Both sugar and alcohol consumption can be harmful if consumed in excess. This article compares the health risks associated with overconsumption of added sugars versus alcohol to determine which may be more detrimental to human health.
TLDR:
In moderation, neither sugar nor alcohol is inherently dangerous. But in excess:
- Sugar is linked to obesity, diabetes, heart disease, fatty liver disease, and tooth decay.
- Alcohol is linked to liver disease, pancreatitis, cancer, vehicle crashes, violence, and addiction.
Overall, the health and social harms associated with alcohol appear greater than those linked to sugar. But both should be consumed in moderation.
Sugar Consumption Trends
Added sugars make up a significant portion of the average American’s caloric intake. According to the National Health and Nutrition Examination Survey (NHANES), from 2005 to 2010, Americans consumed an average of 82 grams of added sugars per day. This is equivalent to around 14% of total caloric intake.
The American Heart Association recommends limiting added sugars to no more than 25 grams (100 calories) per day for women and 36 grams (150 calories) per day for men. By this measure, the average American consumes excess added sugars.
Sources of Added Sugars
Major sources of added sugars in the American diet include:
- Soft drinks, energy drinks, sports drinks – 35% of added sugar intake
- Grain-based desserts – 12.9%
- Fruit drinks – 10.5%
- Dairy desserts – 6.5%
- Candy – 6.1%
- Ready-to-eat cereals – 3.8%
- Sugars/honey – 3.5%
- Tea – 3.5%
Major sources of naturally occurring sugars include fruits, some vegetables, and dairy products. But nutrition experts agree that naturally occurring sugars are not a major health concern.
Health Risks of Excess Sugar Intake
What are the health implications of excessive added sugar consumption?
Obesity
Obesity rates have risen dramatically in the United States over past decades. While many factors contribute to obesity, excessive added sugar intake is implicated as a significant culprit.
Sugary foods and beverages are calorie-dense but nutritionally poor. They promote weight gain by spiking blood glucose and insulin levels, which can drive fat accumulation and inflammation. In studies, higher sugar intake is linked to increased visceral fat, a dangerous type of belly fat.
Diabetes
The spike in blood glucose and insulin from high sugar intake can gradually lead to insulin resistance, impaired insulin secretion, and eventually type 2 diabetes. In studies, people who consumed more added sugars had a higher risk of developing type 2 diabetes.
Cardiovascular Disease
People who get a significant portion of their daily calories from added sugar have an increased risk of dying from cardiovascular disease. High sugar intake is linked to risk factors like obesity, high blood pressure, inflammation, high triglycerides, and low HDL cholesterol.
Fatty Liver Disease
Fructose, a type of sugar, is metabolized primarily in the liver. Excess fructose intake has been linked to non-alcoholic fatty liver disease. Studies in children and adults link sugary beverage consumption to the accumulation of fat in the liver.
Tooth Decay
Oral bacteria feed on simple sugars and release acid as a byproduct, which can erode tooth enamel. Frequent exposure to sugary foods and beverages raises risk for cavities.
| Health Effect | Evidence |
|---|---|
| Obesity | Higher sugar intake linked to fat accumulation, especially dangerous visceral fat. |
| Diabetes | Higher sugar intake linked to insulin resistance and impaired insulin secretion. |
| Heart Disease | Excess sugar linked to risk factors like obesity, hypertension, inflammation. |
| Fatty Liver Disease | Fructose overconsumption linked to fat accumulation in liver. |
| Tooth Decay | Bacteria feed on sugars and release enamel-eroding acid. |
Alcohol Consumption Trends
According to data from the National Survey on Drug Use and Health (NSDUH), 52% of Americans age 12 and over reported being current drinkers of alcohol in 2019. This equates to an estimated 140 million Americans.
The Dietary Guidelines for Americans define moderate drinking as 1 drink or less per day for women and 2 drinks or less per day for men. In 2019, 23% of drinkers reported binge drinking (4+ drinks for women, 5+ for men on a single occasion) in the past month.
Top Sources of Alcohol
The top sources of alcoholic beverages among US drinkers are:
- Beer – about 75% of alcohol consumed
- Spirits – including vodka, whiskey, gin, etc.
- Wine
- Flavored alcoholic beverages like wine coolers, hard seltzers, etc.
Health Risks of Excessive Alcohol Intake
What are the health effects of drinking too much alcohol?
Liver Disease
The liver metabolizes alcohol, but chronic heavy drinking can lead to fatty liver, alcoholic hepatitis, fibrosis, and cirrhosis. Alcoholic liver disease is one of the top causes of alcohol-related death.
Pancreatitis
The pancreas helps digest and absorb nutrients. Repeated overconsumption of alcohol can inflame the pancreas. Acute pancreatitis involves sudden abdominal pain and vomiting. Chronic pancreatitis can destroy the pancreas.
Cancer
Chronic heavy alcohol use is associated with increased risk of mouth, esophagus, larynx, liver, breast and colon cancer. Acetaldehyde, a byproduct of alcohol metabolism, may cause DNA damage.
Heart Disease
Excessive drinking can cause high blood pressure, cardiomyopathy, stroke, and arrhythmia. Binge drinking is particularly linked to sudden cardiac death.
Cognitive Impairment
Excess alcohol can shrink the brain and lead to memory loss, confusion, and cognitive deficits. It also increases fall risk among older adults.
Mental Health Problems
Heavy drinking is linked to increased risk of depression, anxiety, and suicide. Alcohol abuse can rewire brain pathways to crave more alcohol.
Vehicle Crashes
Drinking alcohol negatively affects coordination, judgment, and reaction time. Alcohol-impaired crashes killed over 10,000 people in the US in 2018.
Violence and Crime
Alcohol is linked to intimate partner violence, sexual assault, homicide, and other crimes. Over 25% of violent crimes involve alcohol misuse.
Alcohol Use Disorder
About 14 million Americans have alcohol use disorder (AUD). AUD involves cravings, physical dependence, and an inability to control drinking despite negative impacts.
| Health Effect | Evidence |
|---|---|
| Liver Disease | Chronic alcohol abuse linked to fatty liver, hepatitis, cirrhosis. |
| Pancreatitis | Repeated alcohol overuse linked to pancreas inflammation. |
| Cancer | Acetaldehyde may damage DNA and raise cancer risk. |
| Cardiomyopathy | Alcohol can damage heart muscle. |
| Dementia | Shrinks brain regions involved in memory. |
| Depression | Heavy use linked to higher rates of depression. |
| Vehicle Crashes | Impairs coordination, judgment, and reaction time. |
| Crime & Violence | Linked to 25% of violent crimes. |
| Alcoholism | 14 million Americans have alcohol use disorder. |
Sugar vs. Alcohol: Which Is More Harmful?
Both added sugar and alcohol pose health risks when consumed in excess. But which is worse for you?
Some key differences between sugar and alcohol:
- Sugar provides calories but lacks vitamins, minerals, and other nutrients. Alcohol is “empty” calories.
- Overeating sugar does not typically cause intoxication or addiction.
- There is no known “safe” level of alcohol intake. Some sugar can fit into a healthy diet.
- Alcohol intoxication is directly linked to accidents, injuries, violence, and death. These acute harms are not caused by overconsuming sugar.
Based on available evidence, excessive alcohol consumption appears more acutely harmful and dangerous than added sugar intake alone. However, both should be consumed in moderation as part of an overall healthy diet.
Similarities in Harms
Sugar and alcohol do share some similarities in terms of health risks:
- Chronic overconsumption of both sugar and alcohol can contribute to obesity.
- Both are linked to increased risk of fatty liver disease.
- Heavy intake of sugar or alcohol can raise triglycerides and lower “good” HDL cholesterol.
- Sugar and alcohol can both promote high blood pressure.
Populations at Highest Risk
Those at greatest risk for harm from excessive sugar or alcohol intake include:
- People with obesity, diabetes, hypertension, or fatty liver disease
- Individuals with a family history of heart disease or stroke
- Those with a personal or family history of alcohol abuse disorder
- People taking medications that interact with alcohol
- Children and adolescents
- Pregnant women
Ways to Reduce Harm
Here are some tips to minimize the health risks from added sugars and alcohol:
Limit Added Sugar
- Drink water instead of sugary beverages like soda, juice, and sports drinks
- Limit candy, baked goods, ice cream, and other sweets
- Enjoy whole fruits instead of sweetened juices
- Use less sugar in coffee drinks, cereals, yogurt, etc.
- Sweeten foods with cinnamon, vanilla, etc. instead of sugar
- Check labels and choose low sugar versions of foods
Drink Alcohol in Moderation
- Adhere to drinking limits – 1 drink or less per day for women, 2 for men
- Avoid binge drinking – no more than 4 drinks in a session
- Drink slowly – do not gulp or chug alcoholic beverages
- Eat before and while drinking to slow absorption
- Alternate alcoholic drinks with water or other non-alcoholic beverages
- Do not drink alcohol in risky settings – before driving, swimming, etc.
The Bottom Line
Consuming too much added sugar or alcohol can harm your health. But the acute effects of alcohol intoxication as well as the addiction potential make alcohol the more dangerous substance overall.
However, both sugar and alcohol can be enjoyed sensibly as part of a balanced diet and lifestyle. Moderating intake and making healthy substitutions can help minimize risk and promote wellbeing.
