plenty of options available (cereals, oatmeal and even cookies). Compare the sugar and nutrient content before blindly picking one product over another. Choose products made from whole grains, without added sugar which are high in vitamins, minerals and fiber.

The Bottom Line

It’s sometimes difficult to say whether a single food or ingredient is a healthy, nutritious choice. Foods don’t exist in a vacuum. There is much more to consider than one doughnut when deciding whether you’ve created a healthy lifestyle.

If you eat one doughnut but otherwise make healthy choices such as, eating plenty of fruits, vegetables, whole grains and lean meats and engaging in adequate amounts of physical activity, the one doughnut most likely won’t kill you. At the same time, if you eat one apple but otherwise make bad choices such as eating four doughnuts per day, avoid fruits and vegetables and living off hamburgers, fries and sodas, one apple won’t help very much.

There is little doubt: a high sugar intake over a long period of time leads to serious health issues including obesity, heart disease and type 2 diabetes. Reducing added sugar is one part of improving overall health.

References

1. Gulati, S. (2014). Sugar Intake, Obesity, and Diabetes in India. Nutrients, 6(12), 5955-5974. Retrieved from http://www.mdpi.com/2072-6643/6/12/5955/htm
2. Grimes, C. A. (2012). Dietary Salt Intake, Sugar-Sweetened Beverage Consumption, and Obesity Risk. Pediatrics, 131(1), 14-21. Retrieved from http://pediatrics.aappublications.org/content/131/1/14.short
3. Pan, L. (2014). A Longitudinal Analysis of Sugar-Sweetened Beverage Intake in Infancy and Obesity at 6 Years. Pediatrics, 134(Supplement). Retrieved from http://pediatrics.aappublications.org/content/134/Supplement_1/S29.short
4. Malik, V. S. (2012). Sweeteners and Risk of Obesity and Type 2 Diabetes: The Role of Sugar-Sweetened Beverages. Current Diabetes Reports, 12(2), 195-203. Retrieved from http://link.springer.com/article/10.1007/s11892-012-0259-6
5. Hu, F. B. (2013). Resolved: There is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obesity Reviews, 14(8), 606-619. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/obr.12040/abstract
6. Wang, H. (2013). Consistency Between Increasing Trends in Added-Sugar Intake and Body Mass Index Among Adults: The Minnesota Heart Survey, 1980–1982 to 2007–2009. American Journal of Public Health, 103(3), 501-507. Retrieved from http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2011.300562
7. Overview – Type 2 diabetes. (n.d.). Retrieved from http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/home/ovc-20169860
8. Xi, B. (2014). Intake of Fruit Juice and Incidence of Type 2 Diabetes: A Systematic Review and Meta-Analysis. PLoS ONE, 9(3). Retrieved from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0093471
9. Yang, Q. (2014). Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. JAMA Internal Medicine, 174(4), 516-524. Retrieved from http://archinte.jamanetwork.com/article.aspx?articleID=1819573
10. Consumption of Added Sugars Among U.S. Adults, 2005–2010. (2013, May). Retrieved from http://www.cdc.gov/nchs/products/databriefs/db122.htm
11. Dietary Guidelines 2015-2020: Chapter 1 – Key Elements of Healthy Eating Patterns. (n.d.). Retrieved from http://health.gov/dietaryguidelines/2015/guidelines/chapter-1/key-recommendations/
12. Added Sugars. (n.d.). Retrieved from http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Added-Sugars_UCM_305858_Article.jsp