The European Food Safety Authority (EFSA) address the question, how much sugar is OK to eat for health?

The European Food Safety Authority (EFSA) has published their final Scientific Opinion on the Tolerable Upper Intake Level (UL) of Dietary Sugars. A UL is the maximum amount that can be consumed safely over a long period of time.

EFSA concluded it was not possible to set a UL for sugars, either total, added or free sugars. They could not a set a safe level of intake either, because the risk of adverse health effects increased across the whole range of intakes in a linear way. They did acknowledge that the risk of chronic diseases could not be adequately explored at less than 10% of energy intake due to the low number of studies available. Even so, they concluded, based on available data and related uncertainties, the intake of added and free sugars should be as low as possible in the context of a nutritionally adequate diet.

Prof. Turck, Chair of EFSA’s panel of nutrition experts, stated:

 “We underlined there are uncertainties about chronic disease risk for people whose consumption of added and free sugars is below 10% of their total energy intake. This is due to the scarcity of studies at doses in this range. Data limitations also meant it was not possible to compare the effects of sugars classified as added or free, overall.”

A summary of EFSA’s conclusions include:

• The intake of dietary sugars is a well-established hazard in relation to dental caries in humans.

• Looking at all the evidence, prospective cohort (observational) studies do not support a link between the intake of dietary sugars, in isocaloric exchange with other macronutrients (when replacing other calorie-providing nutrients e.g., starch in the diet), and any of the chronic metabolic diseases or pregnancy-related endpoints assessed.
• Based on randomised control trials on surrogate disease endpoints (markers linked to the development of a disease, rather than the disease outcome itself e.g., liver fat as a marker for liver disease), there is evidence for a positive and causal link between the intake of added/free sugars and risk of some chronic metabolic diseases: The level of certainty for these links is:

• moderate for obesity and dyslipidaemia (high blood fats; > 50–75% probability there is a causal link), 
• low for non-alcoholic fatty liver disease and type 2 diabetes (> 15–50% probability), and 
• very low for hypertension (high blood pressure; 0–15% probability).

This report recommends that public health authorities in European countries should take account of the nutritional status, the actual composition of available foods, and known patterns of intake of foods and nutrients in their populations when providing dietary advice, and the lowest amount free/added sugars that is compatible with a nutritionally adequate diet may vary across population groups and countries.

The full report can be found here.