How Sound Are Recommendations to Cut Added Sugar?

We are in the midst of a great reformulation of food products. A little more than a decade ago, Robert Lustig stirred everyone up with his bold claim that sugar is toxic. So added sugar took over the role of dietary bad boy in place of fat. In 2015, U.S. dietary guidelines started recommending a 10 percent limit on calories from added sugars. The World Health organization went further, setting the limit at 5 percent. But are these recommendations to cut added sugar scientifically sound?

A new narrative review in the American Journal of Clinical Nutrition say no:

“The current public health recommendations to encourage the reduction of both solid and liquid forms of free sugars intake (e.g., sugar reformulation programs) should be revised due to the over-extrapolation of results from SSBs studies.”

A Toxic Subject

Whether or not sugar is toxic, this subject quickly became one for toxic debates. In 2016, the Annals of Internal Medicine published a systematic review of the evidence for guidance on sugar intake. The authors concluded:

“Guidelines on dietary sugar do not meet criteria for trustworthy recommendations and are based on low-quality evidence. Public health officials (when promulgating these recommendations) and their public audience (when considering dietary behavior) should be aware of these limitations.”

Simultaneously, the journal published an editorial, dismissing the conclusions of the study as “tactics that industry often uses to advocate for the safety of unsafe products or question the integrity of science that calls their products into question.”

Their argument was simple. If you don’t buy into the notion that sugar is poison, you must be an industry shill.

Reformulating Our Foods

Today, added sugar gets a special line on Nutrition Facts labels – just like trans fats did back in 2003. So the food industry is busy reformulating the food we eat. They are taking added sugar out and putting other things in to make them look healthier. It’s a big, uncontrolled experiment in commerce.

In the new AJCN review, Rina Ruolin Yan, Chi Bun Chan, and Jimmy Chun Yu Louie point out that this might or might not improve the healthfulness of food:

“When sugar is removed from a food product, the bulk and texture of the product is usually affected, and bulking agents such as modified starch are commonly utilized to solve the issue. However, these agents generally provide energy because they are carbohydrate-based. As a result, eventually the caloric content could even increase compared to the original formulation.”

For two decades now, sugar in the food supply has been declining while obesity has continued to rise. Sooner or later, it will become clear that sugar phobia has not helped to improve our health.

Will we turn to another pseudoscientific meme then? Or instead get curious about a scientifically sound path to better nutrition and public health?

Click here for the new review in AJCN. For the systematic review from Annals, click here, then here for the editorial, and here for further perspective.

Striking Arguments, sketch by Theophile Steinlen / WikiArt

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April 8, 2022