Added Sugars: The Sweetener Hiding in Plain Sight — and Why the Numbers Disagree

What added sugars are

The US Food and Drug Administration's definition is the clearest place to start, because it is the definition that actually appears on a label. Added sugars, the FDA says, include sugars added during the processing of foods (such as sucrose or dextrose), foods packaged as sweeteners (such as table sugar), and sugars from syrups and honey and from concentrated fruit or vegetable juices. They do not include sugars naturally occurring in milk, fruits, and vegetables. That last sentence does most of the work: a plain yoghurt's lactose is not an added sugar, but the sugar stirred into a flavoured yoghurt is; an apple's fructose is not, but apple-juice concentrate used to sweeten a cereal bar is. The FDA also gives the category a labelling anchor: the Daily Value for added sugars is 50 grams per day based on a 2,000-calorie diet, and on a US label the line reads "Includes X g Added Sugars", indented beneath total sugars, because added sugars are part of — not additional to — the total-sugars figure.

The World Health Organization uses a broader term, "free sugars", and the difference between the two terms is a trap worth naming. Free sugars cover everything the FDA counts as added, plus the sugars naturally present in honey, syrups, and fruit juices and fruit-juice concentrates. WHO's guideline explicitly does not refer to the sugars in fresh fruits and vegetables, or the sugars naturally present in milk, because there is no reported evidence of adverse effects from those sugars. So honey is a free sugar under WHO even though nobody "added" it to the honey jar, fruit juice is a free sugar even when it is 100% juice, and a spoonful of table sugar counts under both systems. When an article quotes a percentage without saying whether it means added or free sugars, it is quoting two different totals — and in juice-drinking households, the gap between them is large.

Tip: If you only remember one distinction, make it this one: the molecule does not tell you the category. Glucose is glucose whether it grew in a grape or was refined from corn. What makes a sugar "added" is its history — it was put into the food — and what makes it "free" under WHO is whether it is loose from its original cellular structure, as in juice, syrup, or honey, rather than locked inside whole fruit.

Why they are used everywhere

Added sugars survive in food manufacturing for reasons that go well beyond making things taste sweet, and understanding those reasons is what makes "just remove it" harder than it sounds. Sweetness is the obvious job, and it is also a balancing job: sugar rounds off salt in a tomato sauce, acid in a dressing, bitterness in coffee and chocolate, and heat in a chilli sauce, which is why savoury foods carry sugars that no one would describe as sweet. Beyond taste, sugars are functional. They bulk out a product, hold moisture and extend shelf life, help baked goods brown and rise, lower the freezing point of ice cream so it scoops instead of shattering, and preserve jams and pickles by binding water that microbes would otherwise use. A manufacturer removing sugar from a cake is not removing a flavouring; it is removing a structural ingredient, and the replacement — a bulking agent, a humectant, a different sweetener — brings its own trade-offs. That is why "sugar-free" versions of the same product often read like a different recipe entirely, and why some of them are no lower in energy than the original.

The second reason is economic and logistical, and it is less flattering. Sugar is cheap, stable, and available in many forms — sucrose, glucose syrup, dextrose, invert syrup, fruit-juice concentrate — which lets a manufacturer tune sweetness, texture, and cost independently, and lets the same sweetening job appear under a dozen different names on an ingredient list. That variety is also why ingredient lists are a poor counting tool: a product can list three sweeteners in the middle of its list and still contain more total added sugar than a product listing "sugar" second, because the list is ordered by weight per ingredient, not by category. The FDA's own summary names the main sources for most Americans as sugar-sweetened beverages, baked goods, desserts, and sweets — a list that matches the Australian Dietary Guidelines' examples of foods and drinks containing added sugars: confectionery, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, and energy and sports drinks. The pattern is the same in both countries: drinks first, then the foods people already recognise as treats, then the long tail of savoury and "healthy-looking" products where the sugar is doing a quieter job.

Where you will find them

• Sugar-sweetened drinks — soft drinks, energy and sports drinks, cordials, sweetened teas and coffees, fruit drinks (as opposed to 100% juice, which is still a free sugar under WHO) — the single largest and best-evidenced source
• Confectionery, cakes, biscuits, and desserts — where sugar is a main ingredient, not an additive, and where frequency of eating matters for teeth as much as the amount
• Breakfast cereals and cereal bars — including products marketed with fruit or honey imagery, where juice concentrates and syrups can supply much of the sweetness
• Flavoured yoghurts and dairy desserts — where the added sugar sits on top of the milk's own lactose, so the total-sugars figure is always higher than the added-sugars figure
• Sauces, dressings, marinades, and baked beans — where sugar balances salt and acid, and where a "savoury" product can still carry a dessert's worth of sugar across a serving
• Breads, crackers, and processed meats — in smaller amounts per serving, but eaten daily, so they contribute steadily rather than dramatically
• Foods sweetened with honey, maple syrup, agave, or fruit puree — which count as free sugars under WHO and, for syrups and honey, as added sugars under the FDA, even when the marketing calls them natural
• Flavourings and concentrates — where a sweet carrier can be the bulk of an ingredient that appears on the label only as "flavouring", the same carrier role that makes propylene glycol a familiar name in this guide's food-additive stories

The concern: teeth, weight, and the drink problem

The concern with added sugars has three strands, and they are not equally strong — keeping them separate is what stops this topic collapsing into a single slogan.

Teeth first, because the evidence there is the oldest and least contested. Oral bacteria metabolise dietary sugars into organic acids that demineralise enamel and dentine, and sucrose also helps build the plaque in which those bacteria live. A review by Moynihan and Petersen found convincing evidence, from human intervention studies, epidemiological studies, animal studies, and experimental studies together, for an association between both the amount and the frequency of free-sugars intake and dental caries, and recommended limiting the frequency of foods containing free sugars to a maximum of four times a day, alongside the amount limit. Frequency matters because each exposure restarts acid production: a person who sips a sweet drink all afternoon gives their teeth many more acid attacks than a person who drinks the same amount with a meal, even though the totals match. Europe's food safety authority reached the same starting point in 2022, calling the intake of dietary sugars "a well-established hazard in relation to dental caries in humans". Fluoride and oral hygiene reduce the damage; the evidence reviewed does not suggest they eliminate it.

Weight second, where the mechanism is mostly — but not entirely — calories. A systematic review and meta-analysis by Te Morenga and colleagues, covering 30 randomised trials and 38 cohort studies, found that in adults eating freely (not on controlled diets), reducing dietary sugars was associated with a weight decrease of 0.80 kg and increasing them with a weight increase of 0.75 kg — but that when trials swapped sugars for other carbohydrates at the same total energy, body weight did not change (0.04 kg). The authors' conclusion was precise: among free-living people, intake of free sugars or sugar-sweetened beverages is a determinant of body weight, and the change "seems to be mediated via changes in energy intakes". In other words, sugar makes weight gain easier mainly by making overeating easier — liquid calories do not fill you up the way solid food does, sweet foods are easy to eat in large amounts, and sugary products often displace more filling foods — rather than by some unique metabolic property of the sugar molecule at ordinary intakes. That distinction matters for what to do about it: if the problem were a poison, the dose would be everything; if the problem is mostly extra energy, the whole pattern of eating matters, and a low-sugar product that is still energy-dense has not solved it.

Drinks third, where the evidence sharpens into something more specific. A 2025 dose-response meta-analysis by Della Corte and colleagues, covering 29 prospective cohorts and more than half a million people, found that each additional serving of sugar-sweetened beverages was associated with a 25% higher risk of type 2 diabetes (risk ratio 1.25), and each additional serving of fruit juice with a 5% higher risk (1.05), both at moderate certainty — while added sugar overall showed no association (0.99, low certainty), and total sugar and sucrose at 20 grams a day were inversely associated. The authors' conclusion was blunt: the results "do not support the common assumption that dietary sugar, irrespective of type and amount, is consistently associated with increased type 2 diabetes risk". That does not clear sugary drinks — it indicts them specifically. Liquid sugars arrive quickly, in large amounts, without fibre, protein, or fat to slow absorption, and they are consumed in quantities that would be hard to eat as solid food. A person can drink 40 grams of sugar in a few minutes without feeling full; eating 40 grams of sugar as whole fruit would take effort, time, and a full stomach. The form, not just the molecule, is doing work here, and it is why every guideline in this article, however much they disagree on numbers, agrees on drinks first.

What regulators and reviewers say

The World Health Organization's 2015 guideline is the most quoted document in this debate, and it is also the most misquoted, because it contains two recommendations of different strengths. WHO strongly recommends reducing free sugars to less than 10% of total energy intake, and conditionally suggests a further reduction to below 5%, which on a 2,000-calorie diet works out to roughly 50 grams and 25 grams a day respectively. The 10% recommendation rests on evidence about body weight and dental caries; the 5% suggestion rests on a smaller evidence base about caries — three national population studies comparing intakes below 5% with intakes between 5% and 10% — which is why WHO labelled it conditional, meaning less certainty about the effects of implementing it. WHO's guideline also says the recommendation applies throughout the life course, and that populations currently consuming low levels of free sugars should not increase their intake. It is a population guideline, not a personal prescription: it describes a level at which, across a population, harm is lower, not a threshold below which an individual is safe and above which they are harmed.

The United States takes the same 10% figure and turns it into a label. The Dietary Guidelines for Americans recommend limiting calories from added sugars to less than 10% of total calories per day, and the FDA's Nutrition Facts label makes that visible: the Daily Value for added sugars is 50 grams per day on a 2,000-calorie diet, the label shows grams and percent Daily Value per serving, and the FDA's guide calls 5% of the Daily Value or less a low source and 20% or more a high source. The FDA's framing is deliberately practical rather than moral: it notes that a limited amount of added sugars can be included in an overall healthy eating pattern, and that consuming too much makes it difficult to meet nutrient needs while staying within calorie limits — the displacement argument, stated plainly. Australia's position is less numerical. Guideline 3 of the Australian Dietary Guidelines advises limiting intake of foods containing added sugars (alongside saturated fat, added salt, and alcohol), naming confectionery, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, and energy and sports drinks as the examples — but it sets no percentage target of the WHO kind, and, as the next section explains, Australian labels do not currently separate added sugars at all.

Europe's food safety authority, EFSA, took a different route entirely and arrived somewhere uncomfortable for everyone. Asked by five Nordic countries to set a tolerable upper intake level for dietary sugars, EFSA's panel reviewed the evidence in 2022 and concluded it could not: no level of sugars intake could be identified at which the risk of dental caries or chronic metabolic disease was not increased, over the range of observed intakes, so no upper level or safe level could be set. On the trial evidence, it found a positive and causal relationship between added and free sugars and the risk of some chronic metabolic diseases, with moderate certainty for obesity and dyslipidaemia, low certainty for non-alcoholic fatty liver disease and type 2 diabetes, and very low certainty for hypertension — while the cohort studies, swapping sugars for other macronutrients at equal calories, did not support a positive relationship for those diseases. Its conclusion was that the intake of added and free sugars should be as low as possible in the context of a nutritionally adequate diet. "As low as possible" is not a number, and it is not a ban; it is an admission that the evidence supports a direction — down — more firmly than it supports any particular stopping point, and that the stopping point depends on what else the diet contains.

The debate

The position this site takes follows the form rather than either slogan: the strongest case for action is against liquid sugars and frequent sugary snacking, where the evidence is direct and the mechanism is not merely caloric; the weakest case is for a precise gram target applied to every food, where the evidence itself — WHO's conditional 5%, EFSA's refusal to set a number, the null result for added sugar overall in the 2025 diabetes analysis — says the number is a judgement, not a measurement. A person who stops drinking sugary drinks and stops grazing on sweet foods between meals has addressed the two patterns the evidence most clearly indicts, whatever their exact daily gram total. A person who hits 49 grams instead of 51 by swapping one sweetened product for another with a different sweetener name has addressed a label, not a risk.

Who should cut back first

• People who drink their sugar daily — a daily soft drink, energy drink, sweetened coffee, or large juice is the pattern with the clearest evidence behind it; replacing it with water or an unsweetened drink is the single highest-value change in this article
• Children and teenagers, and their parents choosing for them — teeth are forming, dietary patterns are forming, and sweet drinks and frequent snacking combine the caries risk with the habit risk; WHO's guideline applies to children as well as adults
• People with type 2 diabetes or at risk of it — for whom rapid, liquid sugar loads are the form most directly linked to risk, and for whom the distinction between drinking sugar and eating it is clinically relevant; discuss personal targets with your clinician rather than adopting a population percentage
• People with frequent tooth decay despite good brushing — where frequency of sugary food and drink exposures, including sipping and grazing between meals, is the question to ask a dentist, alongside fluoride exposure
• People whose diet is dominated by discretionary foods — the Australian Dietary Guidelines' term for foods not needed for nutrients that are high in saturated fat, sugars, salt, or alcohol; when these supply a large share of energy, added sugars are usually part of a broader pattern worth addressing as a whole
• Anyone using "natural" sweeteners as a free pass — honey, maple syrup, agave, coconut sugar, and fruit-juice concentrate are still free sugars under WHO, and the first two are added sugars under the FDA; "natural" describes the source, not the metabolic effect

How to spot added sugars on a label

In Australia, this is harder than it should be, and the reason is a policy decision made in 2026. Australian nutrition information panels are required to declare total sugars, which combines sugars naturally present in a food with sugars added as ingredients — they do not separate the two. Food Standards Australia New Zealand considered changing that: Proposal P1058, begun in 2022, would have required added sugars to be listed separately in the panel. On 23 March 2026, FSANZ closed the proposal, finding that requiring the separate listing was unlikely to deliver a clear public health benefit, could impose substantial costs across the food system, and that consumers already use total sugars to compare products. Total sugars declaration remains, and there are no changes to existing labelling requirements as a result of the decision. Whatever you think of that judgement — and a 2026 perspective in Maternal & Child Nutrition argued it leaves parents of infants and toddlers worse off — it is the label Australian shoppers actually face, and it changes the technique: you cannot read added sugars off an Australian panel, so you have to reconstruct them from the ingredient list plus the total-sugars figure.

• Sugar, sucrose, dextrose, glucose, fructose, maltose — the straightforward names; sucrose is table sugar, dextrose is glucose, and all of them count
• Syrups — glucose syrup, corn syrup, high-fructose corn syrup (the subject of its own forthcoming explainer on this site), golden syrup, rice syrup, maple syrup, agave syrup; a syrup is a concentrated sugar solution, whatever plant it came from
• Honey, treacle, molasses — free sugars under WHO and added sugars under the FDA; "raw" or "unrefined" does not change the category
• Fruit-juice concentrate, fruit puree, and fruit-juice solids — used as sweeteners, these count as added or free sugars even though they came from fruit; a cereal bar sweetened only with apple-juice concentrate is not unsweetened
• Names that hide in plain sight — cane juice, cane sugar, evaporated cane juice, barley malt, malt extract, lactose when it is added as an ingredient rather than present in milk; and any ingredient ending in "-ose" that is not already part of a whole food
• The position test — ingredients are listed in descending order of weight down to 1%, so a sweetener in the first few ingredients is a main ingredient, while several sweeteners scattered through the middle of a long list can still add up to a large total; count the category, not the single name
• The total-sugars cross-check — compare like with like: a plain yoghurt's total sugars are mostly lactose, while a flavoured yoghurt's extra grams above the plain version's are a reasonable proxy for what was added, even though the panel will not say so directly
• What "no added sugar" does and does not mean — it means no sugar was added as an ingredient; it does not mean low in sugar, since the food's own ingredients (milk, fruit, fruit puree) can still supply a large total, and it does not mean unsweetened, since sweeteners such as intense sweeteners may still be present

Related: Vitamin C: The Antioxidant Serum Ingredient, Its Forms, and How to Choose One That Works — a reminder, from the other side of this site's shelves, that whole fruit's value was never only its sugar: the same fruit that carries fructose also carries fibre and nutrients that juice leaves behind.

Cutting back without falling for the swap trap

The most effective swap is not a sweetener swap at all; it is a form swap. Water replaces a sugary drink with no calories, no acid attack on teeth, and no label puzzle — and unsweetened sparkling water, tea, or coffee does the same job for people who miss fizz or flavour. Whole fruit replaces juice with the same sweetness packaged in fibre, which slows absorption and limits how much you can comfortably eat: it is difficult to eat four oranges, easy to drink them. For foods, the honest alternatives are smaller portions less often, and recipes where sweetness is doing less structural work — a dressing with less sugar and more acid, a cereal chosen by its total-sugars figure and its ingredient list rather than its front-of-pack fruit imagery. None of this requires a "sugar-free" product, and in many cases a sugar-free product is the worse choice: it may replace sugar with sweeteners and bulking agents, keep the same energy, and teach the same preference for intense sweetness that made the original hard to moderate.

The swap trap has three versions, and they all share one error — treating the source of sweetness as more important than its amount, form, and frequency. The first is the "natural" trap: honey, maple syrup, agave, and coconut sugar are marketed as wholesome alternatives to refined sugar, but they are concentrated sugars with similar energy, they count as free sugars under WHO, and honey and syrups count as added sugars under the FDA. The second is the juice trap: a product sweetened with fruit-juice concentrate can claim "no added sugar" in some framings while delivering the same free sugars as a product sweetened with sucrose, because the concentrate is fruit-derived — the category, not the plant, is what matters. The third is the sweetener trap: intense sweeteners remove the calories but keep the sweetness preference, and WHO in 2023 issued a conditional recommendation against using non-sugar sweeteners for weight control or reducing non-communicable disease risk, on the grounds that replacing free sugars with them does not help long-term weight control. The through-line is unglamorous and, for that reason, trustworthy: less sweetness, less often, in solid rather than liquid form, beats a cleverer sweetener every time.

Checked against the WHO 2015 sugars guideline, the US FDA added-sugars label page, EFSA Journal 2022;20:e07074, Te Morenga et al. 2013, Della Corte et al. 2025, and Food Standards Australia New Zealand Proposal P1058 (closed 23 March 2026) · Last updated 2026-11-05 · How we assess ingredients

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