How Much Sugar is too much?

News Blog readers enjoy snippets regarding sugar. Now that fat has been given a (fairly) clean bill of health, it is perhaps fortunate that we have a public enemy to take its place – ‘pure, white and deadly’. Food labelling usually gives details on “added sugar”. However, this is a poor index of risk for the obvious reason that food or drink may have lots of sugar, but very little added sugar. Fruit juice is often packed with sugar, even if it is not added; our ancestors did not have electronic juice makers. So “free sugar” is the index of risk that should be used. It describes all the rapidly absorbable extra-cellular sucrose, both added and intrinsic.

Two recent WHO-sponsored systematic reviews describe the correlation between free sugar and risk.[1] [2] The risk of both dental cavities and obesity rises rapidly when free sugars account for over 10% of daily energy intake, and the ‘safe level’ is under 5%. The CLAHRC WM Director, consolidating this blog with preceding posts,[3] [4] has two big messages:

  1. Strong public health messages and nudges are needed to control sugar intake at the population level. This, not promotion of exercise, will stop obesity.
  2. Once an individual is obese they will not lose appreciable weight without surgery. But their health, like that of all people, can be radically improved by exercise.

— Richard Lilford, CLAHRC WM Director


  1. Moynihan PJ & Kelly SA. Effect on caries of restricting sugars intake: systematic review to inform WHO guidelines. J Dent Res. 2014; 93(1):8-18.
  2. Te Morenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ. 2013; 346: e7492.
  3. Lilford RJ. More, Yes More, on ‘Pure, White and Deadly’. July 3 2015 [Online].
  4. Lilford RJ. More, Yet More, on ‘Pure, White and Deadly’. July 31 2015 [Online].

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