You could fill a small library with books decrying the harms of sugar: Sugar Busters!, The Case Against Sugar, and perhaps most scorchingly, Hooked: Food, Free Will, and How the Food Giants Exploit Our Addictions. Add that to a number of TikToks extolling the benefits of “quitting sugar,” which have garnered over five million views in a single video. Plus, endless pages of Google search results advise you on how to go “no sugar.” Allow us to let you off the hook. Experts increasingly say that it's important to distinguish between a zero-sugar diet, a zero-added-sugar diet, or a low-sugar diet.
Sugar is an extremely ripe topic for reasons of health, history, and even conspiracies. In the 1960s, Big Sugar made the savvy decision to fund—without disclosing—research that myopically focused on fat and cholesterol as risk factors for coronary heart disease while downplaying sugar’s role, according to a 2016 review published in the Journal of the American Medical Association and detailed in The Case Against Sugar.
Now, there are many good reasons to limit sugar intake. Americans consume much more than medical professionals recommend, and many of our daily prepared foods and condiments have more sugar in them than we might realize. Given this, it’s tempting to go on a zero-sugar diet until you realize that entirely avoiding sugar is not possible or advisable.
Instead, as medical professionals point out, it is worth limiting a specific kind of sweetness: added sugar, sometimes called “free sugar,” which is found in everything from salad dressing to granola.
The type of sugar you consume matters
“One should note that there is a difference between added sugars and naturally occurring sugars in food,” Grace Derocha, registered dietitian nutritionist and national spokesperson for the Academy of Nutrition and Dietetics, tells GQ.
When people think sugar, they usually think about sucrose, says Dr. Robert Carpenter, a Texas A&M School of Medicine clinical professor. “More commonly called table sugar, this disaccharide comprises a glucose molecule and a fructose molecule bound together. This is but one example of a broad set of important substances known as simple carbohydrates.” He explains that simple carbs, like those found in soda and candy bars, are easily absorbed and utilized by our cells as a highly efficient energy source. (By contrast, complex carbs like beans, rice, and oatmeal are absorbed more slowly over time.)
The health risks of excessive sugar
There can be health risks associated with excess sugar consumption. The most serious ones, Derocha says, include type 2 diabetes, certain cancers, tooth decay, and nonalcoholic fatty liver, among others.
An umbrella review published in the British Medical Journal (BMJ) found “significant harmful associations” between dietary sugar consumption and dozens of negative health outcomes, including “18 endocrine/metabolic outcomes, 10 cardiovascular outcomes, seven cancer outcomes, and 10 other outcomes (neuropsychiatric, dental, hepatic, osteal, and allergic).”
Sugar can be a leading cause of inflammation and risk for chronic disease affecting systems throughout our bodies, Carpenter says, noting mounting evidence that “excessive intake of simple sugars may be related to an increased risk for developing certain types of cancer.”
How much added sugar is too much?
Added sugar, as the name implies, refers to sugar that is introduced to food during cooking, baking, or processing: that could be the brown sugar in a cookie, the high fructose corn syrup in a bottle of orange juice, or the tablespoons of white cane sugar added to a coffee before drinking it. Men should consume no more than nine daily teaspoons of added sugar, while women should have just six teaspoons per day, Derocha says, citing the American Heart Association’s recommendations.
Meanwhile, the U.S. dietary guidelines recommend limiting added sugar consumption to less than 10% of their daily calorie intake. For a 2,000-calorie diet, that would be a target of less than 12.5 teaspoons of sugar, according to Derocha.
The BMJ umbrella review goes even further, recommending an upper limit of six teaspoons per day (25 grams) and only one serving of sugar-sweetened beverages weekly.
Where is all the added sugar coming from?
The lead drivers of excess sugar consumption are, according to Derocha, “sugary drinks from soda to sugary coffee drinks and everything in between—candy, desserts, baked goods, ice cream, sugary cereals,” as well as the hidden sugars in pre-made smoothies, fruit juices, yogurt, ketchup, BBQ sauce, salad dressings, bread, and other pantry staples.
“Sweetening agents are commonly added to thousands of processed products across our food system—even those that we don’t traditionally categorize as ‘sweet,’” says Heather Hodson, RDN, CDN, CDCES, a clinical nutritionist at NYU Langone’s Center for the Prevention of Cardiovascular Disease.
In a world where convenience is key, Hodson explains it can be easy to unknowingly reach for products containing these hidden sugar forms. “To make it even more confusing,” she says, “these sweetening agents are listed on the ingredients list as products that we might not automatically associate with being “sugar:” corn syrup, barley malt, dextrose, crystalline fructose, brown rice syrup, and evaporated cane juice are just a few examples.”
Don’t try to avoid all sugar
Just because you’ve read about all the dangers of added sugar doesn’t mean you should throw everything with a sugar molecule out of the window. You won’t have much luck. “Honestly, it is virtually impossible, very impractical, and potentially risky to exclude ‘sugars’ from one’s diet entirely,” says Dr. Carpenter. However, he does recommend significant limitations on the amount of simple carbs for most people, “especially those with chronic inflammatory conditions and metabolic diseases like diabetes.”
Trying to cut out sugar entirely is impractical because it exists in many foods that are good for us. Eating whole foods with naturally occurring sugar, such as fruits, vegetables, and dairy, “is an important component of a balanced and nutritious diet and can actually assist in reducing the risk of chronic disease,” says Hodson.
Derocha never recommends a truly zero-sugar diet “because this would cut out the natural sugars one might find in fruit, starchy vegetables, milk, plain yogurt, and more.”
How to dial back added sugar
The essential key, Carpenter says, is focusing on total carbohydrate intake relative to energy expenditure, according to your age (which affects your metabolism) and level of activity. Being mindful of the specific types of sugars you're consuming is also important, as naturally occurring sugars in fruits and vegetables are not the same as processed and refined sugars.
Derocha says you can cut back on added sugar in fairly low-lift ways. Daily coffee drinkers might reduce the amount of sugar they add by substituting spices like cinnamon, nutmeg, or allspice in their coffee that provide a sweet flavor.
In baking, try easing up on the sugar while experimenting with extracts like vanilla, almond, orange, or ube, which can reduce total added sugar. She recommends you “play with the ratios so it does not have to be overly sweet.”
Cutting out drinks with added sugar, such as soda, pre-mixed coffee drinks, sports beverages, and certain smoothies and juices, can make a big difference. Hodson also advised swapping out sweetened beverages for alternatives as a simple step.
Going the DIY route can also curb added sugar. For example, Derocha suggested adding fruit to plain yogurt or using fruit to sweeten plain oatmeal instead of buying pre-packaged, sweetened versions. That might sound boring, but it’s much better—and easier—than forgoing sugar altogether. If you can prepare your own salad dressings, marinades, and sauces at home—which Hodson notes is often easier than you think—it can help you avoid “sweetening agents that are often added during processing.”
Carpenter says that taking a moment to read the packaging of our foods can lead us to more informed decisions about all parts of our diet, including sugars. Being observant at the grocery store can also uncover unnecessary hidden sugars, and Derocha recommends reading the labels to watch out for extra added sugars that can be found in many different foods. For example, prepared pasta sauce varies in added sugar by brand and variety, even if you aren’t able to taste the difference. “The Nutrition Facts Label now has a separate line identifying Added Sugars, which is an extremely helpful tool for consumers looking to lower their added sugar intake,” says Hodson.
If you want to boil it down to one refrain: Aim not for zero sugar, but rather, try a low-sugar diet, which can be a more sustainable approach.