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Watch out for sugar in disguise

Created date

October 26th, 2010

People with diabetes know to avoid sugar in their diets. Diabetes is a disease in which your blood glucose (sugar) levels are too high. Over time, having too much glucose in your blood can cause serious problems with your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke, and even the need to remove a limb. Cookies, cakes, and sugary drinks are obvious sources of sugar, but can you still get too much sugar in the foods you eat without even knowing it? Hidden sugars are everywhere, says Christine Gerbstadt, M.D., R.D., spokesperson for the American Dietetic Association. Common culprits are salad dressings, ketchup, barbeque sauce, jam, jelly, maple syrup, cooking sauces, and pasta sauces. Some not-so-obvious sources of sugar are breakfast cereals; breads (especially whole wheat and multi-grain varieties); and boxed preparations or mixes for baked goods, dinners, and casseroles, Gerbstadt adds.

Clever advertising

Natural sugar content can be very high in dried fruits and juices, says Raina Patel, M.D. Many fruit juice labels or other products read no added sugar so some people think they are okay for people with diabetes. Even foods containing sugar substitutes may be risky. People with diabetes have to be mindful of the total number of carbohydrate grams in foods. Many foods with sugar substitutes also contain carbohydrates like flour, for instance, that could raise blood sugar. Advertisers are very adept at pointing out positive aspects of their products but not negative aspects, Patel says.

Sugar substitute safety

In general, sugar substitutes have been shown to be fairly safe and not risky for people with diabetes, Gerbstadt says. Examples are aspartame (Equal), saccharin (Sweet N Low), sucralose (Splenda), acesulfame potassium (Sweet One), sugar-alcohol based sweeteners (Sweet Simplicity), Stevia, and fiber-based sweeteners (Sweet Fiber). Some sugar substitutes may cause certain side effects in some individuals (aspartame and headaches, for instance) and should not be used by people who have problems with them, Gerbstadt says. Sugar alcohols like xylitol, mannitol, and sorbitol are less sweet than table sugar and also less sweet than many zero-calorie sweeteners, Gerbstadt continues. You may have to use a lot to get the same sweetening effect as sugar. In some people, that might potentially affect their blood sugar levels. People can have problems with diarrhea if they eat too much of a food containing a sugar alcohol based sweetener, Patel says. It s easy to eat too much, especially if it s desserts or candy.

Double-check labels

Too much sugar can affect cholesterol levels, especially triglycerides, Patel says. Elevated cholesterol is associated with heart disease, and having elevated triglycerides may increase your risk for stroke. Sugar can show up in many forms and many places, so read your labels, Gerbstadt says.

Sugar by any other name

Scrutinize food labels for the following common hidden sugars:
  • agave
  • cane juice
  • cane syrup
  • corn syrup
  • dextrose
  • fructose
  • glucose
  • high fructose corn syrup
  • honey
  • lactose
  • maltose
  • maple syrup crystals
  • molasses
  • sucrose