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Busting sugar myths: Facts, fallacies, and recipes

Many of my column topics are inspired by statements made by clients and by posts that I see in social media websites.  Recently I’ve heard that “sugar is bad, but fructose is good.”  Also, sugar has been blamed for the explosion of obesity around the world. There’s some truth to these statements…what do you think?

First, a short quiz to see how much you know about sugars.

  1. What country consumes the most sugar yearly?
  • Canada
  • China
  • The United Kingdom
  • United States of America


Answer: The USA holds the dubious honor of consuming more sugar per capita than anywhere else in the world.  The USDA reports that the average American consumes between 150-170 pounds of refined sugars yearly, translating to about 126 grams per day, or more than 24 teaspoons daily! UK consumption is 93 grams, in Canada, 89 grams, and China’s consumption averages only about 16 grams. Although I cannot find Ecuador’s per capita consumption, reports show that as poorer countries become increasingly urbanized, there’s a corresponding increase in consumption of animal fat and protein, refined grains, and added sugar, contributing to increased rates of obesity, diabetes, and heart disease.

2. Which of the following sugars is found naturally in milk?

  • Dextrose
  • Fructose
  • Lactose
  • Sucrose


Answer: c. Milk contains different carbohydrates including lactose, glucose, galactose and others.  Lactose is a disaccharide composed of two simple sugars, glucose and galactose, which gives milk it’s sweet taste.

3. Relative to how many calories you eat daily, what is the maximum percentage of your calories that should come from added sugar (excluding the natural sugars found in fruit, vegetables, and dairy) daily?

  • 5%
  • 10%
  • 15%
  • 20%


Answer: a & b.  In 2015, the World Health Organization lowered their recommendation for intake of “free” or added sugars to less than 10% of total calorie intake, but recommends that consuming less than 5% of calories from added sugars (about 6 teaspoons) would provide additional benefits.

  1. If you drink one can (12-oz) sugary soda or sports drink each day for a year, you’re at risk of gaining:
    • 2 lbs/ 0.9 kg
    • 5 lbs/2.27 kg
    • 10 lbs/4.54 kg
    • 15 lbs/6.8 kg


Answer: d.  Research shows that people do not adjust their food intake even if they are quaffing hundreds of calories in liquids.  And most people are drinking far more than a can (12 oz), they’re choosing 20-oz bottles, or drink multiple servings daily.  To calculate: a 12-oz can of Coke contains 140 calories, all from added sugar.  Multiply 140 by 365 = 51,100 calories, divide by 3,500 calories (in one pound) = just shy of 15 pounds or 6.8 kilos yearly.

  1. A Jamba Juice All Fruit Smoothie is a better choice than a Coca-Cola or Pepsi. True or False


Answer: True & False.  The ‘smoothie’ is ‘better’ in that it contains a little protein (3 g), some fiber (3 g), and a little calcium and vitamin C.  But, if you’re watching your calories, a small Banana Berry Smoothie contains 280 calories and 59 grams of sugar – 14.75 teaspoons of sugar (including the carbohydrate from the fruit, frozen yogurt, and sherbet). The advertisement says “no high fructose corn syrup,” but the very first ingredient is “apple-strawberry juice blend” which tells you that this is a highly processed ingredient, and a concentrated source of sugar.  In contrast, a 12-ounce Coke has 150 calories, and no nutritional value. See the Jamba Juice info here.

Sugars, Sweeteners, and Non-nutritive Sweeteners

All caloric sweeteners contain about 20 calories per teaspoon, or about 4 calories per gram. Glucose is a monosaccharide, the primary source of energy for body cells. Fructose is also a monosaccharide, the natural sweetener found in fruit, honey, and some vegetables. Sucrose is commonly known as sugar, and is typically derived from sugar cane or sugar beets.

There are so many different ways to say “sugar”, including sucrose (table sugar), corn syrup and high fructose corn syrup, honey, agave, maple syrup, panela, and molasses.

Some natural sugars do contain minerals and vitamins, including honey, maple syrup, and especially molasses. But in the amounts recommended, they can’t be considered adjuncts to health.

“Natural” sweeteners from juice such as evaporated cane juice, fruit juice concentrates, and nectars are perceived as more “natural” than other refined sugars, but all have the identical effect on blood sugar.

Facts About Fructose and Agave: Not So Sweet

Agave syrup is a refined, processed sweetener made from agave nectar.  In its natural form, agave nectar contains healthful antioxidants, but once processed, it becomes high in fructose, higher than high glucose corn syrup. Excessive fructose (as an added sweetener, not necessarily in moderate amounts of fruit) is linked to nonalcoholic fatty liver disease. High intakes of agave can lead to increased triglycerides and risk for heart disease.

Dr. Andrew Weil says that he no longer uses or recommends agave syrup, and also writes that excessive fructose may increase risk of cancer. A small amount of agave nectar occasionally won’t kill you, but it’s no better than regular sugar or corn syrup.

Weil suggests cutting sweeteners in general to a minimum, and likes authentic maple syrup for its taste and much lower fructose content compared to agave.  In Cuenca, real maple syrup is hard to find, but I know the readers will post their sources in the comments below.

What About Sugar Alternatives?

The U.S. Food and Drug Administration (FDA) regulates non-nutritive sweeteners (NNS) and the approval process includes determination of probable intake, cumulative effect from all uses, and toxicology studies in animals.

Those approved for use in the USA and seen throughout Latin America include: acesulfame potassium (ace-K or Sweet One), aspartame (Equal and NutraSweet), neotame, saccharine (Sugar Twin, Sweet ‘N Low), and sucralose (Splenda).

Non-nutritive sweeteners (NNS) are many times sweeter than sugar, and may be either ‘natural’, such as stevia, or ‘artificial’, such as sucralose (Splenda), and provide little or no calories (energy).

Polyols (sugar alcohols) are also sweeteners, and include sorbitol, xylitol, and mannitol. Typically found in candies, chewing gum and desserts, they’re not calorie-free, but have about half the calories of sugar, and don’t cause tooth decay. Too many polyols can cause gastric effects like bloating and gas.

Plant-sourced sweeteners include luo han guo extract (monk fruit), and the herb stevia, from which an extract and powder is obtained (Stevia, Truvía). But, of course, they’re not totally “natural” since to get them into those little packets that stay shelf-stable, they’re highly processed.  Dates and raisins, and all dried fruits are naturally sweet.  Chop them up and add to your cereals, smoothies, and desserts to add sweetness and fiber.

However, it’s certainly possible to grow, harvest, and enjoy your own stevia at home.  Check out

Does More Sugar = More Obesity?

The epidemic of obesity continues unabated, and countries that formerly had to deal more in malnutrition and under-nutrition are now faced with the consequences of overweight and obesity. A diet consistently high in added sugars is linked to obesity, increased risk for diabetes, and high blood lipids including triglycerides and low-density lipoproteins (LDL). In Ecuador, children are noted to be consuming inadequate amounts of fresh fruits and vegetables, although there’s no shortage of either.  One study cites the “large abundance of competitive foods (junk food) and lack of fresh fruit offered in schools.

However, it’s not just added “sugar” per se that is the worry.  It’s the amount of hidden sugars in foods, some hidden in plain sight.  For example, children’s cereals can contain as much as 30% of their calories from added sugars.  Yogurts, perceived to be a healthy food, are often sweetened with a huge amount of sugar.  For example, an 8-oz cup of fruit-flavored, nonfat yogurt contains 46.5 grams of added sugar.   Of that, only about 11 grams come from lactose (milk sugar), naturally.  The rest, about 35 grams, are added sugar.  That is about 9 teaspoons of sugar.  Imagine buying a cup of plain yogurt, opening it up, and spooning almost 9 teaspoons of sugar into it.  Or giving it to your kid like that.  Have you shopped the cereal aisle lately? There ain’t no fruit in Froot Loops, but there’s plenty of sugar in this brand, and too many others. The marketing to kids makes me furious.  All those “kids” cereals whose first ingredient is sugar are positioned low on the shelf so that the munchkins can’t help but be mesmerized by the bright colors and promises of dessert for breakfast.

Buy unsweetened yogurts and cereals.  You control the sugar. If you like your yogurt less tangy and/or a little sweet, add naturally sweet fruit (mango is my favorite), and for a little more sweetness, drizzle on a bit of organic honey.  Read the ingredient label first.  If sugar is one of the first three ingredients, leave it on the shelf.

Finally, Does Sugar Cause Obesity?

We’re always looking for a villain, but sugar is a distraction.  Yes, too much sugar can contribute to obesity, but it’s the excessive sugars compounded by too much fat and fried foods/junk foods, too few fruits and vegetables, and too little activity that creates this recipe for disaster.

And sweet is a preferred taste.  When every beverage you drink is sweetened, you begin to expect all beverages to be sweet, and when they are not, it’s a letdown.

Similarly to salt…when you’re used to food being highly seasoned with salt, unsalted foods taste flat.

So, break away from that sugar habit, and discover the taste of food. Real sugar isn’t out of my diet absolutely, just not regularly. Desserts are a treat, and I’m not going to eat it if it’s not worth it.  And of course, sugar does more than just sweeten foods; it bulks, browns, and texturizes baked goods. There’s no substitute for sugar in my chocolate biscotti, but I can reduce the amount in the recipe and still get a great cookie.

Here’s a link to my very favorite Biscotti Cioccolato recipe by Linda Wells, published online by the New York Times.  I’ve been making it for more than 20 years.  I cut the sugar back from 1 full cup to ½ cup, without any complaints.


BioMed Central. Dietary intake practices associated with cardiovascular risk in urban and rural Ecuadorian adolescents: a cross-sectional study.

Dr. Weil. What’s wrong with agave nectar? Added sugar: What you need to know.

Growing Your Own Stevia. More people are now obese than underweight, study finds.