Sugar and Your Health

Sugar is found in far more foods and drinks than many people realise. It can appear under dozens of different names on ingredient lists. Products described as natural, organic or unrefined can still contain large amounts of sugar.

Sugar is not an essential part of the human diet. The body needs glucose for certain functions, but that does not mean we need to eat sugar or carbohydrates to obtain it. The body can make the glucose it needs. When carbohydrate intake is very low, it can also obtain much of its energy from fat and use ketones as an alternative fuel.

Research has linked high intakes of added and free sugars to tooth decay, weight gain and certain problems with the body's handling of fats and glucose. Sugary drinks are a particular concern. Independent research has found an association between regular consumption of sugar-sweetened drinks and a higher risk of type 2 diabetes. Research also links high free-sugar intake with other health concerns, although the strength of the evidence varies depending on the outcome being studied.[2,3,4,5]

At Healing by Nutrition, we believe added sugar is best avoided. It is not needed to make a diet nutritionally complete, and there is no nutritional reason to add it to everyday meals and drinks.

This page explains the different names used for sugar, what happens when we consume it, and what scientific research tells us about its possible effects on health.

How Many Names Does Sugar Have?

Sugar does not always appear on an ingredient list under the familiar name sugar. Food manufacturers use many different names for sugars and sweeteners. This can make it harder to recognise how much sugar a product contains. The British Heart Foundation has published a guide identifying 50 names for sugar that consumers may encounter on food labels.[1]

Common names for sugar

These include:

  • Glucose

  • Fructose

  • Sucrose

  • Dextrose

  • Maltose

  • Lactose

  • Galactose

  • Trehalose

  • Invert sugar

These sugars are not all exactly the same. For example, sucrose is ordinary table sugar. It is made up of glucose and fructose joined together.

Different types of sugar

Sugar can also be named after its source, colour or method of production. Examples include:

  • White sugar

  • Brown sugar

  • Cane sugar

  • Beet sugar

  • Raw sugar

  • Muscovado sugar

  • Demerara sugar

  • Turbinado sugar

  • Coconut sugar

  • Palm sugar

  • Date sugar

  • Grape sugar

  • Jaggery

  • Panela

  • Evaporated cane juice

Some of these products have different flavours or undergo different levels of processing. However, that does not automatically make them healthier. Brown sugar, for example, is not a substantially healthier alternative to white sugar simply because it is brown.

Syrups and liquid sweeteners

Sugar can also appear as a syrup or liquid sweetener, including:

  • Glucose syrup

  • Glucose-fructose syrup

  • Fructose-glucose syrup

  • High-fructose corn syrup

  • Corn syrup

  • Rice syrup

  • Brown rice syrup

  • Barley malt syrup

  • Malt syrup

  • Tapioca syrup

  • Golden syrup

  • Agave syrup or agave nectar

  • Maple syrup

  • Date syrup

  • Molasses

These products contain different mixtures of sugars, but they are still concentrated sources of sugar. Calling a syrup natural does not remove its sugar content or guarantee that it is healthier than ordinary sugar.

Fruit-based ingredients

Sugar can also come from ingredients such as:

  • Apple juice concentrate

  • Grape juice concentrate

  • Other fruit juice concentrates

  • Fruit purée

  • Fruit paste

  • Dried fruit powder

The amount and form of sugar depend on the ingredient and how it is used. Juice concentrates are particularly relevant because they can supply concentrated fruit sugars without the structure of the original whole fruit.

Other ingredients that supply carbohydrates

You may also see ingredients such as malt extract, maltodextrin, dextrin, glucose solids, dried glucose syrup and modified starches.

These are not all chemically identical to table sugar. Some, such as maltodextrin and starch-based ingredients, are carbohydrates that the body can break down into smaller units, including glucose. They can still contribute significantly to a product's carbohydrate content.

The practical point is to look beyond the word “sugar”. Check both the ingredient list and the nutrition information. The ingredient list shows which sweeteners and carbohydrate sources have been used, while the nutrition label shows the amount of total sugars in the product.

Are All Sugars the Same?

No. Different sugars are processed differently by the body, and the food or drink they come from matters.

Glucose is an important fuel for the body's cells. After glucose enters the bloodstream, the hormone insulin helps regulate blood glucose levels and allows many cells to take up and use glucose.

Fructose is handled differently. Much of the fructose we absorb is processed by the liver. The liver can turn it into other substances, including glucose and fat. This is part of normal metabolism, but high intakes of fructose-containing sugars can contribute to unwanted effects, particularly when they provide more energy than the body uses. A controlled trial found that drinks sweetened with fructose or sucrose increased the liver's production of fat under the study conditions, while glucose-sweetened drinks did not produce the same effect.[3]

Ordinary table sugar contains both glucose and fructose. Many sweetened drinks and processed foods therefore supply both.

However, it would be misleading to assume that every food containing fructose has the same effect. The amount consumed, the form of the food and the overall diet all matter. The fructose in a sugary drink is not presented to the body in the same way as the fructose contained within an intact piece of fruit.

This distinction does not make added sugar necessary.

Does the body need us to eat sugar for energy?

No. The body needs glucose for certain functions, but eating sugar is not the only way to supply it.

The body can make its own glucose through a process called gluconeogenesis. In simple terms, it can produce glucose from other substances, including glycerol from fat and certain amino acids from protein.

When carbohydrate intake is very low, as on a ketogenic or Carnivore diet, the body can obtain much of its energy from fat. The liver converts some fat-derived substances into ketones, which provide an alternative fuel for the brain and other tissues. The body continues to make the glucose it needs while relying more heavily on fat and ketones for energy.

This means that someone following a well-formulated ketogenic or Carnivore diet does not need to eat sugar to meet their energy needs.

The body needs glucose for certain functions, but eating sugar is not necessary. Adding sugar to food and drinks is a choice, not a nutritional requirement.

Can High Sugar Intake Contribute to Fat Building Up in the Liver?

Yes. High intakes of sugar, particularly from sugary drinks, can contribute to fat building up in the liver.

The liver processes fructose and other nutrients. When we consume large amounts of sugar, especially when we take in more energy than the body uses, some of that energy can contribute to fat production and storage in the liver.

Too much fat in the liver can become a health problem. The condition is now commonly called metabolic dysfunction-associated steatotic liver disease, or MASLD. It was previously known as non-alcoholic fatty liver disease, or NAFLD.

Some people with fatty liver develop inflammation and liver damage. In more serious cases, the disease can lead to scarring and cirrhosis.

A randomised controlled trial examined how drinks sweetened with fructose, sucrose or glucose affected the liver's production of fat. The researchers found that fructose- and sucrose-sweetened drinks increased this process compared with glucose-sweetened drinks under the study conditions. The study was relatively small and measured metabolic changes, rather than proving that these drinks directly cause liver disease in every person who consumes them.[3]

This is important because sugary drinks make it easy to consume a large amount of sugar quickly, without necessarily feeling full.

Sugar is not the only factor involved in fatty liver disease. Excess body fat, genetics, alcohol, some medical conditions and other dietary factors can also play a role. Nevertheless, high sugar intake is a relevant and avoidable concern.

At Healing by Nutrition, we see little reason to make sugary drinks or added sugar a regular part of the diet. Water is a straightforward alternative to sweetened drinks.

What Happens to Your Blood Sugar?

When you eat digestible carbohydrates, your digestive system breaks them down into smaller substances, including glucose. The glucose enters your bloodstream, causing blood glucose levels to rise. Your body releases insulin to help regulate those levels.

This is a normal response to eating. The concern is not simply that blood glucose rises after a meal, but whether the body can keep regulating it effectively over time.

One problem that can develop is insulin resistance. This means that the body's cells respond less effectively to insulin. The body may then need to produce more insulin to achieve the same effect. If blood glucose regulation deteriorates, this can contribute to type 2 diabetes.

Regularly consuming large amounts of sugary foods and drinks can contribute to this problem, particularly when they promote weight gain and fat accumulation in the liver. A systematic review and meta-analysis of prospective studies found that greater consumption of sugar-sweetened drinks was associated with a higher risk of developing type 2 diabetes. The association remained when the researchers adjusted their analysis for body fatness, although observational research cannot establish that sugary drinks alone caused the cases of diabetes observed.[4]

Type 2 diabetes has several contributing factors, including genetics, body composition, physical activity, sleep and some medications. But these factors do not make high sugar intake harmless.

It is also important to distinguish between glucose in the blood and sugar in the diet. The body can maintain the glucose it needs without regularly consuming sugar. When carbohydrate intake is very low, the body can make glucose itself while relying more heavily on fat and ketones for energy.

Does Sugar Make You Gain Weight?

Sugar can contribute to weight gain, particularly when it is consumed in foods and drinks that add energy without making us feel full.

Sugary drinks are a particular concern. A person can drink a large amount of sugar in a short time and still feel hungry soon afterwards. This makes it easier to consume more energy than the body uses.

A systematic review and meta-analysis published in 2013 examined randomised controlled trials and cohort studies involving adults and children. In the trials, reducing dietary sugar was associated with a reduction in body weight, while increasing sugar intake was associated with weight gain. When sugar was exchanged for the same amount of energy from other carbohydrates, the effect on body weight was much smaller or absent. This suggests that the additional energy people consume when they eat more sugar is an important part of the explanation.[2]

This does not mean sugar is the only cause of weight gain. Overall food intake, appetite, activity and other factors matter. However, added sugar can make it easier to consume unnecessary energy, and reducing it removes one source of calories that is not essential to the diet.

For someone trying to lose body fat, replacing sugary drinks with water and reducing foods containing added sugar are practical steps. A lower-carbohydrate approach may also help some people manage appetite and reduce their overall food intake.

Added sugar is not required for energy, weight maintenance or weight loss. A diet can provide the energy and nutrients the body needs without adding sugar.

Is Fruit Juice as Healthy as Whole Fruit?

No. Fruit juice is not the same as whole fruit. Even when no sugar has been added, juice can provide a concentrated amount of sugar in a form that is easy to drink quickly.

When fruit is juiced, much of its original structure is lost. Depending on how it is made, some fibre may remain, but juice generally contains less intact fibre than the original fruit. It also takes much less time to drink the juice of several pieces of fruit than to eat them whole.

The World Health Organization classifies the sugars naturally present in fruit juice and fruit juice concentrates as free sugars. This is different from the sugars contained within intact fruit.[5]

Research on fruit juice and type 2 diabetes is not entirely consistent. A systematic review of prospective studies found a clear association between sugar-sweetened drinks and type 2 diabetes, but the results for fruit juice were less conclusive. That is an important distinction: fruit juice should not automatically be treated as identical to a soft drink, but neither should it be assumed to be harmless simply because the sugar comes from fruit.[4]

Can fruit juice contribute to diabetes?

Fruit juice studies do not all produce the same results. The type of juice, amount consumed and overall diet can influence the findings. However, fruit juice can deliver a large amount of sugar quickly, and it is not necessary for obtaining vitamins or energy.

It is therefore not reasonable to assume that fruit juice is harmless simply because its sugar comes from fruit. The absence of added sugar does not mean that a drink is low in sugar.

At Healing by Nutrition, we consider water a better everyday drink than fruit juice. People who want to reduce their sugar intake have little reason to drink juice regularly when they can stay hydrated without it.

Is Whole Fruit Always Healthy?

Whole fruit differs from fruit juice because it retains its original structure, including fibre and water. This affects how quickly it is eaten and how the body processes it.

Research generally finds that eating whole fruit is associated with a lower or neutral risk of type 2 diabetes, while fruit juice has a less favourable relationship in many studies. However, the results vary by study and fruit product, and associations do not establish cause and effect.[4]

Fruit varies considerably in sugar and carbohydrate content. Berries, for example, generally contain less sugar per serving than grapes or many tropical fruits. Dried fruit is more concentrated than fresh fruit because much of its water has been removed, making it easier to consume a larger amount of sugar in a small portion.

Whole fruit supplies vitamins, minerals and other compounds, but those nutrients can also be obtained from other foods. A person does not have to eat fruit to obtain a nutritionally adequate diet.

It is important not to go beyond the evidence in either direction. Research does not establish that whole fruit generally causes type 2 diabetes, and it would be inaccurate to treat the sugars in intact fruit as identical in effect to the same amount of sugar in a soft drink. At the same time, the fact that a food is natural does not mean it must be eaten or that unlimited amounts are appropriate for every dietary approach.

For people following ketogenic or Carnivore diets, fruit may be limited or excluded because of its carbohydrate content. Other people may choose to include selected fruits according to their preferences and dietary goals.

Our position is that fruit is a food choice, not a nutritional obligation. The amount and type that suit someone depend on their dietary approach, carbohydrate intake and overall diet.

Is Honey Better Than White Sugar?

Honey is often described as a natural or healthier sweetener. However, honey is largely made up of sugars, mainly glucose and fructose, together with water and small amounts of other substances.

Honey contains compounds that have been studied for specific uses. For example, certain medical-grade honey products are used in wound care. Manuka honey, in particular, contains methylglyoxal (MGO), which contributes to its antibacterial properties.[17] These properties have been studied for applications where honey is applied directly to wounds, and certain medical-grade preparations are used in wound care.[18] However, this does not establish antibacterial or other health benefits from eating Manuka honey. Evidence for a particular medical use does not mean that eating honey regularly provides broad health benefits or makes it a healthy everyday sweetener.

Honey is still a source of free sugars. The World Health Organization includes sugars naturally present in honey within its definition of free sugars.[5] If the aim is to reduce free sugar intake, replacing table sugar with honey does not remove the problem.

The same principle applies to maple syrup, agave syrup, date syrup and other sweeteners marketed as natural. Their composition differs, but they remain concentrated sources of sugar.

There is no nutritional requirement to consume honey. Its natural origin does not make it necessarily healthy, and claims that it can heal the body in a broad sense should not be confused with evidence for specific medical uses. The antibacterial properties of Manuka honey when applied to wounds do not establish any health benefit from consuming it.

At Healing by Nutrition, we do not regard honey as a necessary health food or recommend it as an essential replacement for ordinary sugar. If the goal is to reduce added and free sugars, replacing table sugar with honey does not achieve that goal.

What About Alcohol, Beer and Wine?

Alcoholic drinks can contain sugar and other carbohydrates, but the amounts vary. Beer, wine, cider, spirits and mixed drinks are made differently, so their sugar content is not the same.

Beer can contain carbohydrates left over from brewing. Wine contains varying amounts of sugar remaining after fermentation. Cider can also contain considerable amounts of sugar, depending on how it is made. Spirits generally contain little or no sugar when served plain, but liqueurs, cocktails and mixers can add substantial amounts.

However, sugar is not the only concern. Alcohol itself provides calories and carries health risks, regardless of the type of drink.

Is Red Wine Good for Your Health?

Red wine is often described as being good for the heart because it contains plant compounds called polyphenols, including resveratrol. These substances have been investigated for possible health benefits, but this does not establish that drinking red wine protects the heart or improves overall health.

Many studies reporting benefits have observed that moderate wine drinkers experience certain health outcomes less often than some other groups. However, these studies cannot always separate the effects of wine from differences in diet, exercise, smoking and other aspects of lifestyle. The choice of comparison group can also affect the results.

The funding behind research matters, too. An analysis of 60 scientific reviews on alcohol and cardiovascular disease found that reviews by authors with a history of alcohol-industry funding were more likely to report protective effects. The authors found that the reviews by researchers with no known history of alcohol-industry funding had mixed conclusions. This does not prove that every industry-connected review is wrong, but it demonstrates why research funding, conflicts of interest and study methods need to be examined rather than accepting a positive conclusion at face value.[11]

Red wine's polyphenols do not cancel out the risks associated with alcohol. Alcohol increases the risk of several types of cancer, and the World Health Organization has stated that no level of alcohol consumption is completely free of health risk.[12,13]

The National Cancer Institute also notes that there is no evidence that drinking red wine reduces the risk of cancer.[13]

For this reason, the claimed health benefits of red wine should not be treated as an established reason to drink it. Its sugar content is only one part of the picture, and a drink that contains less sugar is not necessarily a healthier choice.

What About Bread, Rice, Potatoes and Other Carbohydrates?

Sugar is only one part of the carbohydrate picture. Foods such as bread, rice, potatoes, pasta and cereals contain starch. During digestion, the body breaks starch down into smaller carbohydrate units, including glucose.

Starch is not chemically the same as table sugar, but it can still raise blood glucose after digestion. The effect depends on the food, how it is prepared, the amount eaten and the individual's response.

Bread is a useful example. Some bread contains added sugar, while other bread does not. Sourdough bread may contain little or no added sugar, depending on the recipe. However, sourdough is not automatically the bread with the least sugar, and having little added sugar does not mean that a bread is low in total carbohydrates.

Fermentation changes sourdough and may affect how some people respond to it. Nevertheless, the starch in bread remains a source of carbohydrate. Someone following a strict ketogenic or Carnivore diet may therefore choose to avoid bread, including sourdough, even when it contains no added sugar.

Rice and potatoes also provide starch rather than necessarily containing added sugar. Their starch is broken down during digestion, supplying glucose to the body.

The important distinction is between added sugar, naturally occurring sugars and starch. They are not identical, but they can all contribute to carbohydrate intake in different ways.

At Healing by Nutrition, we encourage people to understand what they are eating rather than relying only on descriptions such as “natural”, “wholegrain” or “sourdough”. A food can contain little added sugar and still be high in carbohydrates.

Can Sugar Be Addictive?

Some people experience strong cravings for sweet foods, find it difficult to stop eating them, or repeatedly return to foods they had intended to avoid. These experiences can be difficult, and they should not simply be dismissed as a lack of willpower.

Sugar can activate reward-related pathways in the brain. Sweet taste, habits, food availability and the combination of sugar with fat and other ingredients can all influence eating behaviour.

However, there is an important difference between enjoying a food, experiencing cravings and having an addiction similar to drug addiction.

The evidence does not establish that sugar alone produces a drug-like addiction in humans in the same way as substances such as nicotine or opioids. Research into sugar-related behaviour includes animal experiments and studies of eating behaviour, but findings from animals cannot automatically be applied to humans. Highly processed foods may also combine several features that encourage repeated consumption, making it difficult to isolate the role of sugar alone.

This does not mean that cravings and difficulty controlling food intake are imaginary or unimportant. People can experience genuine difficulty reducing sweet foods even without sugar addiction being established as a clinical diagnosis.

From a practical perspective, someone who repeatedly struggles with sugary foods may find it easier to avoid them than to keep trying to moderate their intake. Reducing exposure to sweetened foods and drinks can also help break habits built around them.

At Healing by Nutrition, we take these experiences seriously. A dietary approach that reduces or removes added sugar can be a useful option for people who find that sweet foods make it difficult to follow their intended eating pattern.

Are Artificial Sweeteners Better?

Artificial and other non-sugar sweeteners are often used to replace sugar in drinks, desserts and processed foods. They can provide a sweet taste with little or no sugar, but that does not automatically make products containing them beneficial for long-term health.

Different sweeteners have different properties and have been assessed individually for safety. It is therefore inaccurate to treat all sweeteners as the same substance or to claim that they all have the same effects.

In 2023, the World Health Organization recommended against relying on non-sugar sweeteners as a long-term strategy for weight control or reducing the risk of diet-related diseases. This recommendation was based on the available evidence about longer-term outcomes. It was not a conclusion that every approved sweetener is toxic.[6]

This distinction matters. A recommendation not to rely on sweeteners for long-term weight control is not the same as proof that a particular sweetener causes cancer or another disease.

Aspartame illustrates the difference between identifying a possible hazard and establishing the risk at a particular level of consumption. In 2023, the International Agency for Research on Cancer classified aspartame as “possibly carcinogenic to humans”, based on limited evidence. At the same time, a separate international food-safety committee retained its existing acceptable daily intake.[7]

These assessments addressed different questions: whether a substance might pose a cancer hazard under some circumstances, and what level of intake was considered acceptable based on the available risk assessment.

This does not mean that aspartame has been proven to cause cancer at ordinary levels of consumption. It does mean that the hazard assessment should not be misrepresented as proof that the substance is incapable of causing harm.

There is a simpler option: reduce reliance on sweetness itself. A person does not need to replace every sugary product with a diet version. Water and unsweetened drinks avoid the need for either sugar or a non-sugar sweetener.

Sugar, Dementia and Brain Health

Researchers have investigated whether high sugar intake, especially from sweetened drinks, is linked to dementia and Alzheimer's disease.

Some observational studies have found higher rates of dementia or Alzheimer's disease among people consuming more sugar-sweetened drinks or greater amounts of sugar. These findings have raised questions about possible links between diet, blood glucose regulation and brain health.

There are reasons to investigate the relationship. Type 2 diabetes and cardiovascular disease are associated with an increased risk of cognitive decline and dementia. High sugar intake can contribute to metabolic problems, and the health of the blood vessels is important to the brain.

However, studies of sugar and dementia do not all produce the same results. Observational studies can identify associations, but they cannot by themselves prove that sugar directly causes dementia. Other factors, including general health, physical activity, education, smoking, diet and changes in eating habits before diagnosis, can influence the findings.

The evidence should therefore be taken seriously without being overstated. It would be inaccurate to claim that research has conclusively established that sugar directly causes Alzheimer's disease. It would also be premature to dismiss the subject simply because the findings are not yet consistent.

The practical conclusion does not depend on proving a direct link between sugar and dementia. High sugar intake is already a concern for other aspects of health, and added sugar is not nutritionally necessary. Reducing it is a reasonable dietary choice without making promises about preventing or treating dementia.

Sugar, Type 2 Diabetes and Cardiovascular Disease

The relationship between sugary drinks and metabolic disease has been investigated in numerous studies.

A systematic review and meta-analysis published in the BMJ examined prospective studies of sugar-sweetened drinks and the incidence of type 2 diabetes. The researchers found that greater consumption was associated with a higher risk of developing the condition, including in analyses that accounted for body fatness. Because these were observational studies, they cannot prove that sugary drinks caused every case of diabetes.[4]

Other research has examined how changes in sugar intake affect blood pressure and blood fats. A systematic review of randomised controlled trials found that increasing or reducing dietary sugars could affect some cardiovascular risk factors, although the findings depended on the comparison being made and the amount of energy consumed.[14]

The European Food Safety Authority's 2022 review assessed the evidence on dietary sugars and health. It found that sugar is a well-established cause of tooth decay and that evidence linked added and free sugars with some long-term metabolic health problems. The strength of the evidence varied by outcome, and the panel could not establish a safe upper limit for total, added or free sugar intake.[8]

The concern is not limited to body weight. High sugar intake can contribute to excess energy intake and fat accumulation, while the way the body processes sugar may also affect liver fat, insulin sensitivity and blood fats.

Cardiovascular disease has many contributing factors, including smoking, blood pressure, blood fats, genetics and physical activity. Sugar is not the only cause of heart disease. But the complexity of cardiovascular disease does not make the evidence linking high sugar consumption, particularly sugary drinks, with adverse health outcomes irrelevant.

Our view is that regularly consuming sugary drinks offers little nutritional advantage and exposes people to avoidable dietary sugar. Replacing them with water or unsweetened drinks is a practical way to reduce that intake.

Sugar and Gout

Gout is a form of inflammatory arthritis. It occurs when uric acid crystals build up in joints and cause attacks of pain and inflammation.

The body produces uric acid as it breaks down certain substances. Fructose, one of the sugars found in table sugar and many sweetened drinks, is processed by the liver and can contribute to increased uric acid production.

Research has investigated the relationship between sugar-sweetened drinks and gout. A systematic review and meta-analysis found an association between sugar-sweetened beverage consumption and an increased risk of gout and elevated uric acid levels.[19] However, this does not establish that sugar alone causes gout or that avoiding sugar will prevent or cure it. Gout is influenced by several factors, including genetics, kidney function, medication, alcohol and other dietary factors.

Reducing sugary drinks can be a practical way to reduce free sugar intake, but it should not be presented as a guaranteed treatment for gout. Anyone with gout should seek appropriate medical advice about diagnosis and treatment rather than relying on dietary changes alone.

How Much Sugar Is Too Much?

There is no established level of sugar intake below which all health risks are guaranteed to disappear.

In 2022, the European Food Safety Authority (EFSA) reviewed the scientific evidence on dietary sugars. It concluded that the available evidence did not allow it to set a safe upper limit for total, added or free sugars. The review identified sugar as a well-established cause of tooth decay and found evidence linking added and free sugars with some long-term metabolic health problems. The strength of the evidence differed depending on the condition being studied.[8]

The World Health Organization recommends that adults and children reduce free sugar intake to less than 10% of their total daily energy intake. It suggests that reducing this to below 5% may provide additional benefits, particularly for dental health.[5]

These percentages are public-health targets. They do not prove that consuming an amount just below the limit is risk-free, and they do not mean the body needs sugar up to those levels.

Free sugars include sugars added to foods and drinks by manufacturers, cooks or consumers, as well as sugars naturally present in honey, syrups, fruit juice and fruit juice concentrates. They do not include sugars naturally contained within intact fruit and vegetables or the sugars in milk.

At Healing by Nutrition, we take a simpler position: added sugar is not necessary, and we believe it is best avoided. There is no need to aim for a daily sugar allowance when a nutritionally adequate diet can be built without adding sugar.

Does the Sugar Industry Influence Nutrition Research?

Research funding can influence which questions are investigated, how studies are designed and how results are presented. This is not unique to the sugar industry, but historical evidence shows why it is important to consider who pays for research.

A 2016 analysis published in JAMA Internal Medicine examined internal documents from the Sugar Research Foundation. The researchers found that the organisation sponsored a review of research into coronary heart disease during the 1960s. The review emphasised fat and cholesterol as dietary causes while downplaying evidence implicating sugar. The industry's role was not disclosed in the published paper.[9]

The researchers concluded that the sugar industry had helped shape the scientific debate about diet and heart disease in a way that cast doubt on the possible harms of sugar and placed greater emphasis on fat.

The historical paper received university and public research support. A later correction also acknowledged travel funding from Gary Taubes, co-founder of the Nutrition Science Initiative. That disclosure is worth noting for transparency; it does not change the fact that the paper examined internal historical documents relating to the sugar industry.[9]

A separate systematic review examined research on sugar-sweetened drinks and health. It found that studies with industry connections were much more likely to reach weak or null conclusions about adverse health effects than studies classified as independent. This finding identifies a pattern in the research literature; it does not prove that every industry-funded study is wrong or that every independently funded study is correct.[10]

When assessing nutrition claims, it is useful to ask:

  • Who funded the research?

  • Did the authors have relevant financial ties to an industry?

  • Was the study designed to answer the question being discussed?

  • Were the results consistent with other studies?

  • Were the findings presented accurately?

  • Were limitations and conflicts of interest disclosed?

A single study, whether industry-funded or independent, should not settle a complex nutrition question. The overall body of evidence is more informative.

Can a Low-Carbohydrate Diet Help?

A low-carbohydrate diet reduces the amount of carbohydrate consumed. This usually also reduces sugar intake when sugary foods and drinks are removed.

A ketogenic diet restricts carbohydrate sufficiently for the body to produce more ketones. A Carnivore diet excludes plant foods and therefore removes most conventional dietary sources of carbohydrate, although the exact carbohydrate intake depends on the foods included.

These approaches change how the body obtains energy. With less carbohydrate available, the body can rely more heavily on fat and ketones while producing the glucose it still needs.

Research has investigated low-carbohydrate diets in people with type 2 diabetes. A 2021 systematic review in the BMJ examined 23 randomised trials involving 1,357 participants. It found that low-carbohydrate diets could improve some outcomes, including diabetes remission at six months. Some benefits were less clear at 12 months, and results varied across studies.[15]

This research does not establish that every person should follow a ketogenic or Carnivore diet, nor does it prove that such diets will cure diabetes. Dietary approaches differ, and the right choice depends on a person's goals, health circumstances and ability to follow the diet.

People who take medication for diabetes, particularly insulin or medicines that can cause low blood glucose, should seek medical guidance before making major reductions in carbohydrate intake. Their medication may need adjustment. Prescribed treatment should not be stopped without appropriate medical advice.

At Healing by Nutrition, we focus on practical dietary approaches that reduce reliance on added sugar and help people choose a way of eating that fits their goals and preferences. We do not claim that one diet is suitable for everyone or that dietary changes guarantee a particular medical outcome.

What Can We Take Away from the Research?

The research gives us several important points to consider.

  • Sugar is not essential. The body can make the glucose it needs, and it can obtain much of its energy from fat and ketones when carbohydrate intake is very low.

  • Added sugar is not a nutritional requirement. A diet can provide the energy and nutrients the body needs without adding sugar.

  • High sugar intake is linked to important health concerns. Research connects added and free sugars, particularly in sugary drinks, with tooth decay, weight gain and metabolic problems. The strength of the evidence varies by outcome.

  • Sugary drinks deserve particular attention. They deliver sugar quickly and are associated with a higher risk of type 2 diabetes.

  • Honey and syrups are still sources of sugar. Their natural origin does not make them necessary or automatically healthier than table sugar.

  • Fruit juice is not the same as whole fruit. Its sugars count as free sugars, and it can be consumed quickly in concentrated amounts.

  • Whole fruit is different from juice, but it is not compulsory. Fruit varies in carbohydrate content, and its nutrients can be obtained from other foods.

  • Starch is not the same as sugar, but it supplies glucose during digestion. Bread, rice and potatoes can contribute substantially to carbohydrate intake even when they contain little added sugar.

  • Evidence about sugar and dementia is still developing. Some studies report associations, but the evidence does not prove that sugar directly causes dementia.

  • Sweeteners are not a necessary solution. Instead of replacing every sugary product with a sweetened alternative, people can reduce their reliance on sweet tastes.

  • The source of research funding matters. Historical evidence shows that commercial interests have influenced how the health effects of sugar were presented.

  • Reducing sugar is a practical choice. A nutritionally adequate diet can be built without added sugar, whether someone follows a lower-carbohydrate approach or another dietary pattern.

Our position is that people should understand what they eat and why they eat it. Sugar does not need to be part of every meal, every drink or every day. Removing added sugar can be a straightforward way to reduce unnecessary sugar intake.

Understanding Nutrition Is Only the Beginning

Understanding sugar is one part of making informed dietary choices. The next step is finding an approach that fits your goals, preferences and everyday life.

At Healing by Nutrition, we share our personal experience with food, cooking and strength training. We offer individualised nutrition plans, combined nutrition and exercise programmes, and personal coaching for people who want practical guidance tailored to their circumstances.

We do not promise medical cures or claim that one dietary approach is right for everyone. Our aim is to help people make informed choices and build routines they can follow.

Explore our programmes to find out more about how we can help you develop a nutrition and training approach that fits your goals.

Health disclaimer: This page is for general information and education. It is not medical advice and does not diagnose, treat or prevent disease. We are not medical practitioners or registered dietitians. If you have a medical condition, take medication that may be affected by dietary changes, or are considering a major change to your diet, speak with an appropriately qualified healthcare professional.

Scientific References

[1] British Heart Foundation. 50 Names for Sugar. Consumer information guide on the different names used for sugar on ingredient lists.

[2] Te Morenga, L., Mallard, S. and Mann, J. (2013). "Dietary Sugars and Body Weight: Systematic Review and Meta-Analyses of Randomised Controlled Trials and Cohort Studies." BMJ, 346. DOI: 10.1136/bmj.e7492.

[3] Geidl-Flueck, B., Hochuli, M., Németh, Á. et al. (2021). "Fructose- and Sucrose- but Not Glucose-Sweetened Beverages Promote Hepatic De Novo Lipogenesis: A Randomized Controlled Trial." Journal of Hepatology, 75(1), 46–54. DOI: 10.1016/j.jhep.2021.02.027.

[4] Imamura, F., O’Connor, L., Ye, Z. et al. (2015). "Consumption of Sugar Sweetened Beverages, Artificially Sweetened Beverages, and Fruit Juice and Incidence of Type 2 Diabetes: Systematic Review, Meta-Analysis, and Estimation of Population Attributable Fraction." BMJ, 351. DOI: 10.1136/bmj.h3576.

[5] World Health Organization. (2015). Guideline: Sugars Intake for Adults and Children. Geneva: World Health Organization.

[6] World Health Organization. (2023). Use of Non-Sugar Sweeteners: WHO Guideline. Geneva: World Health Organization.

[7] International Agency for Research on Cancer and Joint FAO/WHO Expert Committee on Food Additives. (2023). Aspartame Hazard and Risk Assessment Results. July 2023.

[8] EFSA Panel on Nutrition, Novel Foods and Food Allergens. (2022). "Tolerable Upper Intake Level for Dietary Sugars." EFSA Journal, 20(2), 7074. DOI: 10.2903/j.efsa.2022.7074.

[9] Kearns, C. E., Schmidt, L. A. and Glantz, S. A. (2016). "Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents." JAMA Internal Medicine, 176(11), 1680–1685. DOI: 10.1001/jamainternmed.2016.5394.

[10] Schillinger, D., Tran, J., Mangurian, C. and Kearns, C. (2016). "Do Sugar-Sweetened Beverages Cause Obesity and Diabetes? Industry and the Manufacture of Scientific Controversy." Annals of Internal Medicine, 165(12), 895–897. DOI: 10.7326/L16-0534.

[11] Golder, S. and McCambridge, J. (2021). "Alcohol, Cardiovascular Disease and Industry Funding: A Co-Authorship Network Analysis of Systematic Reviews." Social Science & Medicine, 289, 114450. DOI: 10.1016/j.socscimed.2021.114450.

[12] World Health Organization. (2023). No Level of Alcohol Consumption Is Safe for Our Health. 4 January 2023.

[13] National Cancer Institute. Alcohol and Cancer Risk Fact Sheet. Includes discussion of red wine, resveratrol and cancer risk.

[14] Te Morenga, L. A., Howatson, A. J., Jones, R. M. and Mann, J. (2014). "Dietary Sugars and Cardiometabolic Risk: Systematic Review and Meta-Analyses of Randomized Controlled Trials of the Effects on Blood Pressure and Lipids." American Journal of Clinical Nutrition, 100(1), 65–79. DOI: 10.3945/ajcn.113.081521.

[15] Goldenberg, J. Z., Day, A., Brinkworth, G. D. et al. (2021). "Efficacy and Safety of Low and Very Low Carbohydrate Diets for Type 2 Diabetes Remission: Systematic Review and Meta-Analysis of Published and Unpublished Randomized Trial Data." BMJ, 372. DOI: 10.1136/bmj.m4743.

[16] Bes-Rastrollo, M., Schulze, M. B., Ruiz-Canela, M. and Martinez-Gonzalez, M. A. (2013). "Financial Conflicts of Interest and Reporting Bias Regarding the Association Between Sugar-Sweetened Beverages and Weight Gain: A Systematic Review of Systematic Reviews." PLoS Medicine, 10(12). DOI: 10.1371/journal.pmed.1001578.

[17] Mavric, E., Wittmann, S., Barth, G. and Henle, T. (2008). "Identification and Quantification of Methylglyoxal as the Dominant Antibacterial Constituent of Manuka (Leptospermum scoparium) Honeys from New Zealand." Molecular Nutrition & Food Research, 52(4), 483–489. DOI: 10.1002/mnfr.200700282.

[18] Vandamme, L., Heyneman, A., Hoeksema, H., Verbelen, J. and Monstrey, S. (2013). "Honey in Modern Wound Care: A Systematic Review." Burns, 39(8), 1514–1525. DOI: 10.1016/j.burns.2013.06.014.

[19] Ebrahimpour-Koujan, S., Saneei, P., Larijani, B. and Esmaillzadeh, A. (2020). "Consumption of Sugar Sweetened Beverages and Dietary Fructose in Relation to Risk of Gout and Hyperuricemia: A Systematic Review and Meta-Analysis." Critical Reviews in Food Science and Nutrition, 60(1), 1–10. DOI: 10.1080/10408398.2018.1503155.

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