Sugar affects health differently depending on its type; understanding the difference between natural and added sugars helps manage risks and make smarter choices for better overall wellness.
Sugar frequently takes the blame for a wide range of health problems, from weight gain to cardiovascular issues. But does it truly deserve its notorious reputation?
Sugar comes in numerous varieties, and these differences are significant for health outcomes, explains Tara M. Schmidt, M.Ed., RDN, LD, a lead registered dietitian and instructor of nutrition at Mayo Clinic in Minnesota.
Before labeling sugar as inherently “harmful,” it’s valuable to examine its origins, its functions in the body and the accompanying nutrients it brings along.
Comparing natural to refined sugar
When the average person discusses sugar, they’re likely referring to added sugars rather than the sugars that naturally occur in whole foods, Schmidt explains.
Naturally occurring sugars in foods don’t appear isolated. They arrive alongside other beneficial nutrients. “Foods containing natural sugar — items like fruit and milk — are simultaneously delivering other tremendously valuable nutrition,” Schmidt explains. For instance, milk delivers protein, calcium and vitamin D, whereas fruit provides fiber and vital vitamins.
Added sugars, conversely, originate from natural sources — including sugar beets, sugarcane or corn — but then undergo refinement or processing into numerous different varieties.
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These processed varieties, such as table sugar and corn syrup, are incorporated into processed foods during manufacturing. This sets them apart from the sugars naturally present in fruit, milk and other whole foods.
“It’s crucial not to demonize sugar entirely, but rather to examine what the food is offering us,” Schmidt explains. “A brownie and an apple might both have sugar, but what accompanies that sugar differs dramatically. An apple delivers fiber and vitamin C, whereas a brownie is more apt to also include saturated fat and sodium.”
Breaking down the health risks of sugar
Cutting back on added sugar is frequently something individuals consider when they aim to shed pounds — and justifiably so. Observational studies have repeatedly demonstrated that elevated consumption of added sugar correlates with obesity and increased body mass index (BMI), especially when ingested through sugar-sweetened beverages.
However, added sugar can trigger a broad spectrum of additional health complications. Research has connected higher sugar consumption to elevated risk of stroke, depression, cancer incidence, high blood pressure and high triglycerides, which are fats in the bloodstream that can elevate the risk of cardiovascular disease. Recent prospective cohort studies have also linked excessive sugar intake to increased blood clots formation and blood platelets dysfunction, further elevating clotting risks in susceptible individuals.
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Added sugar — especially from ultraprocessed foods — can also fuel inflammation, Schmidt explains. Chronic inflammation associated with sugar consumption may lead to metabolic syndrome, fatty liver disease (MASLD), chronic liver disease, liver cancer, and other inflammatory conditions. Some studies additionally indicate that diets rich in added sugar may contribute to insulin resistance, elevated insulin levels, and type 2 diabetes. According to the American Heart Association, limiting added sugars is essential for diabetes management and overall health.
Elevated consumption of added sugars, particularly fructose varieties present in sodas, soft drinks, fruit drinks, and sweetened drinks, can elevate uric acid concentrations in the bloodstream. This heightens the risk of gout, a form of excruciating arthritis caused by the accumulation of uric acid crystals in the joints. Research has demonstrated that individuals who drink sugary beverages daily face substantially greater odds of developing gout compared with those who seldom drink them. Studies involving postmenopausal women have shown particularly strong associations between beverage consumption patterns and liver disease mortality.
Are sugar alcohols harmful or a more sensible sweetener option?
Sugar alcohols aren’t genuine sugar, despite what the terminology might suggest. Sugar alcohols are commonly used in processed products marketed as sugar-free, no sugar, or no added sugar, as well as in reduced-calorie and low-carb products. Schmidt advises using them in moderation.
“Sugar alcohols provide a method for sweetening foods with fewer calories,” Schmidt explains. These carbohydrates — encompassing xylitol, erythritol, sorbitol, mannitol, and maltitol — regularly appear in sugar-free or low-calorie items. One factor behind their popularity is their inability to trigger blood sugar spikes or contribute extra sugar calories, which certain individuals find beneficial for controlling their weight, managing blood sugar levels, or following a balanced diet with reduced carbohydrate intake.
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Sugar alcohols are also known for their low glycemic index and minimal glycemic response, making them popular sugar substitutes for those monitoring their energy intake. Additionally, sugar alcohols are beneficial for oral health and cavity prevention, as they don’t contribute to tooth decay the way regular sugar does.
Nevertheless, moderation is essential. Sugar alcohols undergo different metabolic processing than table sugar through the digestive system. “When consumed excessively, they can trigger digestive complications like gas, bloating, or diarrhea,” Schmidt explains. These digestive issues occur because sugar alcohols are not fully absorbed, and the laxative effect is one of the most common side effects reported by users. Checking nutrition facts and food labels can help you identify sugar alcohols in ingredient lists.
Artificial sweeteners and non-sugar sweeteners provide an alternative method to fulfill sweet desires without calories. “They’re manufactured substances engineered to mimic sugar’s taste,” she explains. “They’re intensely sweet — even when used in minuscule quantities.” These low-calorie sweeteners appear in diet soda, diet drinks, and various other products as sugar substitutes.
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The drawback, Schmidt observes, is their classification as ultraprocessed components. “Choosing whether to incorporate them represents a personal decision rather than an absolute choice,” she explains. Certain people utilize them to decrease calorie intake or regulate blood sugar, whereas others choose to steer clear of heavily processed additives. The FDA has authorized multiple artificial sweeteners for widespread consumption, although research into their long-term health implications continues. When comparing diet drinks to regular soda, dietary factors and individual risk factors should be considered.
Effective approaches for decreasing sugar
If you appreciate sweets, the timing and manner of consumption can create a meaningful impact. “One tactic I frequently recommend is savoring your sweet indulgence alongside a meal,” Schmidt explains. That’s because eating sugar together with protein and fiber moderates the blood glucose elevation. “Your blood sugar elevation becomes more gradual,” she clarifies.
This method can also discourage excessive eating. “You’re less inclined to consume four cookies when you eat one during a meal rather than amid an afternoon energy dip,” Schmidt explains. This tactic also corresponds with dental recommendations. Specialists concur that limiting repeated sugar exposure during the day proves superior for both dental wellness and blood glucose regulation than repeatedly snacking on sweets.
When minimizing added sugar, concentrate on the most significant contributors initially. “For individuals aged one year and above, the primary source of added sugar is sweetened beverages, encompassing sodas, fruit beverages, athletic drinks and energy beverages,” Schmidt states. Sweet treats and confections are the second-largest source.
Decreasing consumption from these sources can have the greatest impact on reducing added sugar. Sweetened beverages — because they provide sugar in fluid form — can account for a considerable portion of daily added sugars without triggering satiety. This may result in elevated total calorie consumption. Studies indicate that even modest decreases in sweetened beverage intake can enhance weight management, blood glucose concentrations, and triglyceride measurements progressively.
Although minimizing added sugar constitutes sound guidance for most individuals, you needn’t eliminate all sugar to enhance your wellness. Schmidt suggests exploring methods to decrease added sugar consumption. Consider using reduced amounts of sweetened creamer in your coffee, select plain yogurt accompanied by fruit for breakfast or snacking, or diminish dessert serving sizes. “Numerous minor modifications exist that, throughout a day or month, can genuinely accumulate,” she states.
Source: Mary Anne Dunkin (March 5, 2026). Is sugar bad for you? Exploring the health debate. Mayo Clinic Press. https://mcpress.mayoclinic.org/nutrition-fitness/is-sugar-bad-for-you-exploring-the-health-debate/
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