Added sugars: Definitions, classifications, metabolism and health implications

Abstract

A B S T R A C TThe sugars added to foods have been featured in recent scientific research, including the publication of the World Health Organization recommendation to limit consumption of added sugars, based on studies on weight gain and dental caries. However, it is possible that there is evidence of an association between excessive consumption and other pathologies, but scientific studies have yet to investigate these associations. Moreover, there is no consensus on the descriptions and definitions of these sugars, with several terms and components used to designate them. In Brazil, there are few studies investigating added sugars, identifying a lack of discussion on this subject. This paper presents a literature review of sugars added to foods, from their definitions and classifications to the metabolism and health effects. The search was performed without limiting dates in the following databases: Web of Science, Scopus, PubMed and SciELO, as well as in national and international official sites. Keywords in Portuguese and English related to sugars added to foods were used, in combination with terms related to systematic review and meta-analysis studies, in order to find research linking added sugars consumption with health damage. The literature indicates that there is a relationship between excessive consumption of added sugars and various health outcomes, including weight gain, type 2 diabetes Mellitus, cancer, and cardiovascular diseases. The different descriptions of sugars in foods may confuse both food consumers and researchers, since each term includes different components. Thus, it is suggested to use the standardized term "added sugar" as the most suitable term for the broader population to understand, because it indicates that those sugars are not natural food components.

Use of added sugars in packaged foods sold in Brazil

“…When analysing the terms, variations in types of sweet spreads and juices were included (e.g. ‘apple juice’ was identified as a term and ‘grape juice’ as another term) ( 3 ) and variations in terms referring to ingredients’ quality and/or purity were not considered (e.g. ‘organic’ in ‘organic sugar’; Table 2).…”

“…These include ingredients such as refined sugar, high-fructose corn syrup, honey and fruit juice concentrate, among others. The term ‘added sugars’ does not include naturally occurring sugars in foods, such as lactose in milk and sucrose and/or fructose in fruits and vegetables ( 1 – 3 ) .…”

Influential degree of polymerization of sugar extraction on alkali pretreatment from sunflower stalk wastes by applied statistical modelling

“…The classification is categorized carbohydrates into four groups: sugars, oligosaccharides, polysaccharides, and polyols. The chemical structural classification was presented in Table 1 from (Scapin et al, 2017).…”

Disponibilidade de informação sobre quantidade de açúcar em alimentos industrializados

“…Epidemiological evidence suggests that high intakes of added sugar is a risk factor for NCDs [7][8][9][10][11] . The term added or "free sugars" refers to all sugars added to drinks and food during preparation or industrial processing 9,12 .…”