Author: Alice Henneman, MS, RDN
Have you heard people say they no longer eat fruit or drink milk because these foods contain “sugar?”
The public has been hearing a lot about cutting about cutting back on sugar. The original recommendations—from the 2015 Dietary Guidelines for Americans (DGA2015), the World Health Organization (WHO) and the American Heart Association (AHA)—were about “added” sugar, not the sugars found naturally in foods such as fruit and milk. “Added sugars” are those sugars added during processing or added when we eat, such as adding sugar to coffee.
Recommendations for sugar
The reason for the original recommendations wasn’t because sugar is a “toxic” substance as some articles claim. Rather, excessive “added sugars” can:
- add extra calories—unless a person is very active—which may lead to weight gain and an increased risk of heart disease and diabetes.
- provide calories but no vitamins or minerals. In turn, some people may cut back eating foods that have more nutrients to avoid gaining weight.
- play a role in tooth decay.
The DGA2015 recommend consuming less than 10 percent of calories per day from added sugars for children and adults. This amount was chosen as—for most calorie levels—there aren’t enough calories left after meeting food group recommendations to stay within a desirable calorie range. For a 2,000-calorie level, this amount would be less than 200 calories of added sugar or as one example, about 12 teaspoons of granulated white sugar.
(NOTE: 4 grams of granulated white sugar equals approximately 1 teaspoon of sugar.)
AHA recommends women consume less than 100 calories of added sugar per day (about 6 teaspoons or 24 grams of granulated white sugar) and men consume less than 150 calories per day (about 9 teaspoons or 36 grams).
WHO recommends, “… adults and children reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (6 teaspoons) per day would provide additional health benefits.” (NOTE: “Free sugars” refers to “added sugars.”)
Does this mean you should never eat “added sugar?” No, but make sure foods with added sugars aren’t crowding out foods with more nutrients. A small amount of sugar may help us consume disease-fighting foods, according to Jill Weisenberger, Registered Dietitian Nutritionist and Certified Diabetes Educator. For example, think about eating cranberries “without some added sweetness,” says Weisenberger.
Sources of “added” sugar
“About half the added sugars in our diets come from drinks—like sodas, fruit drinks, and other sweetened beverages,” according to the DGA2015.
Reading the list of ingredients on the label of foods can help identify added sugars. USDA identifies the following names among those for added sugar on food labels:
- anhydrous dextrose
- brown sugar
- confectioner's powdered sugar
- corn syrup
- corn syrup solids
- high-fructose corn syrup (HFCS)
- invert sugar
- malt syrup
- maple syrup
- nectars (e.g., peach nectar, pear nectar)
- pancake syrup
- raw sugar
- white granulated sugar
Food labels list ingredients from most to least by weight. The ingredient that weighs the most is listed first. Various forms of sugar are highlighted inyellow in this list of ingredients:
Ingredients: sugar, wheat, dextrose, honey, vegetable oil, salt …
Fruit juice and naturally occurring sugar
Though fruit juices contain naturally occurring sugar, USDA’s MyPlate nutrition guidelines state, “Make most of your choices whole or cut-up fruit, rather than juice, for the benefits that dietary fiber provides.”
In May 2017, the American Academy of Pediatrics (AAP) recommended fruit juice should not be given to infants before 12 months of age unless clinically indicated. Juice should be limited to 4 ounces/day for toddlers 1 through 3 years of age; 4 to 6 ounces/day for children 4 through 6 years of age; and 8 ounces/day for youth 7 to 18 years of age. Excessive juice consumption was associated with tooth decay, diarrhea, flatulence and abdominal distension.
AAP further recommended toddlers shouldn’t be given juice from bottles or easily transportable cups that allow them to drink juice throughout the day. Also, toddlers should not be given juice at bedtime. Both practices increase the risk of tooth decay because of a long contact time between the sugar in fruit juice and children’s teeth.
(all references were retrieved June 19, 2017)
- 2015 – 2020 Dietary Guidelines for Americans. Cut Down on Added Sugars. March 2016 at https://health.gov/dietaryguidelines/2015/resources/DGA_Cut-Down-On-Added-Sugars.pdf
- American Diabetes Association. Diabetes Myths at http://www.diabetes.org/diabetes-basics/myths/
- American Heart Association. Added Sugars Add to Your Risk of Dying from Heart Disease at http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Added-Sugars-Add-to-Your-Risk-of-Dying-from-Heart-Disease_UCM_460319_Article.jsp#.WUfxcGjyu71
- American Heart Association. Sugar 101 at http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Sugar-101_UCM_306024_Article.jsp#.WUfxGmjyu71
- Heyman, M.B. & Abrams, S. A., Fruit Juice in Infants, Children, and Adolescents: Current Recommendations. Pediatrics, June 2017, Vol. 231/Issue 6 at http://pediatrics.aappublications.org/content/139/6/e20170967
- Moynihan, P. Sugar and Dental Caries: Evidence for Setting a Recommended Threshold for Intake, Adv. Nutr. 2016 Jan; 7(1): 149–156 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717883
- U.S. Dept. of Agriculture and U.S. Dept. of Health & Human Services. Dietary Guidelines for Americans 2015-2010 at https://health.gov/dietaryguidelines/2015/resources/2015-2020_Dietary_Guidelines.pdf
- U.S. Dept. of Agriculture Center for Nutrition Policy and Promotion. Focus on Fruits. last updated, April 7, 2017 at https://www.choosemyplate.gov/focus-on-fruits
- U.S. Dept. of Agriculture. What Are Added Sugars? Last updated 11/9/2016 at https://www.choosemyplate.gov/what-are-added-sugars
- U.S. Food & Drug Administration. Changes to the Nutrition Facts Label. Last updated 6/19/2017 at https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm385663.htm
- U.S. Food & Drug Administration. Guidance for Industry: A Food Labeling Guide (6. Ingredient Lists). https://www.fda.gov/downloads/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/UCM265446.pdf
- Weisenberger, J. Sugar is Toxic. True or False? at https://jillweisenberger.com/sugar-toxic/
- World Health Organization. WHO Calls on Countries to Reduce Sugars Intake Among Adults and Children. March 4, 2015 at http://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/
Updated January 2, 2019