Sugar and Chronic Disease
The massive intake of sugar in this country is one of the main drivers of chronic disease. Just like drug addiction, sugar causes real “food addiction” in some people, making it hard to stop. And how much is too much? In this article, I’ll explain the evidence and help you set a reasonable goal for daily sugar intake. You’ll also get access to a guide to help you make smart decisions about how much added sugar you consume on a daily basis.
Sugar is everywhere, and linked to chronic disease.
Sugar is ubiquitous in our food supply, in everything from ketchup to bread. If you’ve ever tried a sugar elimination diet and read labels closely, I’m sure you’ve figured out how hard it is to completely avoid sugar in its many forms (high fructose corn syrup, honey, fructose, dextrose, sucrose, fruit juice concentrate, syrup).
According to the National Cancer Institute, data from 2001-20041 indicates that the average American consumed about 22 teaspoons of added sugar every day. Even worse, teenage males (age 14-19 years old) were eating closer to 34 teaspoons a day!
Data from 2007-20102 looks better, indicating average consumption of 17 teaspoons a day and peaking in teenage males at 25 teaspoons a day. Still, this is WAY TOO MUCH!
Excessive sugar consumption is not only linked with cavities, but with chronic disease, including:
- high blood pressure
- fatty liver disease
- high cholesterol
Sadly, we are now seeing increasing rates of these chronic diseases in our teenagers. I saw this firsthand during my residency training in inner city San Antonio, Texas. Obesity in childhood is commonplace there, and I routinely diagnosed teenagers with pre-diabetes and even diabetes. Such a tragedy when in the past this was an “adult onset” condition.
Sugar is a Drug
Addictive drugs cause neurochemical changes in the the brain, such as changes in dopamine and opioid receptor binding, which reinforce addictive behaviors. Likewise, sugar has been shown to stimulate the brain’s reward centers through the neurotransmitter dopamine. And just like other addictive drugs, people can develop a tolerance to sugar, meaning they need more and more to satisfy their sweet tooth. Some people are genetically more prone to sugar addition, which translates to disordered eating and obesity. Thus sugar causes “food addiction” in some people,3 and avoiding sugar is not as easy as using “self control.”
Recommended Daily Intake (RDI) for Sugar
In the Unites States, the U.S. Food and Drug Administration (FDA) developed Daily Values (%DV) to help consumers determine the level of various nutrients in a standard serving of food. Do you know what the %DV is for sugar? Read this label. Do you see it?
Are you surprised that sugar doesn’t even have a recommended DV? The good news is: there’s been progress. In July 2015, the FDA issued a supplemental proposed rule4 that would require the %DV for added sugars.
Luckily, we have other definitive guidelines to rely on.
In August 2009, The American Heart Association (AHA) released guidelines published in Circulation: Journal of the American Heart Association5 with the following recommendations:
- Most women should consume no more than 25 grams, or ~6 teaspoons of added sugar a day.
- Most men should consume no more than 37.5 grams, or ~9 teaspoons a day
- Children ages 4-8 with a daily caloric intake of 1,600 calories should consume no more than 12 grams, or 3 teaspoons a day.
WAIT… do you say 12 grams a day?? If you are giving your child almost any packaged or processed foods, you will likely exceed this.
In March 2015, the World Health Organization published similar guidelines6 for sugar intake for adults and children. WHO advocates limiting “free sugar” consumption to roughly 25 grams (6 teaspoons) per day.
Note that both of these recommendations refer to free or added sugars, which include honey, syrups, fruit juices and fruit juice concentrates. This does not include the sugar naturally present in whole fruits and vegetables, or milk. Although I think it’s worth noting that an 8 oz serving of milk has 12 grams of sugar in the form of lactose.
Added Sugars Add Up
Unfortunately, the food industry makes this tricky for us to navigate. Don’t be fooled by foods packaged and marketed as “health foods.” A great example of this is a green juice called Odwalla’s Superfood Smoothie. One 15.2 oz bottle has 50 grams of added sugar! Yes, it’s all fruit juice. But that’s still a burden on our bodies. Based on AHA’s recommendation for women, that’s 200 %DV for sugar. For children who are recommended to consume less that 12g sugar a day, this is 400% DV! How would consumer behavior change if THIS was printed on the label?
Eat less sugar… you’re already sweet enough!
I challenge you to count your sugar intake at home. As a reference, 1 tsp sugar = 4.2 grams = 16 calories. Be aware that many processed foods contain multiple forms of sweeteners, which makes it hard to really know just how much sugar the food contains.
Need help navigating this? Subscribe to my newsletter below and get the official Institute For Functional Medicine Sweeteners At A Glance Guide. Use this guide to help you make smart decisions about how much added sugar you consume on a daily basis. Also included are some important notes on artificial sweeteners and stevia.