The average American consumes nearly 400 calories from added sugars each day, the equivalent of 22 teaspoons (tsp) worth. The American Heart Association's Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism and the Council on Epidemiology and Prevention released a scientific statement entitled Dietary Sugars Intake and Cardiovascular Health in late 2009. The statement suggests that American women should consume no more than 100 calories and men no more than 150 calories from added sugar each day.

'Added sugar' includes sugars and syrups added to foods during processing or preparation, including sugars and syrups added at the table. The recent increase in average sugar intake is largely because of increased consumption of soft drinks, fruit drinks, desserts, sugars and jellies, candy, and ready-to-eat cereals, with soft drinks and other sweetened beverages accounting for the largest source of added sugars in the American diet. Authors of the paper noted that because food labels do not differentiate between natural sugar and added sugar, it is difficult for the average consumer to make wise choices. However, in 2006, the US Dept of Agriculture (USDA) created a database listing the added sugar content of food (http://www.ars.usda.gov/Services/docs.htm?docid=12107).

Problems linked to a high intake of added sugar
The following are problems linked to a high intake of added sugar, as outlined by the statement:

Insulin resistance: In some studies, fructose was linked to insulin resistance, obesity, hypertension, dyslipidemia, and type 2 diabetes mellitus in humans. Please note that high-fructose corn syrup actually is not made primarily from fructose; it is only 55% fructose and the other 45% is glucose.
Calorie intake: In some studies, soft drink consumption was linked to increased calorie intake, greater body weight, and lower intake of valuable nutrients. The sugar in soda is absorbed very quickly, which might explain why people who consume sugar-sweetened beverages on a regular basis seem to have an increased risk of developing diabetes.
Blood pressure: An emerging but inconclusive body of evidence links a high intake of added sugar to increased blood pressure. In the Framingham Heart Study, for instance, people who consumed more than one soft drink/day had a higher chance of developing hypertension and a 44% increased chance of having a diagnosis of metabolic syndrome.
Triglycerides and cholesterol: When added fats are replaced with carbohydrate, serum triglyceride levels increase and high-density lipoprotein (HDL) cholesterol decreases. However, this is apparently more substantial when refined carbohydrates are used, rather than the carbohydrates found in milk, fruit, etc. Diets that are high in fructose, sucrose, and glucose are linked to increased serum triglyceride levels, particularly in men, sedentary overweight people, people consuming a low-fiber diet, and people with metabolic syndrome.
Chronic hyperinsulinemia: Chronic hyperinsulinemia may cause people to eat more by preventing dopamine clearance from the pleasure center of the brain, increasing the pleasure caused by eating, even when a person has no physiological need to eat. It also promotes eating as a form of self-medication when a person is stressed.
Vitamins, minerals, and fiber: People who consume a large amount of added sugar, especially intake that exceed 25% of total calories, have reduced intake of calcium, vitamin A, iron, and zinc. Intake of sugar also is inversely related to fiber intake.

Recommendations
The following are recommendations as outlined by the statement:

• Limit your discretionary caloric intake (the calories left after you have consumed enough vegetables, fruit, lean protein, low-fat dairy, whole grains, and other foods necessary to stay healthy). The USDA recommends that if you consume a 2000-calorie diet, you should limit your discretionary caloric intake to no more than 267 calories, divided into 18 grams (g) of fat and 32 g of sugar (8 tsp). If you drink alcohol, you need to count this as a part of the daily discretionary calories. Currently, discretionary intake is much too high, 30%-42% of total caloric intake.


• Move more. If you burn more calories, your allowance for discretionary intake will increase. So if you want to eat more, you need to move more!


• Consume no more than 10% of your total calories in the form of added sugar, according to the World Health Organization (WHO).


• Restrict intake of soda and other sweetened beverages.


• Choose whole-food snacks, such as bananas, raisins, and peanuts, rather than high-sugar refined-grain snacks, such as candy bars and soda, to reduce postprandial glucose response.


• Select low-energy density foods, such as fresh fruits and vegetables, skim milk, lean meats, and other unprocessed foods.


• Use discretionary calories to sweeten healthful food choices, such as plain yogurt or whole-grain cereal.


• Remember that sugar is sugar, whether it is from honey, agave syrup, beet sugar, brown rice syrup, etc.


• Read labels. If a food contains no milk or fruit, the sugar column on the Nutrition Facts Label is all added sugar.

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