SugarScience Response to 2015 Dietary Guidelines
By SugarScience Team
We are writing to endorse the scientific advisory committee's recommendations on the 2015 Dietary Guidelines for Americans, especially those regarding limits on sugar consumption.
Over the past 18 months, our team of nationally recognized scientists has collected the most definitive, unbiased research on the impact of sugar on our health, which we made public via SugarScience.ucsf.edu.
Between us, we reviewed 8,000 scientific papers and identified close to 4,000 that were most relevant to human health. As with the DGA advisory committee, we found strong evidence linking the overconsumption of added sugar to diabetes,1,2,3,4,5 cardiovascular disease,6,7,8,9,10,11,12 dental caries,13,14,15 fatty liver disease,16,17,18,19 obesity20 and metabolic syndrome.21 There is also initial evidence that it may be linked with cancer,22,23,24,25 dementia26,27 and premature aging.28,29,30
Together, heart disease and diabetes alone affect more than 107 million Americans, cost the U.S. $365 billion31 annually in health care and lost productivity, and are among the top causes of death32 worldwide, according to the NIH and CDC.
The DGA advisory committee’s recommendation of limiting sugar to 10% of calories is an excellent start in preventing these illnesses. It is not only supported by extensive research and advice by the American Heart Association,6 but also is aligned with the international health standards established earlier this year by the World Health Organization.33 The WHO standards recommend limiting added sugar to no more than 10% of daily calories, with further benefits below 5%.
Among our findings was strong evidence that even one sugary beverage per day raises the risk of dying of heart disease by 34%7 and raises the risk of diabetes by 26%.2 The research also revealed significant conflicts of interest34 in the scientific literature that downplays sugar’s impact, including nearly exclusive industry funding behind reports of any benefits to sports drinks.
In launching SugarScience.ucsf.edu, we discovered that Americans are hungry for evidence-based advice on how much sugar they can safely consume. Americans know that sugar is unhealthy in large quantities and are desperate for clarity on how to change their diets to avoid chronic disease. It is high time we honored that with clear guidelines from our national leaders at USDA and HHS.
We applaud the advisory committee's recommendations and strongly advise you to incorporate them into the new guidelines.
- (2013, February 27). The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data. PLoS One . doi:10.1371/journal.pone.0057873. Retrieved from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0057873
- (2012, January 31). Sweeteners and Risk of Obesity and Type 2 Diabetes: The Role of Sugar-Sweetened Beverages. Curr Diab Rep , 12, 195-203. doi:10.1007/s11892-012-0259-6. Retrieved from http://link.springer.com/article/10.1007/s11892-012-0259-6
- (2006). The metabolic syndrome: a glance at its history. Journal of Hypertension , 24(4), 621-626. doi:10.1097/01.hjh.0000217840.26971.b6. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16531786
- (2010, March). A New Public Health Tool for Risk Assessment of Abnormal Glucose Levels. Preventing Chronic Disease , 7(2). Retrieved from http://www.cdc.gov/pcd/issues/2010/mar/09_0044.htm
- (2004, July). Preventing Cancer, Cardiovascular Disease, and Diabetes. Diabetes Care , 27(7), 1812-1824. doi:10.2337/diacare.27.7.1812. Retrieved from http://care.diabetesjournals.org/content/27/7/1812.full
- (2009, September 15). Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation , 120(11), 1011-20. doi:10.1161/CIRCULATIONAHA.109.192627. Retrieved from http://circ.ahajournals.org/content/120/11/1011.full.pdf
- (2014, April). Added Sugar intake and cardiovascular disease mortality among US adults. JAMA Internal Medicine , 174(4), 516-524. doi:10.1001/jamainternmed.2013.13563. Retrieved from http://archinte.jamanetwork.com/article.aspx?articleid=1819573
- (2015, April 22). A dose-response study of consuming high-fructose corn syrup-sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults.. Am J Clin Nutr , [epub ahead of print]. doi:PMID: 25904601. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25904601
- (2014). AHA Statistical Update:Heart Disease and Stroke Statistics - 2014 Update: A Report From the American Heart Association . Circulation , 129, e28-e292. doi:10.1161/01.cir.0000441139.02102.80 . Retrieved from http://circ.ahajournals.org/content/129/3/e28.extract
- (2011). Metabolic syndrome and heart failure -- the risk, paradox, and treatment. Current Hypertension Reports , 13(2), 142-148. doi:10.1007/s11906-011-0179-x. Retrieved from http://link.springer.com/article/10.1007%2Fs11906-011-0179-x
- (2001). Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA: The Journal of the American Medical Association , 285(19), 2486-2497. Retrieved from http://circ.ahajournals.org/content/106/25/3143.long
- (2011, July 15). Association of the metabolic syndrome with atrial fibrillation among United States adults (from the REasons for Geographic and Racial Differences in Stroke [REGARDS] Study).. Am J Cardiol. , 108 (2), 227-32. doi:10.1016/j.amjcard.2011.03.026. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21530935
- (2004, May). Sugars: the arch criminal?. Caries Res , 38(3), 277-285. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15153701
- (2012, October). All-cause mortality and periodontitis in 60-70-year-old men: a prospective cohort study. J Clin Periodontol , 39(10), 940-6. doi:10.1111/j.1600-051X.2012.01923.x. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22834905
- (2000, June). Dietary determinants of dental caries and dietary recommendations for preschool children.. J Public Health Dent , 60(3), 197-296. doi:PMID: 11109219. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11109219
- (2004, November 24). Prevalence of hepatic steatosis in an urban population in the United States: Impact of ethnicity. Hepatology , 40(6), 1387-1395. doi:10.1002/hep.20466. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/hep.20466/full
- (2006, October 1). Prevalence of Fatty Liver in Children and Adolescents. Pediatrics , 118(4), 1388-1393. doi:10.1542/peds.2006-1212. Retrieved from http://pediatrics.aappublications.org/content/118/4/1388.long
- (2014). New Unsweetened Truths About Sugar. JAMA Intern Med. , 174(4), 525-526. doi:10.1001/jamainternmed.2013.12991.. Retrieved from http://archinte.jamanetwork.com/article.aspx?articleid=1819571
- (2015, January). The Effect of a Low Fructose and Low Glycemic Index/Load (FRAGILE) Dietary Intervention on Indices of Liver Function, Cardiometabolic Risk Factors, and Body Composition in Children and Adolescents With Nonalcoholic Fatty Liver Disease (NAFLD). JPEN J Parenter Enteral Nutr , 39(1), 73-84. doi:10.1177/0148607113501201. Retrieved from http://pen.sagepub.com/content/39/1/73.abstract
- (2015, February 11). Food habits, physical activities and sedentary lifestyles of eutrophic and obese school children: a case-control study.. BMC Public Health , 15, 124. doi:10.1186/s12889-015-1491-1.. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25885348
- (2014, April). Consumption of added sugars and development of metabolic syndrome components among a sample of youth at risk of obesity. Applied Physiology, Nutrition, and Metabolism , 39(4), 512. doi:10.1111/jhn.12223. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24669994
- (2014). A new link between diabetes and cancer: enhanced WNT/beta-catenin signaling by high glucose. Journal of Molecular Endocrinology , 52(1). doi:10.1530/JME-13-0152
- (2011). Diabetes mellitus and risk of pancreatic cancer: A meta-analysis of cohort studies. European Journal of Cancer (Oxford, Englandâ€¯: 1990) , 47(13), 1928-1937. doi:10.1016/j.ejca.2011.03.003. Retrieved from http://www.sciencedirect.com/science/article/pii/S095980491100147X
- (2013). Association between sucrose intake and cancer: a review of the evidence. Nutr Hosp , 28(Suppl 4), 95-105. doi:10.3305/nh.2013.28.sup4.6802. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23834098
- (2013). The impact of glycemic levels in patients with colon cancer. Clinical advances in hematology & oncology , 11(2), 93-94.
- (2012). The Journal of Physiology , 590(10), 2485-2499. doi:10.1113/jphysiol.2012.230078. Retrieved from http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.2012.230078/abstract
- (2013, August 8). Glucose Levels and Risk of Dementia. New England Journal of Medicine , 369(6), 540-548. doi:10.1056/NEJMoa1215740. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMoa1215740
- (2010, July). Nutrition and aging skin: sugar and glycation. Clinics in Dermatology , 28(4), 409-411. doi:10.1016/j.clindermatol.2010.03.018. Retrieved from http://www.sciencedirect.com/science/article/pii/S0738081X10000428
- (2010, March 10). Associations between diet, lifestyle factors, and telomere length in women. The American Journal of Clinical Nutrition , 91(5), 1273-1280. doi:10.3945/ajcn.2009.28947. Retrieved from http://ajcn.nutrition.org/content/91/5/1273
- (2014, December). Soda and Cell Aging: Associations Between Sugar-Sweetened Beverage Consumption and Leukocyte Telomere Length in Healthy Adults From the National Health and Nutrition Examination Surveys. American Journal of Public Health , 104(12), 2425-2431. doi:10.2105/AJPH.2014.302151. Retrieved from http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2014.302151?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
- Health & Human Services, National Institutes of Health, NHLBI. (2012). Fact Book. Retrieved from http://www.nhlbi.nih.gov/about/documents/factbook/2012/chapter4#4_7
- (2013). Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet , 380(9859), 2095-2128. Retrieved from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961728-0/abstract
- (2015). Sugars intake for adult and children: Guideline. (ISBN: 978 92 4 154902 8). Retrieved from http://who.int/nutrition/publications/guidelines/sugars_intake/en/
- (2007, January 9). Relationship between Funding Source and Conclusion among Nutrition-Related Scientific Articles. PLOS Medicine . doi:10.1371/journal.pmed.0040005. Retrieved from http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0040005
Conflicts of interest
Researchers have conflicts of interest when their work is significantly dependent on a funding source that holds a vested interest in the outcome of their research.SugarScience Glossary
World Health Organization
The World Health Organization (WHO) is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. Website: http://www.who.intSugarScience Glossary
A broad term for a group of chronic diseases of the heart, these diseases include problems with blood supply to heart muscle, problems with heart valves and the electrical system of the heart. Another term you will see used to mean the same thing is cardiovascular disease.SugarScience Glossary
Also called Syndrome X is a group of body abnormalities that go along with increased risk of cardiovascular disease, type 2 diabetes and stroke. The definition of this syndrome varies a little worldwide.SugarScience Glossary
A broad term meaning any bodily process in which the liver is injured or does not work as it is supposed to. In this website we focus on liver diseases in which the diet hurts the liverSugarScience Glossary
Any sugar added in preparation of foods, either at the table, in the kitchen or in the processing plant. This may include sucrose, high fructose corn syrup and others.SugarScience Glossary
Usually shortened to just diabetes. Sometimes called sugar diabetes. Look at Type 1 Diabetes and Type 2 Diabetes for more informationSugarScience Glossary
A group of chronic diseases of the brain that cause, memory loss, behavior changes, and abnormal thinking and reasoning.SugarScience Glossary
Abnormal, uncontrolled cell growth in a part of the body, many types. Another of the chronic diseases.SugarScience Glossary