Guidelines for sugar consumption in Europe: Is a quantitative approach justified?

Abstract

Objectives: There is incongruity between the sugar consumption guidelines set in different European countries. A number have adopted maximum limits ranging from 10–25% energy, while others have no quantitative recommendations at all. This raises the question whether or not there should be a common European guideline for sugar consumption.

Design: This paper examines if such a goal for sugar is merited and reviews the published literature on associations between sugar consumption and dental caries, obesity and micronutrient dilution.

Results: Evidence showed that higher intakes of sugar were related to leanness, not obesity, and had no detrimental effects on micronutrient intakes in most people. In the case of dental caries, there was a relationship between frequency of sugar intake and the incidence of decay. However, in populations where fluoride use was adequate, associations between sugar intake and caries rarely reached statistical significance.

Conclusions: The available evidence does not justify a common quantitative recommendation for sugar. It is suggested that dental caries merits a more integrated public health approach where advice on the frequency of foods containing fermentable-carbohydrates is placed in context alongside oral hygiene.