Understanding the ‘sweet stuff’ – natural vs added sugars

Outpatient diabetes and nutrition education program

As diabetes educators, we are asked questions daily about the difference between “natural sugars” and “added sugars.” This is especially true since the FDA’s Nutrition Facts label was changed and the “Total Sugars” section now has a line that says “Contains ___ Added Sugars.”

Some of our customers are now under the impression that they should only be concerned with “added sugars” on food labels versus “total sugars”. Unfortunately, this is not the case. When natural sugars are highly processed, they will have fundamentally similar properties to added sugars.

A common example here is fruit juice. The food label will tell you that 8 ounces of orange soda has 23 grams of “added sugar,” while 8 ounces of orange juice (no pulp) has 23 grams of “natural sugar.” While both will cause a quick blood sugar spike and crash, juice sounds “healthier.” If you choose to eat a medium orange instead, it will contain 10-13 grams of natural sugar, as well as fiber and water. Fiber and water will fill you up and keep you from overeating. Also, your body will have to break down the orange cells before the sugar can be released and the sugar will be absorbed into your blood more slowly.

Technically, the sugar we eat is broken down into glucose in our bodies and processed the same way. The benefit of “natural sugars” comes when they are consumed in whole foods. As mentioned above, the natural sugars in whole fruit are accompanied by fiber and vitamin C. The natural sugars in plain milk and yogurt are accompanied by protein and calcium. All of these can help slow down digestion and reduce spikes in blood sugar levels.

As for “added sugars,” according to the American Heart Association, the daily goal for women is about 24 grams (6 teaspoons) and for men it’s about 36 grams (9 teaspoons). To put this into perspective, a 12-ounce can of cola contains 10 teaspoons of sugar, and 2 tablespoons of bottled barbecue sauce contains about 4 teaspoons of sugar. You can see how quickly this can add up, especially if the diet is high in processed foods. Some processed foods that contain added sugars include:

  • Smoothies
  • Bread
  • Canned fruit and dried fruit
  • Cereal and flavored oatmeal
  • Condiments and salad dressings (eg BBQ sauce, honey mustard, ketchup, French dressing)
  • Energy and granola bars
  • Flavored yogurt
  • Foods with reduced fat and sodium content
  • Nut butter
  • Sauces and soups based on tomatoes
  • Crackers
  • Frozen meals
  • Plant-based milk (almond, coconut, oat)
  • Canned baked beans
  • Protein powder

A diet that contains mostly whole, unprocessed foods—vegetables, fruits, legumes, lean meats, nuts, seeds, whole grains, plain dairy, and eggs—is the best way to reduce added sugars. We realize this can be a challenge with current food prices. So here are some tips to help you start reducing sugars in your diet:

  • Cut back on sugary drinks
    • Instead, drink more water, sparkling water, herbal teas, black tea or black coffee.
  • Switch up your desserts
    • Instead of cakes, pies, donuts and ice cream, try fresh fruit, Greek yogurt with cinnamon or dark chocolate.
  • Limit sauces, condiments and dressings with added sugars.
    • Choose more herbs and spices, mustard, vinegar, lemon juice, pesto or mayonnaise.
  • Choose canned goods without added sugar
    • Avoid versions that are packed in syrup. Instead, look for “packed in water” or “no added sugar” on labels.
  • Limit sugary foods for breakfast
    • Breakfast cereals, even the “healthier” versions, are often full of sugar, as are muffins and pancakes. Instead, try plain Greek yogurt with added fruit and nuts, or eggs with cheese and veggies, or toast with nut butter (no added sugar).
  • Limit high-sugar products that are brought into the house
    • If you must keep them in the house, store these items in “hard-to-reach” places and make fruits, vegetables and nuts more easily accessible.

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