Sugar in our daily lives seems like a "harmless" little pleasure: a spoonful in tea, a piece of candy after lunch, or a sweetened drink to accompany work stress. But once we look at the bigger picture, it becomes clear that it is not just "calories", but a repeated exposure pattern that stresses and slowly reshapes the body's vital systems: from energy and insulin regulation, to visceral fat accumulation, to chronic inflammation, to heart and metabolic diseases and tooth decay.This is why the World Health Organization (WHO) sets a clear limit on the consumption of "free sugars" (added sugars, honey sugars, juices, etc.): less than 10% of total daily energy, and preferably less than 5% to achieve additional benefits, especially in reducing the risk of dental caries across the lifespan (World Health Organization [WHO], 2015).This ceiling does not come from a vacuum; it comes from an accumulation of evidence linking high sugar, especially in beverages, to a long disease trajectory that often starts with a simple imbalance and ends with large health and economic burdens.
At the level of daily "body engineering", sugar acts like a quick button in the energy system: it quickly raises blood glucose, and the body responds by secreting insulin to return glucose to the cells. The issue is not with this process itself, but with its frequent repetition throughout the day, especially when sugar is in liquid form or in highly processed products that are quickly absorbed.The constant repetition of glucose and insulin peaks may over time contribute to insulin resistance, a major gateway to the onset of type 2 diabetes, visceral fat gain and dyslipidemia. This is where the "source of sugar" becomes very important: recent epidemiological reviews and research suggest that sugar from sweetened drinks is more consistently associated with an increased risk of type 2 diabetes, with estimates of a 13% to 30% increased risk for each additional daily serving of sweetened drinks (Malik et al., 2010Imamura et al., 2015). This does not mean that everyone who drinks a sweetened beverage will develop diabetes, but it does mean that frequent daily exposure raises the likelihood at the population level, making it a "behavioral construct" rather than an isolated individual event.In the same vein, the American Heart Association recommends limiting "added sugars" to clear practical limits: about 25 grams per day for women (about 6 teaspoons) and 36 grams per day for men (about 9 teaspoons), because the sugar burden is also associated with heart health and weight (American Heart Association, 2023).
When sugar moves from the blood to the "fat maps" within the body, the relationship between pleasure and disease becomes even more pronounced. Part of the modern issue is that sugar does not come alone, but in a food environment that combines sweetness with an attractive texture, fat and salt, making it easier to consume without paying attention.The liver is a central link: the liver deals with excess energy and sugars, especially fructose, in the context of caloric excess, and this may be associated with elevated markers of non-alcoholic fatty liver disease. Meta-analyses of controlled trials suggest that fructose when delivered in "caloric excess", especially via sweetened beverages, can elevate some markers of fatty liver (Chiu et al., 2014Zhang et al., 2022). In practice, the issue is not the "fruit sugar" inside a whole fruit rich in fiber, but the combination of speed, quantity, and energy surplus provided by sweetened and easy-to-drink products, so that energy enters quickly without adequate satiation, and its effects accumulate over time. With visceral fat accumulation and low-grade inflammation, the risk of cardiovascular disorders increases, not by sugar alone, but by a series of overlapping changes in weight, blood pressure, lipids, and metabolism.
Today, sugar is pervasive and hidden in many everyday products, and repeated exposure changes the baseline of taste: "normal" becomes less sweet to us, and we demand more. This is why the World Health Organization (WHO) also warns against sweetened beverages for young children, and links reducing free sugars to reducing dental caries as one of the most common harms globally (WHO, 2017).In a related aspect of global trends, a study in BMJ indicates that sweetened beverage consumption among children and adolescents (3-19 years) in 185 countries increased by 23% between 1990 and 2018, a figure that illustrates how sweetness is becoming a cross-border "consumption structure" rather than an individual choice (Singh et al., 2024).). This context explains why the advice to "cut down on sugar" seems easy on paper but difficult in reality: the food environment works against it, from intense marketing to the availability of cheap sweetened alternatives to the presence of sugar in products we don't expect.
The bottom line is that sugar reshapes our bodies through two intertwined pathways: a physiological pathway that reprograms energy regulation (glucose and insulin peaks, insulin resistance, visceral fat, fatty liver in certain diets), and an environmental-behavioral pathway that makes exposure frequent, natural, and hidden.So the best approach seems to be less about "prevention" and more about "reducing exposure": reducing sugary drinks as a first priority, reading labels for added sugars, and rebalancing meals with fiber, protein, and healthy fats so that sweetness doesn't turn into repeated bursts of hunger and fluctuating energy.When we set benchmarks such as the World Health Organization (WHO) limit (less than 10% and preferably less than 5% of energy) and American Heart Association limits (25g for women and 36g for men), the decision shifts from guilt to a measurable plan (WHO, 2015; American Heart Association, 2023). Between pleasure and disease, the point is not to kill pleasure, but to break the repetitive daily associations that make sugar a "system" that silently shapes the body.
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