Added Sugar: Dietary Guidelines in the U.S. and Beyond

New U.S. Dietary Guidelines cracks down on added sugar

26 January 2016

There was a time when sugar was the darling of the American food industry, but it seems no more.  The 2015-2020 Dietary Guidelines for Americans, which were published in final form by the U.S. Departments of Health and Human Services (HHS) and of Agriculture (USDA) on January 7, 2016, advises Americans to “consume less than 10% of calories per day from added sugars”.  This recommendation aligns with those already established by the World Health Organization (WHO) last March, and applies specifically to syrups and other caloric sweeteners (“added sugars”), and not to naturally-occurring sugars, such as those in fruit or milk.  Currently, national intakes data indicate that consumption of added sugars account for more than 13% (on average) of total calories per day in the U.S. population, and up to 17% in children, adolescents, and young adults.

The impetus behind this recommendation was rooted in emerging scientific evidence that eating patterns that include lower intake of added sugars are associated with a reduced risk of cardiovascular disease, obesity, type 2 diabetes, and some types of cancers in adults, as well as dental caries in children and adults. 

The impact of the dietary guidelines is widespread; they will be used to inform all of the U.S. federal government’s nutrition initiatives and food-assistance programs.  In addition, labelling the percent daily value of added sugars has been proposed by the U.S. FDA in the forthcoming changes to the Nutrition Facts label.  Further, the U.S. guidelines will undoubtedly influence the development and update of dietary guidelines for other countries.  Currently, Canada’s Food Guide (2007) follows the determination by the Institute of Medicine (IOM) of “a maximal intake level of 25% or less of energy from added sugars” for children and adults.  As dietary information in the U.S. is commonly used as a guide for Canada due to similar demographic and consumption data, it is highly plausible that any future updates to the food guide will be dependent on the information and recommendations of the U.S. dietary guidelines.  In China, the draft 2015 Dietary Guidelines for Chinese Residents has been completed and is currently awaiting publication, and it is anticipated that sugar reduction will be discussed in the draft consultation stages.  In Europe, specific (numerical) recommendations for reducing added sugar in the diet are largely not yet provided, partly due to the variable intakes of added sugars between countries.  While the Nordic Nutrition Council (2012) has recommended that the intake of added sugars should be kept below 10% of total daily energy intake, in line with the WHO, intake of added sugars in Nordic countries is comparatively lower (e.g., 7-8% in Norwegian adults).  At the upper end, intakes of added sugars in Spain and the UK are reportedly about 16-17% in adults, and in Portugal, up to 25% in children.

For the past year, the WHO has been calling on countries to further recommend the reduction of added sugars in the diet to 5% of total energy intake for “additional health benefits”.  Levels this low may be difficult to incorporate into guidelines, especially against the opposing pressures of industry, but not inconceivable.  With the evolution of nutrition research and the rise of more health-conscious consumers, a strong recommendation from the authorities to the public to limit the intake of a particular nutrient will likely have a strong influence on consumer choice.  Inevitably, what this means is that the mark left on the sugar-sweetened beverage, snacks, and sweets industries will be bittersweet: foods that are “low in added sugar” may be chosen over iconic formulations, and opportunities will be afforded to companies that are committed to reformulating or improving the nutrient profiles of their products.

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*Supporting references available upon request

Today's expert blogger, Katherine Li, is a Scientific & Regulatory Associate with broad experience in preparing safety evaluations for food ingredients/additives, novel foods, and flavouring agents, as well as assisting with the scientific substantiation of health claims. She has compiled dossiers for submission to various global regulatory agencies and organizations, such as the United States Food and Drug Administration, Health Canada, and the European Food Safety Authority.