You are trying to be very careful to avoid foods containing sugar, but sometimes the labels are downright confusing because there are so many kinds of sugar.

First of all, just what is sugar? Sugar is a simple carbohydrate that provides four calories per gram or 16 calories per teaspoon. It is added to foods for a variety of reasons other than just to add sweetness. It is used as a preservative in jellies and jams, a bulking agent in ice cream and baked goods, a bodying agent in soft drinks, an aid to fermentation in breads and pickles, and a flavor enhancer in processed meats and salad dressings.

Some sugars are easily recognized on food labels because they end in "-ose." The most common form of sugar is sucrose, usually known as table sugar. It is processed from sugar beets or sugar cane and is a mix of two sugars-glucose and fructose. Brown sugar is ordinary table sugar that is coated with a small amount of molasses. Molasses is that which remains when sugar cane or beet juice is turned into sucrose crystals.

Fructose is found naturally in most fruits and some vegetables. Most people can tolerate the amount of fructose found naturally in fruits and fruit juices without getting the "dumping syndrome"- feelings of shakiness, sweating, heart palpitations, and weaknesss. Many times the amounts used for sweetening foods will cause dumping. High fructose corn sweetener, the most common sweetener in beverages, is now replacing sucrose in a number of food products because it is less expensive. The remainder is mostly glucose with a small amount of other sugars. Honey, produced by bees, is a mixture of fructose, glucose, and water. Honey contains negligible amounts of potassium, iron and selenium and is not any healthier than sucrose.

Glucose, also called dextrose, is found in many fruits and vegetables and is added to processed foods. It is the form of sugar normally found in the bloodstream. All natural sugars are converted to glucose by the body.

All of the above sugars will cause "dumping syndrome." Sugar alcohols, mannitol, sorbitol, and xylitol have the same amount of calories as table sugar but they are absorbed much more slowly and are much less likely to cause dumping. However, they may cause abdominal gas, cramps and diarrhea. Food products labeled "sugar free," "sugarless," and "no sugar" may be sweetened with a sugar alcohol.

Artificial sweeteners or sugar substitutes are calorie free or used in such small quantities that their calorie content is very low. Aspartame (brand name Nutrasweet), saccharin, and acesulfame K (brand name Sunnette), are examples of artificial sweeteners. Although these artificial sweeteners do not cause dumping syndrome, we do not recommend saccharin or aspartame.

Saccharin, 300 times sweeter than sugar, is calory free because it is not absorbed by the body. Recent research results suggest that saccharin is not a health hazard to people. The long-term safety of saccharin continues to be investigated because earlier studies showed a link between its use and cancer.

Aspartame is 180 times sweeter than sugar yet provides only four calories per gram. Because it is used in such small quantities it is virtually calory free. Unfortunately it cannot be used during cooking or baking at high temperatures because heating causes it to break down and lose its sweetness.

There are reports of aspartame causing everything from headaches to dizziness, nausea and mood swings. However, for the time being, (and the number of sceptics continues to grow) studies have failed to confirm a link.

The Food and Drug Administration (FDA) has established 23 milligrams of aspartame per pound body weight as an "acceptable daily intake." One packet of Equal has 35 mg, one can of soda has 180 mg, one cup of yogurt 124 mg, and one cup of pudding 50 mg. Use Equal only sparingly.

Acesulfame K, 200 times sweeter than sugar can be used for cooking and baking as well as in cold foods and beverages. It is not widely used in products. There were some questions about a cancer risk but the FDA review found that over time, rats who ate acesulfame K ended up with no higher incidence of tumors than would be expected to occur naturally in their lifetimes.

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