The menace of added sugar in your daily food and how to avoid it

If you kicked off 2020 by trying to kick the sugar habit, you are probably still adjusting to this new way of eating. Added sugar lurks in so many surprising places, many foods we think of as healthful are really loaded with sugar. And food companies try to trick us by disguising added sugar with names that may sound more wholesome like 'barley syrup' or 'agave' or even 'fruit juice'. Here are the answers to some of your nagging questions.

WHOLE FRUITS OR FRUIT JUICES. The natural sugar in whole fruit (fructose) is accompanied by fiber and nutrients and makes a slow journey through your body. But when sugar is added to beverages or packaged foods, it's more quickly absorbed and burdens the liver. Here are three good reasons to choose whole fruits versus foods with added sugar or fruit juice. Whole fruits contain fiber, which slows the absorption of fructose. Sugars enter the bloodstream more slowly, so the liver has more time to metabolize them. Processed food is digested quickly as soon as it enters our intestines. Fiber-rich foods like whole fruits break down slowly and travel farther through the digestive tract, which triggers the release of satiety hormones that make us feel full. The slow journey of the fiber, fructose and nutrients in whole fruit essentially allows the body to feed the healthy bacteria in our intestine, supporting the health of our microbiome.

TRY TO AVOID BANANAS AND GRAPES. While most fruits make a slow journey through the digestive tract, bananas and grapes are particularly high in fructose given the amount of fiber they contain, so they give us a faster sugar spike. Dr. Robert Lustig of the University of California, San Francisco, calls grapes "little bags of sugar." Enjoy bananas and grapes sparingly and opt for a variety of fruits.

SUGAR IN DRIED FRUITS Dried fruit is packed with nutrients, but the drying process removes the water and concentrates a lot of fruit sugar in a very small bite. The risk is that it takes more dried fruit to fill you up than whole fruits. Raisins and dates are about 60 to 65% sugar, dried figs and apricots are about 50% sugar, and prunes are about 38% sugar. The good news is that dried fruit still has the fiber, and it can be a great snack as long as you are aware of how much you are eating. Another way to weigh the pros and cons of dried fruit is to look at glycemic load, a measure of how fast your body converts a serving of food into sugar. Ideally you should eat foods with a glycemic load of 10 or less. Anything above 20 is considered very high. Prunes have a glycemic load of 10, whereas raisins have a glycemic load of 28. Compare that with whole fruits. Strawberries, apricots, grapefruit, lemon, limes, cantaloupe, nectarines, oranges, pears, blueberries, peaches, plums, apples and pineapple have glycemic loads of 6 or less.

LACTOSE, MILK AND ADDED SUGAR A quarter cup of milk contains about 3 grams of a natural sugar called lactose. The sugar in milk is not considered an "added sugar," and it doesn't overwhelm the liver the way added sugar does. Adding milk or cream to your coffee and enjoying the naturally sweet taste of milk is a great way to kick the added sugar habit in the morning. Drinkers of soy and nut milks need to check the label. Many of those products have added sugar. If you love a few teaspoons of sugar in your morning coffee, try adding more milk and cut the sugar in half to start. Over time you can cut it in half again and wean yourself off the sugar.

SUGAR-PACKED BREAKFAST FOODS. With so much added sugar lurking in granola, cereals, pastries, breads and yogurts, you might as well just call it dessert. But people have had a tough time figuring out alternatives to popular grain-based breakfast foods. Here are some ideas. Eggs are a high-protein option, and while they are also high in cholesterol, many people can probably eat them in moderation without worrying about heart risks. But many people don't want to eat eggs every day. Bacon is also high in protein but, like other processed meats, also shouldn't be consumed daily. (Most plain bacon does not have added sugar, though if it's maple-cured or brown-sugar-cured, it probably does.) Consider eating smoked salmon, tuna or chicken salad for breakfast. Make a vegan breakfast bowl of sweet potatoes, beans and avocado. Try plain, unsweetened yogurt with berries and nuts or sliced apples with sugar-free peanut butter. Or just eat and savor a whole orange or make a fruit salad. Try a breakfast salad with avocado and hard-boiled eggs. Use a big kale leaf to make a breakfast burrito or egg salad wrap. Experiment with cauliflower to make hash browns. Bake a sweet potato and add salsa, yogurt or nuts. Try miso soup, butternut squash soup or another variety of hot soup. You'd be surprised how great soup tastes on a winter morning.

ADDED SUGAR AND OATS. Morning oat-eaters are by far the biggest demographic we've heard from since starting the Sugar Challenge. Because even many whole-grain products still have added sugar, the Challenge urges you to eliminate all grains from your breakfast to explore new options. However, oat-eaters are a committed bunch. If you want to eat oats, check to make sure your brand really has no added sugar (that means it should have no sugar on the ingredient list, and zero grams of sugar on the label.) The Harvard Nutrition Source has a lot of good advice about the health benefits of oats, which are associated with heart health. Steel cut oats are the least processed, meaning they have more fiber and are the best choice. Rolled oats have been partially cooked, making them increase blood sugar faster. Instant oats should be avoided, because they will be rapidly converted to sugar.

MOLASSES AND SUGAR. A tablespoon of molasses has 15 grams of sugar so you are, in fact, eating added sugar - just not added sugar processed by the food industry! The goal of the Sugar Challenge is not to ban all sugars. It's to make you aware of what you are eating so you can choose how much sugar to ingest, rather than letting food makers decide for you. It's great that you bake your own bread. (Bread making is time consuming, so if we all only ate bread we baked, we would probably eat less of it. ) I'd suggest trying a recipe with less added sugar. Most of the time you can cut the sugar by a third to a half without affecting the flavor or texture.

WHAT'S MISSING IN ORANGE JUICE. Even though orange juice is a natural food, the juicing process eliminates much of the fiber and concentrates the sugar, making it a poor choice. Make juice a once-a-week treat. Instead, try ice water with an orange wedge.

FOOD LABELS AND TRUTH Starting in 2020, most large food makers are required to list "added sugar" on the nutrition facts label, but some smaller companies have until 2021 to comply with the rule. As a result, you may see a mix of old and new food labels for another year. The new label will help consumers distinguish between sugars that occur naturally in foods and those that are added. As an example, take a look at the label on whole milk, which shows 11 grams of sugar in a one-cup serving. That sounds like a lot, but the new label will make it clear that all that sugar occurs naturally as lactose and that the same cup of milk has zero grams of sugar. A chocolate milk label will show 26 grams of total sugar, which includes 11 grams of lactose, and the extra information that a serving has 15 grams of added sugar.