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Dear Diabetes: The Basics of Dietary Sugars

What to know about naturally occurring & added sugars

Dear Diabetes: What should I know about dietary sugar – specifically, naturally occurring vs. added sugars?

“Which type of sugar is best?” My clients living with diabetes ask me this often. My answer is not the one they are really after: The best type of sugar is the one that occurs naturally in the food you are eating and not one that is added during processing or preparation. Sugar is naturally present in milk, yogurt and fruit. There are even small amounts of natural sugars in broccoli, mushrooms and other vegetables. These naturally occurring sugars are sitting with a host of other nutrients such as fiber, vitamins, minerals and other health-boosting compounds.

Added sugars are a different story

But when it comes to added sugars – white sugar, honey, agave nectar and others – there is a good news/bad news story. The good news is that many experts and organizations, including the American Diabetes Association (the Association), give the green light to consuming added sugars in moderation. The Association points out that while the type or source of carbohydrate affects blood sugar, the amount of carbohydrate has a greater effect. You can expect your blood sugar to rise much more after consuming a lot of carbohydrate than after consuming just a small amount, whether the carbohydrate is sugar or starch. Thus, I recommend to my clients that they may substitute added sugars for other carbohydrate-containing foods. For example, I might suggest to a client to eat a small unfrosted brownie or stir a tablespoon of sugar into hot tea in place of a slice of bread or an apple since these foods have similar amounts of carbohydrates, which I calculated using the USDA Nutrient Database. As always, however, talk to your healthcare team before changing your meal plan.

The bad news is that added sugars do not provide health-boosting nutrients; while they do provide plenty of calories. Also using the USDA Nutrient Database, I calculated that just 1 tbsp of honey contains 64 calories and 17 grams of carbohydrate. One tsp of table sugar has 49 calories and 13 grams of carbohydrate. The Association, the Dietary Guidelines for Americans  and other health organizations recommend limiting added sugars because they likely contribute to weight problems and other health consequences without improving nutrient intake. The greatest sources of added sugars in the American diet include sugary drinks, candy and baked and dairy desserts.

Sugars at home

So what is the best added sugar? If you plan to use any, the key is to use as little as possible. I advise my clients to choose the one they find the tastiest since none is much healthier than any other. Raw sugar, brown sugar, coconut sugar, agave nectar and molasses are just a few choices. Some may be touted as healthful options, but they are all just added sugars providing empty calories and carbohydrates.

Sugars in packaged foods

This is where it really gets tricky. Nutrition Facts panels identify sugars, but they do not separate added sugars from naturally occurring sugars. For example, if your package of vanilla yogurt lists 20 grams of sugar per cup, it’s impossible to know how many grams of sugar come from the milk and how many come from the sugar added to sweeten it. (Read more tips for understanding Nutrition Facts food labels.) So one solution would be to mix your own fruit into unsweetened yogurt. Then you know that there is no added sugar at all.

The supermarket is filled with foods with hidden sugars. You’ll find them in salad dressings, barbeque sauces, spaghetti sauces, protein bars, cereals and so much more. (Read strategies for smarter supermarket shopping.) Be sure to read the ingredients labels carefully. The following are just some of the words that mean added sugar. And be aware that manufacturers may use several types of sugar in one product.

  • Agave nectar
  • Brown rice syrup
  • Brown sugar
  • Cane syrup
  • Corn sweetener
  • Corn syrup
  • Dextrose
  • Fructose
  • Fruit juice concentrate
  • Glucose
  • High fructose corn syrup
  • Invert sugar
  • Maltose
  • Malt sugar
  • Molasses
  • Sucrose
  • Syrup

Tips to cut intake

Try using a little less sugar in beverages, cooking and baking. Experiment with applesauce, fruit purées or artificial sweeteners in baked goods. Satisfy your sweet tooth with fruits. And choose fewer highly processed foods in favor of home-prepared foods.

My bottom line: Try to limit all types of added sugars. Count all added and naturally occurring sugars toward your carb counts for meal planning purposes.

Jill Weisenberger, MS, RDN, CDE*, FAND is the author of Diabetes Weight Loss – Week by Week, and the upcoming The Overworked Person’s Guide to Better Nutrition, as well as contributing editor at Environmental Nutrition. She has written for many publications including EatingWell, Diabetic Living, Her Sports + Fitness, and LifeScript. Weisenberger is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.

*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.

© 2014 The DX: The Diabetes Experience

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