Policy Point Wednesday - What is an added sugar?

Healthy Americans try to keep track of how much sugar has been added to the products they eat. Unfortunately, this isn't as simple as just reading the nutrition label.  Many simple carbs and sugars occur naturally in healthy foods - for instance, lactose, the natural sugar in milk, is counted under "sugars" in the nutrition label, along with other simple-carb sweeteners - so it's very difficult to tell from the nutrition label just how much added sugar your child takes in from the chocolate milk at school*

Here's an comparison that's easy to make - most people think of yogurt as a healthy food - and it is: it's low in fat, a good source of protein, calcium and other vital nutrients and contains beneficial microorganisms that aid digestion.  Since yogurt is a concentrated form of milk, the lactose in yogurt is concentrated - so the label on plain yogurt might make you think it's been sweetened. A cup of plain nonfat yogurt has about 19 grams of lactose - but it's listed under sugars. For us label-reading sugar-watchers, 19 grams seems like a lot: it would be about 4 teaspoons of table sugar - but though the milk sugars are concentrated in yogurt, so are all the beneficial ingredients.  Those calories are far from empty.

A cup of fruit-flavored yogurt contains an average of 47 grams of sugar – which means that, after you subtract the 19 grams we know occur naturally,  about 7 teaspoons of sugar have been added as flavoring.  For comparison, a cup of pudding has almost 40 grams of sugar – but since the milk sugars aren’t concentrated the way they are in yogurt, (I can’t do the exact math here without making a lot of pudding to figure out the ratio of milk to pudding, but a cup of milk has about 12 grams of sugar) the added sugar is approximately the same in both pudding and yogurt, even though the total sugar listed on the yogurt nutrition label is higher.  The line between yogurt and pudding does begin to get a bit blurry. 

One of the issues we’re facing in trying to reduce the sugars in school lunch is that we don’t know where the sugars are coming from: the school nutritionists call all sugars a “carb” and roll them in together with all the naturally-occurring sugars, fiber, and other carbohydrates to meet the USDA requirement. We aren't protected by the nutrition label because it’s impossible to tell the difference between, say, the sugars added to the canned fruit and the sugars in the fruit itself - and food manufacturers assert that it is equally impossible for them to account for the differences.

Added simple carbs are insidious, too – they’re often in the forms that might sound healthier, like refined fruit juices, brown rice syrup or agave nectar; or they're buried on the ingredients list, hidden by a chemical name ending in -ose.  These might escape the notice of even a label-reading parent who diligently avoids foods with high fructose corn syrup and table sugar. Another tactic is to hide several different simple-carb sweeteners across the ingredients list to make it seem as though the product is lower in sugar than it is, since ingredients are listed in the order of their relative weight in the product- for instance, can you spot at least 6 added sugars in this organic toaster pastry?  Let's face it - table sugar could be accurately described on a label as refined sugar cane juice or even beet juice, but it's still sugar! 

In 1999, the CSPI petitioned the USDA to require better labeling for sugars in foods.  In the petition report, they show that there are a number of ways to analyze and differentiate between naturally occurring sugars and added sugars.   Added sweeteners need to be differentiated clearly on the label, which means we need language to define what constitutes “added” and what constitutes a "sweetener" and what does not.  For example, most no-sugar-added jams are sweetened with concentrated refined fruit juice and, although they have less sugar than their regular counterparts, they are still very sugary - but more importantly, they don't offer any of the nutrition or benefits of fruit in a regular sized serving.  While I still recommend using the nutritional label as a guide, it's important to understand how the system can be manipulated to produce foods we might feel better about eating, but that aren't necessarily any better for us.

*According to the "Dairy Spot for Schools," a website of the Mid-Atlantic Dairy Association, 8 oz of chocolate milk contains an added 4 teaspoons (that's 1 tablespoon plus a teaspoon) of sugar.  By their own data, it contains more carbs than the same amount of orange juice.  While it is important to note that milk has more nutrition than juice, keep in mind that overconsumption of 100% fruit juice, largely because of the easily-ingested simple carbs, is a real concern for the American Academy of Pediatrics.