I recently saw someone rocking a T-shirt that said “Sugar over Everything.” That’s a catchy slogan—you may catch some health problems if you run with it (or if you don’t run with it). The health concerns associated with sugar are well established. Diabetes, weight gain, cavities, heart disease, et cetera—the list goes on like the beat does.
Solely knowing the health risks associated with sugar isn’t enough to make us eat less of it. Most people know what uncontrolled diabetes can do, so writing an exhaustive list of all the bad things sugar can cause won’t scare people straight.
The pen may be mightier than a sword, but a pound cake will destroy my pen every time—no contest. Ultimately when we see sweets, the parts of the brain that correspond to fear aren’t activated; sugar perks up the brain’s pleasure centers. When we see a donut, we don’t think about a stroke 20 years from now; we think happy thoughts about rainbows, unicorns, sprinkles, and how delicious our donut will be. Ok, I may have exaggerated about the rainbows and unicorns, but as a card-carrying grown a** man, sprinkles are amazing.
Sugar is also addictive. So what do we do?
Do we abstain from sugar and avoid it altogether? Do we eat it in moderation? Moderation is typically the most realistic answer, but that begs the question, “What’s moderation?” Let me tackle that question by highlighting some guidelines regarding sugar and illustrating a few visual tools for identifying how much sugar you might be eating.
When we say “sugar,” what are we talking about?
I’m not about to give a Mr. Wizard chemistry lesson on the molecular shape of glucose, fructose, and sucrose. We’ll leave all the “-oses” for your high school chemistry teacher.
Typically, when people talk about the dangers of sugar, they’re almost always referring to added sugar. Added sugar is what it sounds like, extra sugar that’s been added to something.
Yes, sugar can naturally occur in fruits and veggies, but that sugar is trapped within the structure of food. It doesn’t have the same negative health impacts since the body has to liberate the natural sugars confined within the food before absorbing them. Hence, fruits are healthy, and donut holes lead to dialysis. Juice is an interesting exception since it poses a problem even without added sugars. The issue is that the juicing process frees up those naturally occurring sugars, making them easier to absorb, like added sugars. In a study from the 70s, researchers demonstrated this concept by comparing the effects of ingesting an equal amount of sugar in whole apples, an apple smoothie, and apple juice on blood sugar levels. Blood glucose levels rose the least after eating apples and the most after drinking apple juice, with the smoothies landing somewhere in between (1). That said, since added sugar is a problem, how do we know how much added is sugar is too much?
Overall, how many grams of sugar should you have per day?
According to recent guidelines, men and women should eat 36g and 25g of sugar respectively.
I have a love-hate relationship with healthcare guidelines. I love their information, but I hate the fact that few people ever see them. Name kids of a few celebrities then name something you saw about sugar in a health care guideline. Tough, right? Blue Ivy is cute, but she ain’t saving your life (at least not yet, who knows what could happen given her parent’s resources and talents). Only people actively searching for guidelines see them. Guidelines are like underground or independent music artists—it doesn’t matter how good they are, you’ll never know about them if you are not actively looking.
Regarding sugar guidelines, the World Health Organization recommends that people reduce their sugar intake to 5-10% of their total daily calories (2).
That’s sounds good on paper, but it’s tough to follow in reality because few people add up their total daily calories. The American Heart Association (AHA) took it a step further for clarification. According to the AHA, men should consume no more than 36 grams of sugar and 25g for women (3). Great! Wait a minute…how much sugar is that?
A great visual tool for figuring out the sugar content in food
By law, commercial/packaged products are required to list their ingredients and nutritional information based on the Nutrition Labeling and Education act of 1990. The issue with food labels is that everything is listed in grams. In the US, we barely even use the metric system. What’s your weight in kilograms? You probably don’ t know unless you lived in Canada or something.
When I discuss sugar in clinic, I always tell people that 1 gram of sugar is equal to 4 calories and 4 grams of sugar is equivalent to one sugar cube.
After making sure people still have their math skills intact, I go over a great visual resource from sugarstacks.com (4). They break down the sugar content in everyday beverages and snacks by visually depicting sugar content as sugar cubes. The concept is brilliant. Most people are shocked when I show them that a can of pop has 10 cubes of sugar or a can of iced tea has 18 sugar cubes. Check them out if you get a chance. For sugar in a liquid form, 1 teaspoon of honey is the equivalent of 5 grams of sugar. Each teaspoon of honey has about 20 calories. Concerning teaspoons, it’s also helpful to know that 1 teaspoon of sugar is equal to 1 sugar cube.
What’s the bottom line for your sugar intake?
- Limit added sugar
- Be careful with natural sugars in juices
- Men shouldn’t eat more than 36 grams of sugar in a day (150 calories)
- Woman should try to eat less than 25 grams of sugar daily (100 calories)
- Look at nutrition labels to figure out how much sugar is in a product
- Know that 1 gram of sugar is equal to 4 calories
- 1 sugar cube equals 4 grams of sugar
- 1 teaspoon of honey is 5 grams of sugar
- 1 teaspoon of dry sugar is equal to 1 sugar cube or 4 grams of sugar
And, finally, to help with that sweet tooth, check out this healthy sugar alternative that you aren’t using.
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- G B Haber, K W Heaton, D Murphy, L F Burroughs. Depletion and disruption of dietary fibre. Effects on satiety, plasma-glucose, and serum-insulin. Lancet. 1977 Oct 1;2(8040):679-82.
- Source: WHO | Sugars intake for adults and children
- Source: Added Sugars
- Source: Sugar Stacks – How Much Sugar Is in That?
I am a physician and trained chef. I specialize in gastroenterology and nutrition. Currently I work as the Associate Director of Adult Nutrition at the University of Chicago.