How Strong is the Scientific Basis of Sugar Intake Guidelines? Interview with:

Bradley C. Johnston, PhD Prevention Lab, Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Room 11.9859 West, Toronto, Ontario

Dr. Bradley Johnston

Bradley C. Johnston, PhD
Prevention Lab, Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute
Peter Gilgan Centre for Research and Learning
Toronto, Ontario What is the background for this study?

Response: I am scientist at The Hospital for Sick Children and a professor of clinical epidemiology at the University of Toronto and McMaster University in Canada. I have a particular interest in research methodology and preventive medicine. As a research methodologist I am interested in how researchers get to their conclusions. In particular I am interested in the “uncertainty” in estimated treatment or exposure effects.

Many guidelines have methodological issues but it was suspected that the nutritional guidelines were especially problematic. Our study in Annals of Internal Medicine set out to document the issues systematically with respect to sugar intake recommendations from authoritative guidelines. What are the main findings?

Response: To summarize, the nutritional guidelines addressing sugar intake do not adhere to the Institute of Medicine standards for trustworthiness. As a result there is uncertainty around what the true threshold is for daily caloric intake from sugars and important health outcomes.

Guideline developers do not make recommendations that appropriately acknowledge the uncertainty (low quality evidence should be accompanied by weak rather than strong recommendations). What should readers take away from your report?

Response: Among otherwise healthy individuals, the evidence underpinning each of the recommendations (<5%, <10%, <25% calories per day from sugars) is low to very low quality evidence. In other words, we are very uncertain about the effects of sugar on long-term health outcomes of importance to the public.

Although our findings question the specific sugar recommendations from guidelines produced by leading authorities, the findings should not be used to justify high or increased consumption of sugary foods and beverages (candy and sugar-sweetened beverages). What recommendations do you have for future research as a result of this study?

Response: Results from this review should be used to promote improvement in the development of trustworthy guidelines on sugar intake. A summary can be found at: Thank you for your contribution to the community.

Disclosure: This project was funded by the Technical Committee on Dietary Carbohydrates of ILSI North America


The Scientific Basis of Guideline Recommendations on Sugar Intake A Systematic Review
Jennifer Erickson, RD (*); Behnam Sadeghirad, PharmD, MPH (*); Lyubov Lytvyn, MSc; Joanne Slavin, PhD, RD; Bradley C. Johnston, PhD
Published: Ann Intern Med. 2016.
DOI: 10.7326/M16-2020

Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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