You probably know that too much sugar is bad for your health, but a new analysis suggests that how you consume sugar might matter just as much as the amount you take in.
The review of nearly 30 studies, published in the journal Advances in Nutrition, found that drinking sugary beverages like soda may increase your risk of type 2 diabetes more than eating sugary foods like cookies and cakes.
“This research fills an important gap by emphasizing the context in which sugar is consumed,” lead study author Karen Della Corte, PhD, an assistant professor of nutrition, dietetics, and food science at Brigham Young University, told Health.
“Rather than making blanket statements to ‘cut all sugar,’ we now have strong evidence that the source, form, and surrounding nutrients are key determinants of risk,” she said.
Which Is Worse: Drinking or Eating Sugar?
In what Della Corte called the first large-scale analysis of how the type of sugar intake affects health, researchers reviewed 29 studies analyzing the habits of more than 500,000 people across multiple continents.
Their surprising conclusion: Sugar from non-liquid sources wasn’t linked to a higher risk of type 2 diabetes, but consuming sugar-sweetened drinks was.
With every additional daily 12-ounce serving of a sugary beverage like energy and sports drinks, the risk of developing type 2 diabetes went up by 25%. Even fruit juice had an effect, with every added 8-ounce serving raising the risk by 5%.
Not only did sugar from food not have a connection to type 2 diabetes risk, regardless of amount, but it appeared to have a protective effect in some cases, the researchers said. Consuming 20 grams (nearly two tablespoons) daily of table sugar and total dietary sugar, including natural sugar, was linked to a lower risk of type 2 diabetes.
Taken together, the findings show that “not all sugars are created equal,” Della Corte said.
It’s important to note that the study didn’t prove that sugary drinks cause type 2 diabetes—only that there’s an association between the two. While most studies in the analysis adjusted for factors like BMI and smoking, the researchers acknowledged that other lifestyle habits may still explain the increased risk.
Indeed, many people who drink these beverages are also likely to be less physically active, which can impact diabetes risk, said Laura A. Schmidt, PhD, a professor at the Institute for Health Policy Studies and Department of Humanities and Social Sciences at the School of Medicine at the University of California, San Francisco. Still, Schmidt told Health that the study is “impressive in its reach.”
Why Liquid Sugar May Be More Harmful
Sweetened drinks may be more harmful because they don’t have “any of the fiber, protein, or fat that typically slow down digestion” found in food, Della Corte said.
That means they enter your bloodstream quickly, causing a spike in blood glucose and insulin levels and bypassing the brain’s fullness cues. This rapid intake can also overwhelm the liver’s ability to process sugar—especially the fructose component.
In high doses, fructose is converted to fat in your liver, and the buildup of fat is linked to metabolic dysfunctions like hepatic insulin resistance, which drive type 2 diabetes, Della Corte explained.
Schmidt added that other ingredients, such as chemical additives, artificial dyes, and flavorings commonly found in sugar drinks, impact “our delicate metabolic balance.”
Sweetened drinks like sports drinks, soda, and cocktails are typically “bad for your health and should be consumed with caution—ideally, not at all,” she added.
How to Cut Back on Sugary Drinks Without Feeling Deprived
Sugary drinks can feel addictive, Schmidt said. If you do get hooked on them, try to wean yourself off, just as you would substances like alcohol or tobacco, she said. “Be proactive in planning for the times you are likely to crave a soda,” she suggested.
You can start by mixing plain soda water with an equal amount of fruit juice or soda. Then, gradually, week by week, reduce the amount of sugary drinks to the point where you’re just drinking soda water.
If it helps, Schmidt said to add a little lemon or lime juice to add some flavor. “Make this your new habit,” she said.
