The difference between added sugars, natural sugars and artificial sweeteners

Looking to lower your sugar intake? A dietitian explains what you need to know about the various types of sweeteners — and how to choose wisely.
Sugars are added to about 75% of the packaged foods you eat, whether those foods are sweet or not.
Sugars are added to about 75% of the packaged foods you eat, whether those foods are sweet or not.Manuta / Getty Images/iStockphoto

Americans consume, on average, 17 teaspoons of added sugar every day, putting us in excess of the daily limits suggested by the American Heart Association, which recommends:

  • No more than 6 teaspoons per day for women and kids
  • Up to 9 teaspoons per day for men

Going above these limits has been linked to numerous health problems, including heart disease, type 2 diabetes, mood disorders (like depression), weight problems, certain forms of cancer, and cognitive disorders, such as Alzheimer’s disease. In order to get smarter about your added sugar intake, you need to get clear on sweeteners. Here’s what you need to know.

What are added sugars?

Added sugars include the sweeteners that you’re adding to drinks, like tea and coffee, as well as those that manufacturers add to food. When you think of added sugars, you’re probably thinking about foods like cookies, ice cream and soda, but sugars are added to about 75% of the packaged foods you eat, whether those foods are sweet or not. Foods like bread, whole grain cereals, plant-based milk (such as oat milk), granola bars, yogurts, soups, salad dressings and other condiments often contain sneaky amounts of added sugars. At first glance, these amounts may not seem like much, but over the course of a day, they can easily put you over the recommended limit for added sugars.

How to track added sugars

On a food label, added sugars are listed as grams. There are roughly 4 grams of sugar per teaspoon, so the recommendations for daily sugar limits translate to 25 grams for women and kids and 36 grams for men.

When you’re looking at food labels, take note of the added sugar line right beneath the total sugar line. This tells you the amount of added sugar for the typical serving of that food. You’ll also want to zero in on the serving size at the top of the label to get a sense of whether you eat more or less than the standard portion since your added sugars will increase (or decrease) according to how much you eat. Then, compare your item to other similar ones. If you find a food with less added sugar, it could be a better bet.

While you’re scanning food labels, don’t forget to check out the ingredient list. Ingredients are stated in order of predominance, so whatever’s listed first is the main ingredient. If you see a sugary ingredient listed first, or even second, it’s probably a sign you could make a better choice. Also check for artificial sweeteners since they’re often used to replace sugar in packaged foods.

One more note on food labels: Added sugar may show up in many different forms — more than 50 of them, in fact. Some common sweeteners used in packaged foods include fruit juice concentrates (like apple or pear juice concentrate), brown rice syrup, cane sugar, cane juice crystals, high fructose corn syrup, corn sweetener or syrup, evaporated cane juice, maltodextrin and many, many more. It’s good to be alert to these common forms of added sugar, but the newly updated food label also makes it easy to keep an eye on the total amounts coming from the foods you eat.

What are natural sugars?

Natural sugars include the fructose in fruit and the lactose in dairy foods. When you’re limiting your sugar intake, you don’t need to worry about these types of sugars. In fact, both fruit and dairy foods, like yogurt and milk, have other much-needed nutrients, such as fiber and antioxidants in fruit, and calcium and potassium in milk. These are the types of sugars that your body is designed to eat, but since there’s no shortage of packaged foods to meet our demands for convenience and taste, we’re eating alarming amounts of the added type.

What about natural or less refined sweeteners?

Among the many types of sweeteners are ones like maple syrup, honey and coconut sugar, which are considered less refined than heavily processed sweeteners, such as table sugar. But let’s be clear here: Your body doesn’t care. Whenever you ingest a form of added sugar, your body will convert that sugar to glucose in your blood, and then respond by pumping out insulin to keep your blood sugar levels in a stable range. If you consistently eat a sugary diet, your pancreas has to work overtime to produce insulin. At the same time, your cells become less responsive, so the sugar builds up in your blood stream. Ultimately, this can be a risk factor for type 2 diabetes.

Some sweeteners, like maple syrup and honey, are considered healthier because they contain antioxidants and other nutritional bonuses (like anti-inflammatory compounds). But you can find many similar benefits in other unsweetened plant-based foods, like fruits and veggies. These perks are not enough of a reason to overindulge in added sugars, so no matter which sugars you're eating, it’s worthwhile to stay within the recommended limits.

Should I use artificial sweeteners instead?

Artificial sweeteners are often used to replace sugar in packaged foods, and in particular, sugary drinks, like soda. Unlike ordinary sweeteners, these sugar substitutes don’t contain carbohydrates so they don’t have an impact on your blood sugar levels. Since they’re also calorie-free, they can help you manage your weight, particularly if you normally drink sugary drinks and switch to diet ones instead.

That’s good news, but artificial sweeteners may have other consequences. For example, studies link sucralose (which is used in diet sodas and more) with insulin resistance, suggesting that it may impair glucose metabolism. Other studies have linked these types of sweeteners with a higher risk of stroke, heart disease and dying prematurely from any cause.

And while they may help with weight loss, the evidence isn’t conclusive. Some research suggests that when you decouple calories from the super sweet foods or drinks you’re consuming, your food reward pathways get short-circuited, which may leave you with a bigger appetite and more cravings. This could lead to compensating for those calories in other ways, which could then lead to weight gain.

There are also sugar substitutes derived from natural substances, like monk fruit extract, stevia and erythritol. So far, these haven’t raised the same health concerns, however, since they’re newer to the scene, they also haven’t been studied in the same way.

Alternative sweeteners aren’t the end-all-be-all, but they can be part of your sugar reduction plan. Just don’t get carried away. The goal is to limit the amount sweetened foods and drinks you’re having, whether that sweetness comes from a form a sugar or an alternative source.