Sugar comes in many forms including honey, brown rice syrup, corn syrup, and molasses. You should limit all of them. (Fotolia / September 18, 2013)

Our sugar-laden diet is literally killing us. That's the conclusion of a study reported at the annual meeting of the American Heart Association in March (2013). The study authors attributed 180,000 annual deaths worldwide--25,000 in the United States alone--to sugary beverages. Sodas and fruit drinks aren't our only sources of sugar. The average American eats between 22 and 30 teaspoons of added sugar each day, according to the AHA.

"The harmful effects of sugar are primarily due to the weight gain from added sugar in the foods we eat and sugar-sweetened beverages," says Dr. Michelle Hauser, certified chef and nutrition educator and clinical fellow in medicine at Harvard Medical School. "Most of the deaths are related to heart disease, cancer, and diabetes."

SUGAR ALIASES

Sugar comes in many forms--including honey, brown rice syrup, corn syrup, and molasses. You want to limit all of them. By and large, all types of sugar have the same effect on your body--with one exception.

A study in the January 2 issue of The Journal of the American Medical Association looked at brain imaging scans after people ate one of two types of simple sugars--fructose or glucose. Researchers found that fructose, but not glucose, altered blood flow in areas of the brain that stimulate appetite.

"When we take in high-fructose corn syrup and fructose, it stimulates appetite and causes us to eat more," Dr. Hauser says. So you want to especially limit foods containing high-fructose corn syrup (such as sodas and sweetened cereals).

You can control the amount of extra sugar you spoon onto your food, but sometimes it's hard to spot sugar hidden in presweetened packaged and processed products. That's why it's so important to read food labels and to know exactly how much sugar is in the foods you buy.

ARE ARTIFICIAL SWEETENERS BETTER?

Artificial sweeteners, which are sugar-free and typically lower in calories than sugar, might seem like healthier options, but that idea is controversial. A 2012 scientific statement from the AHA concluded that using artificial sweeteners such as aspartame (NutraSweet, Equal), saccharin (Sweet'N Low), and sucralose (Splenda) can reduce the number of calories in your diet, thereby helping you lose weight.

However, there's also evidence that eating these sweeteners, which are generally hundreds--or even thousands--of times sweeter than sugar, can make you crave sweets even more. You undermine the benefit of using artificial sweeteners, for example, if you use a glass of diet soda to justify having a bowl of ice cream.

However, if artificial sweeteners can help you cut back on calories in a meaningful way, then they can be helpful in controlling weight and blood sugar.

"For people who are trying to make small changes to their diet, artificial sweeteners are sometimes a good stepping stone, but they're not a permanent fix," Dr. Hauser says.

You may wonder which artificial sweetener is best. All of the sweeteners on the market are considered safe. There were reports during the 1970s linking saccharin to bladder cancer in rats that were fed extremely high doses of the sweetener. However, later studies didn't find any evidence of the same effect in humans. Aspartame was also linked to cancer at one time, but that association has also been disproved.

Still, if you're concerned about the safety of your artificial sweetener, Dr. Hauser suggests using sucralose, which has not been linked to any adverse health effects. Or, you can try a sweetener containing sugar alcohols (sorbitol, xylitol), although these products cause diarrhea and bloating in some people.

BREAK THE SUGAR ADDICTION

If you're "hooked" on sugar, don't try to eliminate all sugary foods at once. If you deny yourself even a single piece of candy or sliver of cake, you'll only crave sweets more. Instead, eat a healthy diet made up of more satisfying foods--whole grains, fruits, vegetables, healthy oils, and lean protein.

"Steer yourself away from sugar and eat these foods, which are digested more slowly. They'll help to even out your blood sugar and you won't have spikes and crashes all the time," Dr. Hauser says.

Way to help you break the sugar habit:

1. Keep sugary foods away. Don't tempt yourself by stocking candy, cookies, and other high-sugar foods in your cupboards and fridge. "As a substitute for these things, keep fruit around," suggests Dr. Hauser.

2. Sweeten foods yourself. Start with unsweetened iced tea, plain yogurt, and unflavored oatmeal. Then add your own sweetener. No matter how much sweetener you add, you probably won't put in as much as the manufacturer would have, according to Dr. Hauser.

3. Watch for hidden sugars in foods. Be wary of foods where sugar tends to hide, including reduced-fat products.

"When companies take out the fat, they add back almost all the calories in sugar," Dr. Hauser says. Read labels. Avoid products that list sugar as the first ingredient or that contain several different types of sugar (brown sugar, cane nectar, etc.)--it's one way manufacturers avoid having sugar listed as the first ingredient.

4. Eat breakfast. Start out your day with a filling, nutritious meal, so you'll be less likely to give in to cravings. Steel-cut oatmeal, eggs, and fruit are all good breakfast choices.

"When you get used to eating fewer super-sweet things, you crave them less," Dr. Hauser says. "You become more satisfied with less sweet things." You also won't feel guilty on those less frequent occasions when you do splurge. -- Harvard Women's Health Watch

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