How is the American Dietary Guidelines Advisory Committee incorporating the evidence to establish recommendations on sugar?

The Dietary Guidelines for Americans are being revised to produce a version for 2020-25. In June, the 2020 Dietary Guidelines Advisory Committee completed its review of the scientific questions identified by the US Department of Agriculture (USDA) and Health & Human Services and published a Scientific Report. They used three different approaches to examine the evidence: data analysis, food pattern modelling, and systematic reviews.

The Advisory Committee recruited subcommittees to review the evidence on specific topics to go into the Report. One was the Beverages and Added Sugars Subcommittee. It was tasked with conducting systematic reviews to answer four questions:

• What is the relationship between beverage consumption and growth, size, body composition, and risk of overweight and obesity?
• What is the relationship between beverage consumption during pregnancy and birth weight standardized for gestational age and sex?
• What is the relationship between alcohol consumption and all-cause mortality?
• What is the relationship between added sugars consumption and risk of cardiovascular disease?

(Due to a lack of time, the Subcommittee was unable to address the relationship between added sugars and type 2 diabetes or added sugars during pregnancy and gestational weight gain.)

You can read the answers to the questions here.  In summary, no strong evidence was found for any of the questions. The highest level of evidence found was moderate, and this was an association between high alcohol consumption and all-cause mortality. Evidence was also moderate for an association between high sugar sweetened beverage intake and greater adiposity in children (the evidence for adults was limited). The evidence linking sugar-sweetened beverages with increased CVD mortality was limited, and insufficient for added sugars and CVD. The evidence was also insufficient to determine the relationship between sweetened beverages during pregnancy and birth outcomes.

After reviewing all the Subcommittee reports and finding no conclusive data, the Dietary Guidelines Advisory Committee have recommended reducing added sugars to 6% of daily energy instead of the previous 10% to reduce intake of discretionary foods and beverages high in added sugars.

You can read more in Part D of the Scientific Report, chapters 2 (pregnancy),10 (beverages), 11 (alcohol) and 12 (added sugars).

The 2020-25 Dietary Guidelines for Americans are due to be released by the end of the year, however delays are possible due to the COVID-19 pandemic and the US presidential election.