Academics and industry clash over WHO sugar advice

By Joyeeta Basu

- Last updated on GMT

WHO releases final sugar advice for children and adults
Academics have welcomed the WHO’s recommendation to slash added sugar intake to 5-10% of calories – but the food industry has said it is misleading and based on weak evidence.

The World Health Organisation (WHO) made the recommendations in a new report “Guideline: Sugars intake for adults and children”.

Dr Francesco Branca, director of WHO's Department of Nutrition for Health and Development said sugar is a major public health concern for many countries.

“Making policy changes to support this will be key if countries are to live up to their commitments to reduce the burden of noncommunicable diseases,”​ he added.

Keeping added sugars to below 5% of daily calories — about six teaspoons of sugar — would have additional health benefits, the agency added.

The guideline released Wednesday was prepared taking into account comments received from a public consultation and expert peer review.

Evidence-based guidelines

The guidelines finalised the WHO’s draft recommendations​, first published in 2014, and do not relate to sugars found naturally in fruits, vegetables and unsweetened dairy products, it said.

They however included table sugar, honey, molasses, high-fructose corn syrup, glucose and sucrose under as added sugars or “free sugars”.

“We have solid evidence that keeping intake of free sugars to less than 10% of total energy intake reduces the risk of overweight, obesity and tooth decay,”​ added Dr Branca.

The research in addition showed that children with the highest intakes of sugar-sweetened drinks were more likely to be overweight than children with a low intake of such drinks​.

Worldwide response

While academics have come out in support of the guidelines, the sugar industry felt the evidence backing WHO’s suggestions was not strong enough.

Dr Nita Forouhi, MRC Nutritional Epidemiology Programme Leader and Public Health Physician, University of Cambridge, supported the report and called it a “win-win”​ situation. She said it sent out a clear message that “less is better” ​whileallowing room for stakeholder and policymaker consultation. Its strengths lay in its “evidence-based approach and the acknowledgement that the guidelines should not be used in isolation but with other dietary goals”, ​she said.

Professor emeritus of Nutrition and Dietetics, King’s College London Tom Sanders also backed the report. He felt said the 10% target could be “easily met”​ but the conditional recommendation of 5%  to prevent dental caries was much harder, “because it would involve not eating cakes, biscuits, confectionary and all sugar sweetened beverages including fruit juice”​, he said.

The sugar industry however, slammed the report calling it “misleading”​ and backed by “low evidence”​.  The US Sugar Association spokesperson Tonya Allen said, “This guideline misleads consumers. Such a claim is serious, and requires high-quality data, particularly given the potential for consumer confusion and the likelihood that the economic impact to developing countries will be severe.”

There was a need for extensive debate, especially before the 5% value was included in official recommendations, said the European Committee of Sugar Manufacturers (CEFS). “Especially because the data this value is based on was deemed to be of very low quality by both WHO and the dental health review authors,” ​it said.

Sugar in isolation

The sugar industry said that sugar in isolation could not be blamed for obesity and asked people to focus on what the WHO defined as the primary cause of obesity: an imbalance between calories and activity.

Head of Advocacy, a subsidiary of retail group Associated British Foods Katharine Teague said: “What’s required is collaborative action to find real and workable solutions to the obesity crisis. We are committed to playing our part.”

The International Council of Beverages Associations said it welcomed the opportunity to work with the WHO and other stakeholders for practical solutions to health issues. “The solutions should focus on collective efforts across government, civil society and industry that promote balanced diets, regular physical activity and proper oral hygiene,” ​it said.

Food and Drink Europe also promoted a healthy lifestyle above all else. In a statement it said it remained committed to working in partnership with policy-makers and other stakeholders, “to support consumers in making informed food choices and recognise that it is vital to take a coherent approach to tackling obesity and non-communicable diseases, including by promoting physical activity and nutrition education”​.

Registered Nutritionist at Association for Nutrition, Jenny Rosborough felt an active approach was the need of the hour. “We're not yet meeting 10% recommendation, and it's been around for a while. So need to focus now on getting people to work towards it,” ​she said. 

Children’s health

Zoe Griffiths, Registered Nutritionist in the UK said a National Diet and Nutrition Survey showed that the current intake of sugar among children is much higher (15.2%) than the recommended levels (10%) while the levels for adults were also high (11.6%).

The director general of European consumer organisation BEUC, Monique Goyens added the report was reassuring. ​She hoped that the guidelines would inspire the food industry and policy makers to take bold actions to tackle obesity “especially among children”.

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