When we think about foods that raise cholesterol, we normally think of those that are heavy in saturated fats. And while it’s true that these foods, along with those high in trans fats, do increase bad (LDL) cholesterol levels more than others, they certainly aren’t the only factor worth paying attention to.

Americans consume an estimated 20 teaspoons of sugar each day, on average, according to the American Heart Association (AHA). Of course, consumption rates vary from person to person, but there’s little doubt that these empty calories are impacting our health.

Research Links Sugar and Cardiovascular Disease

One study is frequently cited as proving the effects of sugar on cholesterol levels. Researchers found that sugar consumption raised several markers for cardiovascular disease.

They determined that people who consumed more added sugars had lower “good” cholesterol, or high-density lipoprotein (HDL). HDL actually works to take up extra “bad” cholesterol, or low-density lipoprotein (LDL), and transport it to the liver. So, we want our HDL levels to be high.

They also found that these people had higher levels of triglycerides. Either one of these factors can increase your risks of heart disease.

Triglycerides are a type of fat where levels increase after eating. Your body is storing calories that you aren’t using for energy at the moment. Between meals, when you need energy, these triglycerides are released from fat cells and circulate in the blood. According to the Mayo Clinic, you’re likely to have higher triglyceride levels if you eat more than you burn, and if you consume excess amounts of sugar, fat, or alcohol.

Like cholesterol, triglycerides don’t dissolve in blood. They move around your vascular system, where they can damage artery walls and cause atherosclerosis, or the hardening of arteries. This is a risk factor for stroke, heart attack, and cardiovascular disease.

Controlling Your Sugar Intake

The World Health Organization recommends getting no more than 10 percent of your calories from sugar, or even as low as 5 percent, to improve health. The AHA similarly recommends that women get no more than 100 calories each day from added sugars, and men no more than 150 calories — that’s 6 and 9 teaspoons, respectively. Unfortunately, that’s far less than what they estimate that most Americans are getting now.

For perspective, 10 large jellybeans contain 78.4 calories from added sugars, or about 20 grams of sugar (4 teaspoons), which is nearly your entire allowance if you’re a woman.

Learn to recognize sugar on food labels. Sugar won’t always be listed as such on food labels. Ingredients like corn syrup, honey, malt sugar, molasses, syrup, corn sweetener, and any words ending in “ose” (like glucose and fructose) are added sugars.

Find worthwhile substitutes. Not all sugar substitutes are created equal, and some have their own risks. Stevia is one plant-based sweetener that is a true sugar alternative, unlike agave and honey, which still contain sugar molecules.

Just like you monitor your consumption of alcohol, calories, and saturated fats, you should monitor your sugar consumption. There’s nothing wrong with occasional treats, but the effects of sugar could be hard on your heart.