Sugar & Health Index (EU-27)
The ranking
Composite score from 0 (low) to 100 (concerning). Toggle between general population and children: the underlying components change (adult intake + adult obesity + diabetes vs. child intake + child obesity). Click a column header to sort.
Why "most sugar" ≠ "worst health"
The intake / burden mismatch
The countries that consume the most sugar are not necessarily the sickest. Three cases in the table illustrate this:
- Belgium — highest supply figure, yet moderate obesity and diabetes: the FAO number partly reflects transit trade and cross-border buying.
- Portugal — among the lowest free-sugar intakes in the EU (< 8%), yet the highest diabetes prevalence: the burden has other drivers (ageing, sedentary lifestyle) and a lag effect.
- Italy — the lowest adult obesity in the EU, yet one of the worst rates of childhood obesity: a risk that hasn't shown up in adults yet.
The overall trend
Two curves are moving in opposite directions, which makes projection tricky:
- Consumption is falling almost everywhere — sugary drink intake has declined in 21 tracked countries, industry reformulation is widespread, and 14 EU member states now tax sugary drinks.
- Obesity and diabetes keep rising in most countries (lag effects, multiple causes). The IDF projects a 10% rise in regional diabetes by 2050.
Net effect: over 10 years, intake plateaus while the health burden keeps growing — especially where it's already high and public policy is weak.
10-year projection — who is deteriorating fastest
An indicative scenario: starting from the current score, heavily weighting today's childhood obesity (the best leading signal of tomorrow's adult burden), adding the consumption trend, and subtracting a bonus for countries with a tiered sugar tax (the most effective design). The strongest predictor of the sickest country in 10 years is childhood obesity today.
Low adult burden today, but child overweight > 25%, a rapidly westernising diet, and a tax only introduced in 2024. The steepest upward trajectory.
The "Mediterranean paradox": lean adults, but children among the most affected in Europe. These children will become at-risk cardiometabolic adults.
Low supply figure but already high childhood obesity and diabetes, with no sugar tax in place. The adult burden is likely to keep climbing.
Methodology & sources
How the index is calculated
Each score is a transparent composite, computed in-page from per-country values. Variables are scaled 0–100 by linear clamping (e.g. adult free sugars: 6% → 0, 18% → 100; adult obesity: 8% → 0, 28% → 100; diabetes: 3% → 0, 15% → 100).
General population = 45% "intake pressure" + 55% "realised burden".
Intake pressure = 60% estimated adult free sugars + 40% FAO supply.
Burden = 50% adult obesity + 50% diabetes prevalence.
Children = 40% intake (child/adolescent free sugars) + 60% child obesity/overweight.
10-year projection = 0.55 × general score + 0.45 × scaled child obesity + trend adjustment − policy bonus. Trend: rising +6, flat 0, declining −4. Policy: tiered tax −5, flat-rate/other tax −2, none/planned 0.
Confidence (⬤). Green = free-sugar intake measured by a national or multi-centre survey (Austria, Belgium, Denmark, Finland, France, Germany, Hungary, Ireland, Italy, Netherlands, Portugal, Spain, partial Sweden, etc.). Orange = partial indicator or regional cohort (IDEFICS). Hollow = extrapolated from supply data and regional profile (mostly Central/Eastern Europe). These are orders of magnitude, not precision measurements.
Major limitations. Dietary surveys are methodologically inconsistent (different methods, years 2003–2024, sample sizes), socially-desirable under-reporting of "negative" foods, food composition tables that lag recent reformulations, and FAO supply ≠ actual intake. The projection is a scenario, not a forecast.
WHO (2015) — Guideline: Sugars intake for adults and children (free sugar threshold < 10% / < 5%).
Azaïs-Braesco et al. (2017), Nutrition Journal — review of total and added sugar intakes in Europe (11 surveys).
Löwik (2021), Applied Sciences — assessment of sugar intake in Europe (free/added sugars by age group, % of energy).
Graffe et al. / IDEFICS study (2020), Eur J Nutr — free sugars in children (BE, CY, EE, DE, HU, IT, ES, SE).
HBSC (2021/22 survey) & Chatelan et al. (2022) — daily sugary drink consumption among adolescents, 21 countries.
FAO — food balance sheets (per-capita sugar supply), via Landgeist mapping.
Eurostat — EHIS 2019/2022, adult obesity (self-reported BMI ≥ 30).
WHO COSI — round 6 (2022–2024) & Health at a Glance: Europe 2024 — childhood obesity.
IDF Diabetes Atlas (2024) — diabetes prevalence (ages 20–79).
WHO Europe / Tax Foundation / Eurotax — sugary drink taxes by country.
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