High versus low-added sugar consumption for the primary prevention of cardiovascular disease

Bergwall, Sara; Johansson, Anna; Sonestedt, Emily; Acosta, Stefan

doi:10.1002/14651858.cd013320.pub2

Cited by 10 publications

(5 citation statements)

References 133 publications

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“…There is no evidence indicating harmful health effects associated with the consumption of intrinsic sugars. In contrast, several studies have been demonstrating association of excessive added sugar consumption and development or worsening of non-communicable diseases, such as hypertension, cardiovascular diseases, and dental caries ( 5 – 10 ). In 2015, the World Health Organization (WHO) published dietary guidelines recommending limited intake of free sugars to not exceed 5–10% of the total daily energy intake ( 4 ).…”

Section: Introductionmentioning

confidence: 98%

University Students' Knowledge and Perceptions About Concepts, Recommendations, and Health Effects of Added Sugars

et al. 2022

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It is recommended to limit added sugars to below 10% of the daily energy intake, as excessive consumption has been associated with several chronic non-communicable diseases. This exploratory qualitative study used focus groups to investigate the knowledge and perception of Brazilian university students about added sugars concepts, consumption recommendations, and health effects. Focus groups were led by a moderator using a semi-structured discussion guide. The focus groups were recorded, transcribed verbatim, and subjected to thematic analysis. Five focus groups were conducted with a total of 32 participants (50% women, mean age 23 years). Participants could not distinguish added sugars from sugars naturally present in foods and were unaware of the health impacts associated with excessive added sugar consumption, except for the risk of diabetes. Although most participants reported limiting sugar consumption, they had no knowledge of official consumption recommendations. Given that current public policy agendas aim to reduce added sugar intake, there is a need to strengthen strategies for disseminating information on added sugar concepts, recommendations, health effects and how to identify them in the foods products.

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Section: Introductionmentioning

confidence: 98%

University Students' Knowledge and Perceptions About Concepts, Recommendations, and Health Effects of Added Sugars

et al. 2022

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“…It is widely accepted that a healthy and high-quality diet contains a high percentage of health beneficial components such as fiber, unsaturated fatty acids or polyphenols and a low percentage of potentially harmful or unfavorable components like added sugars, saturated fatty acids or sodium (1)(2)(3)(4)(5). Additionally, all essential nutrients must be supplied in sufficient quantities, which is ensured by a varied and balanced diet.…”

Section: Introductionmentioning

confidence: 99%

Development of a metric Healthy Eating Index-2015 and comparison with the Healthy Eating Index-2015 for the evaluation of dietary quality

et al. 2022

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BackgroundDiet quality indices can provide important information about relationships between diet and health independent of energy balance. The Healthy Eating Index-2015 (HEI-2015) is widely used and has been extensively evaluated. However, due to imperial units the HEI-2015 is difficult to apply in countries with metric systems. Our objective was to develop a metric version of the HEI-2015 and compare it to the original. The metric Healthy Eating Index-2015 (mHEI-2015) is intended to simplify the application of a dietary quality index in countries using the metric system.MethodsWe developed a metric database logic following the methodology of the HEI-2015, which allows the application to metric databases and was applied to Food Patterns Equivalents Database (FPED). The HEI-2015 was calculated for the National Health and Nutrition Examination Survey (NHANES) 2017-2018 and the scoring standards for each component of the mHEI-2015 was calibrated against it. For the assessment of agreement between indices, HEI-2015 and mHEI-2015 were calculated for NHANES 2015-2016 and a Bland–Altman plot was created.ResultsHealthy Eating Index-2015 and mHEI-2015 for the NHANES 2015-2016 averaged 52.5 ± 13.5 and 52.6 ± 13.2, respectively. The total scores as well as component scores of the indices were strongly correlated. The Bland–Altman plot revealed a high agreement of the total scores. An illustrated analysis of six different menu plans showed only minor differences between the HEI-2015 and mHEI-2015 component scores.ConclusionThe mHEI-2015 allows for superior analysis of metric dietary data to better examine the relationship between chronic diseases and diet. The streamlined metric methodology enables straightforward application to metric food databases and thus the development of country-specific indices.

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“…Up to 4% of the global disease burden has been related to an unhealthy diet ( 3 ), making diet an important modifiable behavioural risk factor for NCDs. Of the several aspects of an unhealthy diet, the excessive consumption of sugar has been associated with the development or aggravation of several NCDs ( 4 – 6 ). “Sugars” is the generic name of a group of monosaccharides (glucose, galactose, and fructose) and disaccharides (sucrose, lactose, maltose, and trehalose).…”

Section: Introductionmentioning

confidence: 99%

Consumers' Response to Sugar Label Formats in Packaged Foods: A Multi-Methods Study in Brazil

et al. 2022

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Providing information about the sugar content of packaged foods on product labels is an important strategy to lower consumers' sugar intake. This study assessed the effect of exposure to different sugar labels on consumers' understanding of the sugar content of foods and their food choices. In the first phase, five focus groups were conducted with a convenience sample of Brazilian adults to explore their perceptions about food labelling in general and sugar labelling in particular. Based on the qualitative results, four sugar label formats were developed and subsequently tested in a five-arm study on 1,277 adults via a randomised controlled online survey. The formats were: (i) no sugar information—control, (ii) total and added sugar content displayed in the Nutrition Information Panel (NIP), (iii) a front-of-package (FoP) octagonal warning for “high-in-sugar” products, (iv) a FoP magnifying glass warning for “high-in-sugar” products, and (v) a “high-in-sugar” warning text embedded on the NIP. Participants from the focus groups reported being confused about the meaning of “sugar” and “added sugar” on food labels and indicated that more interpretive labels, such as the FoP warnings, would help them choose products with low sugar content. In the experiment, all intervention sugar label formats improved participants' understanding of the sugar content of the tested food products, with the FoP warnings (iii and iv) showing the best results. While non-significant differences among label conditions were observed for food choices, the FoP octagonal warning prompted participants to choose high-in-sugar products less often. Given current public policy agendas aiming to reduce added sugar intake, there is a need to strengthen food labelling policies and nutrition disclosure policies that target the display of added sugar and build consumer awareness in using these tools to avoid high-in-sugar products.

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High versus low-added sugar consumption for the primary prevention of cardiovascular disease

Cited by 10 publications

References 133 publications

University Students' Knowledge and Perceptions About Concepts, Recommendations, and Health Effects of Added Sugars

University Students' Knowledge and Perceptions About Concepts, Recommendations, and Health Effects of Added Sugars

Development of a metric Healthy Eating Index-2015 and comparison with the Healthy Eating Index-2015 for the evaluation of dietary quality

Consumers' Response to Sugar Label Formats in Packaged Foods: A Multi-Methods Study in Brazil

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