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AFRO-NETS> Sugar Consumption and Chronic Diseases

Sugar Consumption and Chronic Diseases
From: Judith Ladinsky <>
28 August 2003
A new review of the evidence from South Africa confirms that high 
consumption of added sugars contributes significantly to the inci-
dence of dental caries and obesity. Published in this month's Bulle-
tin of the World Health Organization, the findings cover both rural 
and urban populations, and add to the growing body of global evidence 
on the influence of diet on chronic disease.
The paper examines the effect of added sugars on a population experi-
encing both under-nutrition and over-nutrition. The information was 
compiled as part of an effort by the South African Department of 
Health to advise on sugar consumption in its dietary guidelines. The 
researchers recommend that added sugars should form no more than 6-
10% of total dietary intake. The wording of the guideline, they sug-
gest, should be "Eat and drink food and drinks containing sugar spar-
ingly and not between meals."
"Countries which have not included a comparable recommendation in 
their dietary guidelines should consider doing so," comments the ac-
companying Bulletin Editorial by Jim Mann, Professor of Human Nutri-
tion and Medicine at Otago University, New Zealand.
The article suggests that increasing problems with dental caries and 
obesity alone justify the new guideline. It reports that total tooth 
loss in adult populations in South Africa reaches up to 35%, while 
obesity affects nearly 20% of adults and 30% of black women. Even in 
children aged 7 to 9, overweight and obesity affect up to 9%.
The research indicated that among adolescents and adults (older than 
10 years), the percentage consumption of added sugars is over twice 
as high in urban populations as it is in rural ones - 12.3% compared 
to 5.9% of total energy intake. In rural areas the sources are mainly 
white table sugar and non-carbonated soft drinks, while in town added 
sugar comes from a greater variety of foods and drinks. Illustrating 
the contrast in the nutritional transition in urban and rural areas, 
the authors note that 33% of urban populations consume carbonated 
soft drinks while only 3% of their rural counterparts do.
The review , by Cape Town-based researchers NP Steyn, NG Myburgh and 
JH Nel, also compares sugar consumption in malnourished populations 
of children to that of well-nourished populations. It finds that in 
many cases sugar displaces protein consumption and significantly di-
lutes iron, zinc and thiamine intake. This suggests that the diets of 
undernourished children would not be improved by the addition of 
sugar-rich foods.
The authors' recommendation is more specific than that of WHO and FAO 
in their March 2003 report Diet, Nutrition and the Prevention of 
Chronic Disease, which is for a dietary intake of less than 10% of 
total energy intake. The more specific range of 6-10% reflects the 
need to account for the varying availability of fluoridated water in 
South Africa, Steyn and his colleagues say. 

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