A cookie now and then rarely feels like a health crisis, but the drinks you sip every day may be the bigger problem. Recent research is drawing a sharper line between eating sugar and drinking it, suggesting the form matters as much as the amount. Two large projects, one focused on heart related illness and another on type 2 diabetes, point in the same direction. The takeaway is uncomfortable for anyone who leans on soda, sweetened coffee drinks, or even some juices as a routine pick me up.
The debate over sugar has been simmering for decades, and it has often treated all sweet sources as roughly the same. Food and Wine notes that back in 1977 The New York Times asked whether sugar was a “villain in disguise,” and the warning bells have rung ever since. Even with repeated calls to cut back, added sugar intake climbed for years, and official guidance has kept urging moderation. What is changing now is the idea that guidelines may need to spell out which kinds of sugar delivery are most damaging. In other words, the can in your hand may matter more than the slice on your plate.
One of the biggest new clues comes from a 2024 study out of Lund University published in Frontiers of Public Health. Researchers worked with data from two major Swedish cohorts, the Swedish Mammography Cohort and the Cohort of Swedish Men, using diet questionnaires and long term follow up that ran through 2019. After accounting for other risk factors, the final sample was close to 70,000 people. During the follow up, 25,739 participants were diagnosed with a cardiovascular disease, which gave the team enough power to compare patterns across different sugar sources.
Instead of lumping all sweets together, the Lund team separated added sugar into three everyday buckets. They looked at sugar “toppings” such as honey, treats like cookies and pastries, and sweetened beverages like soda. They also tracked seven cardiovascular outcomes that included stroke, heart attack, heart failure, aortic aneurysms, atrial fibrillation, and aortic stenosis. The clearest signal appeared in the beverages category. According to Food and Wine, the researchers found sweet drinks were “worse for your health than any other form of sugar.”
Why would liquid sugar stand out so strongly. Suzanne Janzi, a PhD candidate at Lund University and the paper’s corresponding author, pointed to the way beverages slide past your appetite controls. She said, “Liquid sugars, found in sweetened beverages, typically provide less satiety than solid forms” and that can “potentially lead to overconsumption.” She also highlighted how habits shape risk, saying, “Context also matters” because treats tend to show up at celebrations while sweet drinks can become daily staples. When something sweet is both easy to consume and easy to repeat, the body can end up with more sugar than you realize.
One surprising detail from the heart study is that completely avoiding sweets did not look like the best outcome. The researchers observed that occasional treats were linked with better health outcomes than total abstinence. Janzi offered a possible explanation rooted in real world behavior, saying, “This might reflect underlying dietary behaviors” since people who eat very little sugar may be on restrictive diets or cutting sugar because of existing conditions. She added, “these findings suggest that extremely low sugar intake may not be necessary or beneficial for cardiovascular health.” That nuance matters because it shifts the goal from perfection to smarter patterns.
A second major piece of evidence came in 2025 from Brigham Young University, published in Advances in Nutrition. This was a sweeping meta analysis that pooled data from more than 500,000 people across Asia, Australia, Europe, Latin America, and the United States. The researchers examined how different sugar sources related to type 2 diabetes risk. The consistent pattern was that sugar in beverages such as soda and juice tracked with higher rates of type 2 diabetes, while natural sugars in whole fruit could be protective.
Karen Della Corte, the lead author and a nutritional science professor at Brigham Young University, emphasized how clear the trend looked across such a massive dataset. She said, “This is the first study to draw clear dose response relationships between different sugar sources and type 2 diabetes risk.” She also distilled the practical implication in plain terms, saying, “It highlights why drinking your sugar, whether from soda or juice, is more problematic for health than eating it.” That is a direct challenge to the popular idea that juice is automatically a wholesome alternative just because it starts with fruit.
Put together, the two research tracks argue for a more targeted kind of sugar advice. Instead of treating every sweet bite as equal to every sweet sip, they suggest focusing on drinks that deliver sugar quickly with minimal fullness. Della Corte even pointed toward policy level change, writing that “future dietary guidelines might consider the differential effects of sugar based on its source and form.” That does not give desserts a free pass, but it does put sugary beverages in a higher risk category. For many people, reducing sweet drinks may be the most efficient first step.
It helps to know what health organizations already advise, because those numbers give you a reality check when you look at labels. The American Heart Association suggests keeping added sugar to about 6 teaspoons a day for most women and about 9 teaspoons for most men. The World Health Organization recommends limiting free sugars to under 10 percent of total daily energy, and it suggests going below 5 percent for added benefits. In the United States, federal dietary guidance commonly highlights a limit of under 10 percent of daily calories from added sugars. These limits are easier to exceed than most people think when beverages are part of the routine.
For example, a standard 12 ounce can of Coca Cola contains 39 grams of sugar, which is roughly 10 teaspoons. That is basically an entire day’s added sugar for many adults, and it arrives without the slowing effects of chewing, fiber, or protein. Sweetened iced coffees, energy drinks, and fruit flavored beverages can land in the same neighborhood depending on the brand and serving size. Even 100 percent fruit juice concentrates sugar in a way that does not match eating whole fruit, which comes with fiber that changes how fast sugar hits your system. This is why researchers keep circling back to the same point, the drink format is uniquely easy to overdo.
If you want a practical approach, start by auditing what you drink on an average weekday, not your best day. Swap one sugary drink for water, unsweetened tea, or sparkling water with a squeeze of citrus, and see what happens to your cravings and energy over a couple of weeks. If you love juice, consider cutting it with water or choosing smaller servings, and pair sweet foods with meals that include protein and fiber to slow absorption. And if dessert is part of your life, treat it like a planned pleasure rather than a constant background snack, which matches the idea that context changes habits.
Now for a bit of general background that helps explain why these findings keep showing up. Added sugars are sweeteners put into foods and drinks during processing or preparation, while naturally occurring sugars are found in whole foods like fruit and plain dairy. Sugary beverages tend to be absorbed quickly because they do not contain the same fiber structure that whole foods do, and they often do not trigger fullness in the same way solid foods can. That combination can push total daily sugar higher without you noticing, especially when drinks are consumed between meals. Understanding the difference between added sugars and naturally occurring sugars can make label reading less confusing and help you build habits that last.
What changes, if any, would you be willing to make to cut back on sugary drinks, and why. Share your thoughts in the comments.
