Added sugars: the essential guide

01

What counts as added sugar

Added sugars are sugars and syrups put into foods during processing, preparation or at the table. The World Health Organization uses a slightly wider notion, free sugars: added sugars plus the sugars naturally present in honey, syrups and fruit juices.¹

The sugars inside whole fruit, vegetables and plain milk are different. They come with fibre, water and nutrients, and health recommendations do not target them.

02

How much Europeans eat

National dietary surveys show that added sugars provide 7 to 11% of the energy adults eat, and 11 to 17% for children.² Using data from the Member States, EFSA found that added sugar intakes exceed the 10% threshold in several EU countries, especially among children.³

In other words, many adults sit at or above the WHO limit, children are well above it, and almost no population group reaches the 5% level that WHO recommends for additional health benefits.

Where does it come from? For adults, sweet products such as confectionery, cakes, biscuits, jam and table sugar provide 36 to 61% of added sugars, drinks 12 to 31% and dairy products 4 to 15%. Children get more of theirs from drinks (20 to 34%) and dairy (6 to 18%).²

Surveys rely on what people report eating, which tends to underestimate sugary snacks and drinks. Methods also differ between countries, which is why we compare ranges rather than rank Member States.

03

Where it hides

Sweets and soft drinks are the obvious sources. But sugar is also added to many savoury foods and to products marketed as healthy, where few people look for it.

• BreakfastCereals, granola, cereal bars, flavoured yogurts, plant-based drinks
• SavourySliced bread, ketchup, pasta sauces, salad dressings, ready meals
• "Healthy" optionsSmoothies, fruit juices, protein bars, "no added sugar" products sweetened with juice concentrate
• For childrenBiscuits, dairy desserts, and even some infant formulas and baby foods

An organic label is no guarantee either. Our analysis of 59 infant formulas sold in France found organic products with significant amounts of added sugars.⁴ Read the investigation.

04

Why industry adds it

How widespread is it? In the United States, 74% of products in the food supply contain caloric or low-calorie sweeteners, or both.⁵ No comparable figure exists for the EU, because European labels only show total sugars and do not say how much was added.⁶ Closing that data gap is one of our goals.

05

Health effects

An umbrella review published in The BMJ in 2023 brought together 73 meta-analyses. It found significant harmful associations between high sugar intake and 45 health outcomes.⁷

• 18 metabolicincluding obesity, type 2 diabetes and gout
• 10 cardiovascularincluding high blood pressure, heart attack and stroke
• 7 cancersincluding breast, prostate and pancreatic cancer
• 10 othersincluding asthma, tooth decay, depression and early death

Most of this evidence is observational and of low quality, and the links with cancer remain limited, as the authors stress. The strongest evidence concerns body weight: sugary drinks are associated with weight gain, and added sugars with fat build-up in the liver and muscles.⁷

EFSA reached a similar conclusion using randomised trials. It found a causal link between added and free sugars and obesity and blood lipid disorders with moderate certainty, and with fatty liver disease and type 2 diabetes with low certainty. Sugar is an established cause of tooth decay. EFSA could not identify any level of intake without risk.³

06

How the body handles it

1. Fast absorptionWithout the fibre of whole foods, added sugars are digested quickly and blood glucose rises sharply.
2. Insulin responseThe pancreas releases insulin to bring glucose down. Repeated spikes, over years, can wear down the body's response to insulin.
3. Fat production in the liverThe fructose half of sugar is processed mainly by the liver, which turns the excess into fat. This raises blood triglycerides and can lead to fatty liver.
4. Calories that do not fill you upSugary drinks add energy without making people eat less at the next meal, which helps explain their link with weight gain.

This is a simplified summary of mechanisms described in the scientific literature. Individual responses vary.

07

Names on the label

Ingredient lists can use dozens of different names for sugar: one US review counts at least 61.⁸ Using several sugars also pushes each one further down the list, which is ordered by weight.

Sucrose

Ordinary table sugar, from beet or cane. Sweetness, bulk, texture, shelf life.

Glucose, dextrose

A simple sugar. Used in sweets, sports drinks and bakery products for browning and fermentation.

Glucose syrup

Made from starch. Cheap, prevents crystallisation, adds body to sweets, ice cream and sauces.

Glucose-fructose syrup

Also called isoglucose, the EU equivalent of high-fructose corn syrup. Used in soft drinks and processed foods.

Invert sugar syrup

Sucrose split into glucose and fructose. Keeps bakery products and confectionery moist.

Maltose, malt extract

From malted barley or other grains. Flavour and colour in cereals, bread and malted drinks.

Fruit juice concentrate

Concentrated juice used to sweeten products sold as "no added sugar". Counts as free sugar.

Honey, agave, maple syrup

Natural-sounding, but sugars all the same. Agave syrup is mostly fructose.

Maltodextrin

A starch derivative digested into glucose. Not counted as sugar on labels, but used as a cheap filler, including in infant formula.

Also look for: cane sugar, brown sugar, raw sugar, coconut sugar, molasses, treacle, caramel, golden syrup, rice syrup, date syrup, grape must, lactose (when added), galactose, dried glucose syrup.