Global sugar guidelines: an opportunity to strengthen nutrition policy.

The 2014 draft WHO sugars intake guidelines reiterate the 2003 recommendations of the Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases, which recommended that sugar intake should be limited to less than 10% of dietary energy intake. These new WHO draft guidelines present a stronger evidence base on the health benefits of limiting sugar intake to 10% of dietary energy intake as well as indicative evidence of the benefits associated with a further reduction to 5% of dietary energy intake. These WHO draft sugars intake guidelines represent an opportunity to review and strengthen sugar-related nutrition policy, as they provide a benchmark by which to assess current population sugar intakes. Available data (likely to be underestimated due to under-reporting) show that sugar intakes in many countries are higher than the recommended amount, for both children and adults. Adults’ intakes of added sugar as a percentage of dietary energy are about 13–15 % in Canada, the USA and the UK. Studies of children have found that added sugar contributes about 14 % of total dietary energy in Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain Sweden and the USA. The guidelines put forward a clear case that sugar consumption above the recommended levels has negative personal, social and economic costs, particularly through its contribution to dental caries and overweight and obesity, which is a risk factor for a range of other noncommunicable diseases. Governments concerned about population health and rising health-care costs thus stand to benefit from population-level interventions to reduce sugar consumption. The question is how to translate these new recommendations into policy action at the global, national and local level. A large part of the answer lies in policy actions to create supportive environments in which high-sugar foods are less affordable, acceptable and available, and healthier alternatives are accessible. The challenge for public health nutritionists is to support the development and implementation of a comprehensive approach to sugar policy that considers not only the most effective way to support behaviour change, but also changes in food environments and food systems, the special needs of infants and young children and specific target populations most at risk, the broader context of total dietary improvement and sugar as an economic and political issue. What policies are available to support individuals to consume less sugar?