“Is sugar really that bad?” is a question that arises time and time again with clients, usually accompanied by an anxious laugh and a guilty admission of their morning vanilla latte, their daily granola bar or their go-to yogurt. With an environment saturated with “no added sugar” products and the ever-present trends of #quitsugar taking over social media, many patients, clients and shoppers are left wondering what’s OK, what’s risky and what needs to change.

As dietitians, we understand that excessive added sugar can lead to all kinds of issues, from impaired metabolism to energy crashes. But, we also understand that stoking fear of sugar isn’t the answer. We want to educate, not deprive. So, whether you’re decoding Starbucks orders, yogurt aisles or smoothie bars with clients, our goal is simple: Reduce added sugar without reducing pleasure.

Recommendations and clinical considerations for sugar

Before we help clients make healthy changes, it’s worth updating the figures. Clients are usually astonished to learn how little added sugar is recommended and how fast our daily habits can exceed those limits.

Current guidelines: A brief overview

The American Heart Association suggests:

25 grams (6 teaspoons) of total added sugars per day for women.
36 grams (9 teaspoons) of total added sugars per day for men.

The Dietary Guidelines for Americans (DGA) suggest reducing added sugars to less than 10% of daily calories. For a 2,000-calorie diet, that’s roughly 50 grams/day.

When sugar reduction becomes clinical

Some clients may benefit from overall awareness and slight changes, whereas others need more systematic approaches to sugar reduction based on their health status. The priority populations are:

Clients with type 2 diabetes or prediabetes are advised to enhance glycemic control and insulin sensitivity.
People with PCOS or insulin resistance, where excess sugar can worsen hormonal and metabolic symptoms.
Cardiovascular risk patients: Excessive added sugar intake has been associated with elevated triglycerides and inflammation in the body.
NAFLD and metabolic syndrome: to assist liver function and prevent visceral fat buildup.
Pediatric and adolescent patients: Excessive sugar intake can impact mood, concentration and long-term health trajectories.

Balance over fear

Consumers can tune out a sugar conversation with an awareness that they’re being asked to choose between opposites. Our task is to reframe that message: We’re not knocking sugar, but we’re enabling clients to arrive at balance. Instead of restriction, encourage clients to cultivate a greater awareness of sugar. More people respond when we move from “don’t eat that” to “how do we make that work for you?” This lays the groundwork for long-term changes rather than short-term rules.

Sneaky high-sugar staples in your daily routine (and how to swap them out)

For most of our clients, the biggest contributors of added sugar are not cakes and candy; they are lurking in everyday habits. The coffee stop in the morning, the afternoon snack cart or that “healthy” yogurt can send one over the daily recommended amount of added sugar before they even know it. Our role as dietitians is to bring these everyday foods to light and suggest realistic alternatives that don’t leave your clients feeling deprived.

Coffeehouse drinks (e.g., Starbucks, Dunkin’)

Some common options that may be breaking the sugar bank:

A grande caramel macchiato = ~33g sugar.
Matcha lattes with sweetened oat milk = 28-42g sugar.
Flavor cold foam, syrups and sweetened milk build up rapidly.

What to recommend instead:

Request fewer pumps of syrup (each pump adds approximately 5 grams of sugar) or choose sugar-free alternatives if possible.
Select unsweetened dairy or plant-based milks, such as almond, soy or whole milk with no added sugars.
Add spice with cinnamon, nutmeg, unsweetened vanilla powder or a dash of milk + stevia.
Go for an Americano or cold brew with a splash of milk and a shot of syrup for flavor without the sugar high.

Example order swap:

A common choice: Iced caramel macchiato made with oat milk (33g sugar).

Try instead: Iced Americano with a pump of caramel syrup + splash of whole milk (~5-7g sugar).

Sweetened and flavoured yogurts

High-sugar products that clients may be choosing:

Fruit-on-the-bottom and fruit-flavored Greek yogurts usually have 12-20g of added sugar.
Yogurt packs with added granola or candy on top can have up to 22g of added sugar per package.
Children’s yogurts or tubes may contain over 10g sugar in just 3-4 ounces.

What to recommend instead:

Look for yogurts with ≤6g added sugars or opt for unsweetened/plain Greek yogurt.
Add your own fruit, cinnamon, vanilla or a spoon of nut butter for natural sweetness.
Brands like Oikos, Two Good, Siggi’s and Chobani Zero Sugar offer compelling lower-sugar alternatives bolstered with more protein.

Example substitution:

½ cup plain Greek yogurt + ½ banana + sprinkle of cinnamon + 1 tsp almond butter = sweet, satisfying and only ~5g naturally occurring sugar.

Smoothie chains (e.g., Smoothie King, Jamba Juice)

Products that clients may be deceived by:

Fruit juice, sherbet, yogurts and protein powders smoothies with added sugar can contain 40-70g of sugar.
Energy” or “immunity” mixes often contain hidden added sugars from blends and syrups.

What to recommend instead:

Encourage do-it-yourself smoothies using frozen fruits, plain yogurt, milk, greens and seeds.

At chains, suggest:

No added juice. Instead, opt for water, almond milk or coconut water.
No turbinado or honey syrups.
Whole fruit instead of fruit blend or sherbet.

Quick recipe for clients:

1 cup frozen berries + ½ banana + ¾ cup unsweetened almond milk + ½ scoop protein powder + 1 tbsp chia seeds = ~10g total sugar, almost entirely from fruit.

Kombuchas, packaged teas and flavored waters

The nutrition labels don’t lie, but may be hiding behind other marketing:

One 16 oz kombucha = 12-18g sugar.
Many flavored teas, coconut waters and vitamin waters contain added sugars despite a “health halo.”

What to recommend instead:

Look for products with <5g sugar per serving and check whether the sugar is naturally occurring (e.g., from fruit).
Try DIY spa water (cucumber + mint, lemon + basil) or cold brew tea with a splash of citrus.
Brands like Health-Ade Pop and Spindrift offer tasty, low- or no-added-sugar options.
If they love kombucha, encourage them to drink half a bottle at a time and cut it with sparkling water for the same flavor, half the sugar.

Breakfast bars, protein bars and granola

Common hidden places for sugars:

More popular granolas contain 10-12g of sugar per single ¼ cup serving.
Breakfast and snack bars frequently have 15-20g sugar, particularly if they are coated or “fruit-filled.”
Some protein bars are equivalent to a candy bar in terms of added sugars.

What to recommend instead:

Choose granolas with <5g sugar per serving and ≥3g fiber.
Recommend bars with <6g added sugar, >6g protein and minimal syrups or artificial sweeteners.
Suggest DIY options like overnight oats, chia pudding or nut + fruit snack boxes.

Healthier protein or fiber options:

RXBAR, Kind Protein (Low Sugar), Larabar (bite-sized) or That’s It bars.
Or: ¼ cup mixed nuts + 2 dried apricots = protein + fiber + sweetness, ~6g sugar total.

Cutting added sugar doesn’t have to equal deprivation or flavor sacrifice. It’s about making more thoughtful, educated decisions. As dietitians, we can turn the conversation from restriction to empowerment, engaging clients in finding small, sustainable shifts that align with their lives. By honing in on daily swaps and balanced advice, we can encourage habits that really stick.