Do you know how much sugar you're eating?

By John Casey

WebMD Weight Loss Clinic - Feature

Reviewed By Kathleen Zelman, MPH, RD/LD

One hundred and fifty-six pounds. That's how much added sugar Americans consume each year on a per capita basis, according to the U.S. Department of Agriculture (USDA). Imagine it: 31 five-pound bags for each of us.

That's not to say that we get most of the sugar in our diets directly from the sugar bowl. Only about 29 pounds of it comes as traditional sugar, or sucrose, according to The Sugar Association, a trade group of sugar manufacturers. The rest comes from foods.

Of course, those foods include things like candy, soda, and junk food. But plenty of sugar is hiding in places where you might not expect it.

Some types of crackers, yogurt, ketchup, and peanut butter, for instance, are loaded with sugar -- often in the form of high-fructose corn syrup, or HFCS. Use of this sweetener has increased 3.5% per year in the last decade, according to the World Health Organization (WHO). That's twice the rate at which the use of refined sugar has grown.

Where is all that sugar going? In the U.S. diet, the major source of "added sugar" -- not including naturally occurring sugars, like the fructose in fruit -- is soft drinks. They account for 33% of all added sugars consumed, says Kristine Clark, PhD, RD, a spokeswoman for the Sugar Association. Clark is also director of sports nutrition in the athletic department of Penn State University.

According to the USDA, sweetened fruit drinks account for 10% of the total added sugars we consume. Candy and cake come in at 5% each. Ready-to-eat cereal comprises 4% of the total. So do each of these categories: table sugar and honey; cookies and brownies; and syrups and toppings.

The biggest chunk, making up 26% of added sugars, comes from a variety of prepared foods like ketchup, canned vegetables and fruits, and peanut butter.

Another high-sugar category? Low-fat products, which may not be as good for your diet as you think. Some contain plenty of sugar to make up for the lack of tasty fat.

"People are often surprised that a low-fat product may not be that different in calories" than regular products, says Connie Crawley, nutrition and health specialist in the College of Family and Consumer Sciences at the University of Georgia. "A good example is fat-free or low-fat salad dressing, which can be high in sugar."

So what's so bad about all this sugar? After all, sugar can certainly be part of a healthy diet. And while it can cause cavities, there's no firm evidence that it's directly linked to diabetes or other serious health problem.

The problem comes when we simply take in too many calories.

"It's really the extra calories from sugar in our diet that causes health problems like diabetes and obesity, not anything inherently unhealthy about sugar itself," says Jule Anne Henstenberg, RD, director of the Nutrition Program at La Salle University in Philadelphia.

"Foods with a lot of sugar taste good, so we eat can eat too much of them," she says. "The one area where this fact stands out is in drinks. In the last 20 years, we've seen an explosion of sugared drinks in the marketplace: teas, sports drinks, juice-based drinks."

In fact, between 1987 and 1997, consumption of "added sugar" in the United States grew 20%. This trend is also being seen in the developing world, according to the WHO.

That's one reason both the United Nations and the World Health Organization released guidelines in 2003 that say sugar should account for no more than 10% of daily calories. In a 2,000-calorie-a-day diet, that's just 200 calories -- or eight heaping teaspoons of table sugar at 25 calories each. A single can of regular soda, with the equivalent of 10 teaspoons, would put you over.

"Our body fat depends on total calorie intake, not on a particular source of calories."

But some take issue with the reports of our rising sugar consumption. The Sugar Association, a trade group of sugar producers and growers, maintains that the average American consumes no more than 1.6 ounces, or about 9 teaspoons, of added sugar per day.

When the USDA says that we each consume 150 pounds of sugar a year, that figure refers to 'economic consumption,'" says Clark. "That's an estimate of all caloric sweeteners available for sale in a year, but only a fraction of that is for human consumption. The rest goes into export markets, pet foods, alcohol manufacturing, waste and storage, and the like."

No doubt, national estimates of food consumption are subject to much interpretation. But in the real world of everyday eating decisions, what foods should we avoid and what foods should we enjoy to maintain healthy weight?

"Our body fat depends on total calorie intake, not on a particular source of calories," says Crawley. "Of course the tip of the food pyramid [the category that includes sugar and oil] is where most of the empty calories are found, so minimizing choices from there will help."

If you want to avoid hidden sugar:

Read food labels. Ingredients are listed in order of volume, so anything with sugar, corn syrup, glucose (or, in general, words ending in "-ose") near the top of the list is likely to be high in sugar.

When you do choose a product with added sugar, watch your portion size.

Simply avoid processed foods as much as you can -- especially sodas and other sweetened beverages.

And what about artificial sweeteners? While they can be useful in weight maintenance, use them sparingly, says Crawley. All sweeteners have little nutritional value," she said. "I prefer to use a minimum of all of them." That's great, but what if you still crave sweets? Fresh fruit is always your best bet, but if it just won't do the trick, the Sugar Association has a few suggestions:

Angel food cake topped with fruit.

Frozen fruit ices and sorbets.

Low-fat frozen yogurt.

Fruit shakes made with low-fat milk.

Originally published Dec. 16, 2003

Medically updated Jan. 3, 2005.

SOURCES: Connie Crawley, nutrition and health specialist, College of Family and Consumer Sciences, University of Georgia, Athens. Kristine Clark, PhD, RD, director of sports nutrition, Pennsylvania State University, State College. Jule Anne Henstenberg, RD, director, Nutrition Program, La Salle University, Philadelphia. The Sugar Association. American Dietetic Association. WebMD Medical News: "Sugary Foods Making Us Fat."