Each week a nutritionist from the University of Maryland Medical Center provides a guest post to The Baltimore Sun's health blog Picture of Health (baltimoresun.com/pictureofhealth). This week, Mindy Athas weighs in on sugar.

The term sugar is used for a variety of caloric sweeteners from multiple plant sources, including sugar beet, sugar cane, corn, agave, rice, nuts, fruit, vegetables, tree sap and grains. It is also found in all milks. Sugar is readily used in a multitude of foods, drinks, condiments and even medications.


Check ingredient lists for the many names of sugar. Some sound healthful, but sugar by any other name is still sweet. The American Heart Association recommends a maximum of six to nine teaspoons of added sugar daily. This means a daily limit of 24 to 36 grams of added sugar per person. One 12-ounce bottle of soda may have 40 grams of sugar: so pay attention.

Some forms of sugar: agave nectar, barley malt syrup, brown sugar, corn sweetener, corn syrup, corn syrup solids, dehydrated cane juice, dextrin, dextrose, fructose, fruit juice concentrate, glucose, granulated sugar, high-fructose corn syrup, honey, invert sugar, lactose, maltodextrin, malt syrup, maltose, maple syrup, molasses, raw sugar, rice syrup, saccharose, sorghum, sorghum syrup, sucrose, syrup, treacle, turbinado sugar, white sugar, xylose.

How sweet it is

Sugars taste good and are often tied to celebratory events, making them part of our lifestyle. In moderation, sugars can be part of a healthful diet. Naturally occurring sugars, like those found in fruits, vegetables, dairy and grains, provide vitamins, minerals, micronutrients, phytochemicals, water and fiber.

Added sugars provide mostly extra calories, and some forms may affect how we store fat, leading to weight gain and other problems. Added sugars, whether they originated as fruit juice or corn, have been processed and converted into a simple sugar no longer containing the fiber and nutrition they once had. The fiber is crucial, as some studies show fibrous foods, or complex carbohydrates, take longer to digest and metabolize, leading to satiety, fullness and possibly greater calorie-burning potential.

Sugar nation

Our food supply contains huge amounts of sugars, and U.S. consumption has skyrocketed. According to the federal Department of Agriculture, the average American eats over 152 pounds of sugar (from all sources) per year. This breaks down to an average of 32 teaspoons of added sugar per person per day. Most of it is hidden in prepackaged, frozen, canned, boxed, bottled, jarred and other store-bought items. Because of its decreased cost and easy use, high-fructose corn syrup is found in many foods not considered as sweet.

Look for sugar in these common foods: condiments such as barbecue, teriyaki and other sauces, ketchup, salad dressings, marinades, mayo, peanut butter and spreads; crackers, chips, tortillas, pretzels, bread, snack bars, granola bars and, especially, breakfast cereals; fried-food breading, bread crumbs, bagels, muffins, macaroni and cheese, pizza and frozen dinners, pasta sauce, fat-free and low-fat items, deli meats, hot dogs and alcoholic drinks.

Read the label on the package for total carbohydrates and sugars. Look for grams of fiber per serving, if applicable. The sugars and fiber are part of the total carbohydrate amount. Look for foods with more fiber and less (or no) sugar. Labels do not have to differentiate between natural and added sugars. Usually the more processed and refined the food, the more sugar (and calories) it contains.

Sugar baby

We are born with a penchant for sweetness to encourage suckling. It is biologically in our nature to seek sweet tastes, and we have receptors on our tongue and in our gut for this purpose. The palatability of sugar can stimulate appetite, and repeated exposure may increase the preference for sugar. This may intensify in those with a genetic predisposition for sweet flavors. Sugar may act like a drug on our brains, causing us to want it more and more. Some researchers feel it should be regulated much like tobacco and alcohol. Alcohol and fructose have been compared because they are both metabolized by the liver, leading excess intake of either (or both) to increase fat storage and production, which may lead to weight gain.

Weight gain, in turn, increases risk for chronic illnesses such as cardiovascular disease, diabetes, liver disease, and other conditions such as metabolic syndrome, inflammatory responses and immune suppression.

What to choose?

Put sweets into the box of "special occasion" foods. A special occasion is not hitting the vending machine on a Monday afternoon. When seeking snacks, think protein and fiber, or try a big glass of (plain) ice water, as thirst can be misinterpreted as hunger.


Choose drinks with the fewest grams of sugar per serving and wean yourself off sodas and fruit drinks. A squeeze of lemon or sprig of fresh mint can freshen up any glass of water. Make your own iced tea and lemonade so you control the sugar. Try seltzer or club soda with fresh lime juice, and be aware of how many alcoholic drinks you consume daily.

When planning meals and snacks, scour ingredients lists for sugar in all its forms and check the total carb, sugar and fiber grams per serving: multiply those by the number of servings you plan to eat. Seek out the highest-fiber foods available and those made with whole grains. Aim for less than 10 grams of sugar per serving in snack items. Learn to make your own pasta sauce, pizza, bread and pie crusts at home to cut back or eliminate the sugar. Find low- or reduced-sugar versions of condiments and sauces. Choose lower-calorie items, which should naturally reduce the sugar content.

To cut back on your desire for sweets, eat more fresh foods: fruits, vegetables, less refined grains (like barley), nuts, seeds, beans, mushrooms, low-fat dairy, unsaturated fats, tofu and lean protein foods.