Sir, Dr Yeung (BDJ 2007; 203: 291–293) is mistaken in citing the WHO Report 9161 as evidence of a causal role for sugar in obesity, and consequently in those diseases associated with obesity. That report, in common with other recent expert committee reports,2,3 concluded that no such role is indicated by the evidence. Thus it is speculative to assert (BDJ 2007; 203: 122) that the measures proposed by the Faculty of Public Health 'Position Statement' intended (but in no case demonstrated) to reduce sugar consumption would reduce the prevalence of obesity, or materially influence those diseases associated with obesity.
He should also note that the review of evidence of effectiveness of oral health promotion methods by Professor Liz Kay for the Health Development Agency also failed to find evidence that attempts to alter sugar consumption were an effective means of reducing dental caries prevalence.4 In contrast, fluoride toothpaste use has been demonstrated to be highly effective but, unfortunately, is not yet universal, even in this country.5
Public health is best served by professional support of evidence-based and practical interventions, not by tilting at windmills, however fashionable.
References
World Health Organisation/Food and Agriculture Organization. Diet, Nutrition and the Prevention of Chronic Diseases. Report of the Joint WHO/FAO Expert Consultation.Technical Report Series no. 916. Geneva: World Health Organization & Food and Agriculture Organization, 2003.
Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for energy, carbohydrates, fiber, fat, protein and amino acids (macronutrients). Washington: The National Academies Press, 2002.
Health Council of the Netherlands. Dietary Reference Intakes: energy, protein, fats and carbohydrates. The Hague: Health Council of the Netherlands, 2001.
Kay E J . Caries prevention: based on evidence? Or an act of faith? Br Dent J 1998; 185: 432–433.
Walker A, Gregory J, Bradnock G, Nunn J, White D . National Diet and Nutrition Survey: young people aged 4-18 years. Volume 2. Report of the Oral Health Survey. London: The Stationery Office, 2002.
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Cottrell, R. Tilting at windmills. Br Dent J 203, 560–561 (2007). https://doi.org/10.1038/bdj.2007.1061
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DOI: https://doi.org/10.1038/bdj.2007.1061