WHO calls for sugarstriction

22. April 2014

If it were up to the World Health Organisation, humanity should go out of its way to reduce its sugar intake drastically. However more discussion ought to be take place regarding this ambitious step.

Sugar currently does not have it easy. It gets ‘dumped on’ everywhere; it’s called ‘a drug’, or a dangerous time bomb. At regular intervals studies appear on its adverse effects on the body. It is supposed to be responsible for diabetes, cardiovascular disorders, tooth decay and even cancer. For years the World Health Organisation (WHO) has been preaching to consume no more than 10 percent of one’s energy needs as sugar. For a normal-weight adult with an average energy consumption that would amount to around 50 grams of sugar a day, or twelve teaspoons. Now the WHO has further reinforced its stance. In a draft which the UN organisation recently submitted in Geneva, the WHO advocates for a still greater reduction in sugar intake. No more than five percent of energy demands should be met through sugar.

The demands of the WHO relate to all monosaccharides and disaccharides which occur naturally in foods, are used “pure”, or are added to foods. Ultimately honey or fruit juice concentrates are also included.

Rapid increase in diabetes

The WHO wants to confront the growing global problem of human diseases such as adipositas and diabetes. Especially in emerging markets we have observed a rapid increase in diabetes. According to estimates from the International Diabetes Federation (IDF) there are currently 371 million diabetics worldwide and an additional ‘grey’ figure including a further 187 million. Four out of five of these patients live in countries with low or middle incomes. In Germany as well, the disease has long been a problem. Whereas the proportion of diabetics in Germany in 1960 was at 0.6 percent it rose in the late eighties to over four percent. Already today more than seven percent of adults have been diagnosed with diabetes. There exists in addition probably about another two percent. This is made up of the people who have actually developed the disease diabetes, but have however not realised it yet. Above all, the growing problem of obesity continues to produce new diabetics. Currently a quarter of adults in Germany can be considered obese.

An important goal: prevention of dental caries

But it’s not only obesity and its consequences which the WHO seeks to address with its denunciation. One of its main objectives is the prevention of dental caries. The treatment of dental diseases costs the industrialised countries 5-10 percent of their health budgets, the WHO says. Poorer countries would not even have this amount of money available for the care of the sick teeth of its children. Professor Susan Jebb from Oxford University says: “The WHO recommendations send the consumer a clear message about the risks of sugar”. The biggest challenge however, she believes, is to show people a healthy diet.

Labelling on packaging often incomprehensible

The majority are likely not aware of how much sugar they take into their bodies every day. Especially in processed products there is a lot of sugar hiding away, even in foods that are not perceived as very sweet, says the WHO. A tablespoon of ketchup for example contains a teaspoon of sugar, that is about four grams. A glass of lemonade can even contain up to 10 teaspoons of sugar. How much sugar is contained in individual foods can however be difficult to find out. The tiny labels on the packages are often incomprehensible. Hardly anyone knows with how many different names the one sweetener can turn up.

The fact that abstinence from sugar provides benefits is something scientists have already shown. Before the WHO expressed their new recommendation, they evaluated the literature on this subject; 9000 studies were analysed. Also present was one WHO-commissioned meta-analysis from last year: nutritionist Lisa teMorenga and Jim Mann of New Zealand University in Otago crawled through 71 high-quality studies. Although the duration periods of the studies were not particularly long, an effect became apparent regardless: people who adjusted their sugar consumption to current WHO recommendations over this time period between ten weeks and eight months lost on average 0.8 kg of body weight. The authors of the study already came at that time to the conclusion that it would seem reasonable for most countries to control sugar intake in order to reduce the risk of excess body weight and obesity.

Future policy: Comments allowed!

The new push is ambitious. Even the earlier call was a long way from what happens in reality. The average German does not consume 20; the figure itself is also not 50 grams, but rather 90 grams. Until the end of March, interested professional groups will still be able to comment on the new recommendations. Parallel to this there is a peer-review process running based on WHO data. The results from both methods will be incorporated into future policy.

Not everyone might be happy about the calls. The WHO’s new rules could destroy many food producers’ business. Sweetened foods simply make themselves easier to sell. An extra dose of sugar is to the consumer’s liking. The industry would like to leave things as they are. Already a few years ago, when the WHO recommended consuming less than ten percent of one’s daily calories as sugar, the confectionery industry was up in arms. It urged the U.S. Congress to cut off funds to the WHO. Whether this time similar excited reactions will be aroused remains to be seen.

Confusing definitions of the WHO

However, most health experts welcome a sugar reduction. Its only as to how far this should go that there is still disagreement. Professor Tom Sanders of King’s College London for instance points out that there aren’t any studies he is aware of which show such a goal to be feasible. He also holds the WHO’s definitions to be confusing. Thus, sugars in milk or fruit would apparently not be included in the calculation. With a few pieces of fruit and a big glass of milk, one’s sugar consumption level would however reach 60 grams. And Dr. Nita Forouhi of the University of Cambridge also holds the original target of 10 percent to be the more realistic one.

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General medicine, Medicine

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