BMJ 2014;348:g4310 doi: 10.1136/bmj.g4310 (Published 27 June 2014)
Page 1 of 2
News
NEWS Halve sugar intake to 5% of daily calories, says advisory group Matthew Limb London
People’s daily consumption of added sugar should be halved so that it makes up around 5% of the average dietary energy intake, a government advisory group has recommended.
He added, “It’s not all about sugars. It’s very important that the health benefits that we have clearly seen when we reviewed the evidence related to dietary fibre are conveyed as well.”
The committee said that no change was needed to the current recommendation that 50% of the average energy intake should come from carbohydrates, but it recommended proportionate increases in the daily fibre intake for adults and children. It published a 360 page draft report on 26 June for consultation after its review of evidence on carbohydrates and health.1 Public Health England issued a report on how it planned to respond.2
Although some historical improvements in sugar intake had been seen, particularly in young children, there had been “no improvement over the last five years,” Tedstone said. She added, “Being a little bit overweight, being slightly podgy, is raising your risk of serious diseases.”
The Scientific Advisory Committee on Nutrition said that a reduction from the current recommended level of 10% was necessary to curb obesity. It also recommended that children and adults should “minimise” their consumption of sugar sweetened beverages because of an association with type 2 diabetes.
Ian Macdonald, the advisory group’s chairman, said that the review showed “clear evidence” that high added sugar or “free sugar” intake in adults was associated with increased energy intake and an increased risk of obesity. He said that a typical adult would reach the 5% sugar threshold by drinking one average size fizzy drink of 330 mL.
Macdonald, who is also professor of metabolic physiology and director of research in medicine and health sciences at Nottingham University, said that the group had reviewed evidence from prospective, long term cohort studies and randomised controlled trials. These had related to healthy subjects, not people with chronic disease.
He said, “Specifically in adults, in cohort studies, there is an association between sugar sweetened beverages and a risk of type 2 diabetes. In children, from trials and cohort studies, there is clear demonstration that sugar sweetened beverage intake is associated with weight gain and an increase in body mass index which is the measure of overweight and obesity. In all age groups, free sugars intake is associated with dental caries.” Macdonald said that cutting recommended sugar levels from 10% to 5% would reduce the risks from these products to an “acceptable” level. “The challenge will be to get there,” he said. “I would encourage everyone to try and reduce their sugar intake as much as possible. How many lives it will save, we cannot tell you, because those calculations have not been part of our considerations.”
For personal use only: See rights and reprints http://www.bmj.com/permissions
Alison Tedstone, chief nutritionist at Public Health England, said, “Every single population group in England is exceeding the current recommendation for sugar. Some groups, particularly adolescents, are exceeding it by a lot.” She said that two thirds of adults in England were now obese or overweight and that a third of children were overweight or obese by the time they left primary school.
The advisory group has proposed creating a “simpler, easier, and clearer” definition of sugars—free sugars—to capture the main sources of sugars in the UK diet. The term “free sugars” would replace the current terms “non milk extrinsic sugars” and “added sugars.” The definition would include table sugar, sugars added to food products by the manufacturer, cook, or consumer, and sugars naturally present in honey, syrups, and unsweetened fruit juices but excluding lactose in milk and milk products. In terms of average population diets, the committee said that free sugars of around 5% of the daily calorie intake would equate to 25 g of sugar for women (or 5-6 teaspoons) and 35 g for men (7-8 teaspoons). It said people should not get more than 10% of their daily energy intake from free sugars. The group proposed that no change should be made to the current recommendation that 50% of people’s daily energy intake should come from carbohydrates. It said that diet should be based on starchy foods—wholegrain, where possible.
The committee said that adults’ daily fibre intake should be 30 g per day—6 g more than the current advice of 24 g. This could be achieved by consuming all of the following each day: five portions of fruit and vegetables, two slices of wholemeal bread, a portion of high fibre breakfast cereal, a baked potato, and a portion of whole wheat pasta. Public Health England said that it was committed to reducing sugar intake and would work with the wider public health community and other stakeholders to develop useful measures and gather evidence. Tedstone said that the organisation would launch a digital campaign on sugar reduction, “refresh” its advice around the “five a day” campaign regarding fruit and Subscribe: http://www.bmj.com/subscribe
BMJ 2014;348:g4310 doi: 10.1136/bmj.g4310 (Published 27 June 2014)
Page 2 of 2
NEWS
vegetables, and reconsider its advice on fruit juice and smoothies. It added that it would examine advertising aimed at children, including the effects of internet advertising.
Tedstone said, “It would be difficult for public health if a focus on sugar was to lead to an increase in saturated fat intake or an increase in salt intake . . . we want to see an improvement in the overall diet.”
The consultation on the draft report runs until 1 September 2014, and the advisory group intends to publish its final report in March 2015.
For personal use only: See rights and reprints http://www.bmj.com/permissions
1
2
Scientific Advisory Committee on Nutrition. Draft carbohydrates and health report. Scientific consultation: 26 June to 1 September 2014. www.sacn.gov.uk/reports_position_statements/ reports/scientific_consultation_draft_sacn_carbohydrates_and_health_report_-_june_ 2014.html. Public Health England. Sugar reduction: responding to the challenge. June 2014. www. gov.uk/government/news/phe-kick-starts-debate-on-sugar-reduction.
Cite this as: BMJ 2014;348:g4310 © BMJ Publishing Group Ltd 2014
Subscribe: http://www.bmj.com/subscribe
Copyright of BMJ: British Medical Journal is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Page 1 of 2
News
NEWS Halve sugar intake to 5% of daily calories, says advisory group Matthew Limb London
People’s daily consumption of added sugar should be halved so that it makes up around 5% of the average dietary energy intake, a government advisory group has recommended.
He added, “It’s not all about sugars. It’s very important that the health benefits that we have clearly seen when we reviewed the evidence related to dietary fibre are conveyed as well.”
The committee said that no change was needed to the current recommendation that 50% of the average energy intake should come from carbohydrates, but it recommended proportionate increases in the daily fibre intake for adults and children. It published a 360 page draft report on 26 June for consultation after its review of evidence on carbohydrates and health.1 Public Health England issued a report on how it planned to respond.2
Although some historical improvements in sugar intake had been seen, particularly in young children, there had been “no improvement over the last five years,” Tedstone said. She added, “Being a little bit overweight, being slightly podgy, is raising your risk of serious diseases.”
The Scientific Advisory Committee on Nutrition said that a reduction from the current recommended level of 10% was necessary to curb obesity. It also recommended that children and adults should “minimise” their consumption of sugar sweetened beverages because of an association with type 2 diabetes.
Ian Macdonald, the advisory group’s chairman, said that the review showed “clear evidence” that high added sugar or “free sugar” intake in adults was associated with increased energy intake and an increased risk of obesity. He said that a typical adult would reach the 5% sugar threshold by drinking one average size fizzy drink of 330 mL.
Macdonald, who is also professor of metabolic physiology and director of research in medicine and health sciences at Nottingham University, said that the group had reviewed evidence from prospective, long term cohort studies and randomised controlled trials. These had related to healthy subjects, not people with chronic disease.
He said, “Specifically in adults, in cohort studies, there is an association between sugar sweetened beverages and a risk of type 2 diabetes. In children, from trials and cohort studies, there is clear demonstration that sugar sweetened beverage intake is associated with weight gain and an increase in body mass index which is the measure of overweight and obesity. In all age groups, free sugars intake is associated with dental caries.” Macdonald said that cutting recommended sugar levels from 10% to 5% would reduce the risks from these products to an “acceptable” level. “The challenge will be to get there,” he said. “I would encourage everyone to try and reduce their sugar intake as much as possible. How many lives it will save, we cannot tell you, because those calculations have not been part of our considerations.”
For personal use only: See rights and reprints http://www.bmj.com/permissions
Alison Tedstone, chief nutritionist at Public Health England, said, “Every single population group in England is exceeding the current recommendation for sugar. Some groups, particularly adolescents, are exceeding it by a lot.” She said that two thirds of adults in England were now obese or overweight and that a third of children were overweight or obese by the time they left primary school.
The advisory group has proposed creating a “simpler, easier, and clearer” definition of sugars—free sugars—to capture the main sources of sugars in the UK diet. The term “free sugars” would replace the current terms “non milk extrinsic sugars” and “added sugars.” The definition would include table sugar, sugars added to food products by the manufacturer, cook, or consumer, and sugars naturally present in honey, syrups, and unsweetened fruit juices but excluding lactose in milk and milk products. In terms of average population diets, the committee said that free sugars of around 5% of the daily calorie intake would equate to 25 g of sugar for women (or 5-6 teaspoons) and 35 g for men (7-8 teaspoons). It said people should not get more than 10% of their daily energy intake from free sugars. The group proposed that no change should be made to the current recommendation that 50% of people’s daily energy intake should come from carbohydrates. It said that diet should be based on starchy foods—wholegrain, where possible.
The committee said that adults’ daily fibre intake should be 30 g per day—6 g more than the current advice of 24 g. This could be achieved by consuming all of the following each day: five portions of fruit and vegetables, two slices of wholemeal bread, a portion of high fibre breakfast cereal, a baked potato, and a portion of whole wheat pasta. Public Health England said that it was committed to reducing sugar intake and would work with the wider public health community and other stakeholders to develop useful measures and gather evidence. Tedstone said that the organisation would launch a digital campaign on sugar reduction, “refresh” its advice around the “five a day” campaign regarding fruit and Subscribe: http://www.bmj.com/subscribe
BMJ 2014;348:g4310 doi: 10.1136/bmj.g4310 (Published 27 June 2014)
Page 2 of 2
NEWS
vegetables, and reconsider its advice on fruit juice and smoothies. It added that it would examine advertising aimed at children, including the effects of internet advertising.
Tedstone said, “It would be difficult for public health if a focus on sugar was to lead to an increase in saturated fat intake or an increase in salt intake . . . we want to see an improvement in the overall diet.”
The consultation on the draft report runs until 1 September 2014, and the advisory group intends to publish its final report in March 2015.
For personal use only: See rights and reprints http://www.bmj.com/permissions
1
2
Scientific Advisory Committee on Nutrition. Draft carbohydrates and health report. Scientific consultation: 26 June to 1 September 2014. www.sacn.gov.uk/reports_position_statements/ reports/scientific_consultation_draft_sacn_carbohydrates_and_health_report_-_june_ 2014.html. Public Health England. Sugar reduction: responding to the challenge. June 2014. www. gov.uk/government/news/phe-kick-starts-debate-on-sugar-reduction.
Cite this as: BMJ 2014;348:g4310 © BMJ Publishing Group Ltd 2014
Subscribe: http://www.bmj.com/subscribe
Copyright of BMJ: British Medical Journal is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
