Food that is whole and natural, as it is found in its original form from the land or water, will have no added sugars, but it may have natural, inherent sugars. In contrast, food that is produced or manufactured in any type of processing facility may have added sugars if adding sugar is the approach taken by the food’s maker as part of the recipe. A processed food may have both added and inherent sugars, creating a total sugars value that is higher than the added sugars value alone.
For some people, tracking total sugars is crucial. This is true for people with diabetes, high blood pressure and heart disease, fatty liver disease, inflammation, some cancers, and weight gain (Dr. Hu, Harvard), as well as people who wish to limit their total sugar intake, very likely favoring other food components such as fiber and protein. Because total sugars are always either equal to or higher than the added sugars in a food, tracking of total sugars will yield fewer smile and half-smile foods than occurs when tracking only added sugars. Rating fewer foods as smile and half-smile foods, on the one hand, can enable a person to reduce sugar consumption and derive more of one’s daily calories from nutrient-dense foods high in either fiber, protein, or both. This approach can have beneficial health effects without any significant detriment, including improved weight management. On the other hand, tracking only added sugars will yield many more smile, half-smile, and flat-face foods, possibly leading to overall sugar consumption that is higher than one might imagine if desserts and treats are not a large part of your daily diet.
In particular, one interesting outcome of tracking only added sugars is that fruits will have zero added sugars, and they will appear as smile, half-smile, or flat-face foods. Moreover, when fruits or fruit derivatives are added to foods to make them sweeter or more flavorful and palatable, the increased sugar from the fruit will not count as “added sugar” because it is inherent to the fruit. It is a naturally occurring sugar. It will only count as grams of sugar if one looks at total sugars. This outcome is fine to an extent because fruits are delicious and healthful in many ways, and everyone is encouraged to eat approximately two servings of fruit every day. Fruit is an element of the USDA MyPlate eating recommendations.
Only if you track total sugars in food will the sugars in fruit be included in the Smile Food System rating. When you do this, importantly, all whole fruits, which have inherent sugars but no added sugars, will almost always be frown foods. The natural sugar in fruits is usually higher than both its fiber and protein. So, a fruit is a frown food for people who wish to track, or must track for medical reasons, total sugars. This outcome is also fine to an extent, as it is informative and helpful for people who are tracking total sugar intake throughout the day.
This result is true of many vegetables, such as corn and green beans, also. When tracking total sugars, you will see vegetables as frowns. But, if you switch to tracking added sugars, they will be smiles, half-smiles, or frown foods. Unless you are required to monitor sugar consumption with extra care, vegetables are almost always a good addition to your daily diet!
Examples of foods in both categories, both natural and manufactured, are the following.
Whole, natural foods are picked (apples, strawberries), dug up (potatoes, onions), harvested (broccoli, lentils), butchered (beef steak, chicken breasts), milked (cow’s milk, goat’s milk), or extracted (honey, cocoa).
Foods that are manufactured are boundless. Nearly everything in a box, jar, can, bag, or other package has been made by people by blending ingredients, then made available to you in a market, with a shelf life, by preserving and protecting it through canning, freezing, vacuum packing, or some other type of wrapping. The following are just a few examples of foods that are manufactured: yogurt, granola bars, breakfast cereals, salad dressings, ice cream, frozen dinners, corn chips, cookies, and canned soup.
To summarize the difference between added and total sugars, the three most common sugar situations are these:
1. If a food has only total sugars, and zero added sugars, its sugar is fully natural (inherent).
2. If a food’s total and added sugars are the same, it has only added sugars and zero natural sugars.
3. If a food has different (non-zero) values of total and added sugars, the food has both added and natural sugars, and the total sugars will be higher than the added sugars. Tracking added sugars does not provide a full count of all your sugars, but it does let you see where added sugars, like corn syrup and granulated sugar, are inserted into your food choices. Tracking total sugars helps you be strict about monitoring all your sugar intake, including both natural and added sugars.