Understanding Sugars: Free, Added & Natural

Three words that get used interchangeably — but shouldn’t

Most of the confusion comes from three terms being treated as the same
thing. They are not. Getting them straight is the single most useful step
in making sense of a label.

• Naturally-occurring (intrinsic) sugars — the sugars
  built into the structure of whole foods. The fructose locked inside a
  whole apple, the lactose in plain milk. They arrive wrapped in fibre,
  water, protein and a slow-release matrix, which changes how the body
  meets them.
• Added sugars — any sugar a manufacturer, cook, or you
  put into a food: table sugar, glucose syrup, honey stirred into
  a recipe, the sweetener in a cereal. They were not part of the original
  ingredient.
• Free sugars — the term public-health guidance in the UK
  and Europe actually uses. It is the broadest of the three: it covers all
  added sugars plus the sugars released when a food is processed in
  a way that breaks the natural structure — fruit juice, smoothies, honey,
  and syrups all count as free sugars even though no one “added” anything.

The practical takeaway: a glass of orange juice and the same orange eaten
whole are nutritionally different conversations. The whole orange’s sugar
is intrinsic; the juice’s sugar is free. Same fruit, different category.

Why the distinction is more than pedantry

Whole-food (intrinsic) sugars come bundled with fibre and a physical
structure that slows digestion, blunts the rise in blood glucose, and helps
you feel full. Free sugars arrive fast and unaccompanied. That is why the
categories exist — not because the molecules differ at the chemical level,
but because the package they come in changes how the body responds.

This is also why we, as dietitians, rarely tell anyone to “cut out sugar.”
It is neither realistic nor accurate; the sugar in milk, fruit and
vegetables sits comfortably in a healthy pattern of eating. The guidance
that matters for most people is narrower and more humane: keep an eye on
free sugars, the ones added or released during processing.

Reading an EU / UK nutrition label

In the UK and across the EU, the back-of-pack panel is standardised. Under
Carbohydrate you’ll see an indented line:
“of which sugars.” Here is the part that trips everyone up:

“Of which sugars” on an EU/UK label is total sugars — natural and
free combined. It does not separate out added or free
sugars on the panel itself.

So a plain natural yoghurt might honestly declare 7g of “sugars” per
100g — almost all of it lactose, the milk’s own intrinsic sugar — while a
flavoured one declares 13g, where the extra 6g is added. The panel won’t
tell you which is which. To work it out, you read sideways into the
ingredients list.

Use the ingredients list as your detective tool

Ingredients are listed by weight, heaviest first. Free sugars hide under
many names, so scanning for the word “sugar” alone misses most of them.
Watch for:

• sucrose, glucose, fructose, dextrose, maltose, lactose-added
• glucose syrup, glucose-fructose syrup, high-fructose corn syrup
• invert sugar, molasses, honey, agave, maple, rice malt syrup
• fruit juice concentrate and fruit purée (these count as free sugars)
• anything ending in “-ose,” and any “syrup”

A useful rule of thumb: if a form of sugar appears in the first three
ingredients, or several different sugars are scattered through the list
(so no single one looks dominant), the product is sugar-forward regardless
of how modest the “of which sugars” figure looks.

The traffic-light front-of-pack

Many UK products also carry the voluntary colour-coded front label. For
sugars, green is low (5g or less per 100g),
amber is medium, and red is high (more
than 22.5g per 100g). It’s a quick at-a-glance steer, but remember it
reflects total sugars per 100g — for a drink you’ll also want to look at the
per-portion column, because the bottle is rarely 100ml.

Reading a US Nutrition Facts label

The US label, updated in recent years, is arguably clearer on this exact
point — it does the separation the EU panel leaves to you:

• Total Sugars — natural and added combined (the
  equivalent of the EU “of which sugars” line).
• Includes Xg Added Sugars — an indented sub-line that
  breaks out only the added portion, along with a
  % Daily Value for added sugars.

The US “Added Sugars” line is the closest thing on any label to the free-
sugars concept. If you only learn to read one number, read that one.

A worked example. Imagine a fruit-and-milk yoghurt in the US showing
Total Sugars 15g, Includes 8g Added Sugars. That tells you
roughly 7g is intrinsic (the milk’s lactose and the fruit’s own sugar) and
8g was added during manufacture. The 8g is the figure to weigh against the
day’s pattern; the 7g is largely along for the ride with calcium and
protein.

Two labels side by side

Because the same product is described differently on either side of the
Atlantic, it helps to translate. Picture a flavoured drinking-yoghurt:

• UK panel: “Carbohydrate 16g, of which sugars 15g.” You
  infer the free-sugar load by reading the ingredients (glucose-fructose
  syrup high on the list → mostly free).
• US panel: “Total Sugars 15g, Includes 9g Added Sugars
  (18% DV).” The work is done for you — 9g of it is added.

Different formats, same reality. The skill is knowing that “sugars” on a UK
pack and “Total Sugars” on a US pack are the same number, and that neither
tells the whole story until you find the added/free portion.

Practical strategies for trimming free sugars

None of this requires an all-or-nothing diet. Small, repeatable swaps do
more over a year than any heroic week of restriction. The ones we find
genuinely stick:

• Treat drinks first. Sugary drinks are the single largest
  source of free sugars for many people, and liquid sugar barely registers
  as fullness. Diluting juice, switching to water or unsweetened options, or
  simply halving the portion is high-impact and low-effort.
• Buy plain, sweeten yourself. Plain yoghurt with your own
  chopped fruit, or porridge with fruit stirred in, lets you control the
  amount and keeps the intrinsic sugar (and the fibre) doing its job.
• Read the ingredients, not just the panel. Two products
  with the same “of which sugars” figure can be very different once you see
  whether the sugar is added or comes from the food itself.
• Mind the “low-fat” halo. Reduced-fat versions of sauces,
  yoghurts and cereals sometimes carry more added sugar to compensate for
  flavour. Compare labels rather than trusting the front-of-pack claim.
• Let your palate recalibrate. Sweetness preference is
  learned and it drifts. Easing back gradually — half a sugar in tea, then a
  quarter — is more durable than a sudden cut, and within a few weeks the old
  level often tastes too sweet.

Where this connects to diabetes nutrition

For anyone managing diabetes, the free-versus-intrinsic distinction is
especially practical. Free sugars in drinks and processed foods tend to raise
blood glucose quickly, while the same quantity of sugar inside a whole fruit,
buffered by fibre, usually arrives more gently. That doesn’t make fruit
“off-limits” — quite the opposite — but it does explain why a glass of juice
and a piece of fruit behave so differently, and why label-reading is a daily
skill rather than an occasional one.

Total carbohydrate, not just the sugar line, is what most people with
diabetes are taught to track, since starches also convert to glucose. The
sugar figures we’ve covered here sit inside that bigger carbohydrate picture.
Individual targets vary a great deal, so the specifics of carbohydrate
counting, portion sizing and timing are best worked out with your own
diabetes team or a registered dietitian who knows your history.