Is Sugar Consumption Detrimental to Health? A Review of the Evidence 1995—2006

Abstract

Many countries set quantitative targets for added sugars, justifying this by expressing concern about the likely impact of sugar on weight control, dental health, diet quality, or metabolic syndrome. This review considers whether current intakes of sugar are harmful to health, and analyses recent literature using a systematic approach to collate, rank, and evaluate published studies from 1995–2006. Results from high quality obesity studies did not suggest a positive association between body mass index and sugar intake. Some studies, specifically on sweetened beverages, highlighted a potential concern in relation to obesity risk, although these were limited by important methodological issues. Diet adequacy appeared to be achieved across sugar intakes of 6 to 20% energy, depending on subject age. Studies on metabolic syndrome reported no adverse effects of sugar in the long-term, even at intakes of 40–50% energy. The evidence for colorectal cancer suggested an association with sugar, but this appeared to have been confounded by energy intake and glycemic load. There was no credible evidence linking sugar with attention-deficit, dementia, or depression. Regarding dental caries, combinations of sugar amount/frequency, fluoride exposure, and food adhesiveness were more reliable predictors of caries risk than the amount of sugar alone. Overall, the available evidence did not support a single quantitative sugar guideline covering all health issues.

Keywords:

• Sucrose
• obesity
• diet adequacy
• dental caries

ACKNOWLEDGEMENT

This review was made possible by a grant from the Sugar Bureau (UK), a condition of which was that Sugar Bureau representatives or associates played no role in the selection or methodological assessment of papers, nor in the interpretation or writing up of the results. Ruxton and Gardner reviewed the literature, while Ruxton and McNulty wrote the paper.

Notes

^aSelected on the basis of available information;

^bguideline has changed from descriptive to quantitative;

^cguideline has changed from quantitative to descriptive.

^a National Health & Medical Research Council (2003);

^b ILSI (2003);

^cadapted from Ruxton_& Fiore (2005);

^dCREDOC (2004);

^e Alexy et al. (2002b);

^fIcelandic Nutrition Council (2006)

^g Watkins et al. (2005);

^h Overby et al. (2003);

ⁱFagt et al. (2002);

^j Sigman-Grant and Morita (2003).

¹Mean calculated where sugar intakes reported for more than one age group or gender.