Just How Bad Is Sugar For You, Really?

If you were to name something in your diet that causes inflammation or health problems, things like gluten, dairy or soy might come to mind. But what about sugar?

It’s true that some people are gluten or dairy intolerant, but lots of people can also handle eating those things just fine. Sugar is a different story, says Heidi Turner, M.S., R.D.N., a medical nutrition therapist at The Seattle Arthritis Clinic.

“Sugar is the universal inflammatory,” says Turner, who specializes in anti-inflammatory diets to help reduce the pain and symptoms related to autoimmune conditions and inflammatory arthritis. “Everyone is sugar intolerant.” 

Why exactly is sugar so bad for you and so hard to avoid? Here’s what you should know about the added sugar that’s lurking in your diet.

What is added sugar?

When we talk about sugar in the context of your health, we aren’t talking about those sweet strawberries you tossed on your salad for lunch. Sugar that’s naturally occurring in food isn’t an issue, says Turner. 

If you eat a piece of fruit, for example, you’re not only consuming sugar (in the form of fructose), but also fiber, vitamins, minerals and phytonutrients. All of these things help feed the healthy bacteria in your gut and help your body metabolize the sugar found in the fruit. Instead of craving more and more sugar, you’ll stay satiated for a longer period without the massive blood sugar spikes from consuming a treat with a bunch of refined sugar, she says.

The real problem is added sugar that manufacturers put in food during the production process, either to sweeten it or enhance the flavor in some other way, says Michael Schwartz, M.D., director of the UW Medicine Diabetes Institute and the Nutrition Obesity Research Center.

“There aren’t really many sources of pure sugar in nature,” he says. “And so what’s different about table sugar is that we're getting a dose of it in a pure form. That is not something that we evolved to do.”

How added sugar messes up your body

The average American consumes 94 grams of added sugar per day, says Turner. The recommendation for women is no more than 25 grams—or 6 teaspoons—of added sugar per day. Men should have no more than 36 grams of added sugar per day, and for children, just 12 grams—about one can of soda’s worth of sugar—is more than enough, she says.

Eating a diet that’s high in added sugar is bad news for your heart, according to a major 2014 study. The researchers found that eating more than the recommended amount of added sugar may increase your risk of dying from heart disease. Even if you go to the gym and eat your greens regularly, you aren’t immune from the effects of sugar on your health. Eating a high-sugar diet can set you up for disease, even if you’re otherwise healthy, according to a new study. Researchers found unhealthy levels of fat in the blood and livers of men who ate a high-sugar diet, which may increase the risk of heart disease, they report.

And while many people eat sugar as a pick-me-up, it could be having the opposite effect. One recent study found that men who ate a high-sugar diet were more likely to develop depression or anxiety than those who ate a diet lower in sugar.

Sugar is everywhere

Unfortunately, giving up your sugar habit isn’t as easy as deciding to stop adding it to your coffee or saying “no thanks” to the dessert menu. Sugar is hiding out where you least expect it—in everything from dressings and sauces to whole grain bread.

Someday you won’t have to guess whether the sugar you’re eating is naturally occurring or added. The Food and Drug Administration’s redesigned Nutrition Facts label will require food manufacturers to specifically call out added sugars on their packaging. 

The mandate was originally scheduled for July 2018, but the FDA released a proposal on September 29 that will extend compliance dates. Manufacturers with more than $10 million or more in annual food sales would have until January 1, 2020 to comply, while those with less than $10 million in food sales would have until January 1, 2021.

In the meantime, you can still spot added sugars by doing a deeper dive into ingredient lists, says Turner. Added sugar can masquerade as many other things, including brown rice syrup, evaporated cane juice, honey, maple syrup, molasses, or anything that ends in ose, including high fructose corn syrup.

Some of these sugars, including honey, maple syrup and molasses, aren’t as refined. Some people believe that this means they’re healthier, but at the end of the day, it’s all added sugar, says Turner.

“There’s a thought process that if there’s more nutrition to the sugar then it’s going to behave in the body differently, but it’s still added sugar,” she says. “Some are better metabolized in the body than others, but we’re really trying to reduce the overall added sugars brought into the body.”

In other words, if you’re forced to choose between white table sugar and honey, go for the honey. But if it’s a choice between honey or no sugar at all, going sugar-free is your best bet.

Why quitting sugar is so darn hard

Are you ready to quit sugar cold turkey? Good luck. Not only is sugar-free food hard to find, but evolutionary and cultural influences come into play, too. 

Back when food was way scarcer, our ancient ancestors needed to take every advantage they had to consume high calorie foods. So the human brain evolved to perceive sugar—and fat—as very rewarding, says Schwartz. Today, our brains are still wired for feast or famine, even though you can buy thousands of calories of food for a couple bucks at the local convenience store.  

Schwartz agrees that sugar can cause major health problems, but says it isn’t acting alone. The most potent way to activate the brain’s reward system is actually by combining sugar with fat, he says. And much of the American diet contains both of these components. 

That’s why one bite of ice cream never feels like enough and before you know it, you’re looking at the bottom of a pint. Or why you find McDonald’s french fries so hard to resist—the ingredient list includes both dextrose, an added sugar, and fat in the form of canola oil, corn oil, soybean oil and hydrogenated soybean oil. Dip those fries in ketchup and you’re getting even more sugar—this time high fructose corn syrup.

“I wouldn’t say people become dependent on it in the way they become dependent on a drug,” says Schwartz. “But for some people, the anticipation of eating something that is highly rewarding becomes an important focus for how they live each day.”

Addictive qualities aside, there’s also a large social element at play, says Turner. Bad day? Turn to sugar. Celebration at work? Just add sugar. It’s both delicious and comforting, which is part of the reason it’s so hard to get away from, she says.

“Who doesn’t know sugar is bad for them? We know that, but what we're up against are cultural, addictive, emotional and habitual pieces—and that is the bridge between what we know and what we actually do,” she says. “It’s not easy and therein lies the issue.”