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Sweeteners - sugars

Sugars are found naturally in milk and milk products (lactose) and fruits (fructose). Most of the sugar in the American diet is from sugars added during food processing and preparation, or at the table.

Function

Sweeteners made with different sugars:

  • Provide sweet flavor when added to food.
  • Maintain freshness and product quality.
  • Act as a preservative in jams and jellies, and a flavor enhancer in processed meats.
  • Provide fermentation for breads and pickles, bulk to ice cream, and body to carbonated sodas.

When you eat foods containing natural sugars (such as fruit), these foods also include vitamins, minerals, and fiber.

However, many foods with added sugars contain nothing but calories. These foods and drinks are often called "empty" calories.

Most people know that there is a lot of added sugar in soda. However, many people do not realize that popular "vitamin-type" waters, sports drinks, coffee drinks, and energy drinks also contain a lot of added sugar.

Food Sources

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

Sucrose (table sugar) is made from a low-sugar beet juice or sugar cane.

  • Sucrose includes raw sugar, granulated sugar, brown sugar, confectioner's sugar, and turbinado sugar. It is made up of glucose and fructose.
  • Raw sugar is granulated, solid, or coarse, and is brown in color. It forms when the moisture from the juice of the sugar cane evaporates.
  • Brown sugar is made from the sugar crystals from molasses syrup.
  • Confectioner's sugar (also known as powdered sugar) is finely ground sucrose.
  • Turbinado sugar is unrefined sugar made from sugar cane juice.

Other commonly used sugars include:

  • 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, which is produced by bees.
  • Corn syrup and high fructose corn syrup are sugars made from corn. Corn syrup is often used in soft drinks, baked goods, and some canned products. It is a liquid and is made of maltose, glucose, and dextrose sugars.

Sugar alcohols:

  • Mannitol mayh have a laxative effect when eaten in large amounts.
  • Sorbitol is used in many dietetic food products. It is produced from glucose and is also found naturally in certain berries and fruits. It is absorbed by the body at a much slower rate than sugar and has about half the calories of sugar.
  • Erythritol is a naturally occurring sugar alcohol found in fruit and fermented foods. It is 60 - 70% as sweet as table sugar, yet it has less calories, does not raise blood sugar, does not cause tooth decay, and does not cause stomach side effects, unlike other sugar alcohols.

Other types of natural sugars:

  • Dextrose is glucose combined with water.
  • Invert sugar is a sugar that is made by dividing sucrose into its two parts: glucose and fructose. It is sweeter than sucrose and used in a liquid form, and it helps keep candies and baked items sweet.
  • Agave nectar is a highly processed type of sugar from the Agave tequiliana (tequila) plant. It is mostly made up of glucose and fructose sugars. Agave nectar is about 1 1/2 times sweeter than regular sugar. It is often substituted for honey or sugar in recipes.

Other types of natural sugars:

  • Glucose is found in fruits in small amounts. It is also a syrup made from corn starch.
  • 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.

Side Effects

Sugar provides calories and no other nutrients. Sugar or caloric sweeteners can lead to tooth decay .

Large amounts of sugar-containing foods, along with other carbohydrates and fats, can cause obesity in children and adults. Obese people are at much higher risk for type 2 diabetes , metabolic syndrome , and high blood pressure .

Sugar alcohols such as sorbitol, mannitol, and xylitol may have a laxative effect when eaten in large amounts.

Recommendations

Sugar is on the U.S. Food and Drug Administration's (FDA) list of safe foods. It contains 16 calories per teaspoon and can be used in moderation. All of the types of sugars described in this article can be used in moderation.

The American Heart Association (AHA) recommends limiting the amount of added sugars in your diet. The AHA recommendations focus on all added sugars, not just one type, such as high fructose corn syrup.

  • Women should get no more than 100 calories per day from sugar (about 6 teaspoons of sugar)
  • Men should get no more than 150 calories per day from sugar (about 9 teaspoons of sugar)

The Dietary Guidelines for Americans also recommends limiting added sugars. Strategies to reduce added sugars include:

  • Drink water instead of regular soda, "vitamin-type" water, sports drinks, coffee drinks, and energy drinks.
  • Eat less candy; dairy-based desserts such as ice cream; and grain-based desserts such as cookies, cakes, and pies.

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

  • When eaten at meals or snacks, sugars affect blood glucose control the same as other carbohydrates. It is still a good idea to limit foods and beverages containing sugar, and to check your blood sugar levels carefully.
  • Although foods that contain sugar alcohols may have fewer calories, read labels carefully for the amount of carbohydrates and check your blood sugar levels.

References

Johnson RJ, Appel LJ, Brands M, Howard BV, Lefevre M, Lustig RH, et al. Dietary Sugars Intake and Cardiovascular Health: A Scientific Statement from the American Heart Association. Circulation. 2009;120:1011-1020.

Franz MJ, et al. American Diabetes Association Nutrition Recommendations and Guidelines. Diabetes Care. 2008;31 (Suppl 1):S61-S78.

Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33:2477-2483.

United States Department of Agriculture. Center for Nutrition Policy and Promotion. Dietary Guidelines for Americans. 2010. National Academy Press, Washington, DC, 2010.

Updated: 5/5/2011

Alison Evert, MS, RD, CDE, Nutritionist, University of Washington Medical Center Diabetes Care Center, Seattle, WAshington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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