Do You Need to Relax about Sugar?

It’s possible. In the past couple of decades, sugar has become as much of a heart health villain as fat used to be. Much of what we hear about sugar is oversimplified and/or alarmist. “Sugar is toxic!” “Yogurt is LOADED with sugar.” “I don’t eat carrots – aren’t they high in sugar?” 

Certainly consuming an excessive amount of sugar can create health problems, especially if you drink it. But what about the sugar in the much-maligned banana, or a slice of bread? Can you have the occasional bowl of ice cream?

The goal isn’t fear of sugar. It’s understanding it well enough to make it a small part of a your heart-healthy life. Read on for a look at sugar and heart health in practical terms, to solidify your knowledge and hopefully reduce a bit of food stress in the process. 

Sidebar: A quick primer on nutrition studies

I cite lots of research in this post, so I want to start by reviewing the significant limitations of the different kinds of nutrition studies.

Observational studies

For these studies, participants answer questions about how they eat, and then scientists keep track of their health down the road – how many have heart events, how many die, etc. 

Pros	Cons
Usually include lots of people.	Participants may not accurately recall or describe their eating habits.
Long enough to learn about outcomes that matter most, like heart attacks and mortality.	Can never prove cause and effect. For example, on average fruit eaters live longer. Is it the fruit, or is it possible they also exercise more? Study authors adjust for other habits, but it’s always possible that something wasn’t accounted for.

These limitations are why you should never get too fussed when you hear about a new study with unexpected findings. But if most research finds similar results, then we can be more confident.

Randomized controlled trials (RCTs)

In this case, volunteers are randomly asked to make usually just one change, like follow a Mediterranean eating pattern. 

Sugar in whole foods

When sugar is naturally present in foods, you needn’t worry. It isn’t much sugar, relatively speaking, and it comes packaged with nutrients that slow absorption and deliver other benefits — fibre, protein, vitamins, minerals, antioxidants, etc.

(Antioxidants are substances that can counteract free radicals — unstable molecules that damage cells. Antioxidant-rich foods — but not supplements — are associated with lower rates of heart disease.)

If you’d like reassurance that the sugar in bananas, beets, or milk isn’t a problem, or you just want to get pumped about fruits and veggies, here goes…

Fruit

A 2020 meta-analysis found that people who ate the most fruit were 12% less likely to develop coronary heart disease (CHD) and 18% less likely to have a stroke versus those who ate the least. (Especially citrus fruits, apples and pears.) 

How can fruit affect cardiovascular (CV) health this way? Well, a meta-analysis of 22 RCTs found that asking volunteers to eat more berries significantly reduced LDL cholesterol, blood pressure, weight, as well as measures of blood sugar control and inflammation!

But berries are among the lowest sugar fruits. What about fruits the Internet tells us to watch out for, due to their sugar content?

• In a recently published RCT, postmenopausal women randomized to eat two servings of mango every day had significant reductions in blood pressure and cholesterol.
• Eating more grapes is linked to fewer strokes.
• Bananas are one of the most accessible sources of potassium, which can lower blood pressure even more than reducing sodium.

Yay for fruit! 🤸

Vegetables

Veggies with the most natural sugar include beets, sweet potatoes, peas, onions, corn, bell peppers and carrots.

But two weeks of consuming beets or beet juice can improve blood pressure, blood vessel health, and inflammation, despite the sugar content. How about that?

The 2020 meta-analysis mentioned above also found that carrots were among the most beneficial vegetables for heart health outcomes. Serious carrot eaters were 8% less likely to die from CVD and 56% less likely to die of a stroke! No vegetables were found to have a negative effect.

And sweet potatoes are a good source of fibre, beta-carotene (a precursor to vitamin A), vitamin B6, vitamin C, and potassium. A comprehensive 2022 systematic review of RCTs concluded that eating sweet potato can improve blood pressure and blood sugar levels. 

A large US observational study looked at the amount of sugar people got from fruit and vegetables. Getting more didn’t increase CHD risk, unlike “added sugar” and juice.

Dairy

Milk

You might be surprised to hear that milk contains sugar, but the word “lactose,” should ring a bell. Lactose, the sugar naturally found in milk, has a low glycemic index (GI), which means it raises blood sugar gradually.

And like produce, it comes packaged with nutrients – calcium of course, but also protein, vitamin B2 (riboflavin), vitamin B12, potassium, phosphorus, Vitamin A and Vitamin D, which is added during processing.

Drinking milk is generally found to be neutral for heart health, except in some studies with whole milk, which may slightly increase risk of CHD.

It was also linked with significantly increased mortality in a large study of Australians living with CVD, compared to low-fat milk drinkers. (That’s a single observational study, so take it with a grain of salt, but the participants were similar to the typical readers of this blog, so worth mentioning.)

Anyhow, if anything, the saturated fat in (whole) milk may be a concern, but not the sugar.

Cheese (tangent alert)

(However, most observational studies find that saturated fat and salt laden cheese is not associated with increased heart disease risk. Some have even found it to be modestly protective! This may relate to fermentation and its unique combination of nutrients, though the mechanism isn’t fully understood. There’s little sugar in cheese.)

Yogurt and fermented milk

Moving on to yogurt, which is associated with lower mortality, from heart problems and in general, even though most studies don’t differentiate between sweetened and unsweetened, regular or Greek. Same for other fermented milk products like kefir. 

Some (but not all) RCTs find that consuming more dairy reduces blood pressure, especially fermented dairy with live active cultures, like yogurt and kefir. Fermented milk products may even help to reduce cholesterol levels!

So we’re not going to worry about the (natural) sugar content in milk products. Very little research compares sweetened vs. unsweetened dairy, but you may want to limit added sugars by developing a taste for plain or reduced-sugar yogurt. Or, you can think of flavoured yogurt as a nutritious dessert!

(See below to get a sense of how much added sugar yogurt typically contains.)

What if I have diabetes or prediabetes?

Fruit

Even for people with diabetes, eating more fruit is linked to an 18% lower risk of dying from any cause. (And a 10% lower risk of dying from cardiovascular disease — CVD.)

Researchers asked volunteers with prediabetes to add a cup of mango and a whole avocado to their diet every day. Eight weeks of that didn’t affect their blood sugar, insulin, or weight, but they did end up with healthier arteries!

If your blood sugars go high after eating fruit, try a smaller amount — a medium piece or a half-cup — at a time. And have it with a source of protein: Cheese with an apple or plain Greek yogurt with sliced banana should tame the blood sugars so you can enjoy the benefits of fruit.

Sweet veggies

Carrots got a bad rap because early estimates of their GI landed them in the high category. As GI testing became more refined, further tests have actually found them to be low. Either way, a cup of carrots would have a low glycemic load, a more useful measure that considers the amount of carbohydrate as well as the GI.

Sweet potatoes are high enough in carbohydrates that they’re considered a starch for meal planning purposes. So if you think in terms of whole grain or starch occupying a quarter of your plate, that’s about the target portion size for sweet potatoes.

Practically speaking, for example, a cup of roasted sweet potatoes with roasted chicken, mushrooms, and broccoli is a fine meal, even with diabetes. But a chicken burger with a bun and sweet potato fries would be too heavy on the grains and starches.

I should add that the GI of roasted sweet potato is quite high relative to boiled. So if you like them roasted, do it as part of a balanced meal (like above) and keep a lid on the portion size — not always easy to do!

There is lots of other evidence, but hopefully by now you can relax about sugar in fruit, veggies, and dairy.

*Don’t* relax about drinking sugar

At the other extreme, the health effects of liquid sugars are most certainly a problem. From soft drinks to pina coladas, iced tea to Gatorade, the link with heart disease is well established. 

Researchers call these sugar-sweetened beverages (SSBs), and people who drink more are more likely to develop high blood pressure, type 2 diabetes, and heart disease. They have more heart attacks and strokes. The more they have, the more likely they are to die early, in general and from CVD. 

Why so problematic? Drinking sugar doesn’t “offer the same feeling of fullness that someone would get when consuming calories in food form.” That means that the calories in SSBs are more likely to be excess calories, relative to their needs, which can lead to weight gain.

RCTs find that adding SSBs to someone’s diet causes them to gain weight (a meta-analysis found it to be 0.85kg or about 2 pounds, in studies lasting from 3 weeks to 6 months). So not a lot, but it can add up over time.

Even if researchers carefully control calories to prevent weight gain in an RCT, consuming more SSBs can increase cholesterol, blood pressure and triglycerides (or TG — a type of fat that stores excess calories.)

An April 2024 Heart & Stroke Foundation position statement “projected that between 2016 and 2041, sugary drink consumption in Canada will be responsible for more than 63,000 deaths, 300,000 cases of ischemic heart disease, and almost 40,000 strokes.” Yikes.

Don’t drink your sugar? Awesome. You’re in the minority because SSBs are the number two source of free sugars in Canada and number one in the US. 

Yes, that includes fruit juice

That Heart & Stroke statement above includes fruit juice along with other sugary drinks, even if it’s 100% juice with no sugar added. But there are some nuances in the research, which I tackled in this separate post.

What about sugar added to foods

Now this gets interesting. What about foods with sugar added to them, from bread to brownies, cereal to soft drinks? 

While SSBs are clearly a cause of various health problems, the same hasn’t been shown for solid foods with added sugars, such as whole grains or dairy products, according to the Diabetes Canada Clinical Practice Guidelines. 

Even ice cream, which is usually lumped in with other dairy products or desserts, was found to be unrelated to CVD incidence in a meta-analysis which looked at it separately! 

(I’m not saying to have Ben & Jerry’s for breakfast… I bet this finding just shows that a person’s ice cream consumption isn’t much of a factor compared to the many contributors to CVD, dietary and otherwise.) 

Two things matter (healthwise) when it comes to sugar in foods:

1. What kind of food is it? Gummy bears or apple crisp, with its whole grain oats and fruit?
2. How much sugar? A teaspoon in your tea or nearly ten in a “Light” Tim Hortons’ Iced Capp?

To assess the amount of sugar, it helps to understand the terms “added sugar” and “free sugar.”

Added versus free sugar

You’ll see both used… what’s the difference?

Added sugars

These are self-explanatory: sugars that are added to the food by a manufacturer or cook. It’s sugar “added” to your coffee and “added” to granola bars.

Added sugars include any sweetener that has calories, whether it’s white, brown, “in the raw”, coconut sugar, etc.

Free sugars  

“Free sugars” include “added sugars” plus sugars naturally found in honey, syrups, fruit juices, and fruit juice concentrates. (Why call them “free”? As the British Heart Foundation says: because they’re “not locked away inside the cells of food.”)

Although those foods are “natural,” they’re not part of a whole food, so they behave like added sugars. For heart health, consider all free sugars, not just added sugars.

Non-sugar sweeteners

When we talk about sugar, people often ask about non-sugar sweeteners like sugar alcohols (eg. erythritol), sucralose (aka Splenda), and stevia. I’m going to tackle those in another post, but the short answer is that they appear to be less harmful in beverages than sugar, but not necessarily harmless.

So if you have a hard time giving up Coke, switching to Diet Coke would be better, but unsweetened beverages like flavoured sparkling water, tea, coffee, and good old water are your best bet. As always though, find your “sweet spot.”

What about carbohydrates?

Some of the examples above might be low in sugar, but deliver other carbohydrates. Think bread, beer, or muffins, which have both. Astute readers will point out that carbs turn into sugar in the body. True! The digestive system breaks down starches and sugars into a simple sugar called glucose, the body’s chief fuel source. So why ignore the carbs?

Because some carbs and even sugar come with other nutrients the body needs – fibre, vitamins, minerals, and more. Whole grains and legumes, for example, are nutrient-rich, just like fruit.

Free sugar, on the other hand, brings only energy. Good if you need it, running a marathon, or running to a meeting, but ideally we get our energy with benefits. Sugar from fruit, carbs from whole grain toast, etc. (Refined grains are more like sugar – not much in the way of nutrition.)

My point here was to highlight significant sources of free sugar, and help you ease up on others that aren’t so bad. A big part of my job is helping people relax about food through teaching. Knowledge is power.

How much is too much?

The risk from sugar isn’t binary of course. It scales with how much (and how often).

Aim for less than 10% of calories

I usually start with the guidance from the Heart & Stroke Foundation of Canada, which suggests that free sugars make up less than 10% of calories, and “ideally” 5%.

(I’ll translate these percentages into actual food below.)

Heart & Stroke is following the lead of the 2015 World Health Organization (WHO) guideline, which makes a “strong recommendation,” to keep free sugars below 10%, based on the likelihood that excess free sugars (usually from SSBs) may lead to weight gain and then possibly an increased risk of type 2 diabetes and/or CVD. 

But you’d be surprised, the evidence isn’t as strong as you might think. A 2020 systematic review for the Dietary Guidelines Advisory Committee in the US found, surprisingly, that “Insufficient evidence is available to determine the relationship between added sugars intake in adulthood and cardiovascular disease risk profile.”

(They did, however, find that SSBs in adulthood were associated with increased risk of CVD mortality. Just not added sugars in general.)

Similarly, a 2023 systematic review and meta-analysis of observational studies in a variety of populations (including those with CVD, diabetes, and reduced kidney function) found that having more sugar in general was associated with a slight increased risk of dying from any cause or from CVD (9% and 10% respectively). No surprise there.

But strangely no associations were identified between added sugar and mortality. The authors noted that results were limited by differences between the studies.

But still, if you think about it, it’s reasonable to limit free sugars to 10% of what you consume, right? Hard to argue with WHO and Heart & Stroke.

Consider 5% or less

WHO

The WHO’s also gives a “conditional” recommendation to aim for 5% or lower, but that’s actually based on concerns about dental health, not heart health! Still important. 🪥🦷

The 5% guidance is “conditional,” because “there is less certainty about the balance between the benefits and harms or disadvantages of implementing a recommendation.”

The UK’s National Health Service (NHS)

But the NHS in the UK went with a suggested maximum of 5% for adults, based, again, on the likelihood that excess free sugars contribute to weight gain over time.

Their 2015 “Scientific Advisory Committee on Nutrition” report looked at numerous studies and found links for sugars with excess calories and SSBs with type 2 diabetes. Fair enough.

But no association between sugars (both solid foods and beverages) and coronary events, blood pressure, cholesterol, triglycerides, type 2 diabetes, blood sugar, or insulin! The evidence was limited for these relationships, and the authors warned that “the estimated figure of 5% should be treated with some caution.“

Confused? Just remember that the link between SSBs and CV problems is much stronger than for sugar in general.

More recent studies

Since then, a large UK cohort study with about 110,000 participants found that each 5% increase in energy from free sugars was associated with about a 7% higher CVD risk. I don’t usually focus on individual studies, but that one is big and recent, so worth considering.

Also this single study, published in 2023, is worth mentioning, since I’m in Canada. They found 34% higher “CVD hazards” for Canadian men between 55 and 75 with intakes of free sugars from solid foods over 5% of calories versus below. However, the other age and sex-specific groups didn’t demonstrate conclusive associations with CVD.

Isn’t science fun/frustrating? Different populations have different eating habits and health risks, so sometimes studies do come up with conflicting results. 🤷‍♀️

So that’s why 10% is the often quoted number, and 5% is something to consider.

The American take

The Dietary Guidelines for Americans (DGA) recommendation for everyone two or older is to limit added sugars to less than 10 percent of calories per day. (They stuck with “added” sugar, perhaps to keep things simple.)

(Can you believe that the DGA report says that 65% of Americans exceed that? We aren’t any better in Canada, with an estimated 66% of us getting more than 10% of calories from free sugars.)

The AHA recommendations are stricter. They’ve been recommending that Americans aim for less than 25g / 6 teaspoons a day for women and 36g / 9 teaspoons for men since 2009.

Those numbers aren’t based on a percentage of calories. Instead, they represent half of the “discretionary calorie allowance,” the difference between how many calories a person needs and how many it takes to meet their nutritional needs. 

(I guess they left room for a little butter or wine.) 

Some people need more calories than others. If so, you’ll have more (theoretical) discretionary calories, so room for a bit more added sugar. 

But AHA’s 2026 scientific statement on “Dietary Guidance to Improve Cardiovascular Health” makes no reference to those numbers or concepts, instead simply advising people to “limit” or “minimize” added sugars. 

What if I have diabetes or prediabetes?

You might think that a person with diabetes shouldn’t have any sugar, but Diabetes Canada just advises keeping sugars below 10% of calories. 

Diabetes Canada notes that fructose and sucrose raise triglycerides in people with diabetes, primarily at doses exceeding 10% of total calories. The effect wasn’t observed at lower intakes.

Similarly, cardiovascular harms from SSBs appear most pronounced above — you guessed it — 10% of calories.

Translating 5-10% into food

I know this percent of calories concept isn’t very practical, but I wanted you to understand where it comes from. So how much sugar is that?

Let’s say you need 2000 calories a day. (Only for illustration! There’s a good chance you need more, or perhaps a little less.) But to give you a ballpark idea:

• 10% of 2000 calories works out to 50 grams of sugar, helpful to know when reading labels. That’s about the amount in 12 teaspoons (or a quarter-cup) of sugar, if that helps you visualize it.
• 5% is 25 grams of sugar, or about 6 teaspoons (2 tablespoons). 

(A teaspoon of table sugar is about 4 grams.)

Again, if you’re male and/or on the younger or more active side, you probably need more calories than 2000, giving you room for a bit more free sugar. 

That’s a decent amount, wouldn’t you say?

How to put it into action

I usually suggest that people divide their daily nutrient goals by 4, to give a general idea of how much is reasonable at each meal, with some left for snacks. You don’t have to follow that strictly, but it gives you a sense. 

So say you’re aiming for 30 grams of free sugar a day, or about 8 grams per meal — 2 teaspoons. Doable! Then if you see that an Oreo cookie has 5 grams, you can decide that one after lunch is no big deal. (As long as you can stick to just one.)

You might want to jot down and add up your free sugar one day. You’ll probably reassure yourself that you’re doing okay. If not, you’ll learn something.

But don’t do it every day. Live your life. 

How much free sugar do *you* want to aim for?

Guidelines are just guidelines, but it’s your call. What’s a reasonable goal for you most days?

Probably somewhere between 5% and 10%, or 25 and 50 grams, if you think 2000 is about how many calories you need. (Or estimate it here and adjust accordingly.)

Don’t say zero – that’s not realistic. And you’ve seen from the evidence that if your sugar intake comes from foods versus beverages, for the most part, it’s not clear that you need to be that strict. It might even backfire if you feel deprived and resentful.

There are legitimate reasons for free sugar to cross your lips, from dried cranberries on a salad to your granddaughter’s birthday cake. Cookies at holidays and vanilla Greek yogurt because you really can’t do plain.

Mental health matters too, and the pleasure we get from food and social connections are part of that.

Pick a number that will allow you to enjoy food, balancing with a risk of future heart problems that you’re comfortable with. That will make the examples below more meaningful.

What if you can’t resist sugar?

I just want to acknowledge that many people feel out of control around cookies, chocolate, ice cream, and other sugary foods. You might feel like you’re addicted. Food can be very powerful. Setting a daily goal might feel laughable.

Addressing a difficult relationship with food is well beyond the scope of this or any blog post. But I just wanted to let you know that I hear you, and you’re not alone.

If you’re in Alberta, you’re welcome to book a consultation with me for help. If not, ask your doctor to connect you with a dietitian locally.

How to find free sugars on the label

Added sugars are now required on nutrition labels in the US (awesome!), but not Canada (boo!).

So in the US, check the label for added sugars, but be aware that other sources of free sugar, like fruit juice and fruit juice concentrate, might not be included, although their metabolic effect is similar. If you’re not sure, just go with the Total Sugars line.

For example, these fruit bars are accurately labelled “no sugar added,” but do we really believe that downing one of these is the same as eating an apple and 12 strawberries?

Better than a Pepsi, but I’d count that as 17 grams of free sugar.

In Canada, we really have to be detectives. If you see sugar on the Nutrition Facts table, check the ingredient list to see if it’s coming from a food with sugar naturally, like strawberries, or if it’s from added/free sugars.

We’re not going to worry about these strawberries, right?

But what about this? Is it basically the same, but with pureed strawberries?

Check the ingredient list:

It does have strawberry puree, although interestingly, that’s included with the sugars. There are strawberries in the product, but there’s more sugar and water. 😒

But before you give up on this refreshing summer treat, check to see how much sugar. Just 9 grams. You might decide to have that anyhow! But think of those 9 grams as free sugar.

Sugar content of popular foods 

Following are more examples of products I see in my practice, starting with the biggest sources of free sugar.

(I have no affiliation with these or any other food companies. I just like to make things practical. 😊 Also, I used Walmart.ca for most because it’s a fast way to search. And none of these examples include non-sugar sweeteners.)

Sneaky sugar-sweetened beverages

You might not drink these regularly, but I’m including for comparison, for when you see 9 grams of sugar on a vanilla yogurt. Also, some people are surprised to learn that certain drinks have so much sugar.

I’m showing the sugar content for 12 oz or about 355 mL of each, so you can compare with a standard can of pop.

• Pepsi, 355 mL (12 oz) can – 41g

So if you were aiming for 25 or 50 grams of free sugar a day, a can of pop would make a serious dent in it. And many people drink plastic 710 mL bottles, which have 82g of free sugar! 😬

More examples:

• Tropicana Classic Lemonade, 325ml (12 oz) bottle – 39g
• Sprite, 355 mL (12 oz) can – 38g
• San Pelligrino Sparkling Juice, 330mL (12 oz) can – 30g

San Pellegrino rant

These San Pellegrino drinks are a pet peeve of mine. Some, like this one pictured, are fruit juice with sparkling water. I don’t think people realize that they pack 30 grams of free sugar, from the juice. (Some more, some less.)

Others are called “light”, with just 3 grams of sugar, but sweetened with sucralose and acesulfame potassium, which have been linked to higher coronary artery disease risk in a recent study. 😬

The best bet from San Pellegrino are the flavoured sparking waters, with just a dash of fruit juice, and only 1 gram of sugar. Without careful label reading though, it’s hard to tell the difference. If you stock these at home, it’s worth looking for what I highlighted in purple:

Back to our usual programming:

• Canada Dry Ginger Ale, 355 mL (12 oz) can – 34g
• Nestea Lemon Iced Tea, 341mL (12 oz) – 28g
• Gatorade Sports Drink, 355 mL (12 oz) bottle – 21g (I used the small bottles for comparison, but most Gatorade bottles you see are 591 mL, with 34g of free sugar)

For the drinks containing milk below, I estimated the free sugar by subtracting the sugar naturally found in milk.

• Silk Dark Chocolate Almond Beverage, 1.5 cups (or 360 mL) – 21g
• 1% Chocolate Partly Skimmed Milk, 1.5 cups (or 360 mL) – 17g
• Starbucks Classic Hot Chocolate with semi-skimmed milk, tall (355 mL or 12 oz) – 14g
• Starbucks mocha latte, tall (355 mL or 12 oz) – 11g

You can see why these liquid sugars are so problematic for heart health! In addition to being so rapidly consumed and absorbed, they can hide A LOT of sugar, and most have little nutrition to offer.

But like so much in nutrition, it’s not all or nothing. I’d worry if you started each day with a giant mocha latte, but not if your entire annual SSB intake consists of a lemonade on a hot summer day. 

Alcoholic beverages

Sugar isn’t the problem with most alcoholic beverages, with a few exceptions, as you can see below.

• Pina colada, 12 oz (355 mL) – 42g (!)
• Carl Jung Alcohol‑Free Cuvée White Wine, 5 oz (150 mL) – 6g
• Coors Edge Non Alcoholic beer, 12 oz (355 mL) – 4g
• White wine, 5 oz (150 mL) – 1g
• Red wine, 5 oz (150 mL) – 0g
• Regular beer, 12 oz (355 mL) – 0g

(The values with no link come from cronometer.com.)

The sugar might be low for most, but the alcohol itself is a concern. Cancer risk has been linked with even low levels of consumption, and heavy drinking (3 or more drinks a day), is “consistently associated with worse outcomes in every cardiovascular disease entity studied.,” according to the American Heart Association.

What about moderate drinking? Even the CV benefits of that have been called into question by more recent, more comprehensive studies. I have a full blog post about that if you’re curious.

Just for fun, from jelly beans to chocolate

How does that compare to sweet treats? 

I mention jelly beans because years ago there was a small, frequently cited study, in which participants were asked to have 450 calories daily of either a soft drink or jelly beans for four weeks each. (!)

What do you think would happen?

When they drank those extra calories – a little more than three cans of pop – they ate about the same as usual at their next meal, so they ended up taking in more calories than needed and gaining a bit of weight. 

When they ate 450 calories worth of jelly beans (about ⅔ cup), they tended to balance it out by eating less at subsequent meals, keeping their total daily calorie intake stable and avoiding weight gain. 

It makes sense: We have to work to break down jelly beans and other solid food. It’s like exercise for the digestive system! (It actually burns calories.) Even the act of chewing starts signalling the body that we’re getting fed. Drinking not so much.

Isn’t that fascinating? It’s just a small study, but it’s one of the first of many supporting the idea that liquid sugar is more problematic, and that if we eat more sweet foods, over time, we tend to naturally cut back on others.

So compared to the SSBs above, how much sugar was in 450 calories worth of jelly beans? About 84 grams. 

Ouch.

More sweet treats

Here are a few other examples of ways you might satisfy your sweet tooth, with lower sugar alternatives for each:

• Ben & Jerry’s Chocolate Fudge Brownie Ice Cream – ¾ cup – 45g (!)
• Chapman’s Premium Chocolate Fudge Brownie Ice Cream, ¾ cup – 23g
• Chapman’s Frozen Yogurt Dutch Chocolate, ¾ cup – 13g

• Starbucks Ultimate Chocolate Brownie – 42g
• Two-Bite Brownies, each – 6g

• Subway cookies, various – 16-20g
• Subway mini-cookies, various – 4g

• Cadbury Caramilk Chocolatey Candy Bar – 26g
• Lindt 70% Cacao Dark Chocolate, one large square – 3g

• Starbucks Blueberry Muffin – 28g
• Starbucks Cookies & Cream Pop – 14g

• Tim Horton’s Apple Fritter – 23g
• Tim Horton’s Chocolate Dip Donut – 12g

Yes, donuts typically have less sugar than muffins! Isn’t that wild? (Wait ‘til you see the sodium.)

I’m not saying to choose only based on sugar content. It’s okay to consider what you feel like, if you decide to indulge yourself. Just facts here, no judgement here.

Ketchup and other condiments

People tend to be very worried about the sugar hiding in condiments, sometimes with good reason. But some aren’t bad.

I adjusted the serving size to be 1 tablespoon each, for a fair comparison, but that might not be how much you typically eat, so adjust accordingly.. 

Try it yourself: 1 tablespoon = 3 teaspoons, and ¼ cup = 4 tablespoons 

How about that jam?

• Smucker’s Raspberry Spread – 11g
• PC Blue Menu Twice the Fruit 3-Berry Spread – 5g

Stir-fry sauce ingredients:

• LKK Hoisin Sauce – 9g
• VH Teriyaki Stir Fry Sauce – 2g

For a salad:

• Ocean Spray Craisins Original Dried Cranberries – 7g (added sugars only*)
• Kraft Asian Sesame Salad Dressing, 3g
• Kraft Balsamic Salad Dressing, 2g

* I hunted for a US label online for Craisins, and got the added sugar from that.

Fixings for a barbecue:

• Bull’s-Eye Bold Original BBQ Sauce, 6g
• Heinz Tomato Ketchup, 4g
• French’s, Honey Dijon Mustard, 3g

Not bad, but they have the potential to add up, don’t they?

There are lots of other options for stir-fries and salads, marinades, and sauces. How do these compare with the condiments in your kitchen?

Bread, usually not much

Bread is actually a good source of many nutrients, especially whole grain bread. Furthermore, whole grains in general, including bread, are associated with lower total (16%) and CVD (18%) mortality, not to mention cancer at 12%. “Dark bread” is associated with lower rates of CHD.

Some people worry about the sugar that may be added to bread. Let’s see how much, in these local whole grain examples:

• Great Value (Walmart’s brand) 12 Grain Multigrain Loaf* – 5g
• Country Harvest 14 Grains Sliced Bread – 5g
• Dempster’s Signature 100% Whole Wheat Breads – 3g
• Silver Hills Sprouted Grain Squirrelly Bread – 2g
• Cobs Bread Whole Wheat Loaf – 0g

* I adjusted them all to show the sugars in two slices of bread.

Disappointing to see that the first two, which are more affordable options, are the highest in sugar. But if you typically just have one slice in the morning, even if it’s 2-3 grams of free sugar, that’s not much, in the grand scheme.

Small business bakeries are another option, but they’re usually pricier and aren’t required to provide nutrition facts. (You can usually get a list of ingredients if you ask.) Here’s a local favourite with ingredients on their website: Rustic Sourdough Bakery. (A few breads have honey, but otherwise no sugar.)

If you have more than two slices of bread a day, it’s worth checking the sugar content.

Cereal, not so bad actually

Here’s another heart-healthy food. People who eat more whole grain breakfast cereals are less likely to develop CVD in general, and CHD specifically, as well as type 2 diabetes!

It’s always possible that cereal may just be an indicator of a healthier lifestyle, but these findings are consistent across numerous studies.

And it makes sense. Whole grain high fibre cereals can help improve cholesterol levels. Cereal eaters usually have significantly higher intakes of dietary fibre, calcium, iron, magnesium, potassium, and numerous other nutrients.

Which cereals?

Does it need to be low in sugar? Ideally, yes. A 2025 analysis of 186,168 people in the UK didn’t find a link between sweetened cereal and CVD, but having more than 0.5 bowls a day was significantly correlated with a 41% increase cancer-specific mortality risk, which seems worth mentioning. 😬

Additionally, what they called “plain cereal,” one made with refined grains and no “added sugars, artificial colours, or preservatives,” might increase “CVD-specific mortality risk” by 22%. Think Corn Flakes or Special K.

But there’s good news from that study! Muesli and bran cereal were significantly correlated with significantly reduced CVD-specific and cancer mortality risk. Moderate consumption them as well as “of “porridge,” was linked to lower all-cause mortality risk, although this disappeared if people added sugar or artificial sweeteners. Add fruit instead!

So lower-sugar cereal is ideal, but so is enjoying your breakfast! Find the right balance for you.

Cereal examples

These examples are all whole grain cereals, with some of my favourite lower-sugar options at the bottom. All adjusted to a cup of cereal:

• Quaker Harvest Crunch Original Granola, 1 cup (100g) – 23g
• Oatmeal Crisp Vanilla Protein Cereal, 1 cup (58g) – 11g 
• Frosted Mini-Wheats, 23 biscuits (55 g – about a cup) – 11g
• Two Scoops Raisin Bran, 1 cup (59 g) – 9g (added sugars only, not the sugar in the raisins)

I wanted to include Kellogg’s Vector “Meal Replacement” cereal, but the first ingredient is “rice” (not brown rice), so it’s not even a whole grain. And it’s about 10 grams of sugar per cup. Boo.

Next to Cheerios. How about the sugar in those Honey Nut Cheerios?

• Honey Nut Cheerios, 1 cup (29 g), 12g (3 g fibre)
• Multi-Grain Cheerios, 1 cup (30 g), 6g (2 g fibre)
• Original Cheerios, 1 cup (27 g), 1g (3 g fibre)

And I mean “sugar,” which comes before “honey” in the ingredient list! 

Even the Multi-Grain Cheerios are disappointing. Why would they have more sugar than the original, and less fibre?

I like the whole grain cereals from Nature’s Path. They’re moderate in sugar and usually a decent source of fibre. And they taste good! (Again, I have no affiliation.) The first one is a higher-fibre alternative to Cheerios:

• Nature’s Path Organic Heritage O’s, 1 cup (61 g), 6g (but with 6g fibre)
• Nature’s Path Flax Plus Multibran Flakes, 1 cup (44 g), 6g (7 g fibre)
• Nature’s Path Organic Heritage Flakes, 1 cup (49 g), 7g (8 g fibre)
• Nature’s Path Organic Khorasan Wheat Puffs, 1 cup (18 g), 1 gram (only 2g fibre)

These next ones might be bland on their own, but with sliced banana or blueberries, delicious!

• Post Spoon Size Shredded Wheat & Bran, 1 cup (47 g), 0g
• Post Shredded Wheat Big Biscuit Cereal, 2 biscuits (47 g), 0g

Finally, I’d better give a couple of muesli examples, since it did so well in the UK study.

• Bob’s Red Mill Muesli Old Country Style Whole Grain Cereal, 1/2 cup (70 g), 0g
• Alpino Super Muesli Nut Delight, 1/2 cup (128 g), 0g
• Alpen Muesli No Sugar Added, 1/2 cup (50 g), 0g

Those zeros are for free/added sugar. They do have sugar from dates and raisins, ranging from 5 to 10 grams per 1/2 cup. It’s not considered free sugar, but it’s concentrated, so not quite the same as regular fruit.

That’s pretty much the range for cereals. How does your favourite stack up?

If you want more alternatives, I have another post with 16 whole grain cereals under 8 grams of sugar per serving.

Nutritious sweet treats

If you’re feeling like something sweet, why not pair it with a more “cardioprotective” food, like fruit, whole grains, or nuts? Examples:

• Nutella, 1 tablespoon – 11g (included for comparison – there’s more sugar and palm oil in there than hazelnuts, so it’s not doing much for heart health)
• DIY Chocolate Spread 1 tablespoon – 2g (make it yourself in 10 minutes, with cashew butter)
• Chocolate Peanut Butter Fruit Dip – 1 tablespoon – ~1g (another 10-minute recipe, pictured above)

Dessert or breakfast?

• Heart-Healthy Apple Crisp (my recipe), about ¾ cup, 8g (free sugar only)
• Banana-Oatmeal cookies (from my 30-Minute Heart Healthy Cookbook), per cookie, 7g (free sugar only)

Mostly kidding about breakfast, but I’ve been known to start the day with that apple crisp and plain Greek yogurt for protein.

How about sweetened yogurt for a treat? These are for the little (100g) snack sized cups:

• Oikos Greek Yogurt Vanilla, 2%, 6g (added sugar only)
• Oikos 30% Less Sugar Vanilla Yogurt, 0%, 4g (added sugar only)
• Oikos Greek Yogurt, Plain, 2%, 0g (no added sugar)

Like the shredded wheat, you’ll probably want to sweeten that plain one with chopped strawberries or mango or something! Even a drizzle of honey or maple syrup is lovely.

Speaking of which…

Sweeteners: Honey, maple syrup, and more

While scientists have observed small advantages for maple syrup and honey, they have largely similar metabolic effects.

Coconut sugar is perceived as a healthier option, in part because an early study found it had a low glycemic index, but subsequent research (here and here) has found it comparable to regular sugar. The power of marketing, right?

I’ve adjusted these so you can see the sugar content of a tablespoon of each:

• Liquid Honey, 16g
• Agave Syrup, 16g
• Pure Maple Syrup, 13g
• White Sugar, 12g
• Coconut sugar, 12g
• Mrs. Butterworth’s Original Syrup, 11g

The amount of free sugar matters much more than the type, and these are all pretty similar in that respect. (White sugar and coconut sugar have less sugar per tablespoon because they’re crystals, so there will be some air in every tablespoon. Liquids pack more into a tablespoon. Not sure how to explain Mrs. Butterworth’s, but there are a lot of additives on the ingredient list. 🤔)

Anyhow, choose sweeteners for taste or culinary properties, but recognize that they’re all sources of free sugar.

Wrap-up

I hope this helped you get a sense of what sugar in moderation can look like for you. I hope it gave you fresh ideas for lower-sugar ways to satisfy your sweet tooth.

But mostly I hope this has helped you relax about sugar. That was the goal.

Here’s the bottom line: 

The whole food package is what matters. A medium apple has about 19g of sugar, an apple juice box 20g, and a Dunkin’ Donuts apple fritter 17g. They might be the same amount of sugar, but each has a unique health impact.  

If you drink sugar regularly, it’s worth cutting back and/or looking for alternatives. That’s where research finds the strongest link with heart problems. 

If you just eat solid foods with free sugar added, do a quick estimate – just back of the envelope. How much do you think you had today? Tally it up as the day goes along.

Do you think it’s frequently more than 10% of your calories? If so, can  you look for other ways to satisfy those cravings? From mango to massage, homemade Nutella to nature walks, find alternative ways to experience pleasure. 

But if you’re usually in the 5 to 10% range (or less), yay! Especially if most of the sugar comes from whole-grain cereal, yogurt, or a (heart-healthy) apple crisp, you can relax and enjoy.

And if your only sugar comes from fruit, carrots, and beets, have a cookie! It’s okay, really. 

Better heart health, less food stress, and delicious food. That’s the sweet spot! 

If heart health is a priority for you, and you want to keep learning and discovering more “sweet spot” foods, sign up for my weekly(ish) newsletter.