e-Library of Evidence for Nutrition Actions (eLENA)


An online library of evidence-informed guidelines for nutrition interventions and single point of reference for the latest nutrition guidelines, recommendations and related information.

Alternate Text All interventions

Reducing free sugars intake in adults to reduce the risk of noncommunicable diseases

Intervention | Last updated: 19 May 2023


Noncommunicable diseases (NCDs) are the world’s leading cause of death: they were responsible for an estimated 41 million (73%) of the 56 million deaths in 2017. Many of those deaths were premature (i.e. under the age of 70 years) and occurred in low- and middle-income countries. Modifiable risk factors such as unhealthy diet and physical inactivity are some of the most common causes of NCDs, including obesity.

Overweight and obesity are major risk factors for a number of NCDs, including type 2 diabetes, cardiovascular diseases and certain types of cancer. Once considered a problem only in high income countries, overweight and obesity are now dramatically on the rise in low- and middle-income countries, particularly in urban settings.

Dental caries causes pain, anxiety, functional limitation (including poor school attendance and performance in children) and social handicap through tooth loss. The negative health effects of dental caries are cumulative, tracking from childhood to adulthood and most dental caries is now occurring in adults.

Free sugars* contribute to the overall energy density of diets and higher intakes of free sugars threaten the nutrient quality of the diet by providing significant energy without specific nutrients, leading to unhealthy weight gain and increased risk of obesity and various NCDs, particularly dental caries which is the most prevalent NCD globally.

* Free sugars include monosaccharides and disaccharides added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.

WHO Recommendations


WHO recommends a reduced intake of free sugars throughout the lifecourse.

In both adults and children, WHO recommends reducing the intake of free sugars to less than 10% of total energy intake.

WHO suggests a further reduction of the intake of free sugars to below 5% of total energy intake.



Evidence


Systematic reviews used to develop the guidelines


Effect on caries of restricting sugars intake: systematic review to inform WHO guidelines

Moynihan PJ, Kelly SA. Journal of Dental Research. 2014; 93(1):8-18.


Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies

Te Morenga L, Mallard S, Mann J. BMJ. 2013; 346:e7492.


Related systematic reviews


Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids

Te Morenga LA, Howatson AJ, Jones RM, Mann J. Am J Clin Nutr. 2014;100(1):65-79.


Evidence-based guideline of the German Nutrition Society: carbohydrate intake and prevention of nutrition-related diseases

Hauner H, Bechthold A, Boeing H, Brönstrup A, Buyken A, Leschik-Bonnet E, et al. Ann Nutr Metab. 2012;60 Suppl 1:1-58.


Cost-effectiveness Learn More Alternate Text


Relevant cost-effectiveness analyses have not yet been identified.