“Although our findings question the specific sugar recommendations from guidelines produced by leading authorities, the findings should not be used to justify high or increased consumption of sugary foods and beverages,” Johnston said.
Rather, “results from our review should be used to promote improvement in the development of trustworthy guidelines on sugar intake,” he said. For instance, that there has been similar confusion over recommendations for how much water you should drink each day. “Some suggest eight glasses. However, we don’t really know. Perhaps it is 12 or six or four.”
“Studies are more likely to conclude there is no relationship between sugar consumption and health outcomes when scientists receive financial support from food and beverage companies,” he said.
‘Guideline recommendations have to do a better job’
For the paper, Johnston and his colleagues reviewed nine separate guidelines on sugar made by health authorities from around the world between 1995 and 2016.
Using one of the methods, the researchers found that, for otherwise healthy members of the public, the overall quality of evidence to support recommendations made in the guidelines was low to very low.
“In other words, there is a lot of uncertainty around the recommended thresholds, especially for outcomes that are important to the public, (such as) obesity (and) type 2 diabetes,” Johnston said.
According to the other method, the quality of the development of the guidelines was moderate, the researchers found. “That is, guideline recommendations have to do a better job of assessing the quality of evidence underpinning their recommendations and be more transparent on what the quality of the evidence actually is,” Johnston said.
A war against diabetes
Although all of the reviewed guidelines in the paper recommended a decrease in sugar consumption, “the rationale and evidence used to make each recommendation were inconsistent,” the researchers wrote.
But since the researchers reviewed guidelines published over a 20-year period, Schillinger said, they were likely to find inconsistencies. “It is widely known that science evolves over time,” Schillinger said.
“In addition, their claims regarding the low quality of guidelines are based on the application of inappropriate metrics,” he said. One of the methods the researchers used in the paper “is the wrong tool for the job and virtually guaranteed that they would falsely conclude that guidelines are of low quality,” Schillinger said.
Schillinger also pointed to the new paper’s funding as a major limitation, which has been seen before in the history of sugar research.
Those previous studies promoted the consumption of fat as a primary risk factor for heart disease and avoided placing blame on sugar, according to the analysis.
“Added sugars not only provide unnecessary and ’empty’ non-nutritious calories but also appear to affect unique and specific unhealthy metabolic pathways that contribute to obesity and diabetes and heart disease, irrespective of calories,” Schillinger said.
“We are in a public health war against diabetes, and we need to create smart strategies to win this war and prevent needless suffering and death. This is serious business,” he said.
“It is time we fought a home-front war against diabetes,” he said.
“This translates into about 80 to 160 calories derived from added sugars for a youth,” Schillinger said. He said that one can of soda contains about 150 calories worth of sugar.
“Were the public to believe and follow such guidelines, this would mean that profits for junk food companies would fall by half,” Schillinger said. “So there is both a lot of money and a lot of lives on the line.”