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What is appropriate upper limit for added sugars consumption?

11 / 04 / 17

Numerous health and scientific organisations have recommended significant restrictions on upper limits of added sugars consumption. This review paper examined the evidence between sugars consumption and various chronic conditions. The reviewers conclude:

  • Prospective cohort data suggest an association between sugars and weight gain, but mostly from sugar sweetened beverages (SSB). Controlled trial data suggest weak or no associations between sugars and weight gain.
  • Prospective cohort data shows varying levels of association between sugars and heart disease risk factors, and no controlled trial data testing the association.
  • Controlled diet trial data shows varying levels of association (mostly weak or no) between sugars and lipid profile.
  • Controlled trial data suggest weak or no association between sugars and blood pressure.
  • Prospective cohort data suggest an association between sugars and type 2 diabetes, but only in SSB studies. There are no RCTs examining whether sugars in normal people can result in diabetes or pre-diabetes but trials looking at surrogate measures show no association.
  • No prospective cohort studies have assessed sugars with the risk of metabolic syndrome (MS). Controlled trial data suggest varying associations between sugars and MS.
  • No prospective cohort studies have investigated the relation between sugars or SSBs to non alcoholic fatty liver disease (NAFLD). Controlled trials suggest varying levels of association between sugars and NAFLD, with greatest association seen with SSB and higher than normal intake of fructose.

The reviewers conclude that data from higher quality scientific studies show contrasting results but it appears that sugars (including fructose) do not have adverse effects when tested in isocaloric exchange for other carbohydrates and most adverse effects appear under hypercaloric exchange. The effects of sugars are largely dependent on overall diet and energy balance and any recommendations must emphasise this. They say while it appears prudent to avoid excessive calories from sugars, the scientific basis for restrictive guidelines is far from settled. It is unknown whether restrictive guidelines promulgated in isolation from recommendations on overall diet quality will be effective in curbing obesity and metabolic disorders.

Reference: Rippe JM, Sievenpiper JL, White JS et al. What is appropriate upper limit for added sugars consumption? Nutr Rev 2017;75(1):18-36