Added sugar
Added sugar guidelines are under scrutiny.

KANSAS CITY — The Annals of Internal Medicine on Dec. 20 published results of an industry-funded study that concluded “guidelines on dietary sugar do not meet criteria for trustworthy recommendations and are based on low-quality evidence.”

The study questioned the quality of evidence used by the World Health Organization (WHO) and eight other agencies that have recommended reduced consumption of added sugar because of its potential contribution to diabetes, obesity, tooth decay and other negative health effects.

“Public officials (when promulgating these recommendations) and their public audience (when considering dietary behavior) should be aware of these limitations,” the study said.

The study drew criticism from health advocates because it was funded by the Technical Committee on Dietary Carbohydrates of the North American Branch of the International Life Sciences Institute (I.L.S.I. North America), a non-profit foundation made up of numerous individuals from international public and private institutions as well as more than 400 industry members, from which I.L.S.I. receives 60% of its funding. The industry list includes multinational food, beverage and agricultural companies.

“The authors conducted the study independent of the funding source, which is primarily supported by the food and agriculture industry,” the authors said.

The study noted that different organizations, including the WHO, The Scientific Advisory Committee on Nutrition, the U.S. Department of Agriculture and the U.S. Department of Health and Human Services have issued different recommendations with regard to sugar consumption with various rationales for limiting sugar intake based on each organization’s own reviews of available research and conclusions.

“When respected organizations issue conflicting recommendations, it can result in confusion and raises concern about the quality of the guidelines and the underlying evidence,” the authors said.

“The relationship between sugar and health is complex due to multiple interrelated variables, including state of energy balance, macronutrient substitutions and underlying diet and lifestyle patters,” the study said. “Existing evidence of a link between sugar intake and adverse health outcomes has been translated into dietary guidance and recommendations for the general public by authoritative health organizations. As research continues to add knowledge, authoritative organizations have issued public health guidance based on the available evidence. Recent guidelines have included both qualitative and quantitative recommendations that consistently focus on limiting and reducing sugar consumption, especially sources of nonintrinsic (added) sugars.”

The scientists behind the review said more scrutiny of sugar guidelines was needed, The New York Times said in a story on the study.

“The conclusion of our paper is a very simple one,” Bradley C. Johnson, professor of clinical epidemiology at the University of Toronto and McMaster University and lead author of the paper, said in The New York Times report. “We hope that the results from this review can be used to promote improvement in the development of trustworthy guidelines on sugar intake.”