To evaluate the quality of evidence, potential biases, and validity of all available studies on dietary sugar consumption and health outcomes.
All of these findings promote the development of policies worldwide to limit sugar consumption, including sugars taxes, food labelling laws, and restrictions on advertising and marketing. Meanwhile, national and international organisations such as WHO, the US Department of Agriculture, and the US Department of Health and Human Services have recommended reducing the consumption of free sugars or added sugars to less than 10% of total daily energy intake. Therefore, before developing detailed policies for sugar restriction, the quality of existing evidence on the associations of dietary sugar consumption with all health outcomes needs to be comprehensively evaluated. To evaluate the quality of evidence, potential biases, and validity of all studies available on dietary sugar intake and any health outcomes, we did an umbrella review of meta-analyses on this topic.
Dietary Sugar Consumption and Health: Umbrella Review
Yin Huang, Zeyu Chen, Bo Chen, Jinze Li, Xiang Yuan, Jin Li, Wen Wang, Tingting Dai, Hongying Chen, Yan Wang, Ruyi Wang, Puze Wang, Jianbing Guo, Qiang Dong, Chengfei Liu, Qiang Wei, Dehong Cao, Liangren Liu
Systematic reviews and meta-analyses of randomised controlled trials, cohort studies, case-control studies, or cross sectional studies that evaluated the effect of dietary sugar consumption on any health outcomes in humans free from acute or chronic diseases. The search identified 73 meta-analyses and 83 health outcomes from 8601 unique articles, including 74 unique outcomes in meta-analyses of observational studies and nine unique outcomes in meta-analyses of randomised controlled trials.
The search identified 73 meta-analyses and 83 health outcomes from 8601 unique articles, including 74 unique outcomes in meta-analyses of observational studies and nine unique outcomes in meta-analyses of randomised controlled trials.
This umbrella review shows that high dietary sugar consumption, especially intake of sugars that contain fructose, is harmfully associated with large numbers of health outcomes. Evidence for the harmful associations between dietary sugar consumption and changes in body weight (sugar sweetened beverages), ectopic fat accumulation (added sugars), obesity in children (sugar sweetened beverages), coronary heart disease (sugar sweetened beverages), and depression (sugar sweetened beverages) seems to be more reliable than that for other outcomes. Evidence of the association between dietary sugar consumption and cancer remains limited but warrants further research. In combination with the WHO and WCRF/AICR recommendations and our findings, we recommend reducing the consumption of free sugars or added sugars to below 25 g/day (approximately six teaspoons a day) and limiting the consumption of sugar sweetened beverages to less than one serving a week (approximately 200-355 mL/week). To change sugar consumption patterns, especially for children and adolescents, a combination of widespread public health education and policies worldwide is urgently needed.
Huang, Yin, et al. “Dietary Sugar Consumption and Health: Umbrella Review.” BMJ, Apr. 2023, p. e071609. DOI.org (Crossref), https://doi.org/10.1136/bmj-2022-071609.