Sugar

Total sugars includes all simple carbohydrates in a food — both naturally occurring sugars (such as fructose in fruit, lactose in milk, and glucose in honey) and any sugars added during manufacturing or cooking (such as table sugar, high-fructose corn syrup, or concentrated fruit juice). Added sugars are the subset specifically added during processing; these are the ones public health guidelines recommend limiting. The FDA requires added sugars to be listed separately on the Nutrition Facts label in the US.

The FDA and the Dietary Guidelines for Americans recommend that added sugars account for no more than 10% of total daily calories — approximately 50g of added sugars per day on a 2,000 kcal diet. The World Health Organization recommends a stricter limit of less than 5% of calories (~25g) for additional health benefits. There is no specific limit on naturally occurring sugars in whole foods, as these come packaged with fibre, vitamins, and other nutrients.

Refined sugar (table sugar, powdered sugar) is nearly 100% sugar by weight. Honey (~80g/100g), dried fruits (dates ~63g, dried cranberries ~72g with added sugar), jams and preserves, soft drinks (~10g/100ml), and breakfast cereals are among the highest sources of sugars. Naturally occurring sugars in whole fruits range from approximately 5–15g per 100g depending on the variety.

No — the sugars in whole fruit behave very differently from added sugars in processed foods. Whole fruit contains fibre, which slows sugar absorption and blunts the glycaemic response; it also provides vitamins, minerals, antioxidants, and polyphenols. Large-scale epidemiological studies consistently associate higher fruit consumption with lower risks of cardiovascular disease, type 2 diabetes, and all-cause mortality. Fruit juice is more comparable to added-sugar drinks because the fibre is removed or reduced.

Type 2 diabetes is caused by insulin resistance and impaired beta-cell function, driven by a combination of genetic susceptibility, excess calorie intake, excess body fat (particularly visceral fat), physical inactivity, and other factors. Dietary sugar does not directly cause diabetes, but consistently consuming excess calories from added sugars — which contributes to weight gain and high visceral adiposity — is a risk factor for developing type 2 diabetes over time. Naturally occurring sugars in whole foods as part of a balanced diet are not associated with increased diabetes risk.

Fructose is a monosaccharide (simple sugar) found naturally in fruit, honey, and some vegetables, and used as an industrial sweetener in the form of high-fructose corn syrup. Unlike glucose, fructose is metabolised primarily in the liver. Very high doses of isolated fructose — as seen in diets rich in sugar-sweetened beverages — are associated with increased liver fat, elevated triglycerides, and uric acid production. However, fructose from whole fruit at typical consumption levels is not associated with adverse metabolic effects in most studies, partly because the fibre and water in fruit moderate total fructose delivery.