Sugar consumption harm and risk, substitute options, how to cut down
February 17 2018 by
Ray Sahelian, M.D.


The general public knows "sugar" to mean sucrose, also called "table sugar." Sucrose is a carbohydrate sweetener that occurs naturally in every fruit and vegetable in the plant kingdom. It is the major product of photosynthesis, the process by which plants transform the sugar energy into food. Sugar occurs in greatest quantities in sugar cane and sugar beets from which it is separated for commercial use. There is no difference in the sugar produced from either cane or beet. Sugar cane, a giant grass, thrives in a warm, moist climate, storing sugar in its stalk. The sugar beet grows best in a temperate climate and stores its sugar in its white root. Sugar from both sources is produced by nature in the same fashion as all green plants produce sugar-as a means of storing the sun's energy. The "simple" sugars, or monosaccharides (such as glucose), store energy which biological cells use and consume. In a list of ingredients, any word that ends with "ose" probably denotes a sugar. Sucrose is a larger sugar molecule that breaks down into glucose and fructose in the intestine during metabolism. To find out about a no calorie natural sugar alternative, read about stevia, and you may purchase a stevia supplement.
   The most commonly used sugars sucrose, dextrose, and fructose. quickly metabolize into glucose (blood sugar). Glucose ingestion leads to high insulin levels which contribute to a number of age-related disorders.


Heart disease risk and diabetes
Excessive consumption of added sugars, such as those found in most sugar-sweetened beverages, has been linked to increased risk of obesity and several poor health outcomes such as type 2 diabetes and cardiovascular disease.

Q. Does the natural sugar contained in prune juice contribute to the amount of blood sugar and possibly contribute to becoming diabetic?
   A. It depends on the quantity consumed. If it is an ounce or two at one serving, it would not. But if more than 3 or 4  ounces at a time, it could raise blood sugar levels.

Weight gain
Am J Clin Nutrition. 2013. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Departments of Nutrition and Epidemiology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. The relation between sugar-sweetened beverages (SSBs) and body weight remains controversial. Our systematic review and meta-analysis of prospective cohort studies and RCTs provides evidence that SSB consumption promotes weight gain in children and adults.

Added sugars are far more harmful to our bodies than naturally-occurring ones. These are used in processed or prepared foods like sugar-sweetened beverages, grain-based desserts, fruit drinks, dairy desserts, candy, ready-to-eat cereal and yeast breads.


Daily consumption of sugar-sweetened beverages increases visceral adipose tissue.


Sugars are used by the industry to enhance the attractiveness of foods and drinks. These added sugars are not easily identified in food or drink labels. Certain manufactured foods and drinks with 'safe' names, such as dried fruit and fruit juice, still contain free sugars and can be confusing. Guidance states that daily consumption of free sugars should be less than 10% of total energy intake. However, it is found that both tooth decay and obesity are associated with consumption of free sugars in large quantities and at inappropriate times.

Rheumatoid arthritis
Sugar-sweetened soda consumption is consistently associated with an increased risk of several chronic inflammatory diseases such as type 2 diabetes and cardiovascular diseases. Regular consumption of sugar-sweetened soda, but not diet soda, is associated with increased risk of seropositive rheumatoid arthritis in women, independent of other dietary and lifestyle factors. Perhaps this may be true in other autoimmune diseases, that sugar consumption can increase the risk or severity of autoimmune conditions.


The American Academy of Family Physicians suggests how to cut down on sugar:
Avoid baked goodies, candy and other sweets.
Stick to heart-healthy meals and snacks, focusing on whole grains, lean proteins, fruits and vegetables.
Drink water instead of sugary beverages. Whether you are slim or obese, if you drink lots of sugary soda or other sweetened drinks you are more likely to develop type 2 diabetes.
Avoid processed foods, which tend to be high in sugar, salt and fat.
Look for recipes that use less of it, or use unsweetened applesauce or substitutes.


Hidden sources of sugar:
Read label names that indicate added sugar, such as corn syrup, dextrose, corn sweetener or cane crystals. Watch for potential hidden sources of added sugar, such as granola, whole-grain cereal, oatmeal, dried fruit, canned fruit and ketchup.


Alternatives with high antioxidant potential
Many alternatives to refined sugar are available, including raw cane sugar, plant saps / syrups (eg, maple syrup, agave nectar), molasses, honey, and fruit sugars (eg, date sugar). Refined sugar, corn syrup, and agave nectar contain minimal antioxidant activity (<0.01 mmol FRAP/100 g); raw cane sugar had a higher FRAP (0.1 mmol/100 g). Dark and blackstrap molasses had the highest FRAP (4 mmol/100 g), while maple syrup, brown sugar, and honey showed intermediate antioxidant capacity (0.2 to 0.7 mmol FRAP/100 g). Based on an average intake of 130 g/day refined sugars and the antioxidant activity measured in typical diets, substituting alternative sweeteners could increase antioxidant intake, similar to the amount found in a serving of berries or nuts. Many readily available alternatives to refined sugar offer the potential benefit of antioxidant activity.


Humans most commonly use sucrose as their sugar of choice for altering the flavor and properties of beverages and food.   Sugar is prized for its sweet taste and has many other functions in cooking and baking. It contributes texture and color to baked goods. It is needed for the fermentation by yeast, which causes bread to rise. Sugar acts as a bulking agent (ice cream, baked goods) and preservative (jams, fruits), and it imparts a satisfying body or "mouth-feel" to beverages. In non-sweet foods - salad dressings, sauces, condiments sugar enhances flavor and balances acid content in tomato and vinegar-based products.

From fruit-flavored drinks to energy bars, a huge array of sweetened foods and beverages crowds grocery shelves, vending machines, restaurant menus, school lunches and kitchens.



People who think drinks with sugar are a pick-me-up may be in for a letdown. Sweetened beverages actually boost sleepiness. People wishing to alleviate sleepiness through the consumption of a high- sugar, low- caffeine content energy drink -- erroneously believing the 'sugar rush' to be effective -- should avoid drinks that have little or no caffeine. It is caffeine that is particularly effective for alleviating sleepiness, not sugar. After drinking a high sugar, low-caffeine drink, people have slower reaction times and experienced more lapses in concentration than if they consume a caffeine- and sugar-free beverage.


Nutritional Content
Sucrose, white table sugar is empty of all vitamins, minerals, fiber, amino acids and trace elements during the refining process. At 99.5 to 99.9% pure sucrose, it is one of the purest chemicals manufactured. Powdered sugar is pulverized table sugar. During the refining process, the natural sugar that is stored in the cane stalk or beet root is separated from the rest of the plant material. For sugar cane, this is accomplished by a) grinding the cane to extract the juice,- b) boiling the juice until the syrup thickens and crystallizes- c) spinning the crystals in a centrifuge to produce raw sugar; d) shipping the raw sugar to a refinery where it is; e) washed and filtered to remove the last remaining plant materials and color; and f) crystallized, dried and packaged. Beet sugar processing is normally accomplished in one continuous process without the raw sugar stage. The sugar beets are washed, sliced and soaked in hot water to remove the sugar-containing juice. The juice is purified, filtered, concentrated and dried in a series of steps similar to sugar cane processing.


J Agric Food Chem. 2012. Sugar cane and sugar beet molasses, antioxidant-rich alternatives to refined sugar. Molasses, the main byproduct of sugar production, is a well-known source of antioxidants. In this study sugar cane molasses (SCM) and sugar beet molasses (SBM) were investigated for their phenolic profile and in vitro antioxidant capacity and for their protective effect in human HepG2 cells submitted to oxidative stress. According to its higher phenolic concentration and antioxidant capacity in vitro, SCM exhibited an effective protection in cells, comparable to or even greater than that of α-tocopherol. Data herein reported emphasize the potential health effects of molasses and the possibility of using byproducts for their antioxidant activity. This is particularly important for consumers in developing countries, as it highlights the importance of consuming a low-price, yet very nutritious, commodity.

Raw sugar is a tan to brown, coarse granulated solid obtained on evaporation of clarified sugar cane juice. Raw sugar is processed from the cane at a sugar mill and then shipped to a refinery. It is about 98% sucrose. Raw sugar is not sold to consumers. The U.S. Food and Drug Administration notes raw sugar is "unfit for direct use as food or as a food ingredient because of the impurities it ordinarily contains."


You said in a article online "Raw sugar is not sold to consumers. The U.S. Food and Drug Administration notes raw sugar is "unfit for direct use as food or as a food ingredient because of the impurities it ordinarily contains." if you believe that...than what is the product that consumers can purchase called "Sugar in the raw"?
    Raw sugar isn't even really raw. It's just slightly less refined, so it retains some of the molasses. Sugar in the Raw is less processed. According to the FDA, "Raw sugar is the term generally applied to the intermediate food product as it leaves the sugar factory mill for further refinement in sugar refineries before use as food. In general, raw sugar is unsuitable for human food use because it contains extraneous impurities which are removed in the refining process. On occasion the agency has taken action against raw sugar intended for human food use without further refinement which was found to contain impurities rendering it unsuitable for food use. The only practical process for freeing raw sugar of such impurities such as filth, dirt, and decomposition is the usual refining process of sugar refiners."

Blended sugar (sugaridextrose). In some locales, dextrose, a corn-derived sweetener, is added to granulated cane or beet sugar to create a white granulated blend that may be less expensive than traditional sugar. Dextrose is about 70% as sweet as sugar and is more hygroscopic (water attracting). Because of these characteristics, blends may not perform exactly as sugar in certain recipes.


Brown sugar consists of sugar crystals contained in a molasses syrup with natural flavor and color components. Many sugar refiners produce brown sugar by preparing and boiling a special syrup containing these components until brown sugar crystals form. In the final processing the crystals are spun dry in a centrifuge; some of the syrup remains giving the sugar its characteristic brown color. Other refiners produce brown sugar by blending a special molasses syrup with white sugar crystals. Dark brown sugar has a stronger molasses flavor. Lighter types are used in baking, butterscotch and glazes for ham. Richer-flavored dark brown sugar is desirable for gingerbread, baked beans, plum pudding and other full-flavored foods.

Confectioners (powdered) sugar and granulated sugar are not interchangeable. Confectioners sugar is made up of much finer particles than granulated sugar and it contains corn starch (to prevent caking).


Coconut palm sugar is a coarse brown sugar with a caramel flavor which is less sweet then cane sugar. coconut palm sugar is made from the sap of coconut palms. The juice from the sap is boiled in water until the water evaporates and the sugar crystallizes.


Q. Do you have any information regarding coconut palm sugar and health. I understand this sugar is healthier than most natural sugars. It is said to be very high in minerals and amino acids and recently was shown to have a glycemic index of 35. There must be a billion people using palm sugar daily in the orient, but never appears in any product lists here in the US.
   A. We are not familiar with coconut palm sugar, but, in general, any type of sugar should be used in moderation, even if it is healthier than regular processed sugar cane.


Turbinado Sugar is raw sugar that has been refined to a light tan color by washing in a centrifuge under sanitary conditions. Surface molasses is removed in the washing process. In total sugar content turbinado is closer to refined sugar than to raw sugar. It can be purchased in many health food stores and some supermarkets.

Single sugar, or monosaccharide
Glucose is a monosaccharide, or simple sugar.
D-Mannose sugar
L-Rhamnose sugar

Double sugars include:
Lactose found in milk and dairy product
Maltose found in certain vegetables and in beer
Sucrose or table sugar


Danger of sugar in adults and children
Cancer of the Pancreas - Eating lots of sugar and sugar -sweetened foods and soft drinks could increase a person's likelihood of developing cancer of the pancreas.


Liver damage - The suspicion that soft drinks with lots of added sugar are involved in the development of liver disease is strengthened by results of animal experiments. Dr. Ina Bergheim, from the University of Hohenheim in Germany, and associates, tested the effect of sugar -sweetened water on the livers of mice. Some animals had free access to sugar water, while others were given a solution containing an artificial sweetener. Animals fed the sugar drinks ate less food, but they had higher overall calorie intake and weight gain. Examination of the animals' livers showed that fatty liver disease was more common in the group given sugar water, especially when exposed to a type of sugar called fructose. This may explain the increased incidence of liver disease in the US. Consumption of high fructose corn syrup, in foods such as soft drinks, has sky-rocketed over the last decade.


People who consume a lot of processed carbohydrates -- think snack foods and sweets -- and sugary drinks face heightened risks of breast and prostate cancers.


Obesity - Preschool children who are regularly given sugary drinks between meals are more likely to be overweight than their peers. Youngsters who drink sugar-sweetened sodas, sports drinks or juices every day are more likely to be obese than those who have these beverages less often


Americans need to cut back dramatically on sugar consumption, the American Heart Association said in August 2009. The American Heart Association said women should eat no more than 100 calories of added processed sugar per day, or six teaspoons (25 grams), while most men should keep it to just 150 calories or nine teaspoons (37.5 grams). That's far below the 22 teaspoons (90 grams) or 355 calories of added sugar consumed by the average American each day.


Q. Do you have something that will aid in lowering blood sugar? I have had high sugar levels for 9 years and was able to keep it down using a high protein, low carb diet. However in recent months, almost nothing I do brings the sugars down. They open in the mornings at 148 and go higher on some days. I used to be able to keep the sugar levels around 100 with just diet and felt safe, but now am looking for a stronger solution without using drugs.
   A. Please see the link to diabetes page and discuss with your doctor.

Q. I am interested to learn your thoughts about the development of natural super sweet sugars. This effort is part of an evaluation being conducted by the Canadian Innovation Centre, a not-for-profit organization that provides objective third-party assessments of innovative products and ideas before commercialization. The proposed plan is to manufacture a variety of natural super sweet sugars from pure raw sugar cane and sugar beets, using a new refining process that will significantly increase the level of sweetness of each granule of sugar by 400%. The result - less super sweet sugar is needed to achieve the same desired taste as traditionally refined sugar; thus, resulting in lower sugar consumption, fewer calories and a lower glycemic affect on blood sugar level. Additional benefits include: Sufficient carbohydrate to provide the structural requirements, bulk, texture, crystallization, heat and acid stability necessary in most food applications; substantially the same organoleptic properties as traditionally refined sugars, without the unpleasant after-taste and health-related safety concerns of the known high intensity sweeteners; with a number of formulated sugars and sweeteners, super sweet sugars can provide health-benefiting qualities as a sweetener with ingestible nutritional compositions; and, commercialization of this product to the food and beverage industry could generate savings in transportation, distribution, retail shelving space and warehousing costs, from the significantly lower quantity (25%) required to achieve the same benefits as traditionally refined sugar. The objective of this effort is to manufacture a sweetener for retail and the food & beverage industry that is a healthier alternative to traditionally refined sugar and articial sweeteners, and priced in line with refined sugar and significantly lower than natural sweeteners. 1. Is the development of super sweet sugars an attractive proposition? 2. Do food and beverage manufacturers have a need for healthier alternatives to traditionally refined sugar and artificial sweeteners? 3. Do you have any additional comments about sweeteners in general that might assist us in this evaluation? - Our primary goal is to assess the value of the innovation; our secondary goal is to offer suggestions on how to improve the current invention.


Q.  I was at a school workshop the other day and one of the presenters handed out an information sheet about the "evils" of sugar. Now, I know excessive sugar use is not healthy for any individual but on this sheet it stated that "Sugar can lead to alcoholism." Is there any data to support that statement? I know many alcohols are made from sugar but alcohol I would think different. Can you clarify the statement for me?
   A. There is no evidence that sugar intake leads to alcoholism.