America's sweet tooth obsession and its impact on our health
"Added sugar” refers to the sugar that is added during processing. It does not include natural sugars from products such as fruit and dairy products. Even though the FDA does not require that manufacturers identify how much of the sugar content is added versus natural, the vast majority of processed foods and drinks have sugars that have been added. Today, one must become a “label detective” to even recognize the various aliases of sugar. Other names found on labels describing sugar are: organic sugar, raw sugar, honey, brown sugar, molasses, agave syrup, fruit juice concentrates, evaporated cane juice, xylose, maltose, barley malt and maple syrup to name a few. HFCS is 55% fructose and 45% glucose, while table sugar or sucrose is 50% fructose and 50% glucose. So as you can see there is very little difference in the composition, and likewise, very little difference in how the body metabolizes sucrose (or it’s aliases) and HFCS.
How hard is that? Well, consider these facts: flavored yogurts have 25-35 grams of added sugar. Most 12-ounce sodas, energy and sports drinks have 30-40 grams of added sugar per serving with 20-ounce drinks around 65 grams, and popular breakfast cereals contain 10-20 grams of added sugar per serving. Even bran muffins typically range between 18-24 grams per serving of sugar. See the problem?
Complying with the AHA recommendations will require significant changes in eating and drinking patterns. Begin to ask your patients about their sugar consumption. Think of how many are consuming 1-2 sugary drinks daily, in addition to other dietary exposures to sugars. The problem is prevalent.
In fact, in a 2006 study published by the Journal of the American Dietetic Association researchers analyzed the habits of middle school students in Massachusetts and discovered that sugar-sweetened drinks made up 71% of vending purchases, and were selected three (3) times more often by students than bottled water. This study can be considered representative of most student campuses across the country today.
It goes without saying that dental professionals regularly see the visible impact excess sugar consumption has in the oral cavity. Much of that impact comes from sugar-sweetened drinks that also contain citric and/or phosphoric acid, which can lead to a favorable demineralization and caries environment.
In data that analyzed the beverage habits of almost 6,000 children, it was reported that carbonated soft drinks comprised 8.5% of total fluid intake for 2 to 10-year-olds, and they showed a significantly higher caries and decay pattern compared to children of the same age consuming high patterns of fruit juice.(5) Unfortunately, many young children who acquire a taste for sugary drinks carry that preference into adulthood.
Educating patients (and parents) about the AHA guidelines for limiting daily sugar consumption is certainly a good place to start for reducing caries and decay risks, and who knows, might even help save a heart in the process!
References 1. Johnson RK, Appel LF, Brands M, Howard BV, Lefevre M, Lustig RH, Sacks F, Steffen LJ, Wylie-Rosett J. Dietary sugars intake and cardiovascular health: A scientific statement from the AHA. Circulation 2009; 120: 1011-1020. 2. White JS. Straight talk about high-fructose corn syrup: what it is and what it ain’t. Am J Clin Nutr 2008: 88 (suppl): 1716S-21S. 3. Lustig RH. The skinny on obesity. Available at http://www.uctv.tv/skinny-on-obesity. Accessed September 10, 2012. 4. Brown IJ, Stamler J, Van Horn L, Robertson, CE, Chan Q, Dyer AR, Huang C, Rodriquez BL, Zhao L, Daviglus ML, Ueshima H, Elliot P. Sugar-sweetened beverages, sugar intake of individuals, and their blood pressure. Hypertension 2011; 57:695-701. 5. Sohn W, Burt BA, Sowers MR. Carbonated soft drinks and dental caries in the primary dentition. J Dent Res 2006; 85:262-267.
