Many people try not to eat too much sugar, yet it is added to so much food and drink, it is hard to avoid. It goes by more than 50 different names on labels, is present even in seemingly savoury products and the alternatives are confusing and controversial. So is the sweet stuff addictive – and should you cut it out completely?

What exactly is sugar?

We’re all familiar with the stuff you put in your tea or coffee – table sugar (sucrose), made from refined sugar cane or sugar beet. But sugar is a broader term for a simple carbohydrate found naturally in fruits and some vegetables (fructose, glucose and sucrose), dairy products (lactose) and malted grains (maltose).

Is it bad for me?

Not in whole foods such as fruit, veg, milk and plain yoghurt. “These foods offer so many nutrients that are important for overall health,” says Sammie Gill, a senior scientist at the British Nutrition Foundation (BNF). “Fruit has vitamin C, fibre and phytochemicals and milk contains calcium, protein and vitamin B12. You can’t compare a piece of fruit to a bag of sweets or a glass of milk to a can of cola.” Most of us would benefit from more fruit in our diets, not less.

So what kind of sugar should I limit?

“Free” sugars, which means all sugars added by the manufacturer, the cook or the consumer. The usual suspects are fizzy drinks, biscuits, cakes and chocolate.

That seems pretty obvious.

It also includes alcoholic drinks, fruit juices and smoothies (free sugars are released during the juicing process), many breakfast cereals, flavoured yoghurts, sauces and condiments, and a host of other processed food. Or anything with a label featuring the words syrup, nectar, molasses, treacle, words ending in “ose”, such as dextrose, fruit juice concentrate/puree, honey …

Surely honey is OK?!

“Honey often carries a reputation for being healthier than white sugar – it has a strong health halo,” says Gill. “In reality, while honey contains small amounts of vitamins and minerals, the amount is minimal and too low to provide meaningful health benefits.”

So that “healthy” snack containing honey (or maple syrup, or agave nectar) is no better than a chocolate bar? “Ultimately, sugar is still sugar,” says Gill. “There are more than 50 names for it, and while some may sound more natural or healthier, the body processes them in much the same way.”

Manuka honey has traditionally been used to treat wounds, insect bites, burns and other skin conditions, but studies are inconclusive. Public Health England and the National Institute for Health and Care Excellence recommend the occasional use of honey to treat acute coughs and avoid unnecessary antibiotics, but warn that it is still a sugar and can contribute to tooth decay.

Any other surprising sources of sugar?

The Food Foundation’s annual Broken Plate report, which was published last week, found that 74% of baby and toddler snack products contain high or medium levels of sugar, even those with “no added sugar” claims. This is because many include fruit purees. Last year, a report by Action on Sugar found that 68% of “healthy” snack bars sold in the UK – those marketed as high fibre, high protein and/or low sugar – would carry a “high in sugar” warning label in Chile, which has a mandatory labelling system. It also warns that many milk substitutes, such as rice, almond and soya milks, often contain added sugar.

I’ve got a really sweet tooth. Can’t I have some free sugars?

Of course – it is extremely difficult to eliminate all added sugar, and there is very little evidence to suggest you should. After a 2014 review, the official guidance from the WHO and the American Heart Association is that added sugar should make up no more than 10% of your daily calorie intake (200kcal/50g/12 tsp). The UK goes further: based on a 2015 report by the Scientific Advisory Committee on Nutrition (SACN), the NHS says free sugars should be limited to just 5% of calories (30g/seven cubes). The British Heart Foundation puts that in context: “A standard chocolate bar equals 25g of free sugar and a 330ml can of cola equals 35g of free sugar.”

I’m guessing not many people stick to the 30g limit then?

Nope – Britons eat about twice as much as they should, according to the BNF. That is understandable when 30g of sugar equates to a small glass of fruit juice and a flavoured yoghurt – add in a pastry or a bowl of cereal and breakfast alone could be double your daily limit. Children aged four to 18 consume the most sugar (about 12% of their daily calories), with soft drinks as the main source among over-10s. For adults, the main offenders are soft drinks and alcohol combined. Other major sources include breakfast cereal, confectionery, table sugar, fruit juice, biscuits, buns, cakes and pastries.

In a 2023 review, Australian researchers found that global sugar consumption has gone down a little since the turn of the century, but remains high and well above the recommended limits. For example, daily sugar consumption declined from 96.6g to 72.3g per person in the US between 2001 and 2018, but only among adults under 50.

And all this sugar is rotting our teeth?

Yes – especially sugary soft drinks. “Sugar interacts with certain types of bacteria in the mouth to create acids that weaken tooth enamel. Drinking more sugary drinks is linked with a higher risk of cavities,” says Gill. Conversely, “Consuming dairy products that naturally contain lactose provides protective effects against cavities, largely due to the presence of calcium and phosphate, as well as milk proteins such as casein.”

The British Dietetic Association (BDA) advises against drinking fizzy drinks frequently, and drinking fruit juice and smoothies only in small portions (up to 150ml a day) with a meal, not as a snack. It says that while “diet” soft drinks contain sugar-free sweeteners, “most are still acidic enough to harm your teeth if you drink them too often”.

What are the other health risks?

As well as tooth decay, perhaps unsurprisingly the 2015 SACN report found that high intakes of sugar are associated with greater risk of obesity. In Greece, the Hellenic National Nutritional Health Survey (2013-15) found that children consuming more than 10% of their calories from added sugars were 2.57 times more likely to be overweight or obese than those consuming less than 10%.

Action on Sugar says there is also a possible link between excess sugar and high blood pressure, some cancers and non-alcoholic liver disease.

Why are sugary drinks so bad?

“Sugary drinks are generally more problematic because it’s very easy to consume a large quantity of sugar very quickly,” says Gill. Numerous studies have shown that sugary drinks promote weight gain and are linked with various medical conditions. They include the Framingham Heart Study in Massachusetts, which began in 1948 and is on its third generation of participants, and has found that people who drink lots of sugary drinks have significantly more liver fat, less “good” (HDL) cholesterol, and more “bad” (LDL) cholesterol and triglycerides. Other research has found a positive association between soft drink consumption and the risk of type 2 diabetes.

In 2024, an observational study by Lund University of 70,000 Swedes found that sugary drinks had a stronger link to cardiovascular disease than any other form of sugar. The group that drank the most had a significantly increased risk of ischaemic stroke, heart failure, atrial fibrillation and abdominal aortic aneurysm. The researchers said: “Liquid sugar is likely to be less satiating than sugar that is eaten in solid form. This can potentially lead to overconsumption, increasing calorie intake and blood sugar levels.”

Does sugar also affect my mood?

Quite possibly – perhaps even your cognition. The Australian review found a growing body of research has observed “long-lasting impacts of chronic excessive sugar intake on memory, mood, object recognition and concentration”. Correlations have been found between diets high in sugar and depression, anxiety, stress, hyperactivity and behavioural issues. Some studies have shown that drinking lots of sugary drinks while pregnant or breastfeeding is inversely related to “childhood cognitive performance and social-emotional development”. Finally, the researchers say, “the current evidence strongly indicates a major role for refined sugars in cognitive dysfunction and dementia”.

What does it do to my gut?

This is an emerging area of research, but so far sugar has been associated with dysbiosis (disruption) of the gut microbiome. Dysbiosis in turn has been linked with obesity, insulin resistance and non-alcoholic liver disease.

Is sugar addictive?

Kawther Hashem, a senior lecturer in public health nutrition at Queen Mary University of London and the head of research and impact at Action on Sugar, says it is not an addictive substance as such, like nicotine. However, some people may display addictive behaviour, such as bingeing and withdrawal. “We are habituated to having sugar,” she says. “It is in food we find pleasurable, so it’s difficult to have less.” Sugar can increase dopamine and inhibit ghrelin and leptin, reducing the feeling of being full.

Emotions and culture play their part, too. “Our attachment to sugar starts so early – at any children’s birthday party, people will be confused if you don’t want your child to have a slice of cake,” says Hashem. “In so many cultures, we show love through sugary foods. They are given as treats for good behaviour – not long ago, lollipops were even given to children at the dentist!”

So how can I cut down?

Gradually, says Gill. “Cutting something out completely straight away is often hard to sustain. If you usually have a teaspoon of sugar in your tea or coffee, try half a teaspoon and go from there. Swap fizzy, sugary drinks for fizzy water with fruit or a low-sugar kombucha.”

Some people are more susceptible to sugar than others, but everyone can retrain their palate to some extent. “Your taste for sweetness is influenced by your genetics (non-modifiable) and the environment (modifiable),” says Gill. “Choosing lower-sugar options can help the taste become more acceptable. Adjustment happens with repeated exposure, so it takes a bit of time and persistence.”

There’s nothing wrong with an occasional treat, says Hashem – as long as it genuinely is occasional. Supermarkets and food companies want us to treat ourselves all the time: “Every season, every festival, is a marketing opportunity for sugary foods. Easter food is on the shelves straight after Christmas,” she says.

The BNF suggests some simple swaps: instead of sweet snacks, fresh fruit or savoury snacks such as wholegrain crackers with cheese; natural yoghurt with fruit instead of flavoured ones; sugar-free nut butters instead of jam or chocolate spread. It also advises focusing on what you can eat more of: vegetables, pulses and wholegrains. The FoodSwitch app, available in nine countries, allows you to scan barcodes in supermarkets and recommends lower-sugar alternatives.

Doesn’t the UK have a sugar tax?

Yes, the soft drinks industry levy was implemented in 2018, taxing drinks with added sugars. From 2028, it will cover some sugary milk-based drinks too, which were originally exempt. Drinks manufacturers have since reduced sugar content by an average of 47%. “The levy was a positive step forward, yet the food environment is complex and will require a broader overhaul to drive meaningful change,” says Gill. “There has been a sharp rise in the use of sweeteners and while they are generally considered safe, it’s probably best not to rely on them too heavily, especially as emerging observational data suggests potential links with a range of health conditions and disruptions to the gut microbiome.” For example, a Brazilian study last year found sweeteners may harm cognitive health. Other studies have found links between specific sweeteners and obesity, cardiovascular disease and certain cancers.

So I shouldn’t just switch from sugar to sweeteners?

There are two kinds of sweeteners, explains Action on Sugar. High-intensity sugar replacers have no calories and a very sweet taste, and polyols, which are derived from sugar, have low calories and provide bulk as well as sweetness. In the EU, there are 11 approved sugar replacers, including aspartame, saccharin and sucralose, and seven commonly used polyols, including xylitol, sorbitols and isomalt. They are each classed as safe to consume up to their “acceptable daily limit” – as the BDA points out, this means you could theoretically drink 12 cans of a drink sweetened with aspartame daily without exceeding the limit.

In 2023, the WHO published a guideline on sweeteners based on the latest evidence: “WHO suggests that non-sugar sweeteners not be used as a means of achieving weight control or reducing the risk of noncommunicable diseases.” In the UK, the BDA, BNF and Diabetes UK subsequently updated their joint position. They say that sweeteners can be a useful alternative for people who drink a lot of sugary drinks, especially those at risk of type 2 diabetes, but they are best used to support a gradual transition away from sweet tastes. “Sweeteners are not a standalone solution. A healthy, balanced dietary pattern that is lower in sugars, saturated fats and salt, and high in fibre remains key.” Water, they say, is the ideal drink.

That is so boring …

Maybe, but it would also help the planet. According to a 2023 report by Action on Sugar, the UK uses about 100,000 hectares of land to grow sugar beet – roughly the same amount of land as is used to grow vegetables – which damages topsoil. The UK also imports huge amounts of sugar cane (325,000 tonnes this year), which requires large amounts of water and nitrogen to grow, and is transported vast distances.