Sugar has always been ingredient non grata among the medical community - and your mother.

Rotten teeth and extra pounds were the biggest concern. Research now shows that high-sugar diets also can increase the risk of heart disease.

A study released in 2011 by the American Heart Association showed that women who drank just two or more sugar-sweetened beverages a day had larger waists along with a greater risk of diabetes and higher triglycerides, which increases the risk of heart attack.

Sugar has been on the rise in people's diets the past two decades. Today, the average American consumes more than 76 pounds of sugar a year, according to the U.S. Department of Agriculture.

Meanwhile, the amount of "added sugars" in processed foods and beverages continues to rise.

SUGAR AND YOUR HEART

Fructose - a component that makes up about 50 percent of table sugar and of high-fructose corn syrup, and about 40 percent of honey - is the main link between heart disease and added sugars in food, says Cindy Brinn, a registered dietitian and nutrition and diabetes program coordinator at PeaceHealth St. Joseph Medical Center.

The health risk comes from "added sugars" containing fructose, not the small amount of natural fructose in whole fruits, she says.

Brinn says that, unlike glucose, the human body does not use fructose as an energy source. Instead, fructose is sent to the liver, where it is converted to fatty acids and stored as triglycerides in the bloodstream. Triglycerides, while necessary in the body in small amounts, are fats that, in large amounts, can increase the risk of heart attack and stroke.

Agave nectar, which some people consider a natural source of sugar, contains some of the highest amounts of fructose, she adds.

HOW MUCH IS TOO MUCH?

Of most concern to Brinn is research that shows up to 20 percent of American adults ingest more than 15 teaspoons of added fructose each day.

The American Heart Association recommends that adult women consume no more than 100 calories a day from added sugars. That's about six teaspoons of sweeteners, such as table sugar, honey, maple syrup and high-fructose corn syrup.

Men should eat no more than 150 calories a day from added sugars, or about nine teaspoons.

Lift a few heaping teaspoons of sugar into your morning coffee, along with some nondairy creamer that has corn syrup in it, and you may have reached your daily maximum. That's even before you finish your bagel with jam, which might have added sugar.

Studies show that many people consume much more added sugar than they should. According to Brinn, 15 percent of adult men and 21 percent of adult women get more than 25 percent of their daily calories from sugar, with about a third of that sugar coming from beverages like soda.

HIDDEN SUGARS

"Added sugar" - sugar that is added to food products - has increased in the American diet by 25 percent since 1970, but it's difficult to know where those added sugars are lurking.

Products such as bread and prepared tomato sauce often contain added sugars that regular consumers might not be aware of if they don't read the ingredients list. Even then, many processed sugars have names the consumer might not recognize as sugar, including "barley malt," "corn syrup solids," "maltose" and "maltodextrin."

Only recently have some bread companies declared on labels that their product does not contain high-fructose corn syrup. And some fast food manufacturers have been under the gun for adding sweeteners to items such as taco meat.

NATURAL AND LIQUID SUGAR

Brinn says milk sugars, such as lactose, in low-fat products and the naturally occurring sugars in fruit are not something to curb if you want to reduce your sugar intake.

"There's nothing to be worried about when it comes to natural sugars," she says. "What you need to worry about is added sugars."

But sugared sodas and sweetened fruit drinks are another story. The American Heart Association recommends that people consume no more than 450 calories, equal to 36 ounces, of sugar-sweetened beverages a week.

Brinn says sugary sodas and other foods with added sugar edge out nutritious calories from the diet and play a part in the country's obesity epidemic.

KEEP THE SUGAR MONSTER IN CHECK

Brinn suggests that people plan their meals for the week, which will reduce the number of times they reach for quick-and-easy convenience foods that are often high in sugar.

She also suggests that people stay clear of artificial sweeteners or limit them to once a day, because their potential health effects are not fully known.

On the plus side, Brinn says people can satisfy their craving for a daily sweet, as long as it's in moderation.

'Limit sweets to one small serving a day," she says. "It can be sweetened with your choice of a sweetener."

CUT THE SUGAR IN YOUR DIET

Here are seven ways to trim sugar from your meals:

• Eat processed foods, including prepared snacks, less often.

• Eat fruits canned in their own juice rather than in syrup.

• Reduce sugar in recipes by a one-fourth to one-third cup. For example, if a recipe says to use one cup of sugar, use two-thirds of a cup. You likely won't notice the difference.

• Enhance the flavor of foods by using cinnamon, vanilla, cardamom or other sweet-leaning flavorings that don't have sweeteners in them.

• Instead of using a cup of chocolate chips in baked goods, use one-fourth to one-half cup of mini chocolate chips. Or, reduce the chocolate in the recipe and add a quarter-cup of strong brewed coffee or espresso, which enhances the chocolate flavor.

• Buy plain yogurt and sweeten it yourself with a teaspoon of honey or maple sugar and unsweetened fruit.

- Use overripe fruit to top plain oatmeal or dry cereals, or in baked goods. Overripe fruit contains naturally developed sugars.

Ericka Pizzillo Cohen is an Ohio-based freelance writer and former reporter for The Bellingham Herald.