Aim
To assess the quality of evidence, potential biases and validity of all available studies on dietary sugar consumption and health outcomes.
Design
General review of existing meta-analyses.
Data sources
PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews and manual search of reference lists.
Inclusion criteria
Systematic reviews and meta-analyses of randomized controlled trials, cohort studies, case-control studies or cross-sectional studies that evaluated the effect of dietary sugar consumption on any health outcome in humans without acute or chronic diseases.
Results
The search identified 73 meta-analyses and 83 health outcomes from 8601 unique articles, including 74 unique outcomes in meta-analyses of observational studies and nine unique outcomes in meta-analyses of randomized controlled trials.
Significant detrimental associations were detected between dietary sugar consumption and 18 endocrine/metabolic outcomes, 10 cardiovascular outcomes, seven cancer outcomes, and 10 other outcomes (neuropsychiatric, dental, hepatic, bone, and allergic).
Moderate-quality evidence indicated that higher versus lower dietary sugar consumption was associated with increased body weight (sugar-sweetened beverages) (class IV evidence) and ectopic fat accumulation (added sugars) (class IV evidence) .
Low-quality evidence suggested that each serving/week increase of sugary drink consumption was associated with a 4% increased risk of gout (class III evidence) and each 250ml/day increase of sugary drink consumption was associated with a 17% and 4% increased risk of coronary heart disease (class II evidence) and all-cause mortality (class III evidence), respectively. Furthermore, low-quality evidence suggested that each 25 g/day increase in fructose consumption was associated with a 22% increased risk of pancreatic cancer (class III evidence).
Conclusions High dietary sugar consumption is generally more harmful than beneficial to health, especially in cardiometabolic diseases. It is recommended to reduce the consumption of free sugars or added sugars below 25 g/day (approximately 6 teaspoons/day) and limit the consumption of sugary drinks to less than one serving/week (approximately 200-355 ml/week) to reduce the adverse effect of sugars on health. |
PROSPERO Systematic Review Registry CRD42022300982.
Comments
High dietary sugar consumption is often more harmful to health, especially in cardiometabolic diseases, according to an overview review published online April 5 in The BMJ .
Yin Huang of Sichuan University in Chengdu, China, and colleagues conducted an overview of existing meta-analyses to assess the quality of evidence from studies on dietary sugar consumption and health outcomes.
Based on 73 identified meta-analyses (of 8,601 articles covering 83 health outcomes in adults and children), researchers identified significant detrimental associations for dietary sugar consumption with 18 endocrine/metabolic outcomes, 10 cardiovascular outcomes, seven cancer and 10 other outcomes (neuropsychiatric, dental, liver, bone and allergic).
Higher versus lower dietary sugar intake was associated with increased body weight (sugar-sweetened beverages; class IV evidence) and ectopic fat accumulation (added sugars; class IV evidence), with moderate-quality evidence .
However, low-quality evidence showed that each serving/week increase of sugar-sweetened beverage consumption was associated with a 4 percent increased risk of gout (class III evidence) and each 250 ml/day increase of sugar-sweetened beverage consumption was associated with an increased risk of coronary heart disease (17 percent; class II evidence) and all-cause mortality (4 percent; class III evidence). Additional low-quality evidence showed that each 25 g/day increase in fructose consumption was associated with an increased risk of pancreatic cancer (22%; class III evidence).
| It is recommended to reduce the consumption of free or added sugars to less than 25 g/day (approximately 6 teaspoons/day) and limit the consumption of sugary drinks to less than one serving/week (approximately 200 to 355 ml/week) to reduce the adverse effect of sugars on health," the authors write. |
