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Last Updated: Monday, 28 April, 2003, 11:48 GMT 12:48 UK
Sugar intake: You asked a dietician
The WHO says sugar intake is a leading cause of obesity

Dr Wendy Doyle from the British Dietetic Association answered your questions.

  • Click here to read the transcript

    The World Health Organization has accused big business interests in the United States of trying to influence a new report on the dangers of consuming too much sugar.

    The report's guidelines stress that sugar should form no more than 10% of a person's diet.

    But the US Sugar Association, which includes such giants as Coca-Cola, Pepsi-Cola and General Foods, has criticised the WHO, saying that their recommendations are "unfair, misguided and misleading".

    The industry supports a sugar consumption limit of 25%.

    You put your questions on the WHO report and recommended levels of sugar intake to Dr Wendy Doyle, from the British Dietetic Association.


    Jacqui Nicol, Aberdeen:

    In the WHO report, what is the definition of a sugar - does it include only sucrose or also complex sugars like starch?

    Dr Wendy Doyle:

    The WHO refers to 'free' sugars (i.e. added or refined sugar). It does not therefore include intrinsic sugars that are naturally incorporated into the structure of a food such as fructose in fruit. In jargon terms, this means non-milk extrinsic sugars. It does not include starch.

    Juliette Eden, Birmingham

    Do the guidelines include naturally occurring sugars such as in fruit, or only added sugars such as in ready - prepared processed foods (eg cereals)? Realistically, would it be possible to limit sugar to no more than 10% of your diet without avoiding processed foods?

    Dr Wendy Doyle:

    The recommendations include all sugars that are added such as in biscuits, cakes, sweets, puddings, soft drinks, preserves, and many breakfast cereals.

    Re your second question, to some extent it depends on whether you have a sweet tooth or not! Interestingly survey data on British adults just out shows that 46% of men and 35% of women take sugar in coffee, the figures for tea are 34% and 32% respectively so for these people this might be a good start to cutting back. One 330ml can of cola or carbonated fruit drinks contains approximately 35g sugar or 7 teaspoons of sugar. For those who have a sweet tooth undoubtedly it does mean cutting back on processed foods and well as table sugar.

    Chris Hunter, Bedford

    What is the elusive average person's sugar intake as a percentage of their diet, and how are people supposed to estimate easily their daily sugar intake as a diet percentage? Without this information, the WHO advice is meaningless and utterly useless to the people who need it!

    Dr Wendy Doyle

    The Government funded National Diet and Nutrition Survey is considered the best available estimate of our dietary intakes. Recent National Diet and Nutrition Survey data suggests we consume around 16% of our calories a day from these sugars. The recommendation is that no more than 10% of your calories should come from 'free' or added sugars - for women, whose estimated average energy requirement is 1940 kcalories a day, 10% of calories from sugar equates to approximately 50g sugar a day - about 10 tsp sugar. For men requiring on average 2550 kcalories a day, it means no more than about 70g sugar (14 tsp) a day. This sugar can of course be 'hidden' in biscuits, sweets, breakfast cereals and many other sources as well as table sugar.

    Dan Wheatley, London

    The recent controversy at the WHO underlines the ominous growing synergy between the corporate world and political institutions. Is there any such thing as truly independent guidelines on health issues, such as nutrition, and if not what would you suggest is the closest thing to it?

    Dr Wendy Doyle:

    This report was produced as by a group of 30 independent experts on diet, nutrition and prevention of chronic diseases. They worked with a further 30 of their peers to review the best currently available evidence of diet, nutrition and physical activity and its effects on to chronic diseases including heart disease, diabetes, obesity, several forms of cancer, osteoporosis and dental health. I think this is as close to independent as you can hope to get!

    Ian Bray, Oxford

    Isn't this reminiscent of the tobacco industry when it tried for many years to rubbish research that smoking causes lung cancer? Shouldn't research be detached from commercial interests?

    Dr Wendy Doyle

    The WHO report concluded that a diet low in saturated fats, sugars and salt, and high in fruit and vegetables, together with regular physical activity will have a major impact on combating the high global toll of death and disease. This does not seem to me to be promoting commercial interests except perhaps for fruit and vegetable growers but the health benefits of increasing our consumption of these is more or less universally accepted.

    Craig, New Malden, Surrey

    Do you think that countries should be taxing sugar in the same way they tax Alcohol and tobacco?

    Dr Wendy Doyle:

    This is an interesting idea and there is no easy answer to it. It sounds good in theory but the people it will hit hardest will be the low income groups whose consumption of sugar is generally higher than those who are better off according to the latest National Diet and Nutrition Survey. Could that mean they would rather save by not buying fruit and vegetables so they could continue to have their sugar? Consumer research shows that taste ranks number one when choosing food, even before nutrition and price.

    Paul H, Nottingham

    Just take a look at the level of sugar in a box of 'children targetted' breakfast cereal to see how much sugar we are feeding our children! Do you think children are becoming 'normalised' to sweet foods?!

    Dr Wendy Doyle:

    Interestingly, we are born with a preference for sweet tastes but yes, I think advertising of children's foods, including confectionary, soft drinks and breakfast cereals does adversely influence children's food choice.

    Ajana, Hong Kong

    I don't eat any refined sugars and only consume natural sugars found in fruit. Is some refined sugar essential to a diet or I am right to avoid it?

    Dr Wendy Doyle

    Refined sugars provide very few nutrients other than calories. They are called 'empty calories' and are not essential to your diet. Eating a variety of fruit has many health benefits so you will no doubt already be meeting the WHO recommendations of sugars.

    Rachel, Cambridge

    Is it any better to eat sugar substitutes and sweeteners or are they just as bad for you?

    Dr Wendy Doyle

    It's a matter of personal choice. If you are watching your weight sweeteners are usually lower in calories and can help to keep you trim. However you need to control calories in your overall eating plan. Calorie control is part of the weight management formula, regular physical exercise is the other. Although diabetics can include moderate amounts of sugar in their diet, intense sweeteners can satisfy a taste for something sweet without affecting blood sugar. Although they are considered safe, sweeteners are not recommended for young children as they need enough calories to satisfy their requirements for rapid growth.

    Jacqueline, London

    Do you think Britain is in the grip of an obesity epidemic and realistically what can be done to change people's attitudes to their unhealthy diets?

    Dr Wendy Doyle:

    There is no doubt that Britain is in the grip of an obesity epidemic - overweight and obesity are serious problems that affect over 55% of the adult UK population, with 20% being obese. Halting this trend is a major challenge and you pose a difficult question in asking what can be done to change attitudes to unhealthy diets. As the WHO suggests, obesity is a chronic disease and must be treated as such, that is by lifetime management of the problem, not as a quick fix. As individuals, that means making small changes to our eating habits and our physical activity levels that we, as individuals, feel comfortable with and can sustain. In doing this we can move towards following general healthy eating advice, that is to enjoy a wide variety of foods including at least 5 portions of fruit and vegetables every day, moderate our intakes of fat, sugar, alcohol and salt, and include regular physical activity in our daily lives. One encouraging fact is that even modest weight loss confers significant health benefits.

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