While new label rules for added sugar will go into effect by 2021, here's what to look out for anyway.

Our early hominoid ancestors did not have supermarkets stacked to the rafters with food. They did not have a food industry dreaming up ever more devious ways to entice them to eat. They did not have vending machines giving forth bubbly liquid candy in bottles.

Given the lack of such abundance, what they did have was a sense of taste for sugar, salt, and fat to help them find foods with high nutrient and energy content. And it is a sense of taste that endures. Unfortunately, for those of us with easy access to tempting, energy-dense things to eat, our ancient taste for these flavors has helped fuel epidemics of nutrition-related diseases, like obesity and diabetes.

Case in point: On average, Americans consume 17 teaspoons of added sugars a day. That is more than one-third of a cup. It comes in everything from the obvious – cookies, cakes, sodas – to the less obvious, things like bread, yogurt, and savory sauces.

Many people think of sugar at the white stuff in the sugar bowl, but it comes in many forms. Tufts University explains that there are three “simple” sugars in nature – glucose, fructose, and galactose – and that every caloric sweetener in the natural world is formed from a mix of these three building blocks. All of these simple sugars are treated the same by the body when we ingest them.

“There is no evidence of any difference in health impact between the major sugars in the U.S. food supply,” says Dariush Mozaffarian, dean of Tufts’ Friedman School of Nutrition Science and Policy. “Refined sugars like cane sugar, beet sugar, and high fructose corn syrup are all metabolically equivalent.”

There are also sugars in fruits and vegetables. These natural sugars, when eaten with the fruit or vegetable they came from, come with fiber, vitamins, minerals, and phytochemicals and are OK. These sugars are digested slowly in a way our bodies can handle. However, once removed from their original source, they become another added sugar – even if they seem more “natural.”

“Our bodies evolved to metabolize small amounts of slowly digested sugars, such as those in a piece of fruit. When we consume added sugars, we are often getting a high dose of rapidly digested refined sugar,” says Mozaffarian.

Traditionally, nutrition labels for packaged food have not differentiated between natural and added sugars, making it difficult to tell how much added sugar an item contains. Thankfully, the FDA has changed the rules – by 2021, all packaged food labels will be required to show how much added sugars are included.

But even so, it’s fascinating to see what names simple sugars go by. And even when the added sugar labeling rules go into full effect, people need to know that the body metabolizes healthy-sounding “coconut sugar” essentially the same way that it does “high fructose corn syrup.”

Here is a list from Tufts that shows sugar, by any other name, is still sugar. I like that it includes indicator words for easy recognition. Note that the list does not include every name that sugar may sneak by as.

Any ingredient with the word sugar, like:
Beet sugar
Brown sugar
Coconut sugar
Raw sugar
Sugar cane juice
White granulated sugar

Any ingredient with the word nectar, like:
Agave nectar
Fruit nectar
Peach nectar

Any ingredient with the word syrup, like:
Brown rice syrup
Carob syrup
Corn syrup
High fructose corn syrup
Malt syrup
Maple syrup

Any ingredient containing a word ending in “-ose,” like:
Dextrose
Galactose
Glucose
Fructose
Lactose
Maltose
Mannose
Saccharose
Sucrose

And assorted names:
Cane juice
Cane juice crystals
Caramel
Corn sweetener
Evaporated cane juice
Evaporated corn sweetener
Fruit juice
Fruit juice concentrate
Honey
Molasses
Muscovado
Panela (raspadora)
Sweet sorghum
Treacle

Added sugars are associated with adverse health problems, from dental cavities to obesity, diabetes, and cardiovascular disease. The Dietary Guidelines for Americans (DGA) recommend that less than 10 percent of one’s total daily calorie intake come from added sugar. A gram of sugar has four calories, which would mean for someone eating 2,000 calories a day, they should eat a maximum of 50 grams of added sugar – the equivalent of about 12 teaspoons a day.

And Tufts notes that those guidelines are more generous than those of the American Heart Association (AHA). “Given the evidence associating higher intake of added sugars with heart disease, [the AHA] has issued recommendations that are more stringent than the DGA recommendations. The AHA suggests women and children get no more than 6 teaspoons (around 25 grams / 100 calories' worth) of added sugars per day, and men no more than 9 teaspoons (around 36 grams / 150 calories' worth) per day.”

For some perspective, a 12-ounce can of cola delivers 39 grams of sugar. Meanwhile, the Center for Science in the Public Interest notes that the average American drinks just over 38 gallons of soda a year; or about eight 12-ounce cans a week. What could possibly go wrong?