July 17, 2015

expert reaction to final report from SACN (Scientific Advisory Committee on Nutrition) on carbohydrates and health, which makes recommendations on intake of sugar, fibre and carbs

The Scientific Advisory Committee on Nutrition has published its latest guidance on carbohydrates and health.

Prof. Tom Sanders, Professor emeritus of Nutrition and Dietetics, King’s College London, said:

“I am surprised they have recommended a population average as low 5 percent energy. It is in practice a tough target to meet especially when most people are consuming more that 11 percent energy. While I accept there is evidence from the pre-fluoride era showing this lower value prevents caries it may be less relevant now with good oral hygiene. However, the worrying increase in dental caries in children means that the public needs to be reminded that sweets in particular rot children’s teeth and are best not consumed.”

Prof. Jim Mann, Professor in Human Nutrition and Medicine, University of Otago, said:

“SACN comes out strongly in favour of dietary fibre and recommends at least moderate intakes of ‘good’ carbohydrate which is typically also rich in dietary fibre.  I think the public and health professionals have clearly heard and understood the ‘reduce sugar’ message (whether it is implemented is another matter)  but the real problem for many people is to understand the ongoing debate between those who argue for very radical restriction of all carbohydrate containing foods with intakes of fat (regardless of type) and protein unrestricted (advocates of the ‘Paleo’ or LCHF (low carb high fat) diet) and those who continue to argue for saturated fat restriction and at least moderate intakes of appropriate carbohydrate containing foods.  The SACN recommendations based on the best ever examination and interpretation of existing science are incompatible with the low carb high fat dietary approach.  This is a very important message with which to counter the arguments of the proponents of the Paleo diet, which has no serious scientific basis and has the potential to undermine the health benefits which have accrued in the UK and many other countries from conventional nutritional advice.”

Prof. Brian Ratcliffe, Emeritus Professor of Nutrition, Robert Gordon University, Aberdeen, said:

“This report seems well considered and evidence-based. The recommendations to limit free sugars to 5% of energy intake and to aim for 30 g per day for dietary fibre reflect the accumulating evidence that added sugars contribute to excessive energy intakes leading to weight gain and obesity, and that higher intakes of dietary fibre are associated with better health and life expectancy. This is a welcome contribution to clarifying recommendations for public health nutrition.”

Prof. Susan Fairweather-Tait, Professor of Mineral Metabolism, UEA, said:

“This report reflects a substantial body of work, which was built upon a series of systematic reviews, and the in-depth analysis has been carried out very carefully. A number of health aspects are covered but the most controversial aspect of the report is the recommendation for a reduction in free sugars to an average of 5% in the population. This is based upon the relationship between sugar consumption and dental caries in children and adolescents, and also the link to weight gain.

“Three recent reports on carbohydrates and sugar come to slightly different conclusions, and this is most likely explained due to differing terms of reference, the approaches adopted to collate and review the evidence, and the data that were available and selected to form the basis of the recommendations. The UK Scientific Advisory Committee on Nutrition (SACN) report on carbohydrates and health was undertaken to provide clarification of the relationship between dietary carbohydrate and health and make public health recommendations. The aim of the WHO guideline on sugars intake for adults and children was to provide recommendations on the consumption of free sugars to reduce the risk of non-communicable diseases in adults and children. The mandate for the EFSA (2010) opinion on Dietary Reference Values for carbohydrates and fibre was to derive Reference Ranges (lower and upper bound levels), in which sugars were considered as a component of dietary carbohydrates.

“In relation to sugars, all three reports focussed on dental caries and body weight/weight gain. EFSA concluded that the available data did not allow setting an adequate intake or a reference intake range, whereas WHO made a strong recommendation that in adults and children the intake of free sugars should be reduced to less than 10% of total energy intake and a conditional recommendation for a further reduction in free sugar intake to below 5% of total energy intake.

“With regard to free sugars, it will be very interesting to see how the SACN recommendations are implemented.”

Ms Tracy Parker, Heart Health Dietitian, British Heart Foundation, said:

“We welcome the results of SACN’s much needed report which sets out a clear blueprint for halving our sugar intake and dramatically increasing fibre in our diet. The ambitious aims set out by the panel will require a concerted effort across the food chain if they are to make the leap from recommendations to reality for British families.

“We all have a role in improving the nation’s diet. Consumers, communities, industry and government all have a part to play in meeting these new recommendations. In addition to the new guidelines, we should also bear in mind that balance and variety in our diet will continue to be good for our heart health.”

‘Carbohydrates and Health’ by the Scientific Advisory Committee on Nutrition published at https://www.gov.uk/government/publications/sacn-carbohydrates-and-health-report on Friday 17 July 2015. 

The SMC produced a Factsheet on sugar and health which is attached and also available here: http://www.sciencemediacentre.org/sugar-and-health/

Declared interests

Prof. Tom Sanders is a Scientific Governor of the charity British Nutrition Foundation, member of the scientific advisory committee of the Natural Hydration Council, and honorary Nutritional Director of the charity HEART UK.  Prof Tom Sanders is now emeritus but when he was doing research at King’ College London, the following applied: Tom does not hold any grants or have any consultancies with companies involved in the production or marketing of sugar-sweetened drinks.  In reference to previous funding to Tom’s institution: £4.5 million was donated to King’s College London by Tate & Lyle in 2006; this funding finished in 2011. This money was given to the College and was in recognition of the discovery of the artificial sweetener sucralose by Prof Hough at the Queen Elizabeth College (QEC), which merged with King’s College London. The Tate & Lyle grant paid for the Clinical Research Centre at St Thomas’ that is run by the Guy’s & St Thomas’ Trust, it was not used to fund research on sugar. Tate & Lyle sold their sugar interests to American Sugar so the brand Tate & Lyle still exists but it is no longer linked to the company Tate & Lyle PLC, which gave the money to King’s College London in 2006.

Prof. Victoria Burley: “I led the Leeds team that undertook the systematic literature reviews of carbohydrates and cardiometabolic health for SACN.”

Dr Nita Forouhi, Prof. Jim Mann and Prof. Brian Ratcliffe declare no interests.

Prof. Susan Fairweather-Tait: “My only Declaration of Interest is being a member of the EFSA NDA Panel (Dietetic Products, Nutrition and Allergies).”

No other interests received.