New WHO guidelines recommend reducing intake of "free sugars" to less than 10% of daily calories, or less than 5% for even more health benefits

Washington, D.C., 4 March 2015 (PAHO/WHO) — New guidelines from the World Health Organization (WHO) recommend that adults and children reduce their daily intake of "free sugars" to less than 10% of total calories. A further reduction to below 5%—or roughly 6 teaspoons per day in a typical 2,000-calorie diet—would provide additional health benefits, the guidelines say.

The guidelines, published today, were developed according to WHO's rigorous process for guideline development and are based on the latest scientific evidence, with input from leading scientists from around the world and feedback through an open global consultative process.

"Sugar is not an essential nutrient, and solid evidence shows that it can actually be harmful by contributing to overweight, obesity and tooth decay," said Dr. Enrique Jacoby, advisor on healthy eating and active living at the Pan American Health Organization (PAHO), WHO's Regional Office for the Americas. "These guidelines will help countries develop policies and actions to reduce consumption of sugars to improve people's health."

"Free sugars" refer to monosaccharides (such as glucose and fructose) and disaccharides (such as sucrose or table sugar) that are added to foods and drinks by the manufacturer, cook or consumer, as well as sugars that are naturally present in honey, syrups, fruit juices and fruit juice concentrates. The guidelines do not refer to sugars in fresh fruits and vegetables or sugars naturally present in milk, because there is no reported evidence of adverse effects of consuming these sugars.

The guidelines are based on recent scientific evidence showing that adults who consume less sugars have lower body weight and that increasing the amount of sugars in the diet is associated with a weight increase. Research also shows that children with the highest intakes of sugar-sweetened drinks are more likely to be overweight or obese than children with low intake of sugar-sweetened drinks.

Other studies show that rates of dental caries (tooth decay) are higher when free sugars intake is more than 10% of total calories, compared with intake of below 10%. The recommendation of less than 5% free sugars intake is based on population-based ecological studies that showed a reduction in dental caries in countries where the availability of sugars dropped dramatically.

Processed food consumption rising in Latin America
Much of the sugars consumed today are "hidden" in processed foods that consumers do not view as sweets. For example, 1 tablespoon of ketchup contains around 4 grams (about 1 teaspoon) of free sugars. A single can of sugar-sweetened soda has up to 40 grams (about 10 teaspoons) of free sugars.

A recent PAHO/WHO study of 12 Latin American countries shows that their consumption of ultra-processed food and sugar-sweetened drinks increased by nearly one-third on average between 1999 and 2013, and in three of the countries (Bolivia, Peru and Uruguay), consumption more than doubled. The study also showed that body mass index (BMI) increased in all 12 countries during the same period, and the BMI increases were positively correlated with increases in per-capita annual sales of ultra-processed products.

To reverse these trends, PAHO/WHO member countries in 2014 adopted a regional Plan of Action for the Prevention of Obesity in Children and Adolescents, which calls for measures including restrictions on marketing of ultra-processed food and drink products to children, increasing the costs of these foods through taxation, increasing production and accessibility of wholesome fresh foods, and developing new guidelines for preschool and school meal programs and for foods and beverages sold in schools

"These new WHO guidelines will help countries develop their own dietary guidelines as part of their implementation of the plan of action on child obesity," said Jacoby. "The idea is to reduce consumption of overprocessed foods and hidden sugars while also promoting local foods and cooking traditions."

The new guidelines are part of PAHO and WHO's ongoing efforts to promote prevention of noncommunicable diseases (NCDs), such as cardiovascular disease, cancer, and diabetes. These efforts are framed by the WHO Global Action Plan for NCDs 2013-2020, which calls for halting the rise in diabetes and obesity and reducing the burden of premature deaths due to NCDs by 25% by 2025.

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PAHO, founded in 1902, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas. It also serves as the Regional Office for the Americas of WHO.

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