Is sugar really your enemy? A dietitian explains

Ever reached for a slice of birthday cake or sweetener for your morning coffee and wondered, “I shouldn’t, should I?”

Our relationship with sugar is complicated. It’s often part of routines and celebrations, but we may feel guilty about eating sugar and hear conflicting advice about its place in our diet.

Is it better to use natural sugars than refined sugars? What about using artificial sweeteners? Should you try to avoid sugar altogether?

Brittany Thorpe, MS, RD, a registered dietitian and nutritionist at the MultiCare Rockwood Weight Loss & Bariatric Surgery Center, separates sugar facts from fiction so you can make realistic choices that support your health.

What is sugar, and why do we need it?

Sugar is a type of carbohydrate. It’s found naturally in fruits, vegetables, dairy products and grains. Sometimes it’s also added to foods like packaged desserts or snacks.

All sugars break down into a form of glucose, which is the primary energy source for the brain and every cell in the body.

“Sugar is not inherently bad — our bodies need it to function,” says Thorpe, who is also a certified specialist in obesity and weight loss management. “But the source of sugar and the amount and frequency we consume it matters. A diet high in added sugar, for example, is associated with a higher risk of several chronic diseases, including heart disease.”

Naturally occurring sugar vs. added sugar: What’s the difference?

Foods with naturally occurring sugars (like fruit) come with fiber, along with other vitamins and minerals. These foods support your body’s nutritional needs, and they digest slowly, so they won’t cause large spikes in blood sugar levels.

Foods with added sugar — like cupcakes and cookies — tend to have minimal fiber and nutritional value. The body digests these foods quickly, so you’re more likely to experience spikes and then crashes in blood sugar levels. This cycle can leave you feeling sluggish and craving more sugar.

“When people consistently eat a lot of added sugar, they tend to feel hungrier more often — and are more likely to turn to low-nutrient foods to fulfill that hunger,” Thorpe says. “The more added sugar we eat, the more we tend to crave it.”

How much sugar is too much?

So, what should you aim for when it comes to sugar intake?

“The recommendation is not to eliminate sugar completely, because then you’ll miss out on important nutrients found in fruits and other foods with naturally occurring sugars,” Thorpe says. “The goal is to limit added sugar.”

The American Heart Association (AHA) recommends that 6 percent or less of the calories you consume each day come from added sugar. This means:

• Women: 25 grams or less of added sugar per day
• Men: 36 grams or less of added sugar per day

Are natural sweeteners healthier?

“Natural” or minimally processed sweeteners like honey, agave nectar and maple syrup may seem like healthier choices, but they’re still considered added sugar.

“There’s very little difference in how any added sugar — whether it’s a tablespoon of honey or refined table sugar — is processed in the body,” Thorpe says. “They’re both digested quickly and provide little nutritional benefit beyond sweetness.”

Replacing refined sugar with a natural sweetener is not likely to make a significant difference to your health. Consistently overconsuming added sugar in any form can increase your risk for conditions like heart disease and obesity.

Should you use sugar substitutes?

Artificial sweeteners like aspartame, sucralose and saccharin — and plant-based options like Stevia — add sweetness with few or no calories. These products are also known as nonnutritive sweeteners.

“The benefit of nonnutritive sweeteners is that you need less of them for foods to taste sweet and they don’t increase blood sugar levels,” Thorpe says. “If you’re trying to reduce your calorie intake, these may be an option to consider.”

Yet sugar alternatives are not without controversy. Some studies have suggested a potential link between certain artificial sweeteners and cancer, while other studies have found no connection between the two. Findings about the effect of sugar substitutes on the gut microbiome are also inconsistent.

More research is needed to understand the long-term impacts of sugar alternatives. The U.S. Food and Drug Administration has deemed these products safe for use within certain limits.

“Whether or not to use sugar substitutes is a personal decision,” Thorpe says. “The key — regardless of what you use — is moderation. If small amounts of sugar substitutes are effective at helping you cut back on added sugar, then they can be part of a healthy eating plan.”

When considering whether to use sugar alternatives, Thorpe recommends paying attention to how you feel after eating them. Sugar substitutes can cause digestive issues or trigger headaches for some people.

How can I reduce or eliminate added sugar?

Eliminating added sugar completely is not sustainable in the long term for most people. This approach is likely to lead to a cycle of deprivation, craving and then binge eating sugary foods, which isn’t healthy.

Instead, aim for gradual changes that limit added sugar as much as possible. Most people consume well above the AHA guidelines for added sugar, so it may take time to reach those goals.

“A healthy diet includes a balance of whole grains, fruits, veggies and lean protein,” Thorpe says. “If in general you have this foundation, then small amounts of sweets every now and then are OK.”

These tips can help you cut back on added sugar:

Check labels for hidden sugar. Added sugar often lurks in everyday staples such as flavored yogurts, breakfast cereals, granola bars, condiments, salad dressing and spaghetti and pizza sauces.

Make smart swaps. Choose a bowl of Greek yogurt with fresh berries instead of ice cream. Use tomato paste instead of pizza sauce. Make your own trail mix instead of using store-bought. Replace soft drinks with flavored sparkling water. Add a dash of cinnamon, vanilla extract or unsweetened cocoa powder to your coffee instead of flavored creamer.

Avoid liquid sugar. Sweetened coffee drinks, energy drinks, soft drinks and fruit juice often contain high amounts of added sugar and have little nutritional value.