KANSAS CITY — Caloric sweetener consumption and its relationship to obesity and such chronic health conditions as diabetes and heart disease remains a hot button issue in the United States. But as food and beverage usage of caloric sweeteners steadily declines, it is worth asking if the intense focus on reducing consumption is achieving the desired results?

Estimated U.S. per capita deliveries of caloric sweeteners for food and beverage use have fallen from a peak of 151.6 lbs dry basis in 1999 to 127.1 lbs in 2017, according to the U.S. Department of Agriculture’s Economic Research Service. The most impacted ingredient has been high-fructose corn syrup, which has seen food and beverage deliveries fall to 39.8 lbs in 2017 from 63.8 lbs in 1999.

Refined sugar deliveries rose to 69.2 lbs in 2017 from 66.4 lbs in 1999. But when loss at the retail, institutional and consumer levels are factored in, the E.R.S. data show refined sugar deliveries ticked up slightly to 39.7 lbs in 2017 from 39 lbs in 1999.

For the sake of comparison, the prevalence of obesity among adults 20 years of age and over has risen to 39.6 per cent of the population in 2016 from 30.5 per cent of the population in 1999. The prevalence of obesity in youths aged 2 years to 19 years has risen to 18.5 per cent from 13.9 per cent during the same time period.

At 127.1 lbs, caloric sweetener deliveries are at the lowest level since 1986. A study published in 2001 in the Journal of the American Medical Association under the title “Epidemic increase in childhood overweight, 1986-1998” chronicles the weight gain among U.S. children during the period. It correlates with the rise in caloric sweetener deliveries during that period. Yet after 1999, when caloric sweetener deliveries were in decline, the correlation ends.

At the same time caloric sweetener usage has declined the prevalence of obesity has continued to rise.

It is in this context that one must view the plethora of initiatives introduced to reduce caloric sweetener usage, most notably refined sugar use. The American Medical Association, for example, on Nov. 13 adopted a policy to increase consumer awareness of added sugars, which includes urging the Food and Drug Administration to develop front-of-pack warning labels for products formulated with high levels of added sugars.

The National Salt and Sugar Reduction Initiative, which is a partnership of about 100 national, state and local health organizations, intends for food and beverage manufacturers to voluntarily reduce the sugar content of specific food categories by 20 per cent and beverages by 40 per cent by 2025.

Several municipalities in the United States have implemented or are considering levying taxes on caloric sweetener content to curb the consumption of sugary beverages.

The U.S.D.A.’s caloric sweetener data show efforts to reduce use of the ingredients have been successful. It must also be recognized that at the same time caloric sweetener usage has declined the prevalence of obesity has continued to rise.

The complexity of this public health crisis requires a strategy that is much more than the demonization of a single class of ingredients. The data show that while much of the focus remains on caloric sweetener usage the problem will continue to worsen.