Experts respond to WHO sugar recommendations

The World Health Organization (WHO) has released its guidelines on sugar intake - and they’re strict. They recommend that sugar (excluding that in fruit, vegetables and milk) be reduced to less than 10% of total energy intake, and they also suggest that a further 5% reduction would provide additional health benefits.

The 5% recommendation equates to 25 grams, or six teaspoons, of added sugars per day. The 10% recommendation equates to no more than 55 g of free sugars per day, or fewer than 13 teaspoons.

The recommendations have been welcomed by health experts. However, the 5% recommendation may be difficult for many consumers to achieve as it would entail almost complete abstinence from sugar-sweetened foods.

“We have a win-win situation with the WHO’s tiered guidance on sugars intake being under 10% of energy intake as a ‘strong recommendation’ with immediate policy implications, and under 5% as a ‘conditional recommendation’, sending a clear message that ‘less is better’ but allowing room for stakeholder and policymaker consultation and weighing up of trade-offs for the lower cut-off,” said Dr Nita Forouhi, MRC Nutritional Epidemiology Programme Leader and Public Health Physician, University of Cambridge.

“The WHO review also found that intake of sugar-sweetened beverages is associated with body weight, consistent with the reviews undertaken for the Dietary Guidelines for Americans and the Dietary Guidelines for Australians. As these beverages are typically low in nutrients, they are the logical target to achieve sugar reduction in those with high intakes. Replacing sugar-sweetened beverages with drinks containing non-nutritive sweeteners is an effective way of lowering sugar intake, without the challenge of behaviour change,” said Bill Shrapnel, a consultant nutritionist and an advisor to the Sugar Research Advisory Service.

“The WHO review’s evidence-based recommendations are a welcome counter to the hysteria about sugar being whipped up in the media, mostly by people with no qualifications in the science of nutrition. I encourage those people to read the WHO report.”

“The strong recommendation is made to reduce free sugar intake to below 10% energy, which is about 50 g/d in a female on 2000 kcal/d. This is based on evidence showing higher intakes to be linked to obesity and its related disorders. There is currently no evidence supporting a recommended intake lower than 10% for obesity prevention, either from observational studies or randomised control trials (RCTs),” said Professor Tom Sanders, professor emeritus of nutrition and dietetics, King’s College London.

“The target of 10% can easily met be avoiding sugar sweetened beverages and getting fluid intakes preferably from water or sugar-free beverages. The conditional recommendation of 5% is to prevent dental caries (that is an intake of 25 g/d or four heaped teaspoons of sugar) - this target is much harder to meet because it would involve not eating cakes, biscuits, confectionery and all sugar-sweetened beverages including fruit juice.”