Nutrition Diet: What are the IOM dietary guidelines recommend limiting added sugars to?

October 31, 2025 •

3 min read

The average American adult consumes significantly more added sugar than recommended for optimal health, often far exceeding guideline thresholds. But what are the IOM dietary guidelines recommend limiting added sugars to? It's a crucial question for understanding the foundations of modern dietary policy and its evolution towards more restrictive sugar intake targets.

Quick Summary

The Institute of Medicine suggested limiting added sugars to less than 25% of total calories based on nutrient adequacy, a metric that has since been contrasted with stricter health-focused guidelines from other leading organizations. This summary reviews the IOM's perspective alongside current recommendations from the WHO, AHA, and DGA, detailing the health risks of excess sugar.

Key Points

IOM Guideline: The Institute of Medicine (IOM) suggested that added sugars be limited to no more than 25% of total calories to avoid nutrient displacement, not as a health-focused upper limit.
WHO Recommendation: The World Health Organization (WHO) recommends limiting free sugars to less than 10% of total energy intake, with a further reduction to below 5% for additional benefits.
AHA Limits: The American Heart Association (AHA) advises stricter limits, recommending no more than 6 teaspoons of added sugar per day for most women and 9 teaspoons for most men.
DGA Target: The Dietary Guidelines for Americans (DGA) recommends that added sugars make up less than 10% of daily calories for anyone over 2 years old.
Health Risks: High intake of added sugars is linked to a higher risk of obesity, type 2 diabetes, cardiovascular disease, and other health issues.
Hidden Sugars: Many processed and pre-packaged foods contain significant amounts of added sugar, making it essential to read nutrition labels carefully.
Best Practices: Replacing sugary drinks with water and choosing whole foods over processed items are effective strategies for reducing added sugar intake.

The Institute of Medicine's (IOM) Perspective on Added Sugars

The Institute of Medicine's (IOM) 2007 report on Dietary Reference Intakes (DRI) suggested limiting added sugars to less than 25% of total daily calories. This recommendation was primarily based on ensuring adequate nutrient intake, as diets exceeding this threshold were statistically linked to reduced consumption of essential micronutrients. The IOM did not present this as a healthy upper limit, but rather a point at which the risk of a nutrient-poor diet increased.

The Role of Nutrient Displacement

High intake of added sugars often means consuming "empty calories" lacking essential nutrients, which can displace nutrient-dense foods like fruits, vegetables, and whole grains. For example, 25% of a 2,000-calorie diet from added sugar equates to about 125 grams (30+ teaspoons), leaving little room for nutritious foods and potentially contributing to weight gain.

Contrasting Guidelines from Leading Health Authorities

More stringent guidelines focusing on health outcomes have been developed by other organizations since the IOM's report.

World Health Organization (WHO)

The WHO advises limiting daily intake of free sugars to less than 10% of total energy intake for both adults and children. This amounts to about 50 grams (12 teaspoons) on a 2,000-calorie diet. They further suggest reducing intake to below 5% for additional health benefits, such as reducing dental caries.

American Heart Association (AHA)

The American Heart Association (AHA) provides stricter guidelines, recommending limits of no more than 100 calories (about 6 teaspoons or 24 grams) daily for most adult women and no more than 150 calories (about 9 teaspoons or 36 grams) for men to prevent heart disease.

Dietary Guidelines for Americans (DGA)

The Dietary Guidelines for Americans (DGA) recommends limiting added sugars to less than 10% of total daily calories for individuals aged 2 and older, aligning with the WHO's primary recommendation. For children under 2, the DGA advises avoiding added sugars entirely.


Guideline Body	Added Sugar Recommendation	Rationale/Focus
IOM (2007)	Less than 25% of total calories	Nutrient Adequacy: Avoids nutrient displacement.
WHO	Less than 10% of total energy (Ideally <5%)	Disease Prevention: Reduces risk of obesity and dental caries.
AHA	Men: <150 calories (~9 tsp); Women: <100 calories (~6 tsp)	Heart Health: Reduces risk factors like triglycerides, blood pressure, and inflammation.
DGA	Less than 10% of total daily calories	Public Health: Supports a nutrient-dense dietary pattern.

Health Risks of Excessive Added Sugar

Excessive added sugar intake is associated with health problems like obesity, type 2 diabetes, cardiovascular disease, non-alcoholic fatty liver disease, and dental issues. High sugar intake is also linked to increased chronic inflammation. For more details, see {Link: Harvard Health https://www.health.harvard.edu/heart-health/the-sweet-danger-of-sugar}.

Strategies for Reducing Added Sugar Intake

Strategies to reduce added sugar include choosing whole foods, reading nutrition labels, limiting sugary drinks, sweetening foods with fruit or spices, being mindful of sugar in condiments, and cooking at home.

Conclusion: Navigating Added Sugar for Better Health

While the IOM's guideline focused on nutrient adequacy, later recommendations from the WHO, AHA, and DGA provide stricter, health-focused targets. Limiting added sugars is important for health management and reducing chronic disease risk. Prioritizing whole foods and being aware of hidden sugars helps achieve a healthier diet. For more information, visit {Link: CDC https://www.cdc.gov/nutrition/php/data-research/added-sugars.html}.

Frequently Asked Questions

The key difference is the rationale. The IOM's 2007 guideline was based on preventing nutrient displacement—meaning that exceeding 25% of calories from sugar could lead to a diet lacking essential vitamins and minerals. In contrast, recommendations from organizations like the WHO and AHA are set lower and are directly focused on reducing the risk of chronic health diseases associated with high sugar intake.

A simple way to check is to read nutrition labels and compare your intake to the recommended daily limits from health authorities like the AHA or DGA. Tracking your intake for a few days, particularly from sources like sugary drinks, processed foods, and baked goods, can reveal if you are regularly exceeding the recommended thresholds.

While sweeteners like honey, maple syrup, and agave are often less processed, they still contain sugar and should be consumed in moderation. Your body metabolizes them similarly to table sugar, and overconsumption can lead to similar health risks. The key is mindful consumption, as they still contribute to your daily sugar total.

Long-term consumption of excessive added sugar is linked to a higher risk of developing obesity, type 2 diabetes, cardiovascular disease, and non-alcoholic fatty liver disease (NAFLD). It can also contribute to dental decay and chronic inflammation.

Yes, added sugar contributes to weight gain, particularly when consumed in excess. Sugar-rich foods are often calorie-dense but low in fiber and nutrients, leading to overconsumption and a lack of satiety. Excessive calories from any source can cause weight gain, but sugar's effect is particularly noted.

Naturally occurring sugars, like those in fruits and milk, come bundled with fiber, vitamins, and minerals. Added sugars are sweeteners and syrups put into processed foods and drinks during manufacturing. While the body processes both, the fiber in whole foods slows absorption and provides satiety, unlike added sugars, which offer empty calories.

The DGA and AHA recommend that children under the age of 2 should not consume any foods or beverages with added sugars. For children over 2, the AHA suggests a limit of less than 6 teaspoons of added sugar per day.