The good news is that these sources of added sugar are not the ones that most nutrition experts and health organizations are taking fire at, even though they’ve gotten swept up in the anti-sugar crusade. “There are people who are very health-conscious coming to me worried about the added sugar in tomato sauce or yogurt,” Dr. Tewksbury says. “But that’s not the source of added sugars that major organizations and dietitians are worried about.”What experts are sounding the alarm on is the foods and beverages that offer sugar (and calories) in high concentrations, and not much else. Added sugars in and of themselves are not unhealthy—in fact, they’re the same as naturally occurring sugars in terms of their chemical structure and how the body processes them. It’s the large amounts of added sugar and the nutrition-lacking foods people regularly consume them in that are an issue.“These products that are basically nothing but added sugar in high concentrations and little other nutritional value are the sources of the vast majority of the added sugar individuals consume,” Dr. Tewksbury says. According to the 2020–2025 Dietary Guidelines2, created by both the Department of Health and Human Services (HHS) and the Department of Agriculture (USDA), the top offenders by far are sugary beverages (sodas, fruit drinks that are not 100% fruit juice, sports drinks) and processed sweets (cookies, candies, pastries, ice cream). This absolutely does not mean you can never have these items or should feel guilty about enjoying the hell out of them when you do have them! Sugary foods and drinks can absolutely be part of a healthy lifestyle. Health and nutrition experts are generally most concerned about people consistently bypassing daily sugar intake recommendations in a way that can put their health at risk. What are the daily sugar intake recommendations? The 2020–2025 Dietary Guidelines advise capping your daily added sugar intake at 10% or less of your total calories. Each gram of sugar equals 4 calories, so if you eat about 2,000 calories a day (we’re using this general number just for math’s sake), the recommendation is to aim for under 200 calories worth of sugar every day, or 50 grams.Similarly, the World Health Organization (WHO) recommends keeping consumption of “free sugars” (which includes everything that falls under added sugars, plus sugars from 100% fruit juice) at 10% or less of caloric intake. But WHO takes it a step further by saying that reducing intake of free sugars even further, to 5% or less of caloric intake, would offer additional health benefits. No matter the exact number you go by, the general spirit of these recommendations is clearly that “most of us could probably stand to cut back a little bit,” as Dr. Tewksbury puts it.What are the health concerns around added sugar? These numbers may seem arbitrary, so let’s go over why these guidelines exist. Broadly speaking, these recommendations are based on the fact that (a) high added sugar intake over time is associated with negative health outcomes, and (b) most people are eating high amounts of added sugars. According to the Centers for Disease Control and Prevention (CDC), consuming too much added sugar is associated with cardiac and metabolic health issues like obesity, type 2 diabetes, and heart disease. That said, multiple studies have found that some of the strongest evidence for the relationship between sugar consumption and weight gain, diabetes, and heart disease applies to added sugar that comes from sugar-sweetened beverages only. And according to the Dietary Guidelines, sugar-sweetened drinks account for over 40% of the average American’s added sugar intake.
Type 2 diabetes is one of the most common chronic health conditions in the U.S. (a whopping 10.5% of the population has it1)—yet it is woefully misunderstood by most people. There are all kinds of misconceptions about what causes type 2 diabetes. Because of this, you might think you did something wrong if you get a type 2 diabetes diagnosis. But the truth is, the condition is the result of a combination of factors, some of which can be outside of your control. Ultimately, type 2 diabetes occurs when your body doesn’t use insulin properly. The good news is, that there are lots of ways to change that. Keep reading to learn what really causes type 2 diabetes—and what you can do to prevent it.What is type 2 diabetes?In a nutshell, type 2 diabetes is a chronic disease that occurs when your pancreas doesn’t produce enough insulin (or doesn’t use it efficiently), which results in too much glucose (or sugar) circulating in your blood, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Over time, high blood sugar levels can cause problems with your immune, nervous, and circulatory systems. Worth noting: If your body has started having problems producing insulin and using glucose, but your blood sugar hasn’t yet risen to a concerning level, then you may be diagnosed with prediabetes.So, what’s the difference between type 1 and type 2 diabetes? Type 1 diabetes also occurs when there is too much glucose in the blood, but it’s an autoimmune condition, meaning the body attacks the insulin-producing cells in the pancreas.What causes type 2 diabetes?Experts don’t know exactly what causes type 2 diabetes, but there are several factors at play—some are within your control (think: getting enough exercise) while others are outside of your control (like genetics). Here are some possible causes:Insulin resistanceThe main culprit of type 2 diabetes, insulin resistance is when your body doesn’t use insulin efficiently, which leads to high blood sugar. Glucose is what your body uses for energy. But it has a lock on it, meaning it can’t get into your cells on its own; it needs insulin to do that (think of insulin as a key that opens the lock so glucose can enter).Insulin resistance is when your key (insulin) doesn’t work as well as it should. Sometimes it unlocks, and sometimes you have to go through a series of acrobatic hand movements to get the lock to open. Since glucose isn’t getting into your cells consistently, it means there is extra circulating in your blood, increasing your blood glucose, or blood sugar, which may lead to type 2 diabetes.There’s another thing that happens with insulin resistance. Your body can’t make enough insulin to compensate for the extra glucose. As a result, more glucose ends up circulating in your blood, which can damage your cells and lead to complications that affect your eyes, kidneys, and nerves, according to a 2019 study published in the journal Nature.2Excess body fatSo, what causes insulin resistance in the first place? The answer is complicated, and it doesn’t just happen overnight. But one of the main factors is excess body fat, which can cause inflammation throughout your body. That inflammation may then trigger a chain reaction that ultimately leads to insulin resistance and eventually type 2 diabetes, according to a 2015 study published in the journal Lipids in Health and Disease.3It’s important to note that not all people with type 2 diabetes are considered clinically overweight, and not all people who carry excess weight have type 2 diabetes.Your genes and how you grew upInheriting certain genes can increase your risk of developing type 2 diabetes. If you have one parent with type 2 diabetes, your risk increases by 40%, according to a 2015 study published in the journal Genes. If both parents have it, that risk jumps to 70%. And compared to the general population, you have a three-fold increased risk if you have a parent or sibling with type 2 diabetes.4
People of certain races, including African Americans, Latinx, Native Americans, Pacific Islanders, and Asian Americans are also more likely to develop type 2 diabetes, although experts don’t fully understand all the reasons for this elevated risk.What are the signs of type 2 diabetes?Some signs of type 2 diabetes can be subtle, because the condition tends to develop slowly over time compared to type 1 diabetes, per the NIDDK. In fact, it may take several years for symptoms to pop up, so you may not realize you have the disease until it causes certain complications, like heart issues or blurry vision.While having just one on this list isn’t a surefire indicator of the condition, pay attention to whether you’re experiencing several of these, Hien Tran, M.D., an endocrinologist with Texas Diabetes and Endocrinology, tells SELF. Simply having a dry mouth on its own may not be enough to prompt a doctor’s appointment, for example, but if that sign is paired with other symptoms on this list and you also have any of the risk factors mentioned above, it may be worth getting checked out.Now, here are the type 2 diabetes symptoms to keep on your radar:1. You’re drinking a lot of water… and need to pee all the time.Having too much sugar in the blood is tough on the kidneys since those organs are responsible for processing that excess glucose, according to the Mayo Clinic. As a result, they work overtime to eliminate it from the body. As your body loses fluids, you may feel the signs of dehydration creeping in. So, you drink more fluids to make up for it, and the cycle of constantly peeing continues. That’s why frequent urination and increased thirst tend to be the two most common type 2 diabetes symptoms, particularly in the early stages.2. And you need to pee, like, right now.Despite peeing more often, you may also experience the strong need to go but very little—if any—comes out when you do, which is known as “urgency incontinence,” per the NIDDK. Although this is also a big head’s up that you might have a urinary tract infection, especially for people with vaginas, it’s also common with type 2 diabetes.3. Your mouth feels super dry.As we mentioned, when you pee more often, your chances of getting dehydrated go up, which will often kickstart your thirst response. With type 2 diabetes, the excess glucose in your system also takes fluid out of your tissues, making that thirst more ferocious. That can be exacerbated by having a dry mouth, and the feeling that you simply can’t drink enough water or other fluids to switch off that thirsty feeling.Dry mouth is characterized by feeling a lack of saliva often or most of the time, a dry, rough tongue, pain in the mouth, cracked lips, mouth sores or infections, and problems with chewing, swallowing, or even talking, per the NIDDK. Because of this, dry mouth can raise your risk for certain dental problems, like tooth decay and gum disease.4. You have weird changes in your vision.People with diabetes can also develop diabetic retinopathy, which is a condition that can cause damage to the retina (the thin, light-sensitive tissue that lines the inside surface of the back of your eyes) over time, according to the American Optometric Association. That’s because excess blood glucose damages all of the tiny blood vessels in your body, including those in your eyes. This is a problem because the eyes’ blood vessels will then break and leak fluids, resulting in complications like cloudy or blurry vision or difficulty focusing.If type 2 diabetes goes untreated, new blood vessels may form in your retina as a response—but because they’re so fresh, they’re more prone to leaking as well, causing the eye tissue to swell. Over time, if type 2 diabetes continues to go untreated, your risk of vision loss goes up.5. You can’t satisfy your hunger.Even if you have a big meal, you might walk away feeling hungry, the Mayo Clinic says. That’s because insulin resistance is preventing glucose from reaching your cells to give you the much-needed energy boost that food provides—so your brain and muscles keep sending hunger signals as a result.6. You feel tired (and cranky!) all the time.The blood sugar spike you experience after eating can cause major fatigue because the glucose isn’t being processed effectively in your body. Dehydration can also make you feel tired, the Mayo Clinic says, and so can trouble sleeping if your symptoms (like dry mouth or constantly needing to pee) are causing discomfort.