March 01, 2022 — Sugar industry members slam the European Food Safety Authority’s (EFSA) recommendation to keep added and free sugars as low as possible, calling it ‘misleading’ for feelings of consumer sugar safety.

EFSA’s conclusion, which is in line with current recommendations, is the result of a multi-annual safety assessment. It was ultimately unable to set a tolerable upper intake level (UL) for dietary sugars.

“EFSA’s scientific advice will help national public health authorities and nutrition professionals to update specific nutrient targets and recommendations for different consumers in their countries,” an EFSA spokesperson said. EFSA. NutritionInsight.

In contrast, supplier Cosun Beet Company predicts that this advice could stimulate the increased use of artificial sweeteners in traditional products replacing sugar without free choice for consumers who prefer foods without artificial sweeteners.

“Furthermore, it will trigger a huge reformulation effort in various solid foods to replace natural added sugars with flour, starches, fats and oils, artificial thickeners and sweeteners – with no goal of calorie reduction. , it will have no effect on the calories we consume,” says the sugar beet processor.EFSA’s opinion will help national public health authorities in Europe to update future advice for their consumers.

Shape future decisions
The EFSA opinion also contains several recommendations for further research to inform the possible establishment of a UL for dietary sugars in the future.

The request for health risk assessment of dietary sugars was originally submitted by Denmark, Finland, Iceland, Norway and Sweden in 2017.

“This safety assessment of dietary sugars provides us with important insights,” says Anna Karin Lindroos, nutritionist and PhD at the Swedish Food Agency.

“It will be, together with other relevant scientific reports, a useful source when considering sugar intake recommendations and food-based dietary guidelines in the Nordic countries,” she says.

Open floor for entry
EFSA issued its draft opinion last July, noting that a threshold is not possible because all the “dose-response” relationships (between sugar intake and risk of adverse health effects) were positive. and linear. This refers to the clear indication that the risk of adverse effects increases with higher sugar consumption.

Since then, the authority has “refined and clarified” important aspects of its work, through public consultation.

During this period, 723 comments were received from 15 countries. The spokesperson points out that EFSA applied a structured and transparent framework to assess the validity of the included studies and to weigh the evidence, including a thorough and systematic analysis of uncertainties.

Disease risk assessment
Finally, the EFSA underlined the uncertainties concerning the risk of chronic diseases for people whose consumption of added and free sugars is less than 10% of their total energy intake.

“This is due to the paucity of studies at doses in this range,” says Professor Dominique Turck, chair of the EFSA nutrition expert panel that carried out the assessment.

Nevertheless, the review found evidence of a positive and causal relationship between the consumption of added or free sugars and the risk of certain chronic metabolic diseases.

Specifically, there is moderate certainty (greater than 50–75%) for links to obesity and dyslipidemia. At the same time, certainty is low (15-50%) for non-alcoholic fatty liver disease and type 2 diabetes and very low certainty (0-15%) for hypertension. According to the sugar industry, the EFSA opinion confirms once again that dietary sugars are among the most studied ingredients on Earth.

Is it part of a healthy diet?
The European Sugar Manufacturers Association (CEFS) responded to the scientific advice by emphasizing the safety of sugar, noting that it has been used for many centuries.

“The opinion confirms that sugar is a safe product that can be consumed as part of a healthy, sustainable and balanced diet. A healthy diet is essential in the fight against obesity, which is a root cause of diet-related non-communicable diseases,” says Marie-Christine Ribera, CEO of CEFS.

Meanwhile, Kenniscentrum Suiker & Voeding – a Cosun-funded news source – adds that these recommendations could mislead consumers, giving the impression that ingesting a very small amount of sugar may already be harmful to health.

“With one-sided advice on free and added sugars, there is a risk of unintended and negative health side effects,” he says.

Further research potential
Because EFSA’s review was so broad, its scientists will be able to prioritize the data and research gaps needed to set a tolerable upper intake level for dietary sugars in the future.

In particular, he sifted through more than 30,000 publications to identify several areas to target.

“The pooling and reuse of individual human data from research studies would be a valuable source of information. Research should focus on both the health effects of dietary sugars and the impact of clinical and community interventions designed to reduce sugar intakes,” Turck said.

“Finally, we need validated methods to assess intakes and standardization of reporting guidelines and definitions of dietary sugars and their sources,” he continues.

Consideration of food categories
EFSA notes that the human diet includes different categories and sources of sugars, which can be natural or added.

However, data limitations meant that it was not possible to compare the effects of sugars classified as added or free.

Additionally, the limited data meant some foods could not be assessed, such as sweets, cakes and desserts, other sugary drinks such as sweetened milk and milkshakes, and yogurts.

“Although we could not assess their contributions, the impact of other important contributors to sugar intake should be considered by national authorities when establishing food-based dietary guidelines” , concludes Turck.

By Katherine Durrel

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