New Limits on Daily Sugar Intake

By Dianne Lange. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Sugar is in hot water, and the future is anything but sweet for those who rely on vanilla frappuccinos or a Big Gulp for an afternoon kick. Even the vitamin water or yogurt that you think is healthy may have to go if you consult draft guidelines issued by the World Health Organization (WHO) in March 2014. These guidelines are currently undergoing peer review and finalization, based on reaction and input from various stakeholders.

The WHO based its proposed guidelines on evidence revealing how too much sugar is contributing to the worldwide epidemic of obesity and widespread tooth decay. (Dental disease is the most widespread non-communicable disease, or a disease that is non-contagious.)

"These are the areas where most new research and analysis have been developed," says Francesco Branca, MD, director of WHO's Department of Nutrition for Health and Development and professor at the Friedman School of Nutrition Science and Policy at Tufts University. He adds, “Obesity is also a disorder leading to hypertension, diabetes and cancer.”

The guidelines recommend the following:

  • A reduced intake of free sugars throughout life;
  • The intake of free sugars in both adults and children not exceeding 10 percent of total energy intake (i.e., calories); and
  • A further reduction to less than 5 percent of total energy, which gives additional health benefits.

So, What Are Free Sugars?

According to the WHO guidelines, free sugars are monosaccharides and disaccharides. Nutritionist Elizabeth Somer, RD, author of “Eat Your Way to Happiness,” explains, “Monosaccharides are glucose, fructose and galactose. Disaccharides are sucrose, lactose and maltose.” In other words, she says, free sugars are any and all added sugars, including high fructose corn syrup.

You won’t be seeing these tongue-twisting names for sugar on the food labels, but if the new label proposed by the Food and Drug Administration (FDA) is accepted, you will be able to clearly understand how much sugar is in the food itself and how much has been added by food producers. Currently, both naturally occurring and added sugars are lumped together as “sugars” on food labels.

A Nation on a Sugar High

In the U.S., there is no suggested daily value for sugar, but if the WHO proposal passes, the U.S. Institute of Medicine (IOM) may be under pressure to trim their whopping 25 percent suggestion by at least 15 percent.

The American Heart Association already recommends limiting sugar to 8 percent of your total daily calories, which is no more than about six teaspoons a day for women and nine for men. But if you’re an average American, 16 percent of your total daily calories come from added sugars. That’s about 22 teaspoons — significantly larger than the recommended six or nine teaspoons.

Outdoing Mother Nature

“Nature made sugar hard to get; man made it easy,” writes well-known sugar critic and University of California, San Francisco pediatric endocrinologist, Robert H. Lustig, MD, in the journal Nature.

Our bodies were built to handle reasonable amounts of that hard-to-get sugar, but not the overwhelming amounts in sweetened drinks and processed foods often consumed today. All that extra sugar turns your liver into a workaholic, forcing it to work harder and faster to turn the sugar overflow into fat. That process ultimately leads to insulin resistance, the boogeyman underlying obesity, diabetes, heart disease and potentially cancer. Having too much sugar circulating in the blood has also been linked to dementia, even in people who are not diabetic.

Although the food industry questions claims that sugar has a negative effect on health, the evidence linking excessive sugar consumption to chronic disease is accumulating. Branca adds, “New research is appearing on the direct links between sugar intake and cardiovascular disease, and this will be considered in future updates.”

A February 2014 study found that consuming too much added sugar was an independent risk factor for death, due to cardiovascular disease — meaning, excessive added sugar by itself was a risk factor even when other known risk factors such as obesity were already accounted for.

In one investigation, researchers found that drinking one,12-ounce soda a day increased the risk of dying from cardiovascular disease by almost one-third. As Laura Schmidt, PhD, writes in a commentary accompanying the study: “Too much sugar does not just make us fat; it can also make us sick.”

Next Steps

Certainly reducing or removing sugar will lead to a variety of changes, including reformulating processed foods. And it has big-bucks implications for the highly profitable beverage industry.

Some producers are already making changes or planning for them. According to Financial Times, Nestle reduced sugar in its products by 30 percent. By 2020, Unilever aims to lower the sugar in its tea drinks by 25 percent. Last but not least, PepsiCo and Coca-Cola are diversifying into flavored waters and fruit juices.

One way to limit sugar consumption may be to tax sweetened beverages as Canada and some European countries do. Supporters of a sugar tax, such as Lustig, propose adding taxes to processed foods that contain added sugars, as well.

Those opposed to sugar regulations argue that is not the role of government to play “nanny” to the population — that individuals can make their own choices. What’s more, to make a significant difference in consumer choice, experts say the cost of a can of soda, for instance, would probably have to double.

For Family Caregivers

Where you live might help your sugar fixes. In San Francisco, for example, toys can no longer be included in a fast food meal — a marketing gimmick that encourages youngsters to eat up. Some experts suggest removing fructose from the Generally Regarded as Safe (GRAS) list, so that food producers are more restricted with the sweetener.

Lustig is aware of the situation’s reality. He notes, “Sugar is cheap, sugar tastes good and sugar sells, so companies have little incentive to change.” If the WHO proposal is accepted, that motivation may get a boost, but for now, cutting sugar from your life is up to you and your family. 

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