Following a request to update a 2010 safety assessment from five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden), EFSA undertook a comprehensive review of the scientific literature examining the link between sugar intake and the development of various diseases, including obesity, Type 2 diabetes, cardiovascular diseases, gout and dental caries.
“This has been a hugely challenging work so far, involving the evaluation of over 30,000 publications. Our experts and staff have made an immense effort to reach this point and applied the highest standards of scientific rigour throughout,” Dr Valeriu Curtui, head of EFSA’s Nutrition Unit, said today following the publication of the organisation’s draft opinion.
EFSA had been specifically asked if it would be possible to set a science-based cut-off point―called a ‘tolerable upper intake level’ or ‘UL’ ―for total dietary sugars. Below this point, sugar consumption would not cause health problems.
“The UL is not a recommended level of intake. Rather, it is a scientifically derived ‘threshold’ below which the risk of adverse health effects for the general population is negligible, but above which the intake is proven to be linked to adverse health effects, including disease,” EFSA said.
To determine this level ‘requires the identification of a level of sugars intake up to which no adverse health effects are observed’. Such data was not available, meaning the food safety body’s experts were not able to determine a ‘safe’ level of sugar consumption.
“While it was not possible to set a UL, EFSA’s scientists concluded that the intake of added and free sugars should be as low as possible,” the scientific opinion states.
Sugary drinks show strongest links to disease risk
While EFSA was unable to provide guidance on how much sugar is ‘safe’ to consume, the safety authority did confirm – to different degrees of certainty - the link between the various types of sugar in our diets and disease risk.
Dietary sugars range from those that are naturally present in foods like fruit, vegetables and milk to free sugars, which include both naturally present sugars in honey or fruit juice and refined sugars added to processed food and beverages.
Across all diseases examined, the highest degree of risk certainty was associated with consumption of sugar-sweetened beverages. The link to obesity, Type 2 diabetes, hypertension and cardiovascular disease was considered ‘high’ at 75-100% certainty. A connection between the consumption of sugary drinks and the development of gout was rated ‘moderate’ with a 50-75% degree of certainty, while the link to high bad cholesterol and liver disease was much less clear at just 15-50%.
In contrast, fruit juice consumption appears to offer a lower-risk option, with a ‘moderate’ degree of certainty for Type 2 diabetes and gout.
Scientific advice, not policy recommendation
EFSA stressed the role that its opinion is meant to play in the development of dietary guidelines is purely to help inform Member States, who set their own targets.
“This draft assesses solely scientific evidence and does not constitute future policy recommendations or public health guidelines. Those are the responsibility of national public health authorities and international bodies,” Dr Curtui underlined.
Linda Granlund, Director of the Division for Prevention and Public Health, Norwegian Directorate of Health, added: “As one of the five requester countries, the Norwegian Directorate of Health welcomes EFSA’s public consultation on its draft scientific opinion… We will use the extensive scientific findings to update our national food-based dietary guidelines once the opinion is finalised.”
A public consultation will run until 30 September and EFSA will hold a public meeting to discuss the draft opinion on 21 September.
“The additional scientific insights and data we get from consultations help strengthen our scientific assessments, so we welcome and encourage them,” Dr Curtui concluded.