A bottle of soda and five gingerbread cookies. This is the limit for a healthy daily intake of added sugar for most people. This is the opinion of the experts who have developed the scientific basis for the new American dietary recommendations. But their conclusion was swept under the rug.

It is not one of my usual pastimes during Christmas and New Year holidays to read dietary recommendations. But now that the Dietary Guidelines for Americans 2020-2025 was presented on December 29, I found myself stuck in the digital loop for a while. In my defense it’s not like it was an ordinary Christmas this year. The American Dietary Guidelines come every five years and are considered to be the largest review of research on food and health. It gives waves that soon tend to cross the Atlantic and reach other countries as well.

Most remarkable, in my opinion: the Council on added sugar has gone against what its own experts have suggested.

In concrete terms, this means that the old recommendation remains unchanged: added sugar should provide less than 10 percent of the daily energy. It is the same as recommended in Sweden and by the World Health Organization WHO.

So what’s surprising about this?

Well, Dietary guidelines for Americans claim to rest on a scientific basis, but right there – and almost only there – the final recommendation adopted by the Department of Agriculture goes against the 835-page scientific report submitted in July 2020 by its own expert committee, the dietary guidelines advisory committee.

The experts in that committee are appointed in a manner that is extensively regulated by the US Congress. Their proposal was to lower the recommendation for added sugar from 10 percent to less than 6 percent of daily energy.

Almost three quarters of the added sugar we get comes from sugary drinks, desserts, sweets, bars, snacks, pastries and sweet breakfast cereals. It is thus not about naturally occurring sugars in fruit.

The proposal for a level of a maximum of 5 percent stands out. Admittedly, the World Health Organization (WHO) has previously pointed out this level as an unofficial target for the countries that have come furthest with the sugar reduction. The reason has been that the risk of cavities, which is an extremely costly disease for global healthcare, is still increasing at the 5 percent level.

But the American Committee of Experts had taken a new approach. The starting point was this: soft drinks and snacks are largely depleted of essential nutrients in addition to energy. The more sugary junk food we eat, the greater the nutritional demands on all the other food consumed.

In their own analyzes, the experts concluded that it is impossible for almost everyone to get a complete set of necessary nutrients without gaining weight if the amount of added sugar makes up more than 5 percent of the daily energy. Then it does not help even if all other food is healthy and of the best kind. The equation still does not add up.

According to the expert group, added sugar is linked to an increased risk of type 2 diabetes, which is partly due to the link to obesity, which in turn also increases the risk of cardiovascular disease, cancer and other chronic diseases.

Anyone who ingests a lot of added sugar and also keeps track of calories – risks suffering from deficiencies in everything from vitamins, minerals and fiber to protein and essential fatty acids. The only option is to eat more than recommended – and thus gain weight. In some cases we become obese while being malnourished at the same time.

So how did the US Department of Agriculture justify the decision not to follow the clear statement of its scientific experts on this point?

In a comment, the USDA claims that it is difficult to set a specific limit because the scope for added sugar varies depending on the individual energy needs. Those who exercise a lot and have a daily energy need of more than 3000 kcal can have room for “9 to 10 percent of the calories from added sugar”. The recommended limit of 10 percent allows for “a flexible choice of food” but “requires careful planning”.

In addition, the US Department of Agriculture emphasizes that even what is defined as healthy food contains a small amount of added sugar. For those who eat the most, this can equate to up to 2 percent of daily energy (which the USDA includes in the above-mentioned 9-10 percent).

If we compare with the expert group’s scientific report from last summer, the analysis there is completely different. It states that the maximum space for added sugar is 6 percent or less (excluding the amount found in healthy foods) for virtually all Americans and is limited to 3-5 percent of the energy for “a majority of the population.”

Only for the small group that has a high energy balance of 3000 kcal per day or 3200 kcal per day, the space for added sugar is 7 and 8 percent of the total energy, the scientific experts write. In addition, according to them, there are small amounts of added sugar that are also found in healthy food but where the amount is greatest for those who eat the most per day.

Experts point out that, on the contrary, their own estimate probably overestimates the scope for added sugar. The calculation is based on the rather unlikely scenario that just about all food that does not contain added sugar is healthy and nutrient-dense. The calculation also does not allow for any alcohol intake at all because then the space for added sugar shrinks further. The same applies if the amount of fat in the food is increased, then the energy supplement must also be made at the expense of added sugar.

Personally, I am not particularly surprised by these conclusions. In 2003, the Swedish National Food Administration made an attempt to put together a menu called Swedish nutritional recommendations which translated into foods that in each part would correspond to the nutritional recommendations in force at the time. It turned out to be next to impossible to get all the puzzle pieces in place. In order to meet the needs without gaining weight, in a clearly unrealistic way it was necessary to follow a menu planned in the smallest detail that ran over several weeks.

More surprising is that those who deliver recommendations for what we should eat struggle to absorb these parts of science.

Read more

Dietary guidelines for Americans 2020-2025
Scientific Report of the 2020 Dietary Guidelines Advisory Committee
https://www.dietaryguidelines.gov/

Example

So how much added sugar corresponds to 5 percent of the daily energy? Let’s say you lose a total of 2400 calories a day. 5 percent of that is 120 calories. That’s enough for an ice cream, about 100 grams (80 cal) plus 5 small gingerbread cookies (together 40 cal).

Alternatively, you can ignore the ice cream and cookies and choose to drink a single 33 cl soft drink. But then: no more sugar that day. It is a difficult task because sugar is hidden a bit everywhere in different ready-made products.

a gingerbread 6 grams
of which about 2 grams of sugar = 8 cal

ice cream 100 grams
of which 20 grams of sugar = 80 cal

100 grams of soda
Of which 10 grams of sugar = 40 cal

This is a guest post. Any opinions expressed are the writer’s own.