Sugar & Health

Recommended and current intakes

  • Both Australia and New Zealand recommend that 45-65% of total energy should come from dietary carbohydrates, preferably from whole grain sources
  • In Australia and New Zealand there is no specific limit on the total amount of sugar we should be eating, however both countries recommends 'limiting added sugars' 
  • The World Health Organisation suggests limiting 'free sugars' to less than 10% of total energy

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How, and what we eat, including dietary patterns, food choices and intakes of nutrients can impact a person's long term risk of developing certain chronic diseases. To lower chronic disease risk, the Acceptable Macronutrient Distribution Ranges (AMDR), Table 1, were developed to reflect the ideal contribution of protein, carbohydrates and fat to our overall energy intake. The AMDR's, developed by The Food and Nutrition Board of the Institute of Medicine (IOM) are based on the current evidence from ecological studies, case-control studies, cohort studies and intervention studies focused around body weight, cardiovascular disease, Type 2 diabetes, nutrient inadequacy and cancer to name a few.

For carbohydrate, the recommended contribution to daily energy intake is 45-65%.

Table 1: Acceptable macronutrient distribution ranges

Nutrient

% contribution to total energy intake

Carbohydrate

45-65

Fat

20-35

Protein

15-25

 

The primary purpose of carbohydrates is to provide energy. Consumption of carbohydrates also avoids the risk of ketoacidosis. Whilst the amount of dietary carbohydrate required to provide optimal health is unknown, a range of 45-65% of total energy intake was set as a likely reflection that diets high in either fat or protein can have adverse effects. According to IOM and NHMRC, the lower limit of 45% is additionally based on an increased risk of obesity with diets low in carbohydrate and high in protein or fat, with the upper limit being set to accommodate the essential requirements for these nutrients.

How much sugar should we be eating and drinking?

The Ministry of Health and National Medical Research Council have no specific limit on the amount of total sugar we should be consuming. Dietary guidelines simply advise for 'added sugars' and the intakes of foods and drinks high in sugars to be limited. Guidelines encourage that carbohydrates consumed are preferably wholegrain. Setting a specific sugar recommendation has been challenging. There is a lack of consensus on what the recommendation covers; free sugar, added sugar or total sugar. There is also no concise methodology to measure added or free sugar, therefore it would be difficult to monitor or determine a populations performance against the recommendation.

Despite the challenges, international authorities such as the World Health Organisation released recommended intakes for free sugars in early 2015. They state there is strong evidence on the basis of predominantly dental health that intake of free sugars should be less than 10% of total energy. A conditional recommendation was developed to suggest a reduction of free sugars to less than 5% of total energy may provide further health benefits. Further information on these recommendations can be found in this Q&A. The Scientific Advisory Committee on Nutrition (SACN) also reviewed the evidence on carbohydrates and health in a 2015 report. They recommended intakes of 'free sugars' be limited to less than 10% of total energy intake in line with the WHO recommendations.

On the other hand, the European Food Safety Authority (EFSA) reviewed the evidence in 2010 and found insufficient data in order to set an upper limit for intake of (added) sugars. The conclusion was based on risk of dental caries, weight gain, micronutrient density of the diet, serum triglyceride and blood cholesterol. EFSA focused the review purely on the scientific evidence rather than considering the social, economic and political impacts which the WHO recommendations also consider.

Current intake

It is often assumed that both Australian's and New Zealander's are consuming a high intake of sugar, however, based on the latest national nutrition surveys the average person consumes only a moderate amount.

Intake of carbohydrates in Australia is at the bottom end of the recommendation at 45% with 24% coming from total starch and 20% coming from total sugar. The main sources of total starch in the Australian diet, based on the latest Australian health survey were breads and bread rolls (21%), mixed dishes where cereal is the main component (16%), flours and other cereal grains (mainly rice) (10%) and breakfast cereals (9%). The most common sources of total sugar were fruit products and dishes (16%), soft drinks & flavoured mineral waters (9.7%), dairy & milk (8.1%) and fruit & vegetable juices and drinks (7.5%).

Additional analysis of the data to determine added sugar intake is yet to be finalised, however based on previous data Australian's consume around 9-10% of total energy from added sugar.

This is a similar story in New Zealand. Median sugar intake sits around 20-22% of total energy and sucrose, used as a measure of added sugar, is around 9-9.5% of total energy. In New Zealand the main sources of carbohydrate were breads (17%), grains and pasta (9%), fruit and non-alcoholic beverages (9%) and potatoes, kumara and taro (8%). The main contributors to total sugar were fruit (18%), non-alcoholic beverages (17%), sugars and sweets (15%) and milk (10%).

 

NEXT: Sugar and healthy diet

Further reading

  • Ministry of Health (2015) Eating and Activity Guidelines for New Zealand Adults, Wellington.
  • National Health and Medical Research Council (2013) Australian Dietary Guidelines. Canberra: National Health and Medical Research Council.
  • EFSA (2010) Scientific Opinion on Dietary Reference Values for Carbohydrates and Dietary Fibre. EFSA Journal; 8(3):1462.
  • World Health Organization, Diet Nutrition and the Prevention of Chronic Diseases, Report of a Joint WHO/FAQ Expert Consultation. WHO Technical Report Series 916. Geneva, 2003.
  • Ruxton, C. H et al (2010) Is sugar consumption detrimental to health? A review of the evidence 1995-2006. Crit Rev Food Sci Nutr, 50, 1-19
  • Position of the Academy of Nutrition and Dietetics:Total Diet Approach to Healthy Eating J Acad Nutr Diet. 2013;113:307-317

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