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Learn how to avoid sugars, and which ones are worse

Q. Recent recommendations suggest that we should cut back on our sugar intake but sugar is a carbohydrate, an essential nutrient?

A. Yes that statement is correct. Sugar is a carbohydrate and yet sugar should be cut back to the recommended amounts. But what is being referred to here are the simple sugars that are often added to processed foods that need to be cut back. These are recommendations from the American Heart Association and the American Academy of Pediatrics.

Carbohydrates, or CHO, are molecules made up of carbon, hydrogen and oxygen, having varying lengths and shapes. The most common ones are the simple sugars (e.g., glucose, fructose, the sugar found in fruits; sucrose, found in cane sugar; and lactose, the sugar found in milk), and then the complex sugars like starch, and indigestible fibers.

CHO make up one of three major nutrient groups – the other two being fat and protein.

The reason to avoid simple sugars – mostly glucose and fructose – is that they are easily and quickly absorbed from the intestines into our blood stream. This rapidly increases our blood sugar levels and soon to follow is the insulin levels. Insulin drives the sugar into the cells where it is used for energy. Beyond a point, and especially so for fructose, what cannot be used for energy purposes gets stored as fat leading to being overweight or obese.

This fat is stored in various places including the liver resulting in fatty liver. We are seeing more and more children with obesity, fatty liver and diabetes than ever before. The supposition is that sweetened, sugary beverages are a major culprit.

This does not forebode well for the future of our children. It is has also been found that consumption of large amounts of simple sugars can accelerate cognitive decline and dental decay, increase risk of heart attacks and affect the millions of bacteria that live in our guts to protect us from harmful bacteria.

Someone could argue that because fructose is the sugar found in fruits it is OK to consume. That is true because fruits have other nutrients, antioxidants and also long-chain, or complex, CHO’s that provide the fiber and slow down the rapidity with which the sugar is absorbed into the body. Grapes and mangoes are an exception, though!

You could also think of it as natural or unprocessed foods with their sugars are acceptable, unlike what is added to processed and ultra-processed foods.

Complex CHO are an important source of fuel to the body. Complex CHOs that can be broken down by the body’s enzymes help in its slow release and hence slow absorption of the sugars. This is beneficial to the body.

Some complex CHOs that cannot be broken down and constitute as “fiber” are helpful in preventing constipation, reducing risk of obesity and certain cancers, and more recently it’s been discovered that they are fuel to the bacteria – microbiota – that thrive in our gut and protect us.

Over the years, scientists have come up with grams of added simple sugars you could consume in a day. For an adult male it is 9 teaspoons (36 grams) per day. For adult women it is 6 teaspoons (25 grams) and in children it varies from 3-6 teaspoons (12-25 grams). For children less than 2 years of age, avoid foods and liquids with added sugars.

Now look at this: one 12-ounce can of soda contains 39 grams of sugar, an 8-ounce carton of chocolate or strawberry milk can have anywhere from 20-30 grams of sugar, sweet tea anywhere from 30-40 grams of sugar. This means that the day’s quota and more of sugar is gone in one such drink.

Don’t forget that many other foods will have added sugar in them, e.g., ketchup, breakfast cereal, salad dressing, baked beans, juices, sports drinks, candy and much more.

For comparison a banana has about 7 grams of fructose and a host of other good nutrients.

The goal of this article has been twofold: to know that simple sugars are not healthy for the body and to empower yourself by reading labels and avoiding those foods that have added sugar.

Pankaj Vohra is a Pediatric Gastroenterologist at UNM. Please send your questions to