It has now been ten years since I published my first book, The Sugar Casino, a brain dump after 37 years in the sugar industry. I am currently updating it, but I worry I might once again fall into the rabbit hole of sugar and health. While sugar and health are not my area of expertise, I cannot update the book without addressing the subject.
Fortunately, there has been excellent scientific research on the topic over the past decade, leading to greater clarity and less hype.
Ten years ago, when I wrote my book, I was concerned that the body might process sugar in liquid form—whether in a sugar-sweetened beverage (SSB) or fruit juice—differently from sugar in solid foods. Without scientific proof, I wrote:
When you eat an apple, it takes time for your stomach to break down the fibre in the apple to extract the fructose; when you drink a sugar-containing soft drink, that work has already been done for you. Some argue that the “rush” of fructose in a soft drink may overload your liver and encourage it to turn it into fat.
There is another issue with calorific soft drinks: some researchers have questioned whether the mind registers the calories in liquids. For most of human existence, nearly all calories came from solid food. Only in recent history have humans obtained significant calories from liquids. Therefore, it would not be surprising if the human brain is not hardwired to recognise this new phenomenon of calorie-containing liquids.
You can try a simple test at home. One 8-oz (250-ml) glass of apple juice contains approximately 175 calories from three to four apples. This evening, before dinner, drink a glass of apple juice and see if it reduces your appetite. You will find it won’t.
Tomorrow evening, eat three and a half apples before sitting down at the dinner table. Even though you have consumed the same number of calories as the previous evening, you will find that you are far less hungry. Your stomach will feel full, giving you a sensation of “satiety” that will result in you eating less for dinner.
Note that both HFCS and table sugar are similar; they contain approximately the same amounts of glucose and fructose. Glucose is absorbed directly into the bloodstream (activating the brain’s reward system), but fructose must first be processed by the liver. If the liver receives too much fructose at once, it converts some of it into fat.
It appears I was at least partly right. In the largest and most comprehensive meta-analysis of its kind (1), researchers from Brigham Young University, collaborating with researchers from German institutions, found that the type and source of sugar may be more significant than previously believed. They state:
Researchers analysed data from over half a million people across multiple continents, revealing a surprising twist: sugar consumed through beverages—like soda and even fruit juice—was consistently linked to a higher risk of developing type 2 diabetes. Meanwhile, other sugar sources showed no such link and, in some cases, were even associated with a lower risk.
Another study (2), also published this year, raised similar concerns. The authors wrote:
Because of their liquid form, Sugar-Sweetened Beverages (SSBs) are rapidly consumed and digested, resulting in lower satiety, higher caloric intake, and weight gain.
High doses of rapidly digested fructose directly activate hepatic fat synthesis, leading to ectopic fat deposition and metabolic dysfunction in liver and muscle. SSBs may also replace other healthier foods in the diet, contributing to harm through their absence.
In 2023, the British Medical Journal published an umbrella review (3) of dietary sugar consumption and health, highlighting the role that SSBs play:
Generally, sugar-sweetened beverages are the largest source of added sugars, including carbonated and non-carbonated soft drinks, fruit drinks, and sports and energy drinks. Previous surveys have shown that consumption of sugar-sweetened beverages is declining in many developed countries, although consumption levels remain high. However, the consumption of sugar-sweetened beverages is still increasing in many developing countries, which may be attributed to their increased availability, accompanied by economic development.
The message is resonating, particularly among younger generations. In a narrative review of the impact of free sugar on human health (4), the authors state:
The turn of the century witnessed a modest decline in added sugar intake. A report by the US Department of Agriculture noted a 14% reduction in added sugars and sweeteners between 1999 and 2014 [76]. Trends from the US 2001 to 2018 National Health and Nutrition Examination Survey (NHANES) highlighted this reduction, albeit observed only in younger adults (aged 19–50 years) from a mean of 96.6 g to 72.3 g per day, including a reduction in SSBs from 49.7% of daily sugar intake to 37.7% [79].
A similar reduction in sugar was observed in Australia and New Zealand between 1995 and 2011, with the proportion of dietary energy from free sugars declining from 12.5% to 10.9%. The greatest contributor to this decline was again observed in children and young adults.
As a bit of fun, I included a sugar-trader’s diet in my 2105 book (5), writing:
A friend of my wife recently completed a “juice week” during which she consumed only vegetable and fruit juice for seven days. She did it to detox her body and lose weight. My wife asked her whether she had lost weight, and she replied that she hadn’t, but she did feel better and enjoyed the challenge of not consuming anything that hadn’t been blended.
There are two issues with this. The first is that blending fruit may lead to consuming more fruit without feeling full. The second is that the liver might struggle to process all the fructose received at once, potentially converting some of it into fat.
If you eat the fruit whole rather than blending it first, you will not only eat less of it but also allow the fructose to be absorbed more slowly into the body, giving your liver more time to process it. (You should notice the use of the word “may”; this remains a controversial topic.) Therefore, liquifying fruit into smoothies or juice means you will consume more calories and less fibre. Instead of juicing the fruit, eat it whole.
However, I also added:
My grandmother used to say, “A little bit of what you fancy does you good; that is my first rule of healthy eating.”
Or, as Oscar Wilde once famously said, “Moderation in all things, including moderation.”
References
1 Brigham Young University, 2025: Differential risk from sugar in drinks vs solid food.
2 Lara-Castor et al., Nature Medicine, 2025: Burden of disease analysis related to SSBs.
3 BMJ Umbrella Review, 2023: Sugar’s association with 45 adverse health outcomes.
4 Gillespie KM et al., 2023: Narrative review of free sugar impact.
5 Yeah, you’re right. I won’t include a sugar trader’s diet in my new book.
(C) Commodity Conversations 2025
As usual, Jonathan, you stimulate discussion on the subject of sugar. Thank you for the interesting article, I think we all have changed our sugar intake during our adult and perhaps more educated/influenced then as a child. Some of us move less, others more, and I feel motion is the lotion for us all in later life together with a healthy balanced diet. Anyone with a career in sugar will have had arguments against sugar debated with them, it has always been my belief to talk about facts and ignore myths. Is honey less healthy than sugar for example? Well there is more fructose in honey so maybe it is. I love fruit in its natural form and am not a fan of juices or smoothies, maybe the jaw exercise is necessary now I am no longer having trading conversations! The best advice I was given was “Eat less, move more”. Time for me to run to the gym. Happy New Year, Jonathan.