All About Added Sugar

It’s no secret that decreasing your intake of added sugar can dramatically improve health outcomes. Lowering added sugar can prevent or reverse diabetes, and improve heart health, weight, mood, sleep, and even brain health.

There are lots of sweeteners on the market today, and they go by many names including:

The difference between sweeteners

Artificial sweeteners contain no calories, and tend to be much sweeter than regular sugars (about 200-800 times sweeter!).

In a sense, they “bypass” metabolism, which is why they are able to be labeled as zero or low calorie sweeteners. I know being able to enjoy something sweet with no calories sounds very appealing, but the reality is: if it sounds too good to be true, it probably is. Our liver and kidneys do most of the work when processing artificial sweeteners. In general, I recommend avoiding these types of sweeteners, and here is a quick breakdown of why:

• Artificial sweeteners may negatively impact
  • Your satiation and hunger cues, causing cravings and overeating.
  • Gut microbiota. This is a big one. We are only as healthy as our gut, so it’s important to be mindful of anything that may be attributing to poor gut health.
  • Body weight, and may result in greater risk for obesity, and other metabolic diseases.
  • Reward centers in the brain. They “hijack” our taste buds making naturally sweetened foods, like fruits, taste much less pleasurable. This creates more dependency on the artificial sweeteners by activating our dopamine receptors in the brain, making it hard to give them up. (hint hint: you become addicted!)

Sugar alcohols are low calorie sweeteners that are primarily metabolized in the liver. Some sugar alcohols are ok in moderation. The downside is they may cause bloating, gas, and have a laxative effect in some people. I recommend avoiding large amounts of sugar alcohols and eliminating erythritol altogether.

A 2023 study showed an association between erythritol intake and risk for major adverse cardiovascular events (also known as MACE). MACE includes heart attack, stroke, and death as well as increased formation of blood clots and blockage of arteries. It was shown that elevated levels of erythritol (of 1,000-times higher!) were in the blood for hours and up to several days after ingestion. This high level of erythritol in the blood is linked to the formation of blood clots.

Amount of Sweetener

The American Heart Association has established recommendations for daily added sugar consumption (this applies to regular sugars, not including artificial or non-nutritive sweeteners):

• Women, age 19 to 70, should consume no more than 6 teaspoons (equal to 24 grams or ~100 calories)
• Men should consume no more than 9 teaspoons (equal to 36 grams or 150 calories)

To put this in context, one 12-oz. serving of regular cola has about 33 grams of added sugar, so this would exceed the recommended daily intake for women, and is 92% of the daily intake for men.

Use my quick guide below to see where your sweetener stacks up. 

Quick Sugar Guide

This guide gives my recommendations regarding sugar types, allowing you to make mindful choices in your everyday life. The least processed type of sugars are honey and maple syrup. While they are natural, it is important to remember that they still count toward your daily intake of added sugar. I recommend limiting intake to 1.5-2 tablespoons a day or 26-34 grams. 

Sugar alcohols, plant-based sweeteners, raw turbinado, table and brown sugar are ok to enjoy in small amounts. Sugar alcohols, such as xylitol and sorbitol, should be limited to less than 10 grams daily. 

For monk fruit and stevia, it’s recommended not to exceed 2 packets per day. Similarly, table sugar, raw turbinado, coconut sugar and brown sugar should be limited to 6-9 teaspoons daily. 

The last part of the guide is on the sugars that should be avoided because of their various negative effects. High fructose corn syrup, agave nectar, artificial sweeteners, and the sugar alcohol erythritol should be eliminated or consumed sparingly. 

Whenever you find yourself craving something sweet, my top recommendation is to eat fruit! Fruits can satisfy your cravings in the most wholesome way due to their natural sweetness.