Sugar--Is added sugar always added sugar?

After making breakfast for two girls and packing lunches for three (yes, my darling husband takes lunch to work, but only if I pack it), often I find myself dashing out the door, plastic spoon in hand, for a yogurt breakfast on the way to school.  My preferred choice is Fage 2% Greek Yogurt.  Creamy, filling, yummy.  We buy it by the case, choosing the honey version as I figured honey was better since it is "natural".  But is it really better?  Honey is, after all, added sugar.  Is sugar just sugar, regardless of form?  Or does context and kind matter?

 

What led to my recent re-evaluation of my honey Fage obsession was the arrival of two new flavors, blood orange and key lime.  The blood orange and key lime flavors come from add-in gels, made primarily of cane sugar with fruit pulp and juice.  So the honey flavor--just the addition of honey made by bees--is better, right?  Not necessarily.  A quick evaluation of the added sugar is in order.  Plain 2% Fage Greek yogurt has about 6 grams of sugar from the naturally-occurring sugar in milk.  The new fruit flavors clock in at 16 grams of total sugar, so 10 grams of added sugar (2.5 teaspoons).  The honey version has 29 grams of total sugar, thus a whopping 23 grams of added sugar (almost 6 teaspoons)! 
 
Guideline 1--Added sugar is added sugar.

So which yogurt should I grab on my dash out the door?  I think the answer depends on my day.  A day with dessert at dinner?  Perhaps the blood orange yogurt to save some added sugar for later.    Going for an 8 mile run afterschool drop-off?  A little extra sugar might not be a bad idea, to give me the energy I need for a long run.  In the end, the goal remains to keep added sugars to less than 10% of daily calories (see previous post for details).  For me, this is about 55 grams since I estimate my daily calorie needs at around 2,200 calories. 
 
Guideline 2--Context matters.
 
Remember Pop-tarts from the previous post?  With 16 grams of sugar, they are not very different from the new Fage yogurts.  But the yogurt has more to offer.  A quick comparison:
 

	Fage 2% honey	Fage 2% key lime	Strawberry Pop-Tart
Serving	5.3 oz container	5.3 oz container	1 pastry
Calories	190	140	200
Total Fat	2.5g	2.5g	5g
Total Carbohydrates	29g	18g	38g
Sugars (subset of total carbs)	29g   (of which 6 grams are naturally-occurring the yogurt)	16g   (of which 6 grams are naturally-occurring the yogurt)	16g
Protein	12g	12g	2g
Extras noted in the Nutrition Facts panel	10% of daily calcium	10% of daily calcium	10% of daily vitamin A, thiamin, riboflavin, niacin, and vitamin B6

 
From the Pop-Tarts, you primarily get carbohydrates, with a bit of protein and some fat.  The vitamins are from the enriched flour and, while important, are readily available in other grain products, either enriched flours or whole grains.  However, with the yogurt, the added sugars comes with protein and a good serving of calcium.  In choosing foods with added sugars, it is helpful to ask yourself:

• What does the food provide beyond added sugars?  Are the added sugars the majority of the food's calories or just part of the equation?
• Is the food a treat worthy of indulgence?  In in era when you can get any treat at any time, candy corn seems to be a rarity, stocked only in the fall.  I ADORE candy corn (but only the good Brach's kind!).  19 pieces provides 28 grams of sugar.  To answer my own question, yes, the candy corn is worth it.  And, hopefully, I will modify my other foods to take into account the candy corn loveliness. 
  
• Is the food a beverage?  Sweet drinks--from soda to 100% fruit juice to Frappuccinos--make it far too easy to exceed the daily recommendation on added sugars.  For example, a vanilla grande Frappuccino (no whip) with a staggering 67 grams of sugar.  Additionally, liquid calories are not satiating as solid calories, meaning that you will be hungry sooner with sugar sweetened beverages and, therefore, likely eating more overall.

Guideline 3--Eat fruit for something sweet.  And avoid HFCS.

In recent years, Dr. Robert Lustig of UCSF has made the argument that while added sugar is bad, it is the fructose component of sugar (sucrose) that is particularly worrying (remember, sucrose is half glucose and half fructose).  In short, he argues that the liver's ability to handle fructose can be overwhelmed and can lead to, among other things, de novo lipogenesis (making fat) and insulin resistance.  Two mediators of this impact are fiber and exercise.  Exercise basically helps negate some of fructose's effects.  Fiber slows the absorption of sucrose and fructose, providing the liver the necessary time to process the fructose.  Additionally, fiber increases satiety and reduces consumption.  Easy way to think of it--an apple is going to be more filling than a bag of fruit chews.  Both have sugar, but the apple provides fiber, not to mention key vitamins and minerals.

I should note that I don't believe the science is completely settled on this issue.  However, I think there is enough basic science data and population studies to suggest something is going on.  Sucrose is half fructose, so, again, limiting added sugars is best.  But some sugars such as agave syrup and high fructose corn syrup (HFCS) have a higher fructose content.  In HFCS, cornstarch has been modified in the lab, converting some glucose to fructose.  Unlike the 50/50 split of sucrose, the percent of fructose in HFCS can vary from 42% to 90%.  When reaching for something sweet with added sugars, choose a chocolate square made with sugar over the fruit chews made with HFCS.

Guideline 4--Kind matters, but only a little.

Sugar Basics--Any substance ended in -ose is a sugar.  The disaccharide sucrose is processed from sugar cane or sugar beets, then crystalized to form the white sugar.  Raw sugar in the United States is not really raw, but has gone through part of the refining process (true raw sugar would have dirt, insect bits, and like--yummy!).  In cooking, the kind of sugar matters.  For example, brown sugar (white sugar with added molasses) makes dense, chewy cookies (check out this link for a great comparison of different ingredients impact on chocolate chip cookies).

Glycemic Index and Sugars--In recent years, there has been some attention on the glycemic index (GI) of foods.  Basically, the GI is a measure of how quickly (and how high) your body's blood glucose level increases and then decreases after eating.  A high GI means the food increases blood glucose quickly, with a rapid decent.  Low GI means a slower, more modest increase and decrease in blood glucose levels.  The GI information can be particularly helpful to diabetics who are trying to manage and monitor blood glucose levels (an index of foods can be found on this Australian website).
 
Sugars like honey and agave, with their high fructose content, have lower GI levels than table sugar (aka sucrose).  Does that make honey and agave better-for-you sugars?  Not really.  They are still added sugars and count toward your daily limit. 

While in general, high GI foods are highly processed with little fiber, there are no hard and fast rules regarding GI, as cooking method, preparation, ripeness, and other factors influence the GI score.  Low GI foods are not necessarily more healthy.  For example, ice cream is low GI by virtue of its fat content (so the sugar is absorbed more slowly).  But if you are looking to feel full longer, a chocolate chip cookie made with whole wheat pastry flour may be slightly better than a cookie made with white flour as the whole wheat flour's fiber should slow the sugar's absorption (just remember--it is still a cookie!).
 
Sugar Alcohols--Sugar alcohols are not related to drinking alcohol, but instead are sweeteners that usually have fewer calories than sucrose.  You may be familiar with glycerol, sorbitol, mannitol, and xylitol.  One thing to remember about these low calorie sweeteners, often found in sugar-free foods, is that they are incompletely absorbed.  Good news?  Blood glucose levels rise more slowly than with sucrose (and, in the case of sugar-free gum made with xylitol, prevents cavities).  Bad news?  Too much sugar alcohol can cause a laxative effect. 

Honey, Maple Syrup, and Molasses--Too much of these sweeteners is still too much added sugar.  However, honey, maple syrup, and molasses do have a few positive attributes.  Depending on the botanical origin, honey and maple syrup contain anti-oxidants, vitamins, and minerals.  My only caution is watch your honey's origin, as too much of the honey sold is stores is not honey at all.  Blackstrap molasses (a by-product of sugar refining) is a good source of iron and calcium.

Zucchini Bread
 
When I started writing this post, I was going to skip the recipe.  We were in the midst of a birthday celebration week and, between a family party and a sleepover with friends, it seemed we were in an added sugar tsunami! 

But now, the crumbs have settled.  I got some great looking local zucchini from the farmers market.  Fall always makes me think of quick breads, so I raided my cookbook shelf for a oldie of my mom's--Gold Medal Century of Success Cookbook (as in Gold Medal Flour).  The recipe does have added sugar (which I decreased slightly), but has the benefit of encouraging the girls think of zucchini as a "good thing".  My adapted version of the book's zucchini bread recipe:
 
Preheat oven to 325 degrees. 

 
Mix ingredients (I stirred after adding each one):

• 3 cups grated zucchini
• 3 cups whole wheat pastry flour (not Gold Medal but Bob's Red Mill)
• 2 cups granulated sugar
• 1/2 cup of unsweetened apple sauce (the original recipe called for 2.5 cups of sugar, but I just couldn't do it.  The applesauce is still sugar-like, but has some of the benefits of fruit)
• 1 1/4 cups canola oil
• 4 eggs, beaten
• 1 tablespoon, plus 1 teaspoon vanilla
• 2 teaspoons cinnamon
• 1 1/2 teaspoons salt
• 1 1/2 teaspoons baking soda
• 1/2 teaspoon baking powder

 
Pour into loaf pans treated with cooking spray.  This recipe made one large loaf and 4 mini-loaves.  The mini-loaves baked about 20-25 mins and the large loaf was closer to 40-45 mins.  As always, I used a toothpick to check doneness.

References
All quotes and sources are linked in the above text.  General nutrition information came from Whitney and Rolfes' Understanding Nutrition, 13th ed. and from Nutrition for Sport and Exercise, 2nd ed. by Dunford and Doyle.