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Guidelines on ‘added’ sugars are unscientific and unnecessary

Nature Reviews Cardiology volume 19, page 847 (2022)Cite this article

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In her recent Comment article (Guidelines to lower intake of added sugar are necessary and justified. Nat. Rev. Cardiol. 19, 569–570 (2022))1, Kimber Stanhope offers a rebuttal to criticisms that recommendations to reduce the consumption of ‘added’ sugars were based on “low-quality evidence” and “ill-informed opinions”. Given the prominence (and misrepresentation) of my critique2 in that rebuttal1, I write to correct several misconceptions.

To begin, my colleagues and I established that the data underlying the US Dietary Guidelines were physiologically implausible3,4, pseudo-scientific (non-falsifiable)5,6 and “essentially meaningless”5. We further showed that, by obscuring established facts and causal mechanisms7,8, these data created a “fictional discourse on diet–disease relations”6. Therefore, because the rebuttal1 failed to address our conclusions, the critique that recommendations were “ill-formed” and based on “low-quality evidence” stands unopposed. However, more importantly, the author misrepresented the large body of rigorous evidence presented in my critique2 and previous reviews6,8.

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References

  1. Stanhope, K. L. Guidelines to lower intake of added sugar are necessary and justified. Nat. Rev. Cardiol. 19, 569–570 (2022).

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  2. Archer, E. & Arjmandi, B. Falsehoods and facts about dietary sugars: a call for evidence-based policy. Crit. Rev. Food Sci. Nutr. 61, 3725–3739 (2021).

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  3. Ioannidis, J. P. A. Implausible results in human nutrition research. BMJ 347, f6698 (2013).

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  5. Archer, E., Pavela, G. & Lavie, C. J. The inadmissibility of what we eat in America and NHANES dietary data in nutrition and obesity research and the scientific formulation of national dietary guidelines. Mayo Clin. Proc. 90, 911–926 (2015).

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  7. Archer, E., Pavela, G., McDonald, S., Lavie, C. J. & Hill, J. O. Cell-specific “competition for calories” drives asymmetric nutrient-energy partitioning, obesity, and metabolic diseases in human and non-human animals. Front. Physiol. 9, 1053 (2018).

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  8. Archer, E. In defense of sugar: a critique of diet-centrism. Prog. Cardiovasc. Dis. 61, 10–19 (2018).

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  9. Glinsmann, W. H., Irausquin, H. & Park, Y. K. Evaluation of health aspects of sugars contained in carbohydrate sweeteners. Report of Sugars Task Force, 1986. J. Nutr. 116(Suppl.), S1–S216 (1986).

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  10. Committee on Medical Aspects of Food Policy. Report on health and social subjects: 37. Dietary sugars and human disease. Department of Health https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/743792/Dietary_Sugars_and_Human_Disease__1989_.pdf (1989).

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    Edward Archer

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Archer, E. Guidelines on ‘added’ sugars are unscientific and unnecessary. Nat Rev Cardiol 19, 847 (2022). https://doi.org/10.1038/s41569-022-00792-9

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