Sugar isn’t the villain.

For decades, sugar has been cast as the dietary villain, the thing secretly responsible for everything wrong with your health and your weight. But the biology is more nuanced than that, and that fear has caused more confusion and shame than is helpful.

Here’s a useful distinction that gets lost in most of the conversation: not all sugar is the same, and where it comes from matters.

An apple contains sugar, but it also contains fiber, water, and micronutrients that change how your body processes it. When that apple gets pressed into juice concentrate and added to a product during manufacturing, what remains is what we call added sugar, stripped of the fiber that slowed absorption in the first place.

That fiber is doing real work. Eat the apple and its sugar arrives slowly, buffered by everything else the fruit contains. Crunch into Apple Jacks, the brightly colored breakfast cereal, and the apple juice concentrate that ends up in those little rings has been stripped of everything that made the original fruit worth eating.

By the time digestion is complete, your body is just processing glucose either way, but how fast it arrives and what comes along for the ride makes a difference.

The health risks of chronically high added sugar intake are real. Strong observational evidence links excess added sugars to increased risk of T2D, cardiovascular disease, and metabolic changes, though disentangling sugar from overall dietary pattern is genuinely difficult.

For perimenopausal and postmenopausal women, where insulin sensitivity already tends to shift, the cumulative load is worth taking seriously.

If you want to reduce your added sugar intake, beverages are the easiest place to start. Sodas, fruit drinks, juice, sweetened coffees, cocktails: research from NHANES suggests sweetened drinks account for roughly a quarter of added sugars in women’s diets,¹ and unlike food, they don’t do much to satisfy hunger.

But in my view, total restriction isn’t the answer. When foods are forbidden, they become charged. The more practical lever is crowding added sugar out rather than cutting it out.

When meals are built around adequate protein and fiber, you’re more satisfied, less reactive to cravings, and more able to enjoy a “play food” when you want one without it turning into an event. My favorite desserts, milk chocolate with nuts and pistachio ice cream, are things I eat and enjoy.

The goal isn’t elimination. It’s making sure the rest of your day is nourished enough that a little sweetness is just the cherry on top.

How to read an added sugar label

The nutrition facts label now lists added sugars separately from total sugars, which makes it much easier to scan products side by side. A useful benchmark comes from the FDA’s 2024 updated “healthy” food labeling rule: 5 grams of added sugar or less per serving for a snack, and 10 grams or less for a full meal.² Easier said than done, as a quick trip down the yogurt aisle will confirm. But it’s a handy reference point when you’re label-reading, and a simple way to remember it: one hand of fingers for snacks, two for meals.

1. US Department of Agriculture, Agricultural Research Service. Added Sugars in Adults’ Diet: What We Eat in America, NHANES 2015-2016. Food Surveys Research Group Dietary Data Brief No. 24; 2019.

2. US Food and Drug Administration. Use of the “Healthy” Claim on Food Labeling. Final Rule. December 19, 2024.