Mary Poppins sang “A spoonful of sugar helps the medicine go down.” But if she read the latest study on sugar’s effect on our health, she wouldn’t have made the suggestion. The large umbrella review, which included over 8,600 studies, showed that a high consumption of added sugar is associated with significantly greater risks of developing 45 negative health outcomes.

Sugar contributed to such common conditions as diabetes, gout, obesity, high blood pressure, heart attack, stroke, cancer, asthma, tooth decay, depression — even early death — the researchers, from Sichuan University and the University of California, Davis School of Medicine, found.

There has been plenty of previous research showing the negative effects of excessive sugar on our health, but before developing detailed policies on sugar restriction, the researchers wanted to evaluate the quality of the existing evidence.

Consuming added sugar in sugary and processed foods is associated with a far greater risk of developing 45 negative health outcomes, including diabetes, gout, obesity, high blood pressure, heart attack, stroke, cancer, asthma, tooth decay and depression.

To do that, the research teams focused on something called “free sugars.” This includes sugar that’s added in the processing of foods, or packaged as table sugar and other sweeteners, or those sugars that naturally occur in syrups, honey, fruit juice, vegetable juice, purees, pastes, as well as similar products in which the cellular structure of the food has been broken down, according to the U.S. Food and Drug Administration (FDA).

“Evidence of a link between free sugar and cancer remains limited and controversial,” the study’s authors said. However, previous studies have linked sugar to obesity — and obesity is a known factor for various cancers.

In light of the study’s findings, the researchers, along with guidance from the World Health Organization, World Cancer Research Fund and American Institute for Cancer Research, suggest:

    Limit free sugar intake to less than 6 teaspoons (25 grams) per day. There’s that much sugar in 2 ½ chocolate chip cookies and 1 ½ tablespoons of honey.

    Reduce consumption of sugar-sweetened beverages to less than one serving (approx. 200 to 255 milliliters) per week. That’s the equivalent of one 12-ounce soda.

Here are some tips on how you can follow their sugar-cutting advice:

  • Make it a habit to read nutrition labels when you’re grocery shopping, even with those foods that you might not think have lots of sugar in them such as yogurts, condiments, cereals – even bread.
  • Figure out where you’re getting your biggest sugar hit. Is it from sweetened coffee drinks? Desserts? Packaged snacks? Cut back on those culprits.
  • Opt for water sweetened with sliced fruit, instead of sipping sugary drinks.
  • Choose fresh or frozen fruit for dessert and turn down cakes, cookies or ice cream.
  • Use less sugar in your baking. If you really want to sweeten your baked goods, lightly sprinkle sugar on top.
  • Trade flavor for sugar — add plenty of tasty spices to your food.
  • Get enough sleep on a regular basis because we tend to choose foods higher in sugar for that fast energy boost when we’re tired.

“A combination of widespread public health education and policies worldwide is urgently needed,” to change sugar consumption patterns, the team writes. A tax on sugar-sweetened sodas has helped reduce sugar consumption in some cities. Hopefully studies like this one will further educate the public about just how risky our love of sugar can be.

The study is published in The BMJ.