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Sufficient evidence for reducing sugar intake to tackle obesity? (p 1068)
March 24, 2004A Viewpoint article in this week's issue of THE LANCET considers the evidence behind a recent WHO/UN report to restrict consumption of free (added) sugars to counteract obesity and concludes: 'when considered in aggregate they [available studies] provide considerable evidence to suggest that sucrose and other free sugars contribute to the global epidemic of obesity'.
In a joint report published in 2003, an expert consultation from the WHO and the Food and Agriculture Organization (FAO) of the United Nations suggested that free sugars should be restricted to less than 10% total energy, providing further justification for a guideline to restrict sugar intake that is already in place in more than 20 countries. This report provides much of the scientific justification for the proposed WHO global strategy on diet, physical activity, and health.
Jim Mann from the University of Otago, New Zealand, discusses how intensive lobbying from the US food industry threatens the adoption by the World Health Assembly (WHA) of this strategy, in which reductions in fat, salt, and sugar content of foods and increased physical activity are recommended (see also Lancet 2004; 363: 339). He comments: "Industry objections seem to centre largely on the recommended intake of sugar. There are claims by food industries and some governments that evidence on which the recommendations are based is insufficient and that other authoritative reports do not concur".
Dr Mann concludes: "Without doubt, sugar is still of huge importance in the global economy and it is clearly important to consider whether sufficient evidence indeed exists to recommend restriction of intake. Thus, although none of the individual studies might be definitive, when considered in aggregate they provide considerable evidence to suggest that sucrose and other free sugars contribute to the global epidemic of obesity. Reduction of the intake of sugars can make a useful contribution-along with other measures-to lessening of the risk of obesity and its clinical outcomes...South Africa has joined the list of countries that include advice about sugar intake in dietary guidelines. Nations that have not yet included recommendations on sugar intake might well consider an approach similar to that taken by the South Africans: "Consume food and drinks containing sugar sparingly and not between meals".
Lancet
Dr Mann concludes: "Without doubt, sugar is still of huge importance in the global economy and it is clearly important to consider whether sufficient evidence indeed exists to recommend restriction of intake. Thus, although none of the individual studies might be definitive, when considered in aggregate they provide considerable evidence to suggest that sucrose and other free sugars contribute to the global epidemic of obesity. Reduction of the intake of sugars can make a useful contribution-along with other measures-to lessening of the risk of obesity and its clinical outcomes...South Africa has joined the list of countries that include advice about sugar intake in dietary guidelines. Nations that have not yet included recommendations on sugar intake might well consider an approach similar to that taken by the South Africans: "Consume food and drinks containing sugar sparingly and not between meals".
Lancet
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