Table sugar has been plentiful in American diets since the 20th century. Before then, it was an expensive condiment known as "white gold."
Recognizable in this form, consumers also understand that the cheap staple is abundant in their favorite sweet treats. However, common foods in the Standard American Diet are overflowing with hidden sources of sugar.
According to the U.S. Department of Agriculture, sugar consumption per capita increased by 39 percent between the 1950s and the early 2000s. Americans on average eat 16 percent of their total calories from added sugars, mostly from soda, energy and sports drinks, grain-based desserts, sugar-sweetened fruit drinks, dairy-based desserts and candy, according to the U.S. Food and Drug Administration.
For the past few years, there has been a case building against added sugar. In 2009, California physician Dr. Robert Lustig made his famous presentation, "Sugar: The Bitter Truth," calling the white stuff a toxin and a poison. He received a lot of criticism, but more researchers are co-signing on his ideas.
They're connecting sugar to inflammation, the obesity epidemic, type 2 diabetes and other chronic illnesses.
A recent study, published in the Journal of the American Medical Association's Internal Medicine, said there is a "significant relationship between added sugar consumption and increased risk for cardiovascular disease mortality."
While Lustig's views may be considered controversial, health experts and doctors agree that Americans, on average, get far more sugar than their bodies can metabolize.
"Sugar occurs naturally, and when we eat it as a sugar in our fruit, it's not necessarily bad for us because it comes with the fiber and the nutrients," said Stephanie Tyo, a physician at UT Physicians of Gladewater. "But when it comes refined from a factory, too much is usually added to our food."
The transition to a sugary diet came as Americans were being warned they were consuming too much fat.
"When they went to the low-fat movement — that everyone decided wasn't a good idea — they added a lot of sugar to replace the fat to make it still taste good."
Dr. Tyo not only educates her patients on the importance of nutrition to avoid disease, but she also helps them adapt to a new lifestyle.
She said one way to avoid added sugar is to eat at home more often and consume foods that come from nature. Learning to read labels is important for the items you get off the shelf.
"If it's in a package in the grocery store and doesn't rot for a year, it's probably not good for you," Dr. Tyo said. "Make sure sugar isn't among the first three things in the ingredient list, and look out for other names of sugar."
She also cautions making purchases based on health claims. For example, juice packaging may boast of vitamins and "not from concentrate."
"Sometimes there's so much added sugar in a juice, and people think they're being healthy, but I just remind them it's got as much sugar as a Coke does," Dr. Tyo said. "The front of the box might say healthy and low-fat, but you flip it over and there's 29 grams of sugar in it."
When getting out of the sugar habit, granulated cane sugar isn't the only thing to be leery of, Dr. Tyo said.
White foods, or simple carbohydrates, can be burdensome for those trying to lose weight or lower the risk of disease.
"Everyone knows about sugar and sweets, which means cookies and cakes, but I have to remind people it's the bread and potatoes and the pasta and the rice and the tortillas that are almost as damaging," she said. "It just breaks down into sugar, and you still get the blood sugar spikes and cravings."
Government agencies now want to ensure that consumers know what's in their food.
For example, the FDA is proposing that labels distinguish between naturally occurring sugars and added sugar.
Citing an Institutes of Medicine report, the FDA said "although added sugars are not chemically different from naturally occurring sugars, many foods and beverages that are major sources of added sugars have lower micronutrient densities compared to foods and beverages that are major sources of naturally occurring sugars."