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Scientific studies to date have confirmed no causal relationship between sugar consumption and attention deficit/hyperactivity disorder. In general, it was found that sugar does not affect the behaviour or cognitive performance of children. In terms of risk factors/causes, the U.S. Centers for Disease Control and Prevention indicates that current research shows that genetics plays an important role.
Dietary advice for people with diabetes has changed over the last few decades. The latest scientific advice from the European Association for the Study of Diabetes guidelines for diabetes support a moderate intake of ‘free sugars’ as part of a healthy balanced diet by stating that if desired and if blood glucose levels are satisfactory, moderate intakes of free sugars (up to 50 g/day) may be incorporated within the diet of individuals with Type-1 and Type-2 diabetesT1.. Achieving and maintaining a healthy body weight through diet and physical activity is most important for people with diabetes. For individual dietary advice, people should consult their healthcare professional.
Sugar has not been established as a cause of diabetes. Obesity and lack of physical activity are reported to be the major risk factors of Type-2 diabetes.
Type-2 diabetes is characterized either by an inadequate production of the hormone insulin or an inability of the body to utilize the insulin that is available. The body needs insulin to keep blood glucose levels within a narrow range. In most people, when food is consumed, blood glucose levels rise and the body produces insulin to bring them back down. In people with diabetes, this insulin response is defective and, if not treated, blood glucose levels can become dangerously high.
Frequent consumption of foods containing fermentable carbohydrates (such as sugars or starch) may increase the risk of tooth decay, especially in those who do not brush their teeth twice a day with fluoride toothpaste. Fermentable carbohydrates are, for instance, part of bread, cereals, biscuits, sweets or fruits.
CEFS supports the Eurodiet recommendation to limit the number of sugary eating or drinking occasions to 4 per day.
The best way to prevent tooth decay is to follow the advice from the World Dental Federation to brush teeth twice a day with fluoride toothpaste.
Replacing sugars in food does not necessarily lead to an energy reduction. As previously mentioned, sugar has many properties in addition to sweetness; it contributes to the colour, texture and flavour in foods. If sugar is reduced or replaced in carbohydrate based products (e.g., breakfast cereals or biscuits) starch typically substitutes for sugar but does not deliver any reduction in calories. In other products, where sugar is replaced with other ingredients, this may result in little or no calorie reduction in the reformulated product. Moreover, a recent consumers’ survey shows that consumers usually expect foods with a ‘reduced sugars’ claim to be also reduced in energy.
The question of whether there is a difference between the way the body processes calories from liquid products and those in solid foods is an evolving area of research. The U.S. report on Dietary Guidelines (2010) reported “limited body of evidence shows conflicting results about whether liquid and solid foods differ in their effects on energy intake and body weight”. The most important is the balance of energy intake and energy expenditure.
Examples of energy content of some beverages:[1]
| Total sugars (range – g/100 ml) | Fat (average value – g/100 ml) | Energy (average value – kcal/100 ml) | |
| 100% orange juice | 8.4-11.4 | Trace | 42.4 |
| 100% grape juice | 15-16.5 | Trace | 67.5 |
| Sugar-sweetened soda | 9.1-11.2 | Trace | 44.1 |
| 100% apple juice | 9.8-11.5 | Trace | 46.8 |
| Whole milk | 4.6 | 3.6 | 65.1 |
| Semi-skimmed milk | 4.6 | 1.6 | 48.1 |
[1] Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses). Tables de composition nutritionnelle Ciqual 2008.
Obesity is caused by an imbalance between energy expenditure and energy consumed from all types of food and drinks. Thus, as with all foods, it just depends on the quantity eaten. Whatever their source – protein, carbohydrate, including sugar, or fat – once eaten, the body stores any surplus calories.
A number of factors are associated with an increased risk of developing coronary heart disease (CHD) – the main ones are smoking, high blood pressure, high blood cholesterol, and obesity. Current scientific evidence does not support a link between sugar consumption and cardiovascular diseases. The key dietary component in prevention of CHD is dietary fat, particularly saturated fat intake.
Scientific studies in humans do not support the hypothesis that sugar may be physically addictive or that addiction to sugar plays a role in eating disorders. Recently, NeuroFAST, an EU-funded project aiming at investigating the common neurobiology involved in eating behaviour, addiction and stress indicated that the current evidence does not allow concluding that a single food substance can account for the fact that people overeat and develop obesity. In humans, there is no evidence that a specific food, food ingredient or food additive causes a substance-based type of addiction.
For healthy people, fluctuations in blood sugar levels are not an issue. Eating sugar causes a smaller rise in blood glucose level than eating starchy foods like white bread, white rice or mashed potatoes. Sugar is therefore rated as medium glycaemic index (GI). When sugar is added to some foods, such as breakfast cereals, it can actually lower the GI of the final product.
The ‘glycaemic index’ (GI) has been introduced to rank carbohydrates according to their ability to raise blood glucose levels. Glucose is the typical standard against which the GI of other foods is measured and has a GI of 100 (reference glucose). Fructose, on the other hand, has a low GI (≈15) and sucrose an intermediate GI (≈65), i.e. lower than for instance white bread (≈75).