Another Reason to Hold the Added Sugar

Printed with permission from the Cooper Institute.

heap of sugar and a spoon

There has long been the debate as to whether eating too much sugar can cause diabetes. It is widely accepted that eating too much of any food (sugar included) causes you to gain weight which in turn can lead to obesity which, yes, is a predisposition to diabetes. New research, however, provides evidence that there may be a direct and independent link between sugar and diabetes. Researchers looked at food availability in 175 countries and after controlling for a large number of factors—other food types including fiber, meats, fruits, oils, cereals; total calories; overweight and obesity; aging; urbanization; income; physical activity; tobacco use; alcohol use—an increase of sugar in the food supply was liked to higher rates of diabetes (Basu et al, 2013). Specifically for every additional 150 calories of sugar available per person per day, which is about the equivalent of 1-12 oz soda, the prevalence of diabetes in the population rose 1.1 percent. In comparison, an additional 150 calories available of any type only caused an increase in prevalence of 0.1 percent highlighting the fact that it is sugar that is specifically responsible for the increase and not just calories. The researchers also found that longer exposure to high sugar was associated with increased diabetes prevalence, while reduced sugar exposure was associated with a decline in diabetes prevalence.

These results are not meant to undermine obesity’s role in diabetes as the data in this study also shows the strong link between the two, but it does show that additional factors may be at play, and sugar may be an independent factor. It is important to note that “link” does not mean “causation” and further exploration is definitely warranted. There are some limitations of this study. Because of the scale of the study, food availability was looked at versus actual food consumption. Specific added sugar sources were not evaluated such as high fructose corn syrup versus sucrose and populations were studied at large. Studies of individual populations may yield differing results.

Despite these limitations, this study has some powerful evidence to suggest that added sugar availability increases diabetes prevalence overtime when looking at the population at large. These findings provide further support for our current Dietary Guidelines which state the need to reduce added sugar intake. Added sugars contribute an average of 16 percent of the total calories in American diets some of which include (Dietary Guidelines, 2010):

  • high fructose corn syrup
  • white sugar
  • brown sugar
  • corn syrup
  • corn syrup solids
  • raw sugar
  • malt syrup
  •  maple syrup
  • fructose sweetener
  • liquid fructose
  • honey
  • molasses
  • and others

The major sources of added sugars in the diets of Americans are soda, energy drinks, and sports drinks (36% of added sugar intake), grain-based desserts (13%), sugar-sweetened fruit drinks(10%), dairy-based desserts (6%), and candy (6%).

While more needs to be done to fully understand sugar’s role in diabetes, it is clear that lowering added sugar consumption is important for your health for many reasons.  Here are some suggestions on how you can get started:

  • Focus on eating the most nutrient-dense forms of foods from all food groups (vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, lean meats and poultry, seafood, eggs, beans and peas, and nuts and seeds) without added sugar.
  • Reduced the intake of processed foods (you know, the foods that come in a box. Shop the perimeter of the store).
  • Consume fewer and smaller portions of foods and beverages that contain added sugars, such as grain-based desserts, sodas, and other sugar-sweetened beverages.
  • Replace sugar-sweetened beverages with water or unsweetened beverages.
  • Consume juices that are only labeled as 100% fruit juice.
  • Limit the amount of sugar you added to the foods you eat or when cooking (that means hold some of the sugar you sprinkle on top of your cereal. When baking I often use half the sugar the recipe calls for and it is still plenty sweet. In smoothies I let the fruit add the sweetness!).

We know that change doesn’t happen overnight, but give a few of these a try. Your health is worth it!


Basu S, Yoffe P, Hills N, Lustig RH (2013). The relationship of sugar to population-level diabetes prevalence: an econometric analysis of repeated cross-sectional data. PLoS ONE 8(2): e57873. doi:10.1371/journal.pone.0057873

U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010.

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