The World Health Organization has been advocating dietary changes as a means of preventing/ risk reduction for Non-Communicable Diseases for some time now.

The latest guidelines are specific to the intake of sugars in one’s diet, and are based on available epidemiological evidence.

The specific research questions guiding the systematic reviews undertaken were:

• What is the effect of a decrease or increase in free sugars intake in adults and children?

• What is the effect of restricting intake of free sugars to below 10% of total energy?

Basic terminology:

Intrinsic sugars: Those sugars that are naturally present in foodstuffs like fruits and vegetables.

Free sugars: These include monosaccharides and disaccharides added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.

Key findings based on available evidence:

1. No adverse health effects have been reported from consumption of intrinsic sugars. Therefore, the present guidelines do not apply to the consumption of intrinsic sugars.

2. The consumption of free sugars is associated with many adverse health effects. The present guidelines apply to the consumption of free sugars only.

3. Adults who consume less free sugars have lower body weight.

4. Increasing the amount of free sugars in the diet is associated with a comparable increase in weight.

5. Children with the highest intake of sugar sweetened drinks are about 1.5 times more likely to be overweight/ obese than children with a low intake of sugar-sweetened drinks.

6. There is a positive association between free sugar intake and development of dental caries across all ages (<5 years to >65 years).

7. Dental caries development is dependent upon cumulative free sugar intake. Therefore, high free sugar intake may result in dental caries in adulthood even if the individual did not have dental caries in childhood.

8. No adverse health effects were detected when individuals consumed <5% of total energy in the form of free sugars.

Main Recommendations:

A. Strong Recommendation:

Reduce intake of free sugars to <10% of total energy intake.

B. Conditional Recommendation:

Further reduce intake of free sugars to <5% of total energy intake.

Practical Point:

Free sugars are called by 57 names (if not more). One must actively look for the presence of one or more of these names in the food labels, and calculate the amount of free sugars present therein.

The 57 names of sugar (as mentioned on http://www.prevention.com):

Agave nectar                                       Barley Malt                                  Beet sugar         Blackstrap Molasses                          Brown Rice syrup                        Brown Sugar     Buttered Sugar                                   Cane juice crystals                       Cane juice           Cane sugar                                         Caramel                                        Carob Syrup       Caster sugar                                       Coconut sugar                              Corn sweetener Corn syrup                                          Corn syrup solids                         Crystalline fructose Date sugar                                          Demara sugar                               Dextran                   Diastatic Malt                                      Diatase                                          Ethyl Maltol             Evaporated cane juice                        Fructose                                       Galactose               Fruit juice concentrates                      Glucose                                        Golden sugar           Golden syrup                                      High fructose corn syrup              Honey                     Invert sugar                                        Lactose                                          Malt syrup               Maltodextrin                                        Maltose                                          Maple syrup           Molasses syrup                                  Muscovado sugar                         Organic raw sugar Oat syrup                                            Panela                                           Panocha                 Confectioner’s sugar                          Rice bran syrup                            Rice syrup               Sorghum                                             Sorghum syrup                             Sucrose                   Sugar                                                  Syrup                                            Treacle                     Tapioca syrup                                    Turbinado sugar                            Yellow sugar

Useful links

Link to the WHO press release:

http://who.int/mediacentre/news/releases/2015/sugar-guideline/en/

Link to the related WHO information note:

Click to access sugar_intake_information_note_en.pdf

Link to the Guideline Sugars intake for adults and children:

Click to access 9789241549028_eng.pdf

Link to the above mentioned article on prevention.com:

http://www.prevention.com/food/healthy-eating-tips/57-names-sugar