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Reply to: ‘Evidence does not support the reduction of added sugar intake from all food sources’

Nature Reviews Cardiology volume 19, pages 845–846 (2022)Cite this article

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I thank Drs Yan, Chan and Louie for their Correspondence (Evidence does not support the reduction of added sugar intake from all food sources. Nat. Rev. Cardiol. https://doi.org/10.1038/s41569-022-00791-w (2022))1 on my Comment article (Guidelines to lower intake of added sugar are necessary and justified. Nat. Rev. Cardiol. 19, 569–570 (2022))2. The authors feel that their views were misrepresented and the purpose of their letter was to clarify them.

They state that the intention of their review3 was not to exonerate added sugars as being harmless to health. My Comment article did not suggest that this was their intention. However, on the basis of the final sentence of their abstract — “We argue the current public health recommendations to encourage the reduction of both solid and liquid forms of free sugar intake (e.g., sugar reformulation programs) should be revised due to the overextrapolation of results from [sugar-sweetened beverages] SSBs studies”3 — I did conclude that their review, and the other two articles that I discussed, sent the implicit message that consumers should be sceptical about the recommendations to reduce their consumption of added sugar. I stand by that conclusion and also by my firm belief that such a message is harmful to consumers and likely to exacerbate the incidence of dental caries and the epidemic of metabolic disease.

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References

  1. Yan, R., Chan, C. B. & Louie, J. C. Evidence does not support the reduction of added sugar intake from all food sources. Nat. Rev. Cardiol. https://doi.org/10.1038/s41569-022-00791-w (2022).

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  3. Yan, R. R., Chan, C. B. & Louie, J. C. Y. Current WHO recommendation to reduce free sugar intake from all sources to below 10% of daily energy intake for supporting overall health is not well supported by available evidence. Am. J. Clin. Nutr. 116, 15–39 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Khodami, B. et al. Effects of a low free sugar diet on the management of nonalcoholic fatty liver disease: a randomized clinical trial. Eur. J. Clin. Nutr. 76, 987–994 (2022).

    Article  CAS  PubMed  Google Scholar 

  5. Campos, V. et al. Sugar- and artificially sweetened beverages and intrahepatic fat: a randomized controlled trial. Obesity (Silver Spring) 23, 2335–2339 (2015).

    Article  CAS  Google Scholar 

  6. Gallagher, A. M. et al. Low-calorie sweeteners in the human diet: scientific evidence, recommendations, challenges and future needs. A symposium report from the FENS 2019 conference. J. Nutr. Sci. 10, e7 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Magnuson, B. A., Carakostas, M. C., Moore, N. H., Poulos, S. P. & Renwick, A. G. Biological fate of low-calorie sweeteners. Nutr. Rev. 74, 670–689 (2016).

    Article  PubMed  Google Scholar 

  8. Rogers, P. J. et al. Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies. Int. J. Obes. (Lond.) 40, 381–394 (2016).

    Article  CAS  Google Scholar 

  9. Nichol, A. D., Holle, M. J. & An, R. Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials. Eur. J. Clin. Nutr. 72, 796–804 (2018).

    Article  CAS  PubMed  Google Scholar 

  10. Louie, J. C. & Tapsell, L. C. Association between intake of total vs added sugar on diet quality: a systematic review. Nutr. Rev. 73, 837–857 (2015).

    Article  PubMed  Google Scholar 

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Acknowledgements

The author thanks Bettina Hieronimus (Institute for Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Germany) and Desiree Sigala (Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA) for discussion, insight and editing before submission

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  1. Department of Molecular Biosciences, School of Veterinary Medicine, University of California – Davis, Davis, CA, USA

    Kimber L. Stanhope

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Correspondence to Kimber L. Stanhope.

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K.L.S. has received honoraria for speaking from numerous organizations (since 2016: American Diabetes Association, Columbia University, Harvard School of Medicine, Swedish Medical Center and University of Missouri) and from CrossFit for serving as academic organizer of a 2017 conference and lead author of the conference summary report.

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Stanhope, K.L. Reply to: ‘Evidence does not support the reduction of added sugar intake from all food sources’. Nat Rev Cardiol 19, 845–846 (2022). https://doi.org/10.1038/s41569-022-00793-8

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