You've probably seen that commercial - the one where a mother sadly contemplates the mountains of sugar her family consumes daily. Her children pile it on their cereal, then snack on sugar-laden treats washed down with corn syrup-based beverages. Even the teaspoonful or so she dusts over her grapefruit adds up to immeasurable mounds of empty calories.

Then we see her shake off this disturbing image. The scene changes - her family enjoys all of their usual treats, but the dreaded sugar is replaced with a name-brand artificial sweetener. The happy family radiates good health.

The truth is, Americans do consume refined sugars in astonishing amounts; one estimate calculates that the average American downs 135 pounds of sugar annually. For a quick visual, that's 27 5-lb bags of Domino's Crystals per person, every year. Obviously, companies who market sugar substitutes have a vested interest in vilifying sugar. But is it really that bad for us? Is sugar responsible for the current obesity epidemic, and are we better off using sugar substitutes?

To answer these questions, we need to understand how the body processes sugar. Sugars are the body's primary source of energy, and they exist in two different forms:

- Simple carbohydrates, such as table sugar, corn syrup, honey, molasses - even fresh fruits contain simple

sugars. On food labels, sugars are often listed as '-oses' (glucose, sucrose, fructose, maltose,

dextrose, etc.).

- Complex carbohydrates, which are found in cereals, whole grains, and starchy vegetables.

All carbohydrates are metabolized into simple sugars. These are absorbed into the blood stream, triggering the release of the hormone insulin. The insulin instructs our cells to convert the sugars to energy.

The difference between simple and complex carbohydrates is that simple sugars are absorbed rapidly, causing blood sugar levels to spike. Complex carbohydrates take much longer to digest, making it easier for the body to regulate their absorption.

What are the health consequences of too much sugar?

Consuming refined sugars in large quantities causes a sharp rise in blood sugar levels, followed by a quick decline. Eventually, this cycle may impair the function of the pancreas, the organ which secretes insulin. This is a primary factor in type 2 diabetes.

Foods with a lot of added sugar, such as cookies, cakes, frozen desserts, candy, sodas, and non-carbonated soft drinks, are high in calories but offer little nutrition; these foods are a direct cause of obesity, which often leads to heart disease, cancer, and diabetes.

Refined sugar causes brain inflammation, depletes tryptophan, slows thyroid function, depletes testosterone in men and contributes to insulin resistance and dementia.

Too much sugar also causes tooth decay; cavities are alarmingly common among young children. While cavities in baby teeth may not seem like an overwhelming concern, if left untreated they can have harmful long-term consequences, including tooth loss, mouth pain, abscesses, and cosmetic issues.

To complicate things further, sugars often appear where they are least expected. Aside from the obvious culprits like sweets and soft drinks, sugars commonly lurk in these food items:

- So-called 'healthy' cereals;

- White bread;

- Crackers;

- Cured meats;

- Pre-packaged meals;

- Condiments like ketchup, mustard, and salad dressings.

If refined sugar presents such a pervasive health risk, then aren't we better off using sugar substitutes? They provide the sweetness we want without all the calories. Many reduced-calorie treats are made with artificial sweeteners, luring dieters and calorie-counters with this so-called healthier alternative.

Actually, artificial sweeteners come with their own laundry list of health risks. Sugar substitutes such as aspartame, sucralose and saccharine are chemically derived food additives containing such appetizing substances as bleach. Although researchers do not yet know the full extent of the damage they may cause, studies have linked artificial sweeteners to cancer, brain damage, and genetic mutations. Not exactly a healthy choice!

If this is not enough to deter you from sugar substitutes, these chemicals have been shown to alter brain chemistry so that it no longer associates sweetness with calories, thereby encouraging overeating. Combined with inherent metabolic deterrents, these substances actually contribute to weight gain.

Since there are no nutritive benefits to outweigh the risks of consuming sugar substitutes, what to do?

The keyword is moderation. Avoid eating processed foods and consuming sugary beverages, especially soda, and limit sweets. Use applesauce or torbinado sugar in baked goods.

As long as you are eating plenty of foods that are good for you, including fresh fruits and vegetables, whole grains, and lean protein, a tablespoonful of sugar here and there is not going to cause you any harm.