Sugar and Inflammation: The Advice I Give Every Patient
Sugar and Inflammation: What the Science Really Says
Let’s be honest, when it comes to health, there’s a lot of information out there. In fact, I’d say it’s overwhelming. For many people, just trying to make the “right” choices about food, supplements, or lifestyle can become a source of stress in itself. Living in California, and especially in the Bay Area, we’re surrounded by abundance, fresh produce year-round, endless grocery options, boutique wellness products, and countless philosophies about what to eat. The sheer number of choices can create confusion and paralysis.
But here’s the thing: of all the nutrition advice out there, there’s one action supported clearly and consistently by science, and that’s reducing or eliminating sugar. We now understand that chronic inflammation underlies most major disease processes, including heart disease, autoimmune conditions, metabolic dysfunction, and even mood disorders. And sugar is one of the most significant dietary contributors to that inflammation.
That’s why I often tell patients: if you do one thing for your health, especially if you’re dealing with chronic symptoms, start with sugar. It’s one of the most effective, accessible, and immediate steps we can take to feel better, lower inflammation, and support long-term health.
But What Is Sugar, Really?
Often people ask me, “But what is sugar?”, and to me, that question is very telling. It reflects how deeply sugar has been normalized and disguised in our food system. It’s not just the white stuff you scoop into your coffee. Sugar shows up in dozens of forms, often hidden behind labels like “evaporated cane juice,” “brown rice syrup,” or “organic agave nectar.” Many people are unknowingly eating large amounts of it every day, even in foods marketed as healthy. The fact that we have to ask what sugar actually is tells us how disconnected we’ve become from what we’re really putting into our bodies.
If you're reading labels, here are some common names for added sugars to watch for:
Coconut sugar
Malt syrup or barley malt
Rice syrup (brown rice syrup)
Dextrose, glucose, fructose, maltose, sucrose, lactose
Turbinado or “raw” sugar
Invert sugar
Corn syrup solids
Cane sugar
Brown sugar
High-fructose corn syrup (HFCS)
Agave nectar
Honey
Maple syrup
Molasses
Fruit juice concentrate
These may sound natural or harmless, but the body processes them in similar ways, and they can still contribute to inflammation when consumed in excess. Learning to spot these ingredients is an important step in reducing your total sugar intake.
What the Science Says
Excess added sugar intake, especially from refined sugars and sugary beverages, is one of the most significant dietary contributors to chronic low-grade inflammation.
High sugar intake raises blood glucose levels and triggers the release of inflammatory molecules like cytokines (IL-1, IL-6, and TNF-α).
This chronic low-level inflammation has been linked to insulin resistance, cardiovascular disease, joint pain, and metabolic dysfunction.
Reducing or eliminating added sugars has been shown to result in measurable drops in inflammatory markers
CRP (C-reactive protein)
A general marker of systemic inflammation. Elevated in metabolic syndrome, cardiovascular disease, and chronic inflammatory conditions. Sugar intake, especially from sweetened drinks, can raise CRP levels.IL-6 (Interleukin-6)
A cytokine elevated in obesity, insulin resistance, and chronic disease. Regular sugar consumption is linked to increased IL-6, especially in individuals with high visceral fat.TNF-α (Tumor Necrosis Factor-alpha)
A pro-inflammatory cytokine involved in obesity, chronic pain, and metabolic dysfunction. High sugar intake can elevate TNF-α, particularly when combined with processed or high-fat foods.IL-1β (Interleukin-1 beta)
Drives insulin resistance and systemic inflammation. Diets high in sugar, especially fructose, can increase IL-1β activity in fat tissue and the gut.
Other contributors to inflammation include trans fats, highly processed foods, excessive omega-6 fatty acids, and certain chemicals found in food additives.
While some individuals may experience inflammatory reactions to specific foods (such as gluten in celiac disease), these are not typically the primary drivers of systemic inflammation in the general population.
Where Sugar Hides
In addition to sodas and heavily processed foods, sugar hides in many foods that may seem harmless:
Sweetened fruit juices and smoothies – Even 100% fruit juice is low in fiber and high in rapidly absorbed sugars.
Sweetened coffee and tea drinks – Specialty café beverages can contain 30–60 grams of sugar or more.
Baked goods and desserts – Cookies, pastries, and cakes typically combine sugar with unhealthy fats.
Flavored yogurts and dairy products – Often marketed as healthy, but packed with added sugar.
Condiments and sauces – Ketchup, barbecue sauce, and salad dressings frequently contain added sugars.
Energy drinks and sports drinks – High in sugar and artificial ingredients.
Breakfast cereals and granola bars – Even "natural" or "organic" options can be sugar bombs.
Are All Sugars the Same?
Not all sugars are created equal. Whole, unprocessed foods that naturally contain sugar also come with fiber, antioxidants, and nutrients that help regulate blood sugar and reduce inflammation. Better choices include:
Whole fruits – Contain fiber and phytochemicals that slow sugar absorption and fight inflammation.
Berries (strawberries, raspberries, blackberries) — generally 4–7 grams of sugar per ½ cup
Kiwi — about 6 grams per medium fruit
Lemons and limes — very low sugar, about 1–2 grams per fruit
Avocado — technically a fruit, very low sugar (less than 1 gram per half)
Cranberries (fresh) — around 4 grams per ½ cup (unsweetened)
Guava — about 5 grams per ½ cup
Papaya — about 6 grams per ½ cup
Starchy vegetables – Sweet potatoes, winter squash, and others offer steady energy and important micronutrients.
Natural sweeteners – Small amounts of honey and maple syrup, and even dates (although usually less than 1 or 2 per serving) can be tolerated by some people when paired with fiber or protein to minimize blood sugar spikes.
Dark chocolate (70%+ cacao) – Contains flavonoids that may reduce inflammation when consumed in moderation.
My Goal for Patients
When I work with people who are living with chronic inflammation, my goal is to help clear inflammatory triggers from the body. Sugar, especially added and refined sugar, is one of the most potent and widespread triggers we encounter. Reducing it is one of the most evidence-based and impactful steps you can take.
If you haven’t guessed it already, my advice is to avoid sugar whenever possible. That said, it’s perfectly fine to enjoy an occasional treat, like a cookie, birthday cake, or an elegant dessert after dinner. The key is to limit sugar intake as much as possible while still allowing yourself to have fun on special occasions.
It’s not just about symptom relief; it’s about giving your nervous system, digestive system, and endocrine system the opportunity to reset, heal, and function the way they’re designed to.
References
Lustig, R. H., Schmidt, L. A., & Brindis, C. D. (2022). The toxic truth about sugar: a response to critiques. Nature Reviews Endocrinology, 18(3), 131–132. https://doi.org/10.1038/s41574-021-00559-7
Calton, E. K., et al. (2022). A systematic review of dietary patterns and inflammation in adults: findings from observational and intervention studies. Nutrients, 14(3), 540. https://doi.org/10.3390/nu14030540
Kraak, V. I., et al. (2023). Reducing sugar consumption: public health strategies and outcomes. Annual Review of Nutrition, 43, 289–308. https://doi.org/10.1146/annurev-nutr-061222-112452
Kopp, W. (2022). High-insulinogenic nutrition - An underestimated risk factor for chronic Western diseases. Nutrients, 14(10), 2091. https://doi.org/10.3390/nu14102091
Cheng, T. S., et al. (2022). The role of sugar and processed foods in promoting systemic inflammation: a review. Frontiers in Nutrition, 9, 848267. https://doi.org/10.3389/fnut.2022.848267