WHO sugar report slammed by sugar industry AND anti-sugar organisation


Last week the World Health Organisation released a long-awaited report on recommended sugar intake. The news spread like wildfire and social media streams were buzzing with the recommendations: Reduce daily sugar intake to under 10% and additional health benefits reducing to 5%. Now WHO are getting slammed from both the anti-sugar groups and the sugar industry. Let’s just take a step back and look at this.

The sugar manufacturers are saying:

  • The evidence backing the new recommendations is “misleading” and “backed by low evidence” (European Committee of Sugar Manufacturers) [1]
  • Welcomes debate but says the under 5% recommendation is unrealistic. “In practice, such a threshold would be exceeded for instance with the drinking of a mere glass of orange juice. Consideration should therefore be made of the impact this would have on the public understanding of a balanced diet, as this could for example undermine and contradict healthy eating messages such as the “5-a-day” campaign” (European Committee of Sugar Manufacturers) [1].

The anti-sugar group is saying:

  • “There is absolutely NO nutritional requirement for free sugars in our diets, therefore Action on Sugar is disappointed that the 5% recommendation is ‘conditional’.  The WHO used the ‘GRADE system’ for evaluating the evidence which is useful for drug trials, but is not appropriate for the links between diet and health.  This has allowed the food industry to sow the seeds of doubt amongst the WHO, who have failed to come up with the strong recommendation that is so vitally needed, especially for children.” [2]
  • “Free sugars damage health. The leading public health bodies all agree the scientific evidence is solid – hence the urgent need for public health interventions to slash sugar and thus tackle the dental health and obesity crisis” (Action on Sugar) [2]
  • “Professor Simon Capewell, Professor of Clinical Epidemiology at the University of Liverpool and Action on Sugar advisor; “The WHO should be congratulated on this important first step. These are evidence-based recommendations published despite massive industry opposition. The lobbying behind the scenes resembles the tactics previously used by Big Tobacco (denials, delays, and dirty tricks, plus dodgy scientists disseminating distorted evidence).” [2]

The WHO is saying:

  • WHO recommends reducing the intake of free sugars* to less that 10% daily (they list this as a strong recommendation). That’s roughly 50 grams per day (12 teaspoons).
  • They suggest a further reduction of the intake of free sugars to below 5% daily and that it will have added health benefits (they list this as a conditional recommendation**)” That’s roughly 25 grams per day (6 teaspoons). [3]
  • WHO recognises and states in the report that: “The recommendation to further limit free sugars intake to less than 5% of total energy intake is based on very low quality evidence from ecological studies in which a positive dose–response relationship between free sugars intake and dental caries was observed at free sugars intake of less than 5% of total energy intake”. [3]
  • In regards to the low quality of evidence being questioned in the consultation process, WHO stated that: “As noted in the guideline, the quality of evidence is one factor, though an important factor, to be considered when determining the strength of a recommendation using GRADE methodology. These include values and preferences, trade‐off between benefits and harm, and costs and feasibility (…) WHO issues conditional recommendations on topics of public health importance even when the quality of evidence may not be strong.” [4]

My thoughts:

It seems that even the sugar industry is not disputing that we should consume less than 10% of free sugars* daily.  In my book, this is a health win, considering that the one thing that they produce and make their money from is a health risk and has no nutritional requirement in our diets.

Where the battle lies, is the 5% recommendation and the evidence supporting it. After reading the report and press releases from the involved parties, I was left will the following questions: Why present evidence if it’s “very low quality” (WHO’s own words) in the first place from a large and respected organisation like WHO? Why were some trials left out when the final recommendations were made? Why were there only caries studies available to support the 5% recommendation but not weight studies? Why are there no solid actions to act on? I also read through all the notes from the consultation process and although most of these questions were posed and answered (well, some more or less vague), I’m still baffled.

So, what’s next?

Katharine Jenner, Campaign Director of Action on Sugar and Registered Nutritionist says; “These recommendations are all well and good, but until manufacturers stop hiding sugar in our foods in such vast quantities, how can we be expected to lower our intake?  The recommendations need to be translated into something meaningful for the consumer.  Sugars are hidden in so many of our everyday foods; we eat and drink more than our maximum recommendation without even realising it.”  I agree, we need actions to carry out, for consumers to be able to make easy informed decisions in the supermarket. People need to understand the ramifications of excess sugar intake. There is still a misleading focus on fat and despite recent focus on sugar there is still a long way to go.

I hope that each government (and certainly here in NZ – John Key!) looks at:

  1. Improving food and drink labelling to make it easier for the consumer to choose low sugar options
  2. Make strict rules for the use of currently misused and confusing terms such as ‘natural’, ‘low fat’ and ‘healthy’
  3. Educate the public on nutrition and health (explain cause and effect – how sugar is linked to e.g. obesity, type II diabetes and dental diseases)
  4. Set a maximum limit for free sugar content in food and beverages, especially those aimed at children
  5. High taxes on products with high sugar-content
  6. Restrict marketing of high-sugar products geared towards children

Hopefully, with pressure from health organisations, individuals and groups such as Action on Sugar (a group supported by 23 experts around the world), the focus will be kept on the effects of free sugar of human health. I have no doubt that the WHO has been under massive pressure from any group, association and organisation which profits from from selling sweetened products (in 2012 the sugar and sweetener industry was worth $77.5 billion[5]). So, perhaps some might say that the report was lacking, however, I think it’s a huge step for the WHO to release it. Clearly the report has caused ripples all over the world creating focus and attention. Well done!

And for the European Committee of Sugar Manufacturers: It IS entirely possible to reduce your sugar intake to 5% or less. I do it every day and help others to do the same. Even with glucose in some recipes I make, I still consume less than 5% (6 teaspoons). You just have to be knowledge to make the right choices and cook wholesome food. But, without clear directions and knowledge to make informed decisions, then you are right, it is very unrealistic. And yes, the 5-a-day campaigns which suggests drinking juice as a part of your 5-a-day do need to be updated following the WHO’s new recommendations. We shouldn’t be advising people to drink juice every day! So, let’s stand together to help the human population be healthier. Regardless on ‘which side’ of the sugar industry you are on, this affects us all. It could be your mother, friend, son. Let’s make a change!


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*Defined by WHO in their report as: “Free sugars refer to monosaccharides (such as glucose, fructose) and disaccharides (such as sucrose or table sugar) added to foods and drinks by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates”.

**“Conditional recommendations are made when there is less certainty “about the balance between the benefits and harms or disadvantages of implementing a recommendation” (20). This means that “policy-making will require substantial debate and involvement of various stakeholders” (20) for translating them into action”[y]




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