Sugar is the source of all health and wellness evils in the U.S. today. Or, at least, that’s what you might reasonably conclude from the chorus of anti-sugar sentiments that’s been ringing loud and clear for years now.
While demonizing any single food group or nutrient is always more harmful than helpful, it’s also true that average sugar intake is a real public health concern, according to most major health organizations and medical experts.
“People are very concerned about sugar right now, which is a valid concern given most of us do eat too much of it,” Whitney Linsenmeyer, Ph.D., R.D., nutrition and dietetics instructor in the Doisy College of Health Sciences at Saint Louis University and spokesperson for the Academy of Nutrition and Dietetics, tells SELF.
So it’s not surprising that it’s hard to discern how warranted our fear of sugar actually is. We’re here to bring some much-needed rationality to the dizzyingly hyped-up sugar conversation.
All sugar is sugar…kind of.
First, a brief science lesson: There are basically two broad categories of sugars: naturally occurring and added. Naturally occurring sugars are intrinsic to the foods they are found in, typically dairy products and fruits. These sugars generally come in more modest amounts, and alongside a plethora of other good-for-you nutrients like fiber or protein, board-certified health and wellness coach Kim Larson, R.D.N., tells SELF.
The real focus of the current anti-sugar frenzy is added sugars, which are put into packaged foods during processing. They come in many forms, familiar (brown sugar, honey, granulated sugar) and not (maltose, corn syrup solids, anhydrous dextrose). This made them hard to distinguish from naturally occurring sugars on food ingredients labels until the FDA started requiring food manufacturers to list added sugars separately from total sugars on the nutrition facts label.
Added sugars are “ubiquitous in our food supply,” Larson says. They actually show up in relatively small amounts in many items we don’t consider “sweets” in order to enhance or balance the flavor profile. “Sugar plays a really important role in how foods taste,” Colleen Tewksbury, Ph.D., M.P.H., R.D., a senior research investigator and bariatric program manager at Penn Medicine and president-elect of the Pennsylvania Academy of Nutrition and Dietetics, tells SELF. In this way, added sugars can actually play an important role in helping us incorporate nutritious foods into our diets by making them tastier. “A granola bar or a yogurt without any added sugar probably isn’t going to taste very good,” Tewksbury points out
The good news is that these sources of added sugar are not the ones that most nutrition experts and health organizations are taking fire at, even though they’ve gotten swept up in the anti-sugar crusade. “There are people who are very health-conscious coming to me worried about the added sugar in tomato sauce or yogurt,” Tewksbury says. “But that’s not the source of added sugars that major organizations and dietitians are worried about.”
What experts are sounding the alarm on is the foods and beverages that offer sugar (and calories) in high concentrations, and not much else. Added sugars in and of themselves are not unhealthy—in fact, they’re the same as naturally occurring sugars in terms of their chemical structure and how the body processes them. It’s the large amounts of added sugar and the nutrition-lacking foods people regularly consume them in that are an issue.
“These products that are basically nothing but added sugar in high concentrations and little other nutritional value are the sources of the vast majority of the added sugar individuals consume,” Tewksbury says. According to the Dietary Guidelines, the top offenders by far are sugary beverages (sodas, fruit drinks that are not 100 percent fruit juice, sports drinks) and processed sweets (cookies, candies, pastries, ice cream). These two categories alone—the “heavy hitters,” as Tewksbury calls them—account for over 75 percent of the added sugars in the American diet.
Here’s how much sugar health experts want you to stick to—and why.
Currently, most Americans are eating more sugar than recommended. The 2015-2020 Dietary Guidelines, created by the U.S. Departments of Health and Human Services (HHS) and of Agriculture (USDA) advise capping your daily added sugar intake at 10 percent or less of your total calories. So if you eat about 2,000 calories a day (we’re using this very general number just for math’s sake), the recommendation is to aim for under 200 calories worth of sugar every day, or 50 grams. But in reality, Americans are eating on average about 67 grams of sugar per day, accounting for about 270 calories or 13 percent of your daily caloric intake (if you were eating 2,000 calories a day).
Similarly, the World Health Organization (WHO) recommends keeping consumption of “free sugars” (which includes everything that falls under added sugars, plus sugars from 100 percent fruit juice) at 10 percent or less of caloric intake. But WHO goes further, asserting that reducing intake of free sugars even further, to 5 percent or less of caloric intake, would offer additional health benefits. No matter the exact number you go by, the general spirit of these recommendations is clearly that “most of us could probably stand to cut back a little bit,” as Tewksbury puts it.
Broadly speaking, these recommendations are based on the fact that A) High added sugar intake over time is associated with negative health outcomes, and B) Most people are eating high amounts of added sugars. According to the Centers for Disease Control (CDC), consuming too much added sugars is associated with cardiac and metabolic health issues like obesity, type 2 diabetes, and heart disease. Multiple studies have found that some of the strongest evidence for the relationship between sugar consumption and weight gain, diabetes, and heart diseaseapplies to added sugar that comes from sugar-sweetened beverages only—the source of 47 percent of added sugar intake in the U.S.
It’s important to note here that studying nutrition in the real world is always complicated business. There’s little in nutrition science that is 100 percent settled yet (and few findings that haven’t been challenged or disproven over the years). We could debate the merits of various studies all day, but there are two main things to take away from all this sugar data: First, the body of evidence demonstrates that there is definitely a correlation between excessive added sugar consumption and poor health outcomes. Second, we can’t totally prove a cause-and-effect association between the two. The studies that point to this link are mostly observational, meaning they take place in the complex and messy real world where there are a million variables in play—not a neat, controlled lab setting.
For instance, some research suggests it may be the excess calories from sugar that’s behind these negative health effects, as opposed to the sugar in and of itself. There’s also the intuitive possibility that consuming large amounts of products that are made up of primarily added sugar regularly “can crowd out other healthful foods that have the nutrients our bodies need,” Larson points out. And that may play a role in overall health outcomes.
So, really, how much time should you spend thinking about your sugar intake?
There are a couple points to keep in mind when you’re trying to bridge the gap between these public health concerns and what you need to be worried about.
One is the understanding that dietary guidelines are based on average trends observed across large populations over long periods of time. People are so different from one another, and there are so many factors when it comes to the complex picture of your overall health—getting enough sleep and exercise, managing stress, and more—that it really just doesn’t make sense to single out one aspect of health that every individual should obsess about. (This is also a good time to point out that, obviously, people with certain medical conditions—prediabetes, type 1 diabetes, and type 2 diabetes—have to manage their blood sugar, and therefore may think about the role of added sugar in their health differently than people without diabetes.)
The second thing to keep in mind is that added sugar is not an all-or-nothing proposition here. While regularly eating large quantities of sugar-dense foods is associated with numerous poor health outcomes, eating a moderate amount of sugar is not inherently a horrible idea like, say, smoking cigarettes. “We really don’t have enough data to say added sugar is as a whole ‘toxic,’” Tewksbury says.
There’s absolutely nothing wrong with enjoying foods with added sugar. “Sweet foods taste great,” Tewksbury says, “and they can be a part of a healthy diet.” And even if you don’t have a sweet tooth, it’s really hard to avoid added sugar in the food supply today, as Tewksbury points out. So there’s truly no need to Marie Kondo even the sugariest foods out of your life.
Keeping those things in mind, it’s fair to say that ultimately, it’s all about context when it comes to how you look at added sugar. “It’s primarily about how much added sugar you’re having, how often, and what you are eating the rest of the time,” Tewksbury says. As long as you are eating a generally nutrient-rich and varied diet, the exact number of grams of sugar you’re eating probably isn’t worth stressing about. “The hard-and-fast [recommendation] isn’t as important as things like making sure you’re getting in your fruits and veggies or getting enough fiber,” Tewksbury says.
By the same token, if you’re looking at your diet holistically (and all the other factors playing into your health) and realizing the amount of added sugar you are eating may be making you feel crappy in some way, then it can’t hurt to experiment with cutting back here and there just to see how you feel. For example, you might be filling up on added sugar snacks to the point that you’re missing out on, say, the fruits and nuts you’ve been trying to eat more of to get more vitamins and protein in your diet. Or maybe you reliably experience hunger pangs and an energy crash a few hours after your morning pastry. Or, if you’re trying to watch your caloric intake for whatever reason and having a tough time doing so, cutting back on simple sugar intake is a helpful tactic for many people, Tewksbury points out.
But again, remember that added sugar is just one part of your diet, and your diet is just one part of your health, so tracking or reducing your added sugar intake might not necessarily make sense for you. “Let’s say someone I’m working with is achieving whatever they perceive to be their health goals—being able to run a marathon or having more energy or losing weight,” Tewksbury says. “If sugar isn’t an issue or cutting sugar isn’t a priority for them, it may not be something we even talk about.”
It’s definitely tempting to pin all of our woes on sugar. The idea that there’s one thing we need to remove from our diets to achieve optimal health is so appealing that we, as a society, keep buying into this kind of magical thinking every few years, merely swapping in one target (fat, cholesterol, gluten) for another. “I think we’re always going to demonize one nutrient or food and praise another,” Tewksbury says. “Right now, we love fat and hate sugar. But I think that will shift with time.”
Ultimately, a serving of common sense goes a long way towards tempering the heated discussion around sugar—and the mental energy you spend thinking about it.