A global outlook on sugar

Sugar is rarely out of the headlines at the moment, whether it is in reference to the number of children having rotten teeth extracted under general anaesthetic; the quantity of soft drinks consumed by teenagers; or our very British love of cakes to celebrate every occasion. How does our consumption of sugar compare to that of other countries across the world? The following content is taken from the second edition of The Oral Health Atlas published by the FDI World Dental Federation.

Sugars are part of the bigger family of sweeteners – substances that are either naturally part of or added to food and drinks and create the sensation of sweetness. They are an important, essential source of daily energy intake, but their excessive consumption has severe consequences. As part of a high-calorie diet, they have increasingly been recognised as causes for major non-communicable diseases (NCDs) such as diabetes and obesity.

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The nomenclature used for sugars and sweeteners is complex. Free sugars – all sugars added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and fruit juices – are the only cause of tooth decay in children and adults.

Sugar consumption shifts the healthy mix of bacteria present in the mouth towards bacteria that convert sugars into the acids that demineralise tooth enamel. Repeated episodes of sugar intake throughout the day increase the frequency of acid attacks and the risk of developing tooth decay. Sugar consumption is influenced by many biological, behavioural, social, cultural and environmental factors. Worldwide consumption has tripled over the past 50 years, and this increase is expected to continue, particularly in emerging economies. To curb the growing epidemic of tooth decay and other NCDs, the World Health Organisation (WHO) recommends limiting the daily consumption of free sugars to 5% or less of total energy. This is equal to 25 grams or five teaspoons of sugar per day.

A number of measures are being explored to reduce global sugar consumption. These include additional taxes on products with high sugar content, reducing the overconsumption of sugar-sweetened beverages, limiting sugar content of foods and drinks, introducing regulations for transparent labelling of food ingredients, and constraining the marketing to children and adolescents of food high in sugars.

FDI World Dental Federation recommendations

Policies for sugar reduction

• 1 Enforce higher taxation on sugar-rich food and sugar-sweetened beverages

• 2 Ensure transparent food labelling for informed consumer choices

• 3 Strongly regulate sugar in baby foods and sugar-sweetened beverages

• 4 Limit marketing and availability of sugar-rich foods and sugar-sweetened beverages to children and adolescents

• 5 Provide simplified nutrition guidelines, including sugar intake, to promote healthy eating and drinking.