If you’re a typical American woman, you consume more than three times as much sugar as you should — roughly 60 pounds a year — and that can take a toll on your health and well-being.
Some of those ways are well-known — among them weight gain and an elevated risk for diabetes, liver disease, high blood pressure, stroke and heart problems. Others may surprise you: From the blues and bloating of PMS to increased odds for miscarriage, gestational diabetes and birth defects and a higher risk for the hormone disorder polycystic ovary syndrome (PCOS).
That’s why it’s important for women to go easy on sweets and limit intake of added sugar to the daily recommendation of 6 teaspoons a day.
"It all boils down to moderation," Bodenheimer said.
Unfortunately, your hormones and even your eating habits can make you crave sugar — and it can sneak into your diet where you least expect it.
We asked Bodenheimer what sugar does to a woman’s body and how women can tame their sweet tooth.
1. How does a woman’s menstrual cycle factor in?
With shifting levels of estrogen and progesterone every month, there can be a decrease in serotonin — a chemical produced by your nerve cells that’s a natural mood stabilizer. Decreased levels of serotonin can lead to feelings of depression, anxiety — and sugar cravings. Sugar boosts serotonin levels, which makes you feel better for a while — but then you want more. This is an issue with PMS and also during perimenopause, the period before a woman’s periods stop for good, and during menopause.
2. How does pregnancy affect sugar levels and vice versa?
Pregnancy is characterized by insulin resistance — which means cells in your muscle, fat and liver don’t respond well to insulin and your blood sugar levels go up. That can lead to diabetes, high cholesterol, high blood pressure and a serious complication of pregnancy called preeclampsia. We try to maintain tight blood-sugar control in pregnant women — especially those with existing diabetes. For some, insulin injections will be necessary.
3. How does high blood sugar affect mom and baby?
It can have effects on both. Pregnant women who don’t have tight glycemic control are at higher risk for diabetes during and after pregnancy, miscarriage, having a very large baby (9 to 11 pounds), fetal heart defects — and even fetal death. The baby can also be born with low blood sugar; fortunately, breastfeeding is a great way to help regulate that.
4. How does sugar contribute to polycystic ovary syndrome (PCOS)?
As with pregnancy, insulin resistance occurs with PCOS, so blood sugar levels can rise. A woman with PCOS has a 2.5-fold higher risk for developing Type 2 diabetes. Insulin resistance can also lead to production of androgens, which are hormones that lead to male characteristics like body hair.
Typically, a woman will come in and say her periods are irregular or she can’t get pregnant. We diagnose PCOS if she has two of three signs: irregular periods; high levels of testosterone in her blood; and an ultrasound finding known as the "string of pearls," which is a bunch of little cysts on the ovary. Along with that, you can also see high blood pressure, high cholesterol and lipids in the blood, as well as Type 2 diabetes. The cause of PCOS is unclear and there is no cure, but limiting sugar is critical.
5. Where is all this sugar coming from?
Sugar comes from natural sources like fruit and milk as well as additives. Beverages (including soft drinks, fruit drinks, energy drinks and sweetened coffee and tea) are the No. 1 source of added sugars, followed by snacks and sweets, according to the American Heart Association.
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6. How can women avoid too much sugar?
The biggest source is high fructose corn syrup — you find that in everything almost. Read product labels. Look also for corn sweetener, honey, molasses, brown sugar, and sugar molecules ending in "ose" (such as dextrose, maltose and sucrose). Look also for sorbitol, which is in many processed foods. A lot of times our bodies have trouble digesting that and other complex sugars, which can lead to bloating. If you are constantly bombarding your body with these complex sugars, that’s when you’re going to get these symptoms. If you’re limiting sugar intake, your body is not going to be overwhelmed.
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7. Are sugar substitutes the solution?
Moderation is really the key, but if you’re leaning to sugar substitutes, I’d lean to a natural one such as stevia or agave syrup, which are derived from plants. There’s another, xylitol, which doesn’t raise blood sugar or insulin levels. But, with all of these, we need more research in humans to understand whether they are safe and well-tolerated or not.
8. What do you recommend?
Again, it all comes down to moderation, to watching labels and trying to avoid processed foods as much as you can. (And that includes almost anything you find in the freezer aisle, such as chicken nuggets and so forth.) The U.S. Department of Agriculture recommends five servings of vegetables and fruit a day — but remember, fruit also contains sugar and calories and one serving is the size of a tennis ball. Pay attention to portion control.
Avoid snacking. But if you do snack, avoid sugary treats. Some trail mixes are relatively low in sugar — again read the label. Nuts and raw vegetables are also good choices. And pay attention to your body: Eat when you are truly hungry, and not because you’re simply tired or bored.
9. Focus on lifestyle
Controlling sugar intake boils down to a healthy and sustainable diet. A lot of women use an app to track what they eat and watch their calories and within six months, they no longer need it. It’s not a quick fix; it’s a lifestyle change, and I use the word “sustainable” a lot because it’s what is going to last a lifetime. Find a family medicine specialist near you.