Sugar and Bone Health: What You Need To Know

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Consuming too much sugar can have a negative impact on your bone health. Learn more about why sugar and osteoporosis do not go hand-in-hand.

Disclaimer: If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Well Guide contain information from peer-reviewed research, medical societies and governmental agencies; however, these articles are not a substitute for professional medical advice, diagnosis, or treatment.

We all know that consuming excessive amounts of sugar isn't good for our health. While it's okay to indulge in treats occasionally, prioritizing nutrient-rich foods like fruits, veggies, and lean proteins is key for avoiding chronic disease. Plus, too much sugar can leave you feeling less than great. But here's what you may not realize: sugar might also have a negative impact on your bones.

In this article, you'll learn about sugar and its impact on bone health so you can make healthy choices for your body.

What is Sugar?

Let’s start with the basics: sugar is a carbohydrate that our bodies convert into glucose for energy. When we talk about limiting sugar in our diet, we primarily mean added sugars. These are sugars that are added to foods and beverages during processing or preparation, not like the sugar naturally found in foods like fruit (Rippe, 2016).

Sugar has many other names, which can make it tricky to spot on ingredient labels. Some common forms of added sugars include:

  • High fructose corn syrup
  • Brown rice syrup
  • Dextrose
  • Malt syrup
  • Cane juice
  • Maltose

It’s also worth noting that while some brands may try to sell forms of sugar like maple syrup, agave, or honey as a healthier choice, once you eat them, these types of sweeteners have the same effect on your body as regular sugar.

Sugar and Its Effect on the Body

Sugars are first digested with the help of enzymes in the mouth and then further broken down by stomach acids and even more enzymes. Your body carefully regulates how much sugar stays in your blood. Once sugar leaves the small intestine and enters the bloodstream, it triggers the pancreas to release insulin. Insulin is a hormone that helps move sugar from your blood into your body’s cells to be used for energy (Hantzidiamantis, 2022).

Under normal conditions, the body can handle these fluctuations in blood sugar levels effectively. If this system is out of balance and blood sugar stays high, it can lead to health problems like insulin resistance or diabetes (Li, 2022)

Insulin resistance means the cells don’t respond to insulin as they should or the body doesn’t make enough insulin. Insulin resistance increases the risk of developing type 2 diabetes, heart disease, and other health conditions, but there's also a close connection between diabetes and bone loss. High blood sugar is associated with reductions in bone density and an increased risk of fractures (Montagnani, 2011).

Sugar and Bone Health

Studies have found that sugar-sweetened beverages, like soda, sweetened teas, or fruit juice with added sugar, are associated with significant reductions in whole-body bone mineral density (BMD) (Ahn, 2021). BMD is a measurement of bone strength and is used to measure osteoporosis or osteopenia. Other studies have found that drinking soda is associated with an increased risk of fractures (DiNicolantonio, 2018).

A foundational reason that sugar may contribute to poor bone health is that high-sugar foods or drinks may take the place of other foods that provide important nutrients for bone health. But there may be other factors for the link between sugar and bone health as well. For example, some studies have found that sugar could increase the excretion of essential nutrients (like calcium, magnesium, and potassium) from your body (DiNicolantonio, 2018). These minerals are vital for maintaining strong and healthy bones.

There’s also a close relationship between insulin and bone health, and some research suggests that high insulin levels can interfere with the normal reabsorption of minerals like calcium (Cipriani, 2020). Inflammation, which is often associated with insulin resistance and diets high in refined sugar, is also linked to bone loss and bone resorption (Epsley, 2021).

Sugar and Osteoporosis

Several studies have connected high-sugar, high-fat diets to an increased risk of osteoporosis. Multiple studies have found a connection between a Western diet pattern, which tends to be higher in sugar, to higher rates of osteoporosis and bone fractures in women (Munoz-Garach, 2020).

In other words, there are multiple ways sugar can impact bone health, making it an important factor to consider when assessing the overall risk for diseases like osteoporosis and osteopenia.

How Much Sugar is Too Much?

According to the American Heart Association, women should limit their daily sugar intake to no more than 6 percent of total calories, which is around 100 calories or six teaspoons, on average. For men, the recommended limit is no more than nine teaspoons or around 150 calories per day (AHA, 2021).

The Dietary Guidelines for Americans recommend limiting sugar to no more than 10 percent of total calories. For someone who eats 2000 calories, this equals about 200 calories a day (USDA, 2020).

Either way, it is important to be mindful of your sugar intake and make healthier choices to reduce the potential impact on your bone health.

Common Sources of Sugar

You can find sugar hidden in all kinds of foods, from sauces to dressings and even bread. But, the most common sources of added sugar in the US include (USDA, 2020): 

  • Sugar-sweetened beverages, including sodas, fruit drinks, and energy or sports beverages.
  • Candy and sugars.
  • Breakfast cereals and bars.
  • Sweetened yogurt and milk.
  • Desserts and sweet snacks like cookies, brownies, doughnuts, cake, or ice cream
  • Sandwiches

Sugar Alternatives That Are Better for Your Bones

If you're trying to cut back on sugar but still love a little sweetness, you do have options. Stevia and monk fruit are natural sweeteners that have become more popular in recent years. They add a sweet flavor without any additional calories or impact on blood sugar levels.

Another option is to use whole fruits like berries, dates, and bananas to naturally sweeten foods and beverages. These options also provide added nutrients like vitamins, minerals, and fiber, which can benefit bone health.

The Bottom Line on Sugar and Bone Health

Sugar can have a negative impact on bone health if consumed in excessive amounts. Try to limit your intake of added sugars while including a variety of nutrient-rich foods in your diet. If you have a sweet tooth, consider using natural alternatives or incorporating whole fruits for added sweetness and nutrients.

If you find it challenging to cut back on sugar, try gradually reducing your intake and replacing it with healthier options. Small changes to your diet and lifestyle can add up and make a positive impact on your overall health and bone strength (and many people find that completely cutting sugar can lead to cravings and over-indulging later on). Ultimately, balance and moderation are key to maintaining a healthy diet for strong bones. 

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References

  1. Added Sugars. American Heart Association. November, 2021. Accessed October 6, 2023. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/added-sugars 
  2. Ahn H, Park YK. Sugar-sweetened beverage consumption and bone health: a systematic review and meta-analysis. Nutr J. 2021;20(1):41. Published 2021 May 5. doi:10.1186/s12937-021-00698-1
  3. Cipriani C, Colangelo L, Santori R, et al. The Interplay between bone and glucose metabolism. Front Endocrinol (Lausanne). 2020;11:122. Published 2020 Mar 24. doi:10.3389/fendo.2020.00122
  4. DiNicolantonio JJ, Mehta V, Zaman SB, O'Keefe JH. Not Salt But Sugar As Aetiological In Osteoporosis: A Review. Mo Med. 2018;115(3):247-252.
  5. Epsley S, Tadros S, Farid A, Kargilis D, Mehta S, Rajapakse CS. The Effect of Inflammation on Bone. Frontiers in Physiology. Published 2021 Jan 5;11:1695. doi: 10.3389/fphys.2020.511799 
  6. Hantzidiamantis PJ, Lappin SL. Physiology, Glucose. In: StatPearls. Treasure Island (FL): StatPearls Publishing; September 19, 2022.
  7. Li M, Chi X, Wang Y, Setrerrahmane S, Xie W, Xu H. Trends in insulin resistance: insights into mechanisms and therapeutic strategy. Signal Transduct Target Ther. 2022;7(1):216. Published 2022 Jul 6. doi:10.1038/s41392-022-01073-0
  8. Montagnani A, Gonnelli S, Alessandri M, Nuti R. Osteoporosis and risk of fracture in patients with diabetes: an update. Aging Clin Exp Res. 2011;23(2):84-90. doi:10.1007/BF03351073
  9. Muñoz-Garach A, García-Fontana B, Muñoz-Torres M. Nutrients and Dietary Patterns Related to Osteoporosis. Nutrients. 2020;12(7):1986. Published 2020 Jul 3. doi:10.3390/nu12071986
  10. Rippe JM, Angelopoulos TJ. Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding. Nutrients. 2016;8(11):697. Published 2016 Nov 4. doi:10.3390/nu8110697
  11. Dietary Guidelines for Americans, 2020-2025. 9th Edition. U.S. Department of Agriculture and U.S. Department of Health and Human Services. December 2020. Accessed October 6, 2023. https://www.dietaryguidelines.gov/

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