Sugar vs. sweeteners: Why less is always best

by Kaiser Permanente |
Happy person drinking green juice

Sweet treats and sugary drinks are everywhere. Even many of our favorite fruits, such as mangoes and grapes, are high in sugar.1 But when people eat or drink too much sugar, they boost their risk of health problems like weight gain, diabetes, heart disease, and cavities.2 Plus, drinking artificially sweetened soft drinks may lead to a higher risk of stroke and dementia.3 So, what can you do about all the sweet stuff? The first step is understanding the different kinds of sugar.

Natural vs. added sugar

Natural sugar is a simple carbohydrate found in some foods and drinks. Many healthy foods, like dairy products, vegetables, and fruit, have natural sugars like lactose and fructose. They provide the body with calories, or "energy."

Foods with natural sugars also provide essential nutrients that help prevent disease.4

But when sugar is added during manufacturing, like with many fruit juices and sliced bread, it adds calories, but no essential nutrients. And the body digests those added sugars very quickly, making them a poor source of energy.2 All kinds of added sugars are found in foods you might not expect, so it’s a good idea to check your food labels. One common example of an added sugar is high-fructose corn syrup.

Soft drinks, fruit drinks, flavored yogurts, and processed foods are the top sources of added sugar.5 But added sugar also exists in less obvious things like bread, sauces, and salad dressing.

So many sweeteners

Of course, sugar tastes good. So when people want the flavor of sugar but also want to limit how much they’re getting, they turn to sweeteners. Some people use artificial sweeteners like Sweet’N Low6 or natural sweeteners like honey.

But are they all created equal?

Surprisingly, their nutritional values aren’t that different. Here are a few basics about household sweeteners.

Refined sugar

When many people think of sugar, they think of cane sugar, also known as refined sugar, table sugar, or sucrose. It’s made by processing sugar cane and sugar beets. Refined sugar has about 16 calories per teaspoon.7

Sugar substitutes

Sugar substitutes, like NutraSweet and Sweet’N Low, are synthetic artificial sweeteners.6 They often contain few or no calories and taste much sweeter than refined sugar. They’re sometimes called "intense sweeteners."

Natural sweeteners

Natural sweeteners include honey, molasses, and coconut sugar. They may seem like healthier choices than refined sugar, but they aren’t much different. Your body processes honey and sugar the same way since they’re nutritionally similar.8

Less is best

Ultimately, no matter what kind of sugar you choose, the key is to use less. According to the American Heart Association, women should consume no more than 6 teaspoons of added sugar per day. Men should consume no more than 9 teaspoons.9

Some easy ways to eat or drink less sugar include:

  • Reading food labels for sugar in its many forms
  • Keeping it out of your home
  • Trying recipes that leave out added sugar
  • Drinking water instead of juice

For example, instead of buying ice cream, make your own frozen banana whip. You just need bananas, unsweetened almond milk, and a splash of vanilla. Remember, even natural sugars can increase your chance of cavities,2 so moderation is key.

FoodData Central, U.S. Department of Agriculture, accessed January 29, 2020.

5 Reasons Why Sugar is Bad for You,, April 2, 2019.

Matthew P. Pase et al., Sugar- and Artificially Sweetened Beverages and the Risk of Incident Stroke and Dementia: A Prospective Cohort Study, Stroke, American Heart Association, April 20, 2017.

Natural vs. Refined Sugars: What’s the Difference? Cancer Treatment Centers of America, October 26, 2022.

The Sweet Danger of Sugar, Harvard Health Publishing, November 5, 2019.

Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only

"Sugars, Granulated," FoodData Central, U.S. Department of Agriculture, accessed December 15, 2022.

Artificial Sweeteners and Other Sugar Substitutes,, October 8, 2020.

Added Sugars, American Heart Association, November 2, 2021.