"Commentary” on sugar (published in Nature) is not supported by scientific evidence

The commentary, "The toxic truth about sugar," which appeared in the February issue of the journal Nature is inconsistent with the large body of scientific evidence regarding sugar consumption and health. Thorough scientific reviews such as the Institute of Medicine, Dietary Reference Intakes (DRI) report, does not support the view that sugar is "toxic" and a cause of non-communicable diseases, including obesity, hypertension or cardiovascular disease.

The DRI report, which forms the basis of Canada's dietary guidance, reviewed all available evidence on the effects of total and added sugars on chronic disease and concluded that there was insufficient evidence to set an upper level of total or added sugars. Current dietary recommendations suggest a maximum intake of added sugars of 25% of total calories. In Canada, added sugars consumption is estimated to be 10-13% of total energy intake, well below the recommended maximum.

Consumption of added sugars is not increasing as the authors suggest. In Canada, consumption of sugar (sucrose) has declined over the past 4 decades and consumption of total added sugars is estimated to be stable or modestly declining as a percentage of total calories. Recent literature has also reported added sugars consumption to have either remained stable or declined in countries such as Australia, the United Kingdom, and the United States. Obesity rates continue to rise, contrasting trends in added sugars consumption.

Added sugars and naturally occurring sugars are metabolized the same way in the body. Sugars (naturally occurring and added) are found in a wide variety of foods, such as fruits and vegetables, dairy products, cereals and grain products. Sugar plays a vital role in many sensory and food safety aspects of food - sugar contributes to the texture, flavour, and appearance of foods, acts as a natural preservative, enables the fermentation process to occur, and exhibits antioxidant functions.

Scientific background:

Sugar is not toxic or addictive

"There is no support from the human literature for the hypothesis that sucrose may be physically addictive or that addiction to sugar plays a role in eating disorders."

• The plausibility of sugar addiction and its role in obesity and eating disorders. Benton D, Clinical Nutrition. 2010;29:288-303.

Sugar consumption does not cause obesity and other chronic diseases

"Based on the data available on dental caries, behavior, cancer, risk of obesity, and risk of hyperlipidemia, there is insufficient evidence to set a UL for total or added sugars "

• Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Institute of Medicine, Washington, DC: National Academies Press, 2005.
• Dietary Reference Intakes for Sugars, 2004 

Other reviews:

• Is Sugar Consumption Detrimental to Health? A Review of the Evidence 1995-2006. Ruxton CH, Gardner EJ, McNulty HM. Critical Reviews in Food Science and Nutrition 2010;50:1-19.

Sugar intake does not cause diabetes

"Studies failed to demonstrate an obvious relationship between the intake of total simple carbohydrates and glycaemic control or risk to develop a type 2 diabetes and particularly specific evidence is missing in terms of sucrose effect on diabetes."

• Diabetes, insulin resistance and sugars Laville M, Nazare JA. Obes Rev 2009;10 Suppl 1:24-33.

Other Links:

• Canadian Diabetes Association, 2011
• American Diabetes Association, 2011
• World Health Organization, 2011

Sugar intakes have been stable or declining while obesity rates have been increasing

• Estimated Intakes of Added Sugars in Canada and Relationship to Trends in Body Weight Canadian Sugar Institute, 2011
• Consumption of added sugars is decreasing in the United States. Welsh JA, Sharma AJ, Grellinger L, Vos MB. American Journal of Clinical Nutrition 2011;94:726-734.
• The Australian Paradox: A Substantial Decline in Sugars Intake over the Same Timeframe that Overweight and Obesity Have Increased Barclay AW, Brand-Miller J. Nutrients 2011;3:491-504

No one macronutrient is uniquely responsible for the rise in obesity rates

• Diet composition and obesity among Canadian adults. Langlois K, Garriguet D, Findlay L. Health Rep 2009;20:11-20.

Added sugars consumption in Canada is well below the DRI suggested maximum of 25% of energy intake and well within dietary recommendations for total carbohydrate (sugars and starches).

• Sugar consumption among Canadians of all ages Langlois K, Garriguet D. Health Rep 2011;22:3.
• Further analysis of Statistics Canada Health Report: Sugar consumption among Canadians of all ages Canadian Sugar Institute, 2011