The European Committee of Sugar Manufacturers (CEFS), representing the European sugar producing sector, takes note of the new WHO (World Health Organisation) Guideline on Sugars Intake for Adults and Children, and supports the scientific debate on sugars and health.
We note the clarification in the report that WHO has retained its recommendation that “free sugars” can provide <10% of total energy intake.
We believe that before a <5% value can be included in official recommendations, extensive debate must take place, as called for by WHO, especially because the data this value is based on, was deemed to be of very low quality by both WHO and the dental health review authors. In practice, such a threshold would be exceeded for instance with the drinking of a mere glass of orange juice. Consideration should therefore be made of the impact this would have on the public understanding of a balanced diet, as this could for example undermine and contradict healthy eating messages such as the “5-a-day” campaign.
It should be noted that the WHO intake recommendations are based purely on dental health data. The authors of the WHO-mandated systematic review on “free” sugars and weight gain concluded that any effect of sugar on weight gain is purely due to the consumption of excess calories and not a specific effect of sugar per se. This review highlights the fact that obesity is an extremely complex and multidimensional problem, and preventing obesity requires the balance of managing calorie intake coming from all foods, including sugar, with energy expenditure. Therefore, simply advising an individual to decrease sugar intake without taking into account overall diets and other factors will not solve the current obesity crisis. The WHO recommendations notably have to be put in the context of each country’s food culture, which has an impact on individuals’ food patterns.
In regards to dental caries, WHO and OECD data shows that in Western countries, the trend of dental caries prevalence in children and adolescents has declined over the last 35-40 years while the average sucrose supply in these countries has remained constant. It is well established that the best way to reduce the risk of dental caries is to maintain good oral hygiene practices, including the use of fluoride toothpaste. The decline in dental caries prevalence has mirrored the introduction and uptake of fluoridation, fluoride toothpastes and mouthwashes. The frequent consumption of fermentable carbohydrates, including sugars, has been linked to dental caries risk, but merely advising individuals to reduce their sugar intake without taking into account their overall oral hygiene and the frequency of consumption will not reach the sought goal to reducing caries occurrence.
CEFS participated in the public consultation on the WHO draft guideline launched in March 2014 and looks forward to remaining a constructive and collaborative partner in supporting people to achieve and maintain a healthy lifestyle.
Correspondence for media inquiries:
Marie-Christine Ribera, CEFS Director General: firstname.lastname@example.org
Emilie Majster, CEFS Senior Adviser Scientific & Regulatory Affairs: email@example.com
 CEFS, the European Committee of Sugar Manufacturers (in French, Comité Européen des Fabricants de Sucre), is acting as the voice for European sugar manufacturers and refiners (62 companies across 21 Member States).
 Moynihan PJ et al. (2014) Effect on caries of restricting sugars intake: Systematic review to inform WHO guidelines. J. Dent. Res., 93(1):8-18.
 Te Morenga L et al. (2013) Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ; 346: e7492.
 OECD database available at https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_STAT; WHO oral health database, Malmö University, available at https://www.mah.se/CAPP/.
 CEFS Comments to the Draft WHO Guideline on Sugars Intake for Adults and Children. 28 March 2014 at https://cefs.org/wp-content/uploads/2014/04/CEFS-Comments-to-Draft-WHO-Guideline-on-Sugars-28-03-2014.pdf.