If you’re reading this, there’s a good chance you need to shake your sugar habit.

According to research from the Centers for Disease Control and Prevention, three out of four Americans consume too much added sugar, with high-fructose corn syrup and other refined sugars making up more than 10 percent of their daily calorie intake. (The government’s current dietary guidelines recommend capping added sugar intake at 10 percent of daily calories.)

Thing is, most people just aren’t aware of how much sugar they’re consuming—or that many of the health-related downers we deal with regularly are actually sugar-related, says neuroscientist Nicole Avena, Ph.D., author of Why Diet’s Fail: Because You’re Addicted to Sugar. And we’re talking issues as serious as life-threatening disease, not just fat gain.

Here are nine surprising signs you’re eating too much sugar—and how to cut back.

1. You Look Older Than You Are

Emerging research shows that the sugar in your bloodstream naturally attaches to proteins or lipids (fats) to form molecules called ‘advanced glycation end products’ or AGEs. These molecules, among other things, are believed to contribute to premature aging, says Rob Danoff, D.O., director of the family residency program at Jefferson Health Northeast in Philadelphia. These aptly-named AGEs can damage skin proteins and break down collagen and elastin, all of which contributes to wrinkles. A 2016 review published in Scientific Reports suggests that AGEs may also contribute to the development of skin spots through the years.

2. Your Cholesterol Is Out Of Control

Excess sugar contributes to inflammation within artery walls and negatively impacts cholesterol and triglyceride levels (both of which are risk factors for heart disease), Danoff says. One 2014 JAMA Internal Medicine study shoes that a diet high in sugar may raise your risk of dying of heart disease, no matter your weight and exercise levels.

3. Your Sleep Stinks

Stop putting sugar in your sleepy-time tea! In one Columbia University study, the people who consumed the most sugar throughout the day experienced the most arousals (periods in which you move out of the deeper stages of sleep) throughout the night. Those who ate less sugar? Fewer sleep disturbances.

4. You’re Constantly Thirsty (And Peeing)

The constant ‘fluids-in, fluids-out’ routine is a hallmark of a chronically high sugar intake, says Danoff. When there is too much sugar floating around in your bloodstream, your kidneys produce extra urine in attempts to flush it out, and you pee more than usual. When that happens, your hydration levels drop, which drives you to then chug more water, starting the cycle all over again. If you’re experiencing these symptoms, Danoff recommends talking to your doctor about testing your blood sugar levels, since excessive thirst and urination can be signs of diabetes.

5. You’re ALWAYS Hungry

Filling up on sugar stokes your appetite. After all, the body digests sugar quickly and churns out the hormone insulin to shuttle that sugar out of the blood stream and into the body’s cells. The quick spike—and drop—in blood sugar can leave you low in energy and hungry enough to snack and snack and snack.

6. You See Your Dentist Far Too Often

You’ve probably heard the ‘sugar rots your teeth’ argument (a dozen times) before. But get this: Research suggests sugar may truly be the number-one driver of tooth decay. One BMC Public Health study notes that about 92 percent of U.S. adults experience tooth decay, while just two percent of Nigerians—who consume an average of two grams of sugar per day—deal with the issue.

7. You’re Anxious Or Depressed

Managing your mental health isn’t as simple as cutting back on sugar, but science suggests the sweet stuff does play a role. For example, one 2017 study out of University College London found that men who ate the most sugar had a 23 percent higher risk of suffering from mental disorders. “People often use foods, including those that have added sugars, to self-medicate or make themselves feel better when something isn’t going well for them,” Avena says. Similar to drugs and alcohol, sugar activates areas of the brain associated with reward and can “lead to changes in the brain that make us want to eat more sugar, and can cause a vicious cycle of overeating, feeling depressed, and overeating.”

8. You Get Sick Often

Throwing back sugar may make it tougher for your body to fight off invaders, with one 2014 National Institutes of Health review linking high sugar intake to poor immunity. Researchers note that a meal’s overall glycemic load (a.k.a. its ability to spike your blood sugar levels) is what seems to suppress immune function, putting meals dominated by carbs or sugar in the hot seat. That’s why Danoff always asks his patients who complain of frequent illness about their diets.

9. Your Brain Feels Like Mush

You know those blood sugar highs and lows that eating a lot of sugary foods causes? Those lows basically deprive your brain of energy, Avena says. But the link between sugar and cognitive issues may go even beyond that. One Nutrients review suggests that, long term, high sugar intake may impair the function of the hippocampus, the part of the brain that regulates memory.

What To Do About It

Do any (or all) of these symptoms sound familiar? Avena’s advice is simple: Just try to cut back. “I know that seems like obvious advice, but most people try to quit cold-turkey and sugar-free, and that just isn’t realistic.”

Related: I Cut Out Added Sugar For Two Weeks—Here’s What Happened

Instead, take a step-by-step approach to reducing sugar intake by swapping out just one major source of sugar in your diet (like fruit juice) for a lower-sugar alternative (like water or tea). “Once that change sticks, make another small substitution,” she says.

If you’re not sure where you’re getting your sugar, chances are it’s from a box, bottle, or jar. Research shows that ultra-processed foods—foods like frozen pizza and soda—are responsible for 90 percent of Americans’ added sugar intake. Fortunately, food manufacturers will soon (well, in 2020…) have to include added sugars on their nutritional labels, which should make finding—and avoiding—it much easier.

Until then, though, look at foods’ ingredient lists for words like high-fructose corn syrup, molasses, agave, evaporated cane juice, honey, turbinado, rice syrup, fruit juice concentrate, or anything that ends in ‘-ose,’ and avoiding those ingredients as much as possible, says Avena.

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