This March, the World Health Organization (WHO) is asking for public input on its soon-to-be-released guidelines on sugar consumption. The most recent WHO statement on sugar was created in 2002, and recommended that sugars make up no more than 10 percent of an adult’s caloric intake every day – a figure which limits sugar intake to 12 teaspoons per day for the average adult.
However, WHO is now considering a new set of guidelines that would cut that recommendation in half: advising adults to keep sugar consumption at just 5 percent of their total daily energy intake.
Six teaspoons of sugar isn’t very much, especially considering that both artificial and naturally occurring sweeteners are included under the broad category of sugars. According to figures from the National Institute of Health, one 12 ounce serving of orange juice contains 7.5 teaspoons of sugar. Is the World Health Organization discouraging the consumption of juice?
In some senses, yes. Plenty of health care groups, such as the American Academy of Pediatrics and the United Kingdom’s Action on Sugar, already warn consumers that juice consumption should be regulated because of fruit juice’s highly concentrated sugar content. Even 100 percent fruit juice with no added sugar can still raise blood sugar and contribute to obesity and tooth decay. In 2013, the British Dental Association announced that parents should desist from giving fruit juice to their children, due to juice’s high levels of sugar and acid that cause cavities, bacteria growth and other damage to the teeth.
Indeed, the World Health Organization has highlighted dental disease as one of the biggest health care issues caused by excessive sugar intake. According to WHO’s introduction to its draft guidelines on sugar intake, health care advocates around the globe should be concerned about the link between dental problems and sugary drinks, especially seeing as diseases related to dental hygiene are the most common type of non-communicable illnesses worldwide. Dental diseases can cause pain, embarrassment and limitations in functionality; and what’s more, reparative dental care is expensive and often unaffordable.
If better education and guidelines on sugar consumption could be implemented, many people might be spared from the physical and mental effects of tooth loss and disease. Of course, limiting sugar intake can cut down on other non-communicable health issues too, including diabetes and heart disease, and WHO’s desire to rewrite its sugar guidelines may be a reaction to increasing rates of lifestyle disease in low and middle income countries.
Although developing nations for a long time struggled primarily with communicable diseases such as malaria, HIV and typhoid, many of these countries are now facing a surge of illnesses that were once considered problems only in developed places; illnesses related to lifestyle and diet. Globalization has brought fast food – with its high fat and sugar contents – to more parts of the world, and as income potential and mechanization increase, physical activity will often decline. A 2006 publication from the Disease Council Priorities Project showed that 80 percent of all fatalities related to cardiovascular disease occurred in low and middle income countries – and much of that disease is caused by obesity and high glucose, risk factors that could be mitigated with reduced consumption of sugar.
Furthermore, as health care professionals are well aware, excessive sugar intake contributes to diabetes: a disease that affects 347 million people around the world, 80 percent of whom are in low and middle income nations. Diabetes prevents the body from regulating its own blood sugar, and can lead to complications in diet, blood flow and heart function. When not properly cared for, diabetes can cause blindness, impaired function of the feet and cardiovascular disease. Although type 1 diabetes is genetic, type 2 diabetes is caused by choices in lifestyle and diet – and overconsumption of sugar has been proven, time and time again, to greatly increase a person’s risk of developing diabetes.
Advocates of WHO’s draft sugar guidelines are hopeful that stricter recommendations on sugar consumption can curb global rates of diabetes; saving lives (and lots of money) in the process. In the United Kingdom, some have even called for a sugar tax. While speaking to a group of British MPs at the beginning of March, Dame Sally Davies explained that due to sugar’s addictive nature and harmful properties, the government ought to consider taxing it. In January 2013, a group of medical organizations across the U.K. proposed a levy on of 20 pence-per-liter to be imposed on every soft drink purchase.
Although there is much agreement as to the health harms caused by sugar, WHO’s draft guidelines may still prove too strict for international approval. A professor at the King’s College London School of Medicine, Tom Sanders commented to the BBC that meeting WHO’s guidelines of 6 teaspoons of sugar per day would prove very difficult, insinuating that it might be better to leave the regulations where they are in order to avoid discouraging people from monitoring their sugar intake.
Limiting sugar consumption to just 5 percent of daily energy intake may prove even more difficult than it seems, considering that so much sugar is found in foods not normally seen as sweet. As pointed out by WHO’s own notes to the media in introducing its draft guidelines, sugars are often hidden within processed foods: a tablespoon of ketchup, for example, contributes 1 teaspoon of sugar to daily intake. And while everyone knows that fizzy drinks contain a large amount of sugar, consumers may be surprised to learn that one can of soda can have up to 10 teaspoons of sugar – meaning that if a person wishes to follow the WHO draft guidelines on sugar consumption, soft drinks must almost certainly be done away with entirely.
The World Health Organization is already achieving some health success in that it has opened up a global conversation about diet, sugar and disease so it will be interesting to see the final nutrition recommendations that emerge.