Ask the Doctors: Checking for added sugar on labels can be tricky

glaDear Doctor: I’ve read that “added sugars” should be limited to 10 percent of our total daily calories. But how are added sugars listed on nutritional labels? Are they part of the carbohydrates category? Does the sugar in a peach or a glass of milk count?

Dear Reader: Ah, nutrition labels. They’re a wellspring of useful information and occasional confusion. But with a little decoding, you can use nutrition labels to set a course toward mindful and healthful eating.

Sugars are carbohydrates that are found in fruit and milk and, to a lesser extent, vegetables. They are either naturally occurring or are added to food during processing. Naturally occurring sugars are those that are present in a food, whether a banana, carrot, peach, glass of milk or spoonful of honey, exactly as harvested. Added sugars are those that are used in the cooking or processing of a food item to change its flavor.

One of the challenges to identifying added sugars is that they go by so many different names. A label that says sugar, brown sugar, raw sugar, molasses or honey is pretty easy. Move on to sugars like maltose or dextrose, and things are trickier.

One rule of thumb is that if a word ends in “ose,” there’s a good chance that sugar is involved. Fructose, glucose, high-fructose corn syrup, lactose and sucrose — all these are sugars. One exception is sucralose, an artificial sweetener that goes by the name Splenda. A bit trickier are ingredients with the word “syrup,” like cane syrup, agave syrup and corn syrup. And if you see something like “fruit concentrate,” that’s also an added sugar.

You’re absolutely right that when it comes to added sugars, the federal Centers for Disease Control and Prevention (strongly) suggest that we keep them to less than 10 percent of our daily diet. That means someone who eats 2,000 calories per day should limit added sugars to less than 200 calories per day. Considering that each gram of sugar has 4 calories, that’s still a hefty allowance for sweets.

So how do you track added sugars? First of all, naturally occurring sugars do not count toward the total. If you eat a fresh pear, even though it contains 17 grams of sugar, you have eaten zero grams of added sugars. Artificial sweeteners also do not factor in the added sugars count.

The challenge comes with existing nutritional labels, which don’t plainly identify added sugars. The “sugars” or “carbohydrates” designation indicates both naturally occurring and added sugars. That means you have to do a bit of sleuthing. Read the list of ingredients for telltale sugars. The higher up they appear on an ingredients list, the greater percentage of added sugars the product contains. Check serving size — remember 4 calories per gram of sugar — and then guesstimate.

If you think this is a crummy way to track added sugars, we heartily agree. The good news is that the FDA has ordered a new nutritional label that clearly states the grams of added sugars. The bad news is that although the label was approved in 2016, it won’t make its debut until July 2018.

Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.