Sugar industry sour on WHO report

Barbara Sibbald

The US Sugar Association wants Congress to reconsider its funding of the World Health Organization after a WHO report recommended that “added sugar” be limited to 10% of a person's caloric intake. The association says the report, from WHO and the UN's Food and Agriculture Organization, is “scientifically flawed” because other research indicates that up to 25% of daily calories can be provided safely by added sugars. (“Added sugar” includes all sugar added as an ingredient in processed and prepared foods such as breads and cakes, as well as sugar eaten separately or added to food at the table. This includes everything from white sugar to maple syrup, but not naturally occurring sugars such as lactose.) As for the call for Congress to reconsider its US$177 million in annual WHO funding, assocation CEO Andy Brisco commented: “We stand firm in our commitment to do what's necessary … because we feel they have issued a misguided report.”

Figure. Yes, maple syrup is indeed an “added sugar” Photo by: Canapress

However, an American coauthor of the Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases says the report (www.who.int/hpr/nutrition/) is scientifically valid and that its 10% limit is virtually the same as the recommendation in the US Food Guide. Dr. Shiriki Kumanyika, a professor of epidemiology at the University of Pennsylvania, says the 10% limit was also recommended in a 1990 WHO report. The new report, released Apr. 23, tackles global health problems such as obesity and diabetes.

But the Sugar Association claims the report is based on only 11 scientific references and doesn't consider the Institute of Medicine's (IOM) 2002 Dietary Reference Intakes Report, which suggests a dietary limit of 25% for added sugars. “For whatever reason [WHO] has ignored one of the most important reports … with 279 references and 25 800 study participants,” said Brisco.

Kumanyika says it's not relevant to compare the 2 reports. The IOM report measured how much added sugar could be consumed before it displaced micronutrients. Kumanyika says it was not designed to provide dietary guidelines. “It was talking about human tolerance, and the sugar association has misinterpreted it,” says Kumanyika. The WHO/FAO report, on the other hand, provides ranges for dietary guidelines, but setting specific limits is up to individual countries.

WHO is also under pressure from the sugar industry in the UK and Europe and from some food industry groups, but it stands by its findings, saying they concur with conclusions in 23 national reports.

“WHO believes that the findings represent the best available science in the world,” said spokesperson Jon Liden.

But the author of the 1990 WHO document that first set the 10% limit believes the sugar industry might succeed in stopping the report this time. Professor Phillip James, now the British chair of the International Obesity Taskforce, said the sugar industry's ability to affect world health guidelines was bolstered by the accreditation of the International Life Sciences Institute to WHO and the FAO. The institute's founding members include Coca-Cola, PepsiCo and General Foods.

The Center for Science in the Public Interest says per capita consumption of added sugars in the US has increased by 28% since 1983, and the average teenage American boy now consumes at least 50 kg of sugar per year. It says a typical American now gets 16% of calories from added sugars, and teenagers get 20%. — Barbara Sibbald, CMAJ