Food & nutrition

Added sugars, free sugars, and total sugars: definitions, labels, and health evidence

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Sugar terminology depends on the question. “Total sugars” includes naturally occurring and added sugars. The US label’s “added sugars” describes sugars added during manufacture and certain sweeteners. WHO’s “free sugars” also includes the sugars naturally present in honey, syrups and fruit juices.[1][2]

Three measures that are often confused

Three measures that are often confused
Measure	What it includes	Important distinction
Total sugars	Naturally present sugars plus added sugars.	An unsweetened milk product can still contain total sugar.[1]
Added sugars — US label	Sugars added during processing, packaged sweeteners and relevant syrups or concentrates.	An “includes” amount is already part of total sugars.[1]
Free sugars — WHO	Added sugars plus sugars naturally in honey, syrups, juices and juice concentrates.	Whole-fruit sugars and sugars naturally in milk are excluded.[2]

Fruit, juice, and honey are useful examples

WHO counts juice sugars as free sugars without added sugar. Whole-fruit sugars are excluded. Honey and syrups also count; “natural” does not change the category.[2]

A “no added sugar” statement does not tell you that total sugars are zero. FDA’s label definitions distinguish sugars already present in ingredients from sugars added during processing. The claim therefore cannot substitute for reading the total-sugars line and considering the food itself.[3]

The Daily Value is a label reference

FDA’s added-sugars Daily Value is 50 g for a reference 2,000-calorie diet. “Includes 7 g added sugars” means those 7 g are within the total-sugars amount, not extra grams to add again. A label reference is not a requirement to consume that amount or a personalized target.[1]

WHO’s 2015 guideline recommends free sugars below 10% of energy and conditionally suggests below 5%, based on less certain evidence. At an illustrative 2,000 calories, these correspond to 50 g and 25 g. Energy needs and sugar definitions differ.[2]

Why the replacement food matters

Te Morenga and colleagues’ 2013 review found that reducing sugars in freely chosen adult diets was associated with weight reduction, while exchanging sugars for other carbohydrates at equal energy did not change weight. The authors interpreted the weight effect as arising through changed energy intake. This is historical evidence, not a complete review of every later sugar study.[4]

The finding does not mean that a nutrient has no other health effects when weight stays stable. It means that a question about body weight needs to specify energy intake and the comparator. Dental outcomes, for example, need their own evidence rather than being inferred from the scale.[4]

Tooth decay is a separate outcome

A 2022 review updated the dental evidence with studies published during 2011–2020. Its authors rated the combined cohort evidence moderate for lower caries below 10% of energy, and low for additional benefit below 5%. These are the review authors’ assessments; the Atlas has not independently repeated them.[5]

The update found both positive and null associations across studies. Lower sugar intake reduced observed caries risk; it did not establish that crossing a percentage threshold guarantees healthy teeth. Its inclusion of cross-sectional and ecological designs also limits causal interpretation.[5]

A sugar target belongs within the whole dietary pattern

WHO’s guideline focuses on free sugars, unhealthy weight gain and dental caries. It is intended to work with other nutrient guidance and local dietary patterns. Reducing one sugar-containing food does not establish the quality of the replacement or guarantee weight loss. The distinction between free sugar and total sugar also prevents applying its target indiscriminately to all intact fruit or milk.[6]

Glucose, fructose and sucrose identify different sugars

Glucose and fructose are simple sugars. Sucrose, familiar table sugar, joins one of each in a molecule. Ordinary corn syrup is mainly glucose; enzymes convert some of it into fructose to make high-fructose corn syrup (HFCS). Common HFCS formulations contain 42% or 55% fructose, rather than being pure fructose. The remaining sugars are largely glucose. These ingredient names describe composition; compare the finished food’s sugar amount too.[7]

Evidence & uncertainty

Evidence supports reducing excessive free-sugar intake, particularly for tooth decay and energy balance. Evidence strength varies by outcome and comparison. Replacing sugar with an equal amount of energy is a different experiment from removing sugary drinks without replacing their calories.[4]

Selected-source overview · Independent review pending

Published questions

Are free sugars and added sugars the same?

Selected-source overview · Independent review pending. Read the evidence context.

Not exactly. WHO free sugars include sugars naturally in juice, honey and syrups as well as added sugars. The US added-sugars label follows a different definition.[2]

Evidence behind this answer

WHO calls on countries to reduce sugars intake among adults and children
official guideline summary · 2015
Selected relevant official page passages inspected · Free-sugar definition; strong below-10% and conditional below-5% recommendations