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Over the last several decades, sugar has taken on the villain's role in the American diet. General sugar-bashing has led to "sugarphobia" as Jukes calls it and the unfounded fear that eating refined sugar causes many health problems, including heart disease, diabetes, anxiety, fatigue, depression, hyperactivity, and even criminal behavior.

But, in fact, added sugar at current levels is not detrimental to health. According to the landmark 1986 FDA Report of Sugars Task Force, sugar, when consumed normal or moderate quantities, cannot be linked to any disease, nor does it create a dependency.

Walter Glinsmann, M.D., FDA's associate director for clinical nutrition and senior author of the task force report, explains that members of the task force estimated the intake figures and trends of both added and naturally occurring sugars, based on USDA data. They also reviewed the scientific literature dealing with possible harmful effects of sugar consumption on numerous conditions, including tooth decay, glucose tolerance, diabetes mellitus, lipidemias (high blood fat), cardiovascular diseases, obesity, gallstones, and cancer. "Based on that work," says Glinsmann, "we decided that sugars are safe as they are now used in the food supply." If there is a significant change in the way Americans consume sugars, he adds, then scientists must reevaluate their role.

As Glinsmann observes, FDA does not say that eating unlimited amounts of sugars is safe. "There are not good or bad foods, only good or bad diets," he says. "If half your diet is pure sugar, that is not healthy. ... In a normal, varied diet, there are no adverse effects of sugar itself."

The task force did find that sugar can cause dental cavities, he says, but adds that so can other fermentable carbohydrates, such as dried fruit and honey, under the right conditions.

Despite the report, some consumers persist in linking sugar consumption with assorted ills, such as hyperactivity and aggressive behavior in children. This is often reported by parents who say that their children are uncontrollable after eating candy and other sugary sweets.

Glinsmann points out that sugar has not been shown to be a factor in hyperactivity. Studies of children and adolescents at the National Institutes of Health in Bethesda, Md., and elsewhere have looked at groups of individuals served sugar or a placebo (an inactive substance given as a control when testing another substance). Glinsmann points out that no researcher has found that sugar has had any discernible negative effect on children's behavior. To the contrary, sugar often has a soothing effect.

It also calms adults, says Wurtman, who has studied the relationship between carbohydrate consumption and mood. When people report having a sugar high or jitters, Wurtman asks them what was happening before they took a mouthful of something sweet. "When people feel the need to eat," she says, "They usually are jittery. But 20 minutes after eating, they are no longer jittery." In fact, the opposite happens: After eating sugar, people become calm or even sleepy, she says, an effect caused by sugar raising the level of a calming brain chemical called serotonin. Sugar in its pure form is the best nonprescription antidepressant, she says.

Sugar by Other Names

Numerous nutritive and nonnutritive substitutes for sucrose vie for its place as a sweetener. All nutritive substitutes - such as honey, concentrated fruit juices, dextrose (also known as glucose), maple and corn syrups, fructose (levulose or fruit sugar), sugar alcohols, and high-fructose corn syrup contain and contribute calories.

Perhaps the most commonly used nutritive sweetener is high-fructose corn syrup, a sweet product manufactured from cornstarch and containing a high level of fructose, explains Kyd Brenner, director of public affairs for the Corn Refiners Association in Washington, D.C. High-fructose corn syrup is very close to the composition and calorie content of cane sugar, he says, and the syrup can be used as a direct and inexpensive substitute for cane sugar when liquid sweeteners are called for. It is used extensively in soft drinks, condiments, jams, jellies, and wine and is not available for home use.

Of the sugar alcohols, sorbitol (60 percent as sweet as sucrose with about the same number of calories per gram) is used in such products as hard and soft candies and chewing gums. Xylitol, another sugar alcohol, has limited FDA approval for special dietary uses. A third sugar alcohol, mannitol, has been removed from the GRAS (generally recognized as safe) list, and is regulated as an 'interim' food additive. This means that its current use is considered safe, but some questions have been raised that must be resolved to fully determine what limitations, if any, should be imposed. Mannitol is still being used in some products.

Both mannitol and sorbitol, when taken in large amounts, can cause diarrhea. Products whose reasonably foreseeable consumption may result in a daily ingestion of 50 grams of sorbitol or 20 grams mannitol must bear the labeling statement: "Excess consumption may have a laxative effect."

The sugar polymer polydextrose, because of its bulking properties, is used to replace a number of the technical effects of sucrose in various baked goods, salad dressings, frozen desserts, and candies. Because of its structure, polydextrose is not readily digested, so it is a low-calorie sucrose substitute. But it does not provide sweetness, so it is likely to be used with a nonnutritive sweetener. FDA is presently considering petitions for its use in other products such as in fruit and peanut butter spreads, sweet sauces, toppings, and syrups, and as a formulation aid in film coatings in vitamin and mineral supplement tablets.

Tags: Nutrition, Diabetes

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