Call from World Health Organization on countries to reduce sugar intake among adults and children.


By Angeli Robles, |

The World Health Organization (WHO) released new guidelines that recommend adults and children to reduce their daily intake of sugar. Further reduction to below 5% or approximately 25 grams (6 teaspoon) a day would give more health benefits.

Guidelines on sugar intake of adult and children.

Free sugars or monosaccharides (glucose, fructose) and disaccharides ( sucrose or table sugar ) are added to foods and drinks by the producer, cook or consumers and naturally presented sugar into honey, syrups, fruit juices and fruit juice extract.

Dr. Francesco Branca, Director of WHO’S Department of Nutrition for Health and Development said that “we have solid evidence that keeping intake of free sugar to less than 10% of the total energy intake reduces the risk of overweight, obesity, and tooth decay.” “Making policy changes to support this will be the key if the countries are to live up to their commitments to reduce the burden of non-communicable disease.

These guidelines from WHO does not refer to sugars from fresh fruits and vegetables because there is no reported evidence of adverse effects from consuming this sugar.

A large amount of these sugar consumed today are “hidden” in processed foods that are not considered as sweets. For example, 1 tablespoon of ketchup contains approximately 4 grams (around 1 teaspoon) of free sugars. A single can of sugar sweetened soda contains up to 40 grams (around 10 teaspoon) of free sugar.

Worldwide intake of free sugar differs by age, setting and country. In Europe, adult intake ranges from about 7-8% of total energy intake in countries like Hungary and Norway, and 16-17% in countries similar to Spain and the United Kingdom. Intake is much higher among children, ranging from about 12% in countries like Denmark, Slovenia and Sweden nearly 25% in Portugal. There are also rural/urban differences. In rural communities of South Africa intake is 7.5%, while in the urban population is 10.3%.


STRONG RECOMMENDATION: Reduce sugar intake to less than 10% of total energy
The recommendation is based on the analysis of the latest scientific evidence. This evidence show two evidences: First, adults who consume less sugars have lower body weight. Second; increasing amount of sugar in the diet is associated with a weight increase. Furthermore, research shows that children with the highest intakes of sugar-sweetened drinks are more likely to be overweight or obese than children with low intake of sugar- sweetened drinks.

The recommendation is further supported by evidence showing rates of dental caries (tooth decay) when sugar intake is above 10% total energy intake.

Based on the quality of supporting evidence, these recommendations are ranked by WHO as “strong”. This means they can be adopted as policy in most situations.

CONDITIONAL RECOMMENDATION: Further reduction to less than 5% of total energy intake
Given the nature of existing studies, recommendation of reducing intake of free sugars to below 5% of total energy is presented as “conditional” in the WHO system for issuing evidence.
Some epidemiological studies have been undertaken in population with low sugar intake. Only three national population-wide studies allow a comparison of dental support with sugar ingestion less than 5% of total energy intake compared with 5% but less than 10% of total energy intake.

These studies (population-based ecological) were conducted on the time before the second World War where sugar availability dropped dramatically from 15kg per person per year to as low as 0.2% in 1946. This “natural experiment”, which demonstrated a reduction of dental caries, offers the basis for the suggestion that reducing the ingestion of free sugars below 5% of total energy intake would provide extra benefits in the form of lower dental caries.

WHO is issued conditional recommendation even when the quality may not be strong on problems of public health importance. A conditional recommendation is an example where the desirable effects of adhering to the recommendation probably outweigh the undesirable effects but this trade-off’s need requires clarification, for that reason, stakeholder dialogue and consultations are needed before the recommendation is implemented as policy.

Updating the guideline on free sugar intake is part of WHO’s ongoing efforts to update existing dietary goals to prevent NCDs. The sugar guidelines should be used in conjunction with other nutrient guidelines and dietary goals, those related to fatty acids, including saturated fat and trans-fat to be exact.

More than 170 comments were received from representative of government agencies, United Nations agencies, nongovernmental organizations, industries and academic institutions as well as other interested individuals. In 2014 an expert peer review was processed and undertaken. The final guide was prepared by taking account from comments received from the public consultation expert peer review.

Countries can translate the recommendation into food-based dietary guidelines that consider locally available food and customs. In addition to this, some countries are implementing other public health interventions to reduce free sugar intake. This is consists of nutrition labelling of food products, restricting marketing to children of food and non-alcoholic drinks that are high in free sugar, fiscal policies targeting foods and beverages that are high in free sugars, and dialogue with food manufacturers to reduce free sugars in processed foods.

Note to editors
Reducing free sugars intake to less than 10% of total daily energy intake was recommended by the WHO Study Group for the first time in 1989 and was further elaborated by a joint WHO/FAO Expert Consultation in 2002. This new updated WHO guideline calls for further reduction of free sugars intake to less than 5% of total energy intake if possible.

Promoting healthy diet was a key theme of the Second International Conference on Nutrition (ICN2) convened jointly by the Food and Agriculture Organization of the United Nations (FAO) and WHO in November 2014. At ICN2, more than 170 countries adopted the Rome Declaration on Nutrition and a Framework for Action, which highlight the need for global action to end all forms of malnutrition, including obesity and diet-related NCDs.

The sugars guideline is also part of WHO’s effort to reach targets set by the Global Action Plan for NCDs 2013-2020 to halt the rise in diabetes and obesity and reduce the burden of premature deaths due to NCDs by 25% by 2025. Similarly, the sugars guideline contributes to the work of WHO’s Commission on Ending Childhood Obesity, which aims to raise awareness and build momentum for action to address childhood obesity.

via Medical Observer

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