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Sugars & Sweeteners

Overview

The term sugar is used to describe a wide range of compounds that vary in sweetness.

Common sugars include:

Glucose

Fructose

Galactose

Sucrose (common table sugar)

Lactose (the sugar found naturally in milk)

Maltose (product of starch digestion)

Sugars are found naturally in milk products (lactose) and fruits (fructose). Most of the sugar in the American diet is from sugars added to food products.

Function

Some of the functions of sugars include:

Provide sweet flavor when added to food.

Maintain freshness and food quality.

Act as a preservative in jams and jellies.

Enhance flavor in processed meats.

Provide fermentation for breads and pickles.

Add bulk to ice cream and body to carbonated sodas.

Many foods with added sugars often add calories without other nutrients. These foods and drinks are often called "empty" calories. By contrast, foods containing natural sugars (such as fruit) also include vitamins, minerals, and fiber.

Most people know that there is a lot of added sugar in regular soda. However, popular "vitamin-type" waters, sports drinks, coffee drinks, and energy drinks also may contain a lot of added sugar.

Food Sources

Some sweeteners are made by processing sugar compounds. Others occur naturally.

Sucrose (table sugar):

Sucrose occurs naturally in many foods, and it is commonly added to commercially processed items. It is a disaccharide, which is made of 2 simpler monosaccharides--glucose and fructose. Sucrose includes raw sugar, granulated sugar, brown sugar, confectioner's sugar, and turbinado sugar. Table sugar is made from sugar cane or sugar beets.

Raw sugar is granulated, solid, or coarse. It is brown in color. Raw sugar is the solid part left when the liquid from the juice of the sugar cane evaporates.

Brown sugar is made from sugar crystals that come from molasses syrup. Brown sugar can also be made by adding molasses back to white granulated sugar.

Confectioner's sugar (also known as powdered sugar) is finely ground sucrose.

Turbinado sugar is a less refined sugar that still retains some of its molasses.

Raw and brown sugars are no healthier than granulated white sugar.

Other commonly used sugars:

Fructose (fruit sugar) is the naturally occurring sugar in all fruits. It is also called levulose, or fruit sugar.

Honey is a combination of fructose, glucose, and water. It is produced by bees.

High fructose corn syrup (HFCS) and corn syrup are made from corn. Sugar and HFCS have almost the same level of sweetness. HFCS is often used in soft drinks, baked goods, and some canned products.

Dextrose is chemically identical to glucose. It is commonly used for medical purposes such as in IV hydration and parenteral nutrition products.

Invert sugar is a natural form of sugar that is used to help keep candies and baked items sweet. Honey is an invert sugar.

Sugar alcohols:

Sugar alcohols include mannitol, sorbitol, and xylitol.

These sweeteners are used as an ingredient in many food products that are labeled "sugar-free", "diabetic", or "low carb". These sweeteners are absorbed by the body at a much slower rate than sugar. They also have about one half of the calories of sugar. They should not be confused with sugar substitutes that are calorie free. Sugar alcohols may cause stomach cramps and diarrhea in some people.

Erythritol is a naturally occurring sugar alcohol found in fruit and fermented foods. It is 60% to 80% as sweet as table sugar, but has fewer calories. Also, it does not result in as much of a rise in blood sugar after meals or cause tooth decay. Unlike other sugar alcohols, it does not cause stomach upset. Erythritol is used in many foods marketed to people with diabetes, and it is a main ingredient in Stevia and monk-fruit sweetener products. A recent study linked consuming erythritol to a mildly increased risk of adverse cardiovascular events such as heart attack, stroke, and death. More research is needed to understand the implications of this study and possible long-term adverse effects of using erythritol and other no- and low-calorie and artificial sweeteners.

Other types of natural sugars:

Agave nectar is a highly processed type of sugar from the Agave tequiliana (tequila) plant. Agave nectar is about 1.5 times sweeter than regular sugar. It has about 60 calories per tablespoon compared to 40 calories for the same amount of table sugar. Agave nectar is not healthier than honey, sugar, HFCS, or any other type of sweetener.

Glucose is found in fruits in small amounts. It is also a syrup made from cornstarch.

Lactose (milk sugar) is the carbohydrate that is in milk. It is made up of glucose and galactose.

Maltose (malt sugar) is produced during fermentation. It is found in beer and breads.

Maple sugar comes from the sap of maple trees. It is made up of sucrose, fructose, and glucose.

Molasses is taken from the residue of sugar cane processing.

Stevia sweeteners are high intensity extracts derived from the stevia plant that are recognized as safe by the FDA. Stevia is 200 to 300 times sweeter than sugar.

Monk fruit sweeteners are made from the juice of the monk fruit. They have zero calories per serving and are 150 to 200 times sweeter than sugar.

What are sugar substitutes?

Sugar substitutes taste sweet but don’t contain sugar. They have fewer calories than sugar, and some have no calories at all. Foods labeled “sugar-free,” “keto,” “low carb” or “diet” often contain sugar substitutes, which fall into three categories: artificial sweeteners, sugar alcohols and novel sweeteners.

Artificial Sweeteners

Most artificial sweeteners (also called nonnutritive sweeteners) are created from chemicals in a lab. A few are made from natural substances like herbs. They can be 200 to 700 times sweeter than table sugar.

These sweeteners don’t contain calories or sugar, but they also don’t have beneficial nutrients like vitamins, fiber, minerals or antioxidants. They are regulated by the U.S. Food and Drug Administration (FDA) as food additives.

Traditionally, artificial sweeteners have been the only option for people who need to monitor their blood glucose levels or weight. Some experts believe that artificial sweeteners pose health hazards, from weight gain to cancer. But research on this is ongoing, and past studies showing health risks were conducted on animals, not humans. Studies on people have shown these products to be generally safe if more than the acceptable daily intake for each is not consumed.

The FDA has approved several artificial sweeteners:

Acesulfame potassium (Ace-K)

Advantame

Aspartame

Neotame

Saccharin

Sucralose

Is sugar bad for you?

Sugar isn’t inherently bad. Actually, it’s necessary: Our bodies run on sugar. The body processes the carbohydrates from food and turns much of it into glucose (sugar). The cells pull the glucose from the bloodstream and use it for fuel and energy. Removing natural sources of sugar and other carbohydrates from your diet — fruits, dairy products and grains — is not a healthy choice. But you can make choices about where sweetness in your foods is coming from.

Side Effects

Table sugar provides calories and no other nutrients. Sweeteners with calories can lead to tooth decay.

Large amounts of sugar-containing foods can contribute to excess weight gain in children and adults. Obesity increases the risk for type 2 diabetes, metabolic syndrome, and high blood pressure.

Sugar alcohols such as sorbitol, mannitol, and xylitol may cause stomach cramps and diarrhea when eaten in large amounts.

Recommendations about Sugars

Sugar is on the United States Food and Drug Administration's (FDA) list of safe foods. It contains 16 calories per teaspoon or 16 calories per 4 grams and can be used in moderation.

The American Heart Association (AHA) recommends limiting the amount of added sugars in your diet. The recommendation extends to all types of added sugars.

Women should get no more than 100 calories per day from added sugar (about 6 teaspoons or 25 grams of sugar).

Men should get no more than 150 calories per day from added sugar (about 9 teaspoons or 36 grams of sugar).

The United States Department of Agriculture (USDA) Dietary Guidelines for Americans also recommends limiting added sugars to no more than 10% of your calories per day. Some ways to reduce your intake of added sugars include:

Drink water instead of regular soda, "vitamin-type" water, sports drinks, coffee drinks, and energy drinks.

Eat less candy and sweet desserts such as ice cream, cookies, and cakes.

Read food labels for added sugars in packaged condiments and sauces.

There is currently no daily recommendation for the naturally occurring sugars found in milk and fruit products, but too much of any sugar can have negative effects on your health. It is important to have a balanced diet.

The American Diabetes Association nutrition guidelines state that you do not need to avoid all sugar and foods with sugar if you have diabetes. You can eat limited amounts of these foods in place of other carbohydrates.

If you have diabetes:

Sugars affect blood glucose control the same as other carbohydrates when eaten at meals or snacks. It is still a good idea to limit foods and drinks with added sugar, and to check your blood sugar level carefully.

Foods that contain sugar alcohols may have fewer calories, but be sure to read the labels for the carbohydrate content of these foods. Also, check your blood sugar level.

Get the Facts: Added Sugars

At a glance

Data indicate that Americans eat and drink too many added sugars. How much people consume varies by age, race, and ethnicity.

Consuming too many added sugars can contribute to health problems such as weight gain and obesity, type 2 diabetes, and heart disease.

The Dietary Guidelines for Americans 2020–2025 has recommendations for added sugar intake across the lifespan.

About added sugars

To live healthier, longer lives, most Americans need to move more and eat better. This includes consuming fewer added sugars. Consuming too many added sugars can contribute to health problems such as weight gain and obesity, type 2 diabetes, and heart disease.

Added sugars are sugars added during the processing of foods. Added sugars include foods packaged as sweeteners, sugars from syrups and honey, and sugars from concentrated fruit or vegetable juices. Added sugars do not include naturally occurring sugars in milk, fruits, and vegetables.

The leading sources of added sugars in the US diet are sugar-sweetened beverages, desserts, and sweet snacks. Examples of desserts and sweet snacks are cookies, brownies, cakes, pies, ice cream, frozen dairy desserts, doughnuts, sweet rolls, and pastries.

Recommendations about Added Sugars

The Dietary Guidelines for Americans 2020–2025 recommends that:

People age 2 years or older limit added sugars intake to less than 10% of their total daily calories. That means:

For a 2,000 calorie diet, no more than 200 calories should come from added sugars.

200 calories equal about 12 teaspoons of added sugar from both food and beverages.

Children younger than 2 years should not be given any foods or beverages with added sugars.

A leading objective for Healthy People 2030 is to reduce the consumption of added sugars by people aged 2 years or older.

Consumption of sugar-sweetened beverages among children

Too many children in the U.S. are drinking sugar-sweetened drinks at a young age.

In 2021, data from the National Survey of Children’s Health found 57.1% of children aged 1 to 5 years had consumed at least one sugar-sweetened beverages in the past 7 days.

The map below shows the percentage of children aged 1–5 years who drank at least one sugar-sweetened beverage in the preceding week.

Should I cut sugar from my diet?

Removing all sugar from your diet means you might miss important nutrients found in fruits, whole grains and dairy. Diets that cut out all carbohydrates and sugars, such as the ketogenic diet, can be harmful to your health.

Without sugar, our bodies must find alternative sources of energy. So, they use ketone bodies (substances produced by the liver) for fuel ― basically, the body goes into starvation mode. A diet without any carbohydrates or sugars may cause “keto flu,” with symptoms such as headache, fatigue and brain fog.

Dietitians recommend cutting way back on highly refined foods and beverages with added sugars and artificial sweeteners, but not removing all carbohydrates from your diet.

So, what are some sweet ways to stay healthy?

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Here are a few tips for people who want to reduce the refined sugars in their diets:

If you absolutely must use a sweetener, consider a sugar substitute like stevia or try using a mixture of sugar and stevia.

Load up on whole foods such as fruits, vegetables, whole grains, dairy products, lean proteins, seafood, nuts and seeds.

Skip the soda, energy drinks, sweet teas and fruit juices.

Use whole fruit as a sweetener. Add a mashed banana to oatmeal, or blend dates into a smoothie.

Read the nutrition facts label on food packages and avoid “healthy” foods that have added sugar, like granola or energy bars.

Consumption in children and young adults

In 2017–2018, the average daily intake of added sugars was 17 teaspoons for children and young adults aged 2 to 19 years.

By sex

The average daily intake of added sugars was 18 teaspoons for boys and 15 teaspoons for girls.

By age and race and ethnicity

Among children aged 2 to 5 years, the average daily intake of added sugars was:

13 teaspoons for non-Hispanic Black children.

12 teaspoons for non-Hispanic White children.

11 teaspoons for Hispanic children.

7 teaspoons for non-Hispanic Asian children.

Among children aged 6 to 11 years, the average daily intake was:

19 teaspoons for non-Hispanic Black children.

18 teaspoons for non-Hispanic White children.

16 teaspoons for Hispanic children.

12 teaspoons for non-Hispanic Asian children.

Among young people aged 12 to 19 years, the average daily intake was:

20 teaspoons for non-Hispanic Black young people.

20 teaspoons for non-Hispanic White young people.

15 teaspoons for Hispanic young people.

14 teaspoons for non-Hispanic Asian young people.

Consumption in adults

In 2017–2018, the average daily intake of added sugars was 17 teaspoons for adults aged 20 or older.

By sex

The average daily intake of added sugars was 19 teaspoons for men and 15 teaspoons for women.

By race and ethnicity

The average daily intake of added sugars was:

19 teaspoons for non-Hispanic Black adults.

17 teaspoons for non-Hispanic White adults.

16 teaspoons for Hispanic adults.

10 teaspoons for non-Hispanic Asian adults.

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