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How much sugar is OK? Paper adds to debate

Jacqueline Howard | 12/20/2016, 6 a.m.
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— 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.

In the United States, dietary guidelines made by the federal government are released every five years, so consumers may have to wait until 2020 for new guidance.

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.

The Sugar Association, previously called the Sugar Research Foundation, funded studies on sugar health risks in the 1960s and '70s, according to a historical analysis published online in the journal JAMA Internal Medicine in September.

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.

A separate paper published in the American Journal of Preventive Medicine in October shed light on how Coca-Cola and PepsiCo have sponsored national health and medical organizations.

"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.

"To illustrate the seriousness of the war on diabetes, in the first 10 years of the Iraq (and) Afghanistan war, about 1,500 US soldiers lost a limb in battle," Schillinger said, citing a 2015 report (PDF) released by the Congressional Research Service.

In comparison, over the same time period, about 730,000 adults with diabetes lost limbs, Schillinger said. About 73,000 lower-limb amputations were performed in adults with diagnosed diabetes in 2010 alone, according to a 2014 National Diabetes Statistics Report (PDF).

"It is time we fought a home-front war against diabetes," he said.

Schillinger added that he stands by current governmental guidelines recommending that added sugar should not exceed between 5% and 10% of your daily calories.

"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.

The average percent of total daily calories from added sugars consumed among men and women between 2005 and 2010 was 13%, according to the Centers for Disease Control and Prevention.

"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."