The Ultimate Guide to Refined Sugar: Guidelines, Health Risks and Alternatives

Sugar has become a big part of our daily lives, often hidden in processed foods and drinks. We’re naturally drawn to sweet foods, as for our ancestors sweetness meant a safe source of energy. But these days sugar is everywhere, so it’s really easy to eat more than we need.

Sugar isn’t something you need to fear or cut out completely, but most of us would benefit from eating less of it. In this article, I’ll explain what sugar actually counts towards your limit, how much is recommended, where it hides, what to make of “refined sugar-free” and sweeteners, and some practical ways to cut back.

What is refined sugar?

Refined sugar, often called table sugar or white sugar, is sugar that has been extracted and purified from sugar cane or sugar beet. The process removes almost all of the fibre, vitamins and minerals from the original plant, leaving almost pure sucrose.

What are free sugars?

When it comes to health guidelines, the term to know is “free sugars”. This is the type of sugar we’re advised to limit, and it covers more than just white sugar.

Free sugars aren’t the same as added sugars. When fruit is juiced or blended, its natural sugars are released from the cell walls, so they count as free sugars in the UK, even with nothing added.

That doesn’t mean there’s anything wrong with having a fruit smoothie. A smoothie made with whole fruit still keeps the fibre, and it can be a really nutritious way to start the day. The key is not to make it all fruit. Balance it out with things like leafy greens, avocado, oats, seeds, nut butter, soy yoghurt or soy milk. These add protein, fibre and healthy fats, which make your smoothie more filling and help slow down how quickly the sugars are absorbed.

How much is recommended?

• UK: free sugars should make up no more than 5% of your daily energy. That’s a maximum of 30g a day for anyone aged 11 and over, 24g for children aged 7 to 10, and 19g for children aged 4 to 6.
• Worldwide: the World Health Organization recommends less than 10% of your daily energy from free sugars, ideally less than 5%.
• Australia: the dietary guidelines don’t set a number, but advise limiting foods and drinks with added sugars.
• US: added sugars should make up less than 10% of your daily energy.

In the UK, most adults eat around double the recommended amount, and teenagers eat even more. The biggest sources are sugary drinks, cereals and cereal products, sweets, chocolate, biscuits and cakes, table sugar and fruit juice.

To put the 30g limit into perspective:

• A 330ml can of regular cola contains around 35g of free sugars, more than the whole daily limit
• A 150ml glass of orange juice contains around 13g
• A 125g pot of flavoured yoghurt can contain around 10g
• A teaspoon of honey or maple syrup contains around 4 to 5g

Why it’s worth cutting back

Teeth

Free sugars are the main cause of tooth decay. Bacteria in the mouth feed on sugar and produce acids that damage tooth enamel. How often you have sugar matters too, so sipping sugary drinks throughout the day is particularly bad for your teeth.

Weight

Sugary foods and drinks are easy to overeat, as they’re high in calories but not very filling. Sugary drinks are especially linked with weight gain, because liquid calories don’t fill you up the way food does.

Heart health and type 2 diabetes

High sugar intakes are linked with a higher risk of heart disease and type 2 diabetes, largely through weight gain. Eating a lot of sugar can also raise triglycerides, a type of fat in the blood. Sugary drinks show the strongest links, which is why they’re the best place to start cutting back.

Energy and hunger

Sugary foods eaten on their own are digested quickly, so they don’t keep you full for long and you may find yourself hungry again soon after. Pairing sweet foods with protein, fibre or fat, for example fruit with a handful of nuts, helps keep you fuller for longer.

Nutrient intake

Diets high in sugary foods tend to be lower in nutrient-dense foods like fruit, vegetables, wholegrains, beans and lentils, simply because they take up space in your diet. This can mean missing out on fibre, vitamins and minerals.

Other links

Some studies have linked diets high in sugar with a higher risk of depression and acne, and high-sugar diets may contribute to inflammation. The evidence here is mostly observational, so it’s not clear sugar is the cause, but it’s another reason to keep free sugars in check.

Spotting sugar on labels

Sugar can be hard to spot on ingredients lists, as it goes by lots of different names. Many end in “-ose”, like glucose, fructose, sucrose, maltose and dextrose. Others include:

• Invert sugar syrup
• Corn syrup and high fructose corn syrup
• Molasses and treacle
• Hydrolysed starch
• Fruit juice concentrate
• Honey, agave and other syrups

Ingredients are listed in order of weight, so the higher up sugar appears, the more there is. If you see several types of sugar listed, they can add up to a lot.

On UK nutrition labels, a food is high in sugar if it contains more than 22.5g of total sugars per 100g, and low in sugar if it contains 5g or less per 100g. Bear in mind total sugars includes natural sugars from fruit, so check the ingredients too.

Hidden sugars in unexpected foods

It’s not just obvious sweet treats that contain sugar. Some foods you might not expect include:

• Sauces and condiments: ketchup, barbecue sauce, sweet chilli and many salad dressings can contain a lot of added sugar.
• Flavoured yoghurts: even those marketed as healthy often have added sugar. Choose plain soy yoghurt and add your own fruit.
• Plant milks: many sweetened versions contain added sugar. Choose unsweetened, ideally calcium-fortified.
• Granola and breakfast cereals: many shop-bought versions are surprisingly high in sugar. Look for lower-sugar options or make your own with oats, nuts and seeds.
• Pasta sauces: many jarred sauces contain added sugar, along with lots of salt. Making your own with tinned tomatoes is easy, and you can batch cook and freeze it.
• Bread, wraps and burger buns: many packaged breads contain added sugar, so check the ingredients.
• Dried fruit: the natural sugars in dried fruit don’t count as free sugars, but some brands add extra sugar or syrup, so check the label.
• Protein bars: often seen as a healthy snack, but many are packed with sugar or syrups.

What about “refined sugar-free”?

“Refined sugar-free” usually means a food is sweetened with something other than white sugar, such as honey, maple syrup, agave, coconut sugar or dates. It’s easy to assume these are much healthier, but most of them aren’t that different.

Honey, syrups and coconut sugar all count as free sugars, and your body handles them in much the same way as white sugar. They do contain tiny amounts of vitamins, minerals and antioxidants, but not enough to make a real difference. Agave has a lower GI, but that’s because it’s mostly fructose, which doesn’t make it healthier.

Whole fruit is the exception. Using whole dates, mashed banana or grated apple in recipes adds sweetness along with fibre, vitamins and minerals, which makes them a better choice than syrups.

So, a refined sugar-free treat isn’t automatically a healthy one, but recipes sweetened with whole fruit are a step in the right direction.

What about artificial sweeteners?

Many people turn to sweeteners as an alternative to sugar. Common examples include aspartame, sucralose, saccharin and stevia, which are often found in diet drinks and “sugar-free” products.

Sweeteners approved for use in the UK, EU and Australia have been assessed as safe within their acceptable daily intakes. You might have seen headlines in 2023 about aspartame being classed as “possibly carcinogenic”, but this was based on limited evidence, and the safe daily limit stayed the same. An adult would need to drink more than 9 to 14 cans of diet drink a day to go over it.

That said, there are a few things worth knowing:

• Swapping sugary drinks for diet versions can help reduce your sugar intake, but the World Health Organization advises against relying on sweeteners for long-term weight control, as the benefits haven’t been shown to last.
• Some studies suggest sweeteners may affect gut bacteria, but research is still ongoing.
• They keep your taste buds used to very sweet flavours, so cutting back on sweetness overall may be more helpful in the long run.

Overall, sweeteners are fine in moderation, especially as a swap for sugary drinks, but water and unsweetened drinks are best for everyday.

Practical tips for reducing your sugar intake

Summary

Most of us eat more free sugars than recommended, and cutting back can benefit your teeth, weight, heart health and overall diet. The biggest wins come from reducing sugary drinks, checking labels for hidden sugars and sweetening with whole fruit where you can.

Remember, “refined sugar-free” doesn’t automatically mean healthy, and there’s no need to cut sugar out completely. Small, gradual changes are the most sustainable way to reduce your intake while still enjoying your food.