Core Viewpoint - The article discusses the impact of sugar consumption on health, emphasizing the need for sugar control as a central trend in modern dietary practices. It highlights the potential risks associated with strict sugar restriction and the effects of different dietary approaches on weight loss and metabolic health [6][8][21]. Summary by Sections Sugar Consumption and Health - Sugar, particularly free sugars, is linked to increased caloric intake and various health issues such as obesity and metabolic disorders. Keeping free sugar intake below 5% of total daily calories can help reduce caloric intake by approximately 100 kilocalories [7][8]. Dietary Approaches and Clinical Trials - A recent clinical trial involving 60 participants over 12 weeks compared three dietary groups: a normal sugar intake group (MODSUG), a reduced free sugar group (LOWSUG), and a strict low-carbohydrate ketogenic group (LOWCHO). Both LOWSUG and LOWCHO groups showed significant weight loss, but the LOWCHO group experienced adverse changes in glucose tolerance and lipid profiles [9][15][16]. Metabolic and Microbiome Changes - The LOWCHO group exhibited a significant decrease in glucose tolerance and an increase in various low-density lipoprotein (LDL) particles, while high-density lipoprotein (HDL) levels decreased. Additionally, the gut microbiome diversity was notably altered, with a decrease in beneficial Bifidobacteria, which could lead to digestive health issues [18][20]. Long-term Health Implications - The article warns that while weight loss can be beneficial for heart health, the ketogenic diet may not improve cardiovascular health due to negative changes in sugar and fat metabolism. It suggests that simply controlling free sugar intake might be a more prudent approach for cardiovascular health [21].