How to cut back on added sugar, reduce your risk of chronic disease, enjoy dessert more wisely, and take simple daily steps toward a healthier life.
By Laurence T. Gayao, MD
Let me begin with a confession: I like sugar.
Give me a good dessert menu, and my resolve to eat healthy can suddenly become a subject for further medical investigation. I can explain the dangers of excessive sugar to a patient, but put a delicious piece of cake in front of me, and that medical knowledge may briefly take a coffee break!
I suspect I am not alone.
When we are young and healthy, we seldom worry about what we eat. We tell ourselves, “I don’t have diabetes, so why should I worry about sugar?”
Unfortunately, the absence of diabetes today doesn’t guarantee that we won’t develop it tomorrow. Many chronic diseases develop gradually, sometimes over decades, before symptoms finally get our attention.
After spending decades in medicine, I have come to appreciate something that deserves far more attention: preventing disease is often better than waiting for it to develop and then trying to treat it.
I wish I had understood more about the long-term effects of diet and lifestyle when I was younger. Perhaps I would have made some different choices. But hindsight is a wonderful teacher—although it has a rather annoying habit of showing up late!
The good news is that we can make better choices at any age.
Why Has Sugar Become Such a Concern?
For many years, public discussion about nutrition focused heavily on dietary fat and cholesterol. We now understand that the relationship between food and chronic disease is more complex. The types of fats we eat, the overall quality of our diet, physical activity, genetics, sleep, and other lifestyle factors all matter.
Sugar deserves particular attention, especially added sugar found in soft drinks, sweetened coffee, candy, cakes, cookies, breakfast cereals, and many processed foods.
Unlike whole fruits and vegetables, which provide fiber, vitamins, minerals, and other beneficial compounds, many sugary products supply substantial calories with little nutritional value.
Excessive consumption of added sugar can contribute to weight gain and increase the risk of type 2 diabetes and cardiovascular disease. Sugary drinks are particularly concerning because we can consume a surprising amount of sugar without feeling as full as we might after eating solid food.
Sugar is not the sole cause of every chronic disease, but consuming too much of it is a habit worth addressing.
The Sugar in Your Glass May Surprise You
Consider a regular 12-ounce can of soda.
It contains roughly 10 teaspoons of added sugar—about 40 grams—and approximately 150 calories. Some beverages contain even more.
Now imagine drinking that soda while eating a slice of cake, followed by a couple of cookies later in the afternoon.
The sugar adds up quickly.
And unlike money, calories don’t disappear simply because we would prefer not to count them!
The problem is not an occasional sweet treat. It is the repeated consumption of excess sugar, particularly when combined with too little physical activity and an overall poor-quality diet.
Over time, this pattern can contribute to excess body fat, insulin resistance, and other metabolic problems.
Five Health Problems Associated With Excess Sugar
1. Type 2 Diabetes
Eating sugar does not automatically give you diabetes. Type 2 diabetes develops through a combination of factors, including genetics, insulin resistance, excess body fat, physical inactivity, and other influences.
However, regularly consuming large amounts of added sugar—especially from sugary beverages—can contribute to weight gain and increase the risk of developing type 2 diabetes.
The pancreas produces insulin, a hormone that helps glucose move from the bloodstream into cells. When the body becomes resistant to insulin, the pancreas must work harder to maintain normal blood glucose levels.
Eventually, the system may struggle to keep up.
The encouraging news is that lifestyle changes can help prevent or delay type 2 diabetes in many people at increased risk.
2. Fatty Liver Disease
Our liver processes many of the nutrients we consume, including fructose, a sugar found in fruit and table sugar.
When we regularly consume excessive calories, particularly from sugary beverages and other sources of added sugar, the liver may accumulate excess fat.
This can contribute to metabolic dysfunction-associated steatotic liver disease, formerly commonly called non-alcoholic fatty liver disease.
The condition can progress in some people to liver inflammation, scarring, and more serious liver disease.
The lesson? Your liver works hard enough without having to process a daily river of sugary drinks.
3. Cardiovascular Disease
Excess added sugar can contribute to weight gain and may adversely affect triglycerides, blood pressure, and other cardiovascular risk factors.
These are important concerns because heart disease remains a major cause of illness and death.
As someone who has experienced serious coronary artery disease firsthand, I have a personal appreciation for the importance of prevention. We should not wait until our arteries demand our attention before we begin taking our lifestyle seriously.
Heart health involves much more than sugar alone. Blood pressure, cholesterol, smoking, physical activity, diet quality, genetics, and appropriate medical care all play important roles.
4. Chronic Inflammation and Other Chronic Conditions
Chronic inflammation has been linked to many long-term health problems, including cardiovascular disease, type 2 diabetes, and certain other disorders.
A diet high in added sugar and ultra-processed foods may contribute to metabolic dysfunction and inflammation, particularly when it promotes excess body fat.
However, we should be careful not to blame sugar alone for every inflammatory or autoimmune condition. Diseases such as rheumatoid arthritis have complex causes, and their development cannot be explained by diet alone.
A balanced, nutrient-rich eating pattern is one practical way to support overall health and reduce some preventable risk factors.
5. Tooth Decay
Here is one health problem for which the sugar connection is especially clear.
Bacteria in the mouth use sugars to produce acids that damage tooth enamel. Frequent exposure to sugary foods and drinks increases the risk of cavities.
So, while your sweet tooth may be delighted, your dentist may have a different opinion.
Limiting sugary snacks and drinks, brushing with fluoride toothpaste, and maintaining regular dental care can help protect your teeth.
Natural Sugar Versus Added Sugar: Know the Difference
Not all foods containing sugar deserve the same treatment.
Whole fruits naturally contain sugar, but they also provide fiber, water, vitamins, minerals, and other beneficial nutrients. Their structure helps make them more filling than many processed sweets.
Vegetables contain varying amounts of naturally occurring carbohydrates and offer valuable nutrients and fiber.
Milk also contains naturally occurring lactose.
Added sugars, by contrast, are sugars and syrups introduced during food preparation or processing. They can be found in soft drinks, sweetened teas, flavored yogurts, packaged snacks, sauces, desserts, and numerous other products.
Fruit juice deserves special attention. Even 100% fruit juice can deliver considerable sugar without the fiber found in whole fruit. Drinking a large glass of juice is not nutritionally equivalent to eating a whole orange.
My practical advice: Choose whole fruit more often than juice, and make water your everyday beverage of choice.
Understanding Carbohydrates
Carbohydrates are an important source of energy. The goal is not to eliminate every carbohydrate from your diet but to choose nutritious sources and limit excessive added sugar.
Glucose
Glucose is a simple sugar that circulates in our blood and serves as an important fuel for the body’s cells.
Carbohydrates from food are digested and absorbed at different rates. The effect on blood glucose depends on the food’s composition, portion size, preparation, and what else we eat.
Sucrose
Sucrose is ordinary table sugar. It consists of glucose and fructose joined together.
During digestion, it is broken down into these two simple sugars. Sucrose occurs naturally in some plants, but much of the table sugar and added sugar in processed foods comes from refined sugar sources.
Starch
Starch is a complex carbohydrate found in foods such as potatoes, beans, oats, rice, and whole grains.
Digestible starch is broken down into glucose. Contrary to a common misconception, starch can also raise blood sugar, sometimes quite rapidly.
The effect depends on the type of food, how it is prepared, the portion consumed, and the presence of fiber, protein, and fat in the meal.
That is why a bowl of minimally processed oats and a large serving of highly refined starch should not automatically be considered equivalent.
Fiber
Dietary fiber is found in vegetables, fruits, legumes, nuts, seeds, and whole grains.
Some fibers are soluble, while others are insoluble. They have different effects on digestion, bowel function, cholesterol, and blood glucose.
Fiber-rich foods generally help us feel full and support digestive health. Some types of fiber are also fermented by beneficial gut bacteria.
If you struggle with constipation, increasing fiber gradually and drinking enough water may help. Increase fiber sensibly, however, because a sudden large increase can cause bloating or discomfort.
The bottom line: Don’t fear all carbohydrates. Choose more whole grains, beans, vegetables, and whole fruits, while reducing refined grains and foods loaded with added sugar.
Ten Practical Ways to Protect Your Health From Excess Sugar
Knowing what sugar can do is one thing. Changing our daily habits is another. Here are ten practical steps that can make a difference.
1. Cut Back on Sugary Drinks
Start with the easiest change: replace regular soda, sweetened tea, and sugary fruit drinks with water or unsweetened beverages.
If you drink several sugary beverages a day, begin by replacing one or two. Gradual changes are often easier to maintain than a dramatic promise to give up everything you enjoy.
2. Read Food Labels
Don’t let clever packaging fool you.
Look at the Nutrition Facts label, especially the line for Added Sugars. Check the serving size, too. A bottle may contain more than one serving, which means you could consume considerably more sugar than you realize.
Sugar also appears under names such as sucrose, glucose, dextrose, corn syrup, and fruit juice concentrate.
A few seconds of label reading can help you make a more informed choice.
3. Eat More Whole Foods
Make vegetables, whole fruits, beans, nuts, seeds, and whole grains regular parts of your meals.
These foods provide nutrients and fiber that many highly processed snacks lack.
You do not need an expensive health-food shopping spree. Ordinary foods prepared simply can be excellent choices.
4. Be Mindful of Portions
Even nutritious foods can contribute excess calories when portions are very large. With sweets, portion size matters especially when they are eaten frequently.
Enjoy a small serving when you choose to have dessert rather than turning one serving into an unplanned second and third helping.
Remember: the goal is not to win a competition for the cleanest plate. It is to nourish your body appropriately.
5. Enjoy Dessert at the End of Your Meal
Here is a practical habit for people who love dessert as much as I do.
If you’re going to enjoy a sweet treat, consider having a modest portion at the end of a balanced meal rather than eating it by itself as a snack.
When dessert follows a meal containing protein, fiber, and other nutrients, the overall meal may slow digestion and moderate the rise in blood glucose compared with eating rapidly absorbed carbohydrates alone.
However, this is not a magic trick that neutralizes sugar. The amount of sugar still matters, and eating dessert after a meal does not cancel its calories.
A small serving of dessert after a balanced meal is a reasonable compromise for many people who want to enjoy sweets while making healthier choices.
I prefer a sustainable eating plan that leaves room for an occasional treat over one that makes me dream about cake all day!
6. Take a 10-Minute Walk After Meals
One of the simplest habits you can adopt is walking for about 10 minutes after a meal, when practical and safe.
Physical activity helps muscles use glucose for energy and can reduce the rise in blood sugar after eating. Even short walks can contribute to better glucose management.
You don’t need a gym membership, special clothing, or a personal trainer shouting encouragement at you.
Start with a comfortable pace and build gradually according to your abilities. If you have balance problems, significant mobility limitations, or medical restrictions, ask your healthcare professional how to exercise safely.
For those able to do so, a short walk after meals is a useful habit that can add up over time.
7. Include an A1C Test in Your Routine Health Checkup When Appropriate
This is an important recommendation I want readers to remember.
During your annual health checkup, ask your healthcare professional whether a hemoglobin A1C test should be included in your blood work, particularly if you are age 35 or older, have excess weight, have a family history of diabetes, or have other risk factors.
The A1C test estimates your average blood glucose level over approximately the previous three months. Unlike a fasting blood glucose test, it generally does not require fasting.
Here is how the standard A1C ranges are interpreted for nonpregnant adults:
- Below 5.7%: Normal range.
- 5.7%–6.4%: Prediabetes range.
- 6.5% or higher: Diabetes range.
An elevated A1C can indicate prediabetes or diabetes. However, a result in the diabetes range generally needs confirmation with repeat testing or another appropriate diagnostic test unless the clinical circumstances clearly establish the diagnosis. Certain medical conditions can also affect A1C accuracy.
Prediabetes is a warning sign, not a reason to give up. Early identification gives you an opportunity to make lifestyle changes, work with your healthcare professional, and reduce your risk of progressing to type 2 diabetes.
People with normal results may not need testing every year; the appropriate interval depends on their age, risk factors, and previous results.
Please don’t wait for excessive thirst, frequent urination, or other symptoms before discussing screening. Type 2 diabetes can develop quietly.
8. Stay Physically Active
Regular exercise helps improve insulin sensitivity, supports weight management, and benefits the heart, blood pressure, muscles, and bones.
Walking is an excellent starting point, but choose activities appropriate for your health and fitness.
Consistency matters more than heroic efforts followed by weeks on the couch.
9. Don’t Forget Sleep and Stress Management
Healthy living involves more than food and exercise.
Inadequate sleep and chronic stress can affect appetite, food choices, and metabolic health. Establishing a regular sleep schedule, maintaining social connections, and making time for relaxation can support your overall well-being.
A healthier lifestyle is a collection of habits, not a single miracle food or supplement.
10. Make Small Changes You Can Maintain
You don’t need to overhaul your entire life tomorrow morning.
Start with one or two manageable changes: drink water instead of soda, reduce added sugar in your coffee, eat whole fruit instead of drinking juice, serve a smaller dessert, or walk for 10 minutes after dinner.
Once those habits become routine, add another.
And if you slip up? Don’t declare the entire health campaign a failure because you ate a piece of birthday cake. Resume your healthy habits at the next meal.
Perfection is a difficult standard to maintain, particularly when somebody brings homemade pie to the table.
Prevention Is Better Than Waiting for Disease
We spend enormous resources treating chronic diseases, many of which are influenced by preventable risk factors. Medical treatment is essential when disease develops, but we should also invest in helping people stay healthy in the first place.
As a physician, I believe health education should begin long before someone receives a diagnosis. Families, schools, healthcare professionals, communities, and public-health organizations all have roles to play.
We need to make healthy choices easier and more accessible—not simply tell people to exercise more and eat less while surrounding them with inexpensive, heavily marketed, highly processed foods.
We should also remember that people develop diabetes and other chronic illnesses for many reasons. They deserve understanding and effective care, never blame or shame.
My hope is that more people will learn how everyday habits influence long-term health and that healthcare systems will place greater emphasis on prevention alongside treatment.
We may not be able to prevent every illness, but we can often improve our odds.
A Final Word From One Sweet-Toothed Physician
I am not suggesting that we must never eat sugar again. Life is too short to turn every family celebration into a nutritional courtroom!
But we should understand the difference between an occasional pleasure and a daily habit that may gradually undermine our health.
Choose whole foods more often. Limit added sugar. Enjoy dessert in sensible portions, preferably at the end of a balanced meal. Take a 10-minute walk afterward when you can. Discuss appropriate A1C screening with your healthcare professional.
And remember, a healthy lifestyle is not a temporary diet. It is a way of living that supports us through the years.
If I could give my younger self one piece of advice, it would be this: Don’t wait until your body starts sending you medical bills before you begin taking care of it.
Start today. Your future self may thank you—and perhaps your dentist will, too!
Happy healthy eating!
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