Lower added sugar

TL;DR. Added sugar is sugar added to food, separate from the sugar already in fruit or milk. The evidence against it is deeper than for any other single dietary input. Fructose, half of table sugar, is handled like alcohol in your liver. Liquid sugar skips your full signal. The average US teen eats 30 teaspoons a day against a WHO ceiling of 6. You do not have to quit. A 50 percent cut, mostly from drinks and a short list of packaged foods, gets most of the gain.

What this goal does

This goal flags foods that lean on added sugar. It leaves whole fruit, plain dairy, and starchy vegetables alone. The aim is to move added sugar back to where it used to live: a treat, eaten on purpose.

With this goal on, the scanner blocks items where added sugar is the main event, warns on items where it is present but not dominant, and rewards items with no added sugar or whole-food sweetness. You can run this goal on its own. Most people do.

Evidence in 3 paragraphs

Start with the biochemistry. Sucrose and high-fructose corn syrup are each about half fructose. Every cell can burn glucose. Fructose almost all goes to your liver. It enters liver cells without insulin and slips past the main brake in the sugar-burning pathway, so what your liver cannot burn it turns into fat. Robert Lustig, in Metabolical, says fructose acts like alcohol in your liver. Kids now get the diseases of drinkers, including type 2 diabetes and fatty liver, without ever taking a drink.

The population data lines up. Walter Willett's Nurses' Health Study, summarized in Eat, Drink, and Be Healthy Chapter 9, found that each daily sugar-sweetened drink raises type 2 diabetes risk by about 15 percent. Liquid sugar is the worst form. It absorbs in minutes and slips past the satiety signals that solid food triggers. A 20-ounce Coke holds about 16 teaspoons of sugar, drunk in three minutes. A glass of OJ delivers roughly the same fructose load. Gary Taubes, in The Case Against Sugar, traces a century of natural experiments where sugar arrived in a population and obesity and diabetes followed within a generation.

Most people eat far more than the limit. The WHO caps added sugar at 10 percent of daily calories, with a softer goal at 5 percent. On a 2,000-calorie diet that is 12 teaspoons, or about 6 under the tighter goal. The American Heart Association caps kids at 3 to 4 teaspoons a day. The average US teen eats about 30 teaspoons a day, against a WHO ceiling of 6 teaspoons for women and children (Spector, Food for Life, Ch. 29). Most of it comes from a short list: soda, juice, sweet coffee drinks, breakfast cereal, flavored yogurt, granola bars, sauces, and store-bought bread. Swap three or four of those and you cut intake in half.

What helps

• Plain water, coffee, tea, or sparkling water as your default drink.
• Whole fruit. Berries are best. Fiber slows the sugar down and you chew, which slows you down too.
• Plain Greek yogurt with fresh fruit instead of flavored yogurt.
• Real rolled oats, eggs, or last night's leftovers for breakfast instead of cereal.
• Unsweetened nut butter with one ingredient.
• Dark chocolate at 70 percent or higher, eaten slowly, as dessert.
• Reading the "Added Sugars" line on the Nutrition Facts panel. It was added in 2016 over industry objections. Use it.

What hurts

• Soda, sports drinks, energy drinks, sweet coffee drinks, and fruit juice. Liquid sugar is the worst form.
• Breakfast cereal. Most boxed cereals run 25 to 56 percent sugar by weight.
• Flavored yogurt. A 6-ounce cup can hold 4 to 5 teaspoons of added sugar.
• Granola bars and protein bars with three or more sweeteners on the label.
• Sauces. Ketchup, BBQ sauce, salad dressing, pasta sauce, teriyaki.
• "Natural" sweeteners. Honey is about 50 percent fructose. Agave runs 70 to 90 percent fructose. The PREDICT continuous-glucose data shows their blood sugar spikes look nearly identical to refined sugar (Spector, Ch. 29).
• The split-ingredient trick. Makers spread one sweetener across three or four names so none rises to the top of the list. Cane sugar, brown rice syrup, honey, and tapioca syrup on the same bar add up to a lot of sugar.

You do not need to memorize all 250-plus names for added sugar. Two patterns catch most of them: anything ending in -ose except lactose, and any word with "syrup" or "concentrate."

How the scanner uses this

The scanner reads the Nutrition Facts panel and the ingredient list. It does not need you to count grams.

Hard rules. A product fails this goal if either is true:

• More than 25 grams of added sugar per serving.
• Sugar, in any form, appears in the top 2 ingredients.

Soft rules. A product gets a warning if any is true:

• 5 to 25 grams of added sugar per serving.
• High-fructose corn syrup, agave, or fruit juice concentrate appears anywhere in the ingredient list as a sweetener.

Bonuses. A product gets a small boost if:

• 0 grams of added sugar.
• Sweetness comes from whole fruit listed in the ingredient list, like dates or raisins or whole berries.

The hard rules are blunt on purpose. They catch the worst offenders without much thought from you. The soft rules nudge you toward the better version of the same food. The bonuses reward the real thing. Whole fruit, plain dairy, and plain vegetables count as zero added sugar even when their total sugar number is high. An apple has 19 grams of sugar. It is still an apple.

Worked examples

Coca-Cola, 12 oz. 39 g added sugar, sugar listed second. Two hard-rule failures. Block.

Tropicana Orange Juice, 8 oz. 22 g sugar, all from concentrate, no fiber. Counts as added sugar because it acts like added sugar in your liver. Soft-rule warning, plus a liquid-sugar flag.

Clif Bar, Chocolate Chip. 17 g added sugar. Organic cane syrup is the first ingredient. Hard-rule failure on the top-2 rule. Block.

Honey Nut Cheerios. 12 g added sugar per 1-cup serving. Sugar and honey both appear in the top 5 ingredients. The serving size is small, so the gram count looks softer than it is. Soft warning, plus a split-sweetener nudge.

Plain Greek yogurt, 6 oz. 0 g added sugar. Cultured milk is the only ingredient. Bonus.

Fresh berries, 1 cup. 0 g added sugar. Whole fruit. Bonus.

Lara Bar, Cashew Cookie. 0 g added sugar. Two ingredients: cashews and dates. Bonus for whole-fruit sweetness.

Related reading

• Sugar, the clearest case. The long-form story of fructose, the insulin cascade, glycation, and the industry capture that delayed the science by 40 years.
• The ultra-processed food problem. Why added sugar tends to travel with refined seed oils and refined flour.
• Reading labels. How to read the "Added Sugars" line and the ingredient list.

Sources

1. Lustig, R. Metabolical (2021) — fructose as hepatic ethanol; de novo lipogenesis; child fatty-liver epidemic.
2. Taubes, G. The Case Against Sugar (2016) — epidemiologic case across a century of natural experiments.
3. Willett, W. Eat, Drink, and Be Healthy (2017 ed.), Chapter 9 — liquid sugar bypasses satiety; 15 percent T2DM risk per daily SSB; Nurses' Health Study.
4. Spector, T. Food for Life (2022), Chapter 29 — 250-plus ingredient-list synonyms for added sugar; average US teen at ~30 tsp/day vs. WHO 6 tsp ceiling; PREDICT CGM data on honey, maple, agave.
5. World Health Organization. Guideline: Sugars intake for adults and children (2015) — 10 percent and 5 percent of daily calories.
6. American Heart Association. Added Sugars and Cardiovascular Disease Risk in Children (2016) — 3 to 4 teaspoons per day cap for kids.