Q: When it comes to how much sugar I eat, should I be more worried about the total amount I eat each day or how much I eat at one time?
A: Both can be a concern, each in different ways. If you eat a lot of high-sugar foods throughout the day that usually means you’re getting extra calories that make weight control more difficult. And gaining excess body fat increases risk of several forms of cancer, as well as diabetes, heart disease and a variety of other health problems. In addition, studies show that people eating a lot of foods with added sugar tend to eat diets low in health-promoting foods that provide fiber and protective nutrients. Note that the focus here is on sugar added to food and drink. Foods containing natural sugar, like fruit and unsweetened milk and yogurt, do provide nutritional value and are not linked to excess weight, in part because they are more filling and less likely to be eaten to excess. How much sugar you eat at one time is also important, especially for people with type 2 diabetes, prediabetes or early stages of insulin resistance, because eating a lot of sugar all at once influences how much your blood sugar surges after you eat. Increases in blood sugar are not from sugar consumption alone, however, as virtually all of the carbohydrate you eat causesa temporary rise in blood sugar. People with these medical conditions or who are overweight (and thus more likely to have insulin resistance without knowing it), can best enjoy small amounts of higher-sugar treats, like a small piece of cake, at a meal that is not already loaded with other carbohydrate-containing foods likely to raise blood sugar, such as mashed potatoes, white bread or white rice. A registered dietitian can guide people with diabetes or prediabetes to identify the pattern for distributing these sugar and non-sugar carbohydrate foods that is best for them.