Is Eating Sugar Really That Bad for Us?

Personal Health

Want to gross yourself out? Imagine eating eight teaspoons of sugar straight out of the bag. Yeek, right? That's how much sugar is in a can of Coke. A Grande Vanilla Starbucks Frappuccino has 11. A McDonald's Strawberry Triple Thick Shake has 27.

The American Heart Association's latest guidelines stipulate that a moderately active woman should eat no more than six teaspoons of sugar per day; her male counterpart no more than nine. Yet according to the AHA's latest statistics, the average American devours 22, and the average teenager devours 34.

Sugar is being blamed far and wide for the catastrophic rise in obesity, diabetes and cardiovascular disease -- not to mention acne and tooth decay. In his bestselling book Anticancer: A New Way of Life (Viking, 2009), Doctors Without Borders cofounder David Servan-Schreiber avows that refined sugars "directly fuel the growth of cancer." Killjoy. I gave up sweet drinks years ago, but I would live on ice cream if it wasn't so embarrassing.

It's a biblical-sounding question: Can something that tastes like heaven really be so bad? But this begs further questions: Good for whom? Bad for whom? Precisely how? Well, we know it's good for business. Soft drinks represent a $115 billion industry in this country. Candy represents a $32 billion industry. (Americans spend $2 billion on Halloween candy alone.) According to the Centers for Disease Control, the annual cost of treating obesity-related medical conditions topped $140 billion in 2008, having nearly doubled in the previous decade. Diabetes isn't simply a matter of insulin injections. Blindness and amputations, anyone?

Like any territory where our bodies and other people's profits intersect, sugar is a battlefield.

We enter that fray within hours of being born.

"When a brand-new baby is struggling to make sense of this scary world," says nutrition therapist Elyse Resch, coauthor of Intuitive Eating (St. Martin's, 2003), "the first thing it tastes is breast milk or formula." Both fluids are rich in lactose, a disaccharide containing glucose, which the human body requires for survival; it's our cells' chief energy source. "Tasting that sweetness," Resch says, "what's the baby going to think? 'Hey, every time I eat this, I'm going to get really calm and my tummy's going to feel better and I'll be happy.'"

But somewhere between the nipple and the artisanal chocolate, we transfer our affection from lactose to other sweet-tasting chemical compounds derived from other sources; mainly sugarcane, corn, beets and fruit. Although each of these sweeteners -- too often collectively called "sugar" or "sugars," which has traditionally landed sucrose, aka white sugar, with most of the bad rap -- possesses a different chemical makeup, all of them contain a certain percentage of glucose. When sugar enters the bloodstream during digestion, the pancreas releases insulin, a hormone that regulates the blood-sugar level by allowing cells throughout the body to absorb and use the glucose. Frequent deluges of glucose wreak havoc on blood-sugar levels. When an overwhelmed pancreas produces little or no insulin or the cells stop responding to whatever insulin is produced, glucose builds up in the bloodstream. That's what we call diabetes.

And because the refining process strips away all enzymes, vitamins, minerals, fiber and other nutrients, refined sweeteners comprise nothing but empty calories. The body can metabolize these sweeteners only by drawing upon its own micronutrient storehouses: in other words, by draining its reserves. This process hinders the body's ability to metabolize fatty acids; increased fatty-acid storage leads to obesity.

In which case, refined sugars aren't just not food. They're arguably antifood.

"A lot of things being sold as foods have low or zero nutritional value aside from calories," says Joel Kimmons, a nutritional epidemiologist with the CDC's Division of Nutrition, Physical Activity and Obesity. "From a health and culinary perspective, the foods that we feed our children, our families and ourselves need to have more than calories -- they should include a wide variety of vitamins, minerals, protein, phytonutrients and fiber. The problem with sugar and other refined foods is that they dilute the nutritional content of your diet overall. It becomes more difficult to meet your nutritional requirements within your calorie limits every time you add sugar."

Yet we add so much. Those 22 teaspoons a day -- which comprises all sweeteners put into foods during processing and preparation by the manufacturer and the consumer -- amount to 156 pounds per person per year, according to the USDA. This figure is "shocking," avows Anticancer author Servan-Schreiber, railing against what he calls "the sugar boom" and noting that in 1830, the average American ate only 11 pounds of sugar a year.

Right, but it's everywhere. (Every four grams of sugar, as listed on food labels, equals about one teaspoonful.) And it goes by so many names. Maltodextrin, rice syrup, dextrose, galactose -- to choose from two dozen. Especially ubiquitous, in a country whose government subsidizes corn production, is high-fructose corn syrup (HFCS), a lower-cost alternative to cane sugar that was first developed in the 1950s, entered the processed-food scene bigtime during the late 1970s, and now represents between 40 and 50 pounds of our annual 156.

Many food activists, including Michael Pollan, point damning fingers at the fact that the industrialized world's recent rise in obesity coincides with the mainstreaming of HFCS. For this, many blame HFCS's high fructose content: 55 percent as compared to white sugar's 50 percent. Several studies, such as one performed at the University of Texas in 2008, suggest that fructose metabolizes differently than glucose does and transforms into body fat much more rapidly than glucose does. Yet many, including a 2007 University of Maryland project, argue the opposite. "Based on the currently available evidence," reads the Maryland report, "the expert panel concluded that HFCS does not appear to contribute to overweight and obesity any differently than do other energy sources."

In any case, the corn industry has a powerful public-relations department that, based on past experience, will track me down and send me another stern-but-upbeat missive in 3, 2, 1 denouncing HFCS's bad press and insisting that, as cited on the industry's Web site,, "High fructose corn syrup is simply a kind of corn sugar. It has the same number of calories as sugar and is handled similarly by the body."

The corn industry's basic line is that HFCS "is no worse than sucrose," aka white sugar, says the CDC's Joel Kimmons. "The error they're making is in saying, 'We're just as good as sucrose.' Sweeteners are a problem simply because they provide calories without the concomitant required nutrients. Some researchers suggest that problem with sugar is fructose," which has been blamed not just for weight gain but also for illness; one 2008 University of Florida study links fructose consumption with liver disease; a University of Cincinnati study that same year links it with kidney disease and hypertension. A study published last year by the Minneapolis-based nonprofit Institute for Agriculture and Trade Policy reported detectable levels of mercury in 17 out of 55 food products containing HFCS that had been purchased the previous year. Even what appears innocent probably isn't: While the body can easily handle the amount of fructose in a single piece of actual fruit, fruit juices -- even those without added sweeteners -- are a different story.

Kimmons says HFCS is probably not handled much differently by the body than sucrose, given the similarity between the molecular makeup of both sweeteners. "However, the functional properties of HFCS have led to its being in all sorts of foods into which traditionally we would never consider putting a sweetener. It's even in bread," Kimmons laments.

HFCS's texture allows it to be used in ways that sugar can't.

"In addition to providing sweetness," we read at, HFCS "gives chewy breakfast bars their soft texture and also protects freshness. High fructose corn syrup keeps products fresh by maintaining consistent moisture."

A five-minute wander through my own kitchen reveals the presence of HFCS or just-plain-corn-syrup in seven different "savory" products, including Del Monte tomato sauce and a loaf of Old Country Round Top Wheat & Bran Bread.

Now I'm officially depressed.

Because I have a relationship with sugar. Sweetness means more to me than other flavors, for better or worse. Like most Americans, I was raised to cherish sugar, anticipate sugar and crave sugar as a reward, a prize, a balm for broken hearts and shattered self-esteem. At the exact same time, like most Americans, I was raised to fear sugar, loathe sugar and shun sugar as a poison, a fattener, an uglifier and thus ruiner of (especially female) lives. The first half of that equation has evolutionary roots. Forced to submit to four actual seasons, our rural ancestors instinctively gorged on fruit, honey and the "fat of the land" at harvest time, packing on enough pounds to carry them through nutritionally sparse winters. Those with the keenest appetite for sweets ate the most, thus gained the most, thus were likelier to survive and reproduce than their skinny sweet-shunning neighbors.

The second half of that equation -- sugar as the core of what some would call addictions -- "is what happens when we start to believe that an innate pleasure is forbidden," says Intuitive Eating author Elyse Resch. As infants, we learn to love lactose. "Then in childhood they soothe you by giving you lollipops. Families celebrate special times by going out for ice cream. Growing up, we learn that sugar soothes us and cheers us up, because it drives the serotonin in the brain. But then at a certain point you're told, 'No, you can't have it.' And the more you're told you can't have something, the more you want it."

This is what eating disorders look like. Liberation comes when we release the notion of can't-have-it, Resch says, and instead learn to read our cravings carefully. And even though we imagine that we'll want a whole box of Mystic Mints, she says that nine times out of 10 we really won't.

"I was the diet queen in my twenties," says Resch, who is now 64. "I binged. I ate those seven cookies in a row. I've been there, but I know that the obsession can go away, along with the worry and the desperation. We have such tremendous wisdom within us. If we listen, it will let us know what we want and why we want it, especially if we're not acting out of desperation and rebound and we're not trying to control ourselves. Your body knows that you're not going to feel well if you eat what you don't need. And if you're truly listening to your body, you're not going to want a lot of sugar. Maybe a little bit with a meal or after a meal, but that's okay, because I really don't think sugar is all that bad for you. I like sugar, and I have sweets throughout the day -- okay, not candy bars for breakfast," Resch says, but she highly recommends Trader Joe's Old-Fashioned Cinnamon Grahams.

"I work with a lot of people who describe themselves as not being able to control their cravings for sugar," says nutrition therapist Karen Scheuner, who helps clients with eating disorders at the My Weigh therapy center in Oakland, California. "It is clear that food marketers do a really good job of priming us to crave sugar in the sense that it is ubiquitous, easy to buy and relatively cheap. On one hand our culture tells us to eat it, and on the other, it tells us to feel guilty for having eaten the chocolate cake. ... Sugar is both widely abundant and forbidden," Scheuner says.

Given that I have suffered so much for sugar, and given that I work so hard to compartmentalize it, making the absolute most of it in highly regulated small amounts, exalting over the half-brownie or lone macaroon with the rigid-backed rapture of the former anorexic, given that my isolated rendezvous with sweetness dot my waking hours like shiny, tiny holidays, I need to know what is sweet and what is not and I resent sugar's intrusion into non-treat foods. Special K, indeed. For someone with my history, it amounts to a violation, a kind of assault.

Being force-fed fructose is offensive enough. But -- not to sound elitist or anything -- the monosaccharide fructose simply doesn't taste as good as the disaccharide white sugar and not nearly as good as more expensive and boutique sweeteners such as raw sugar, brown sugar, maple sugar, honey, agave nectar and yacón syrup. (Refined honey, by the way, has more calories than table sugar and about the same nutritional value, which is basically nil.)

Agave nectar in particular is gaining ground amid the storm of controversy surrounding sucrose and HFCS. Refined from the sap of the flower-stalk of a spiky succulent native to central Mexico and better known stateside as the century plant, agave is the current darling of health-conscious chefs such as Sharon Fernandes, co-owner of the Germantown, Tennessee-based Stonehouse 27 spice company. Fernandes decided to use agave in her home kitchen and then in her line of Indian cooking sauces "after I started reading food labels when my daughter was young. I realized that every single thing I'd been buying at the store had high-fructose corn syrup in it. Everything was corn, corn, corn and more corn. I had to offer the public something different, and I thought pure agave nectar was just beautiful." Its texture evokes liquid velvet. Its flavor is oddly light and neutral: sweetness spoken as Hello, there rather than a shout. Hailed as a godsend for diabetics because of its low glycemic index, agave is nonetheless higher in fructose than HFCS.

First admitting, then appreciating the differences in flavor is a key to reducing sugar consumption, says Mireille Guiliano, bestselling author of French Women Don't Get Fat: The Secret of Eating for Pleasure (Knopf, 2004).

"Learn to enjoy the first three bites. That's all you need. Eat slowly, savor. The bad sugar is in sodas, cakes, cookies -- all the stuff with HFCS. Read labels and don't buy anything with HFCS. It's poison," Guiliano tells me. "If you eat the bad stuff ... your body will go into a sugar crave that can last a few hours to a few days. So think before you eat, pay attention to how fast you eat and remember that once you start eating, your brain, not your stomach, will signal satiety. Twenty minutes is required for the stomach to feel full and since most people gulp down the sweets much faster, it wastes calories and makes you fat."

"On the other hand, don't fool yourself and believe you can do totally without sugar -- most people can't," she says. "If you like chocolate, try a little square at the end of a meal and have dessert once in a while." Echoing Intuitive Eating author Resch, Guiliano adds: "The important thing is to not consider sugar as a temptation or 'guilty pleasure,' as some would say -- though not a French woman. If you look at sweets that way, you'll crave them even more and give in easily. Find a balance and remember: If you have dessert tonight, then no pain au chocolat for breakfast tomorrow. It's doable with a little practice."

Guiliano recommends honey "because it's so sweet, as well as divinely flavorful, [so] you can use less -- in my case, about half the amount of processed sugar."

That's what all this advice from everyone except the soft-drink, fast-food, candy and corn industry boils down to: using less. In urging us to go from 22 teaspoons of sugar per day to six or nine, the American Heart Association is asking us to cut down on sugar by 70 percent. We can try. But manufacturers shouldn't make it so difficult, sneaking sugars into everything from salad dressing to breakfast cereal and using cheap, zero-nutrition sweeteners as virtual filler. We could refuse to buy those products, or those companies could be pressured in other ways. A tax on anything containing more than four grams of sugar per serving, anyone?

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