For the last sixteen months, top health and nutrition experts have been hard at work reviewing the scientific research that will inform the 2020-2025 Dietary Guidelines for Americans. Yesterday, via webcast, they finally shared the fruits of their labor.
Though some of their findings were a foregone conclusion (most of the research protocols and draft conclusions had already been posted online, for those with time on their hands and a real zeal for nutrition science), there were a few standout moments that may have taken listeners by surprise.
Like this one: the committee announced a new recommendation that would limit added sugar intake to no more than 6 percent of total daily calories. (On a standard 2,000 calorie diet, that’s about two and a half tablespoons every day.) That’s down from the previous limit of 10 percent recommended in the 2015-2020 Dietary Guidelines—and it’s kind of a big deal.
So why the change, and what does this mean for public health?
The science supports eating less added sugar.
As we wrote in our 2019 report, Delivering on the Dietary Guidelines, the 2015-2020 Dietary Guidelines were the first to recommend limiting added sugars to no more than 10 percent of total calories—a monumental step forward in protecting public health.
But even then, research seemed to support a lower threshold.
Here’s why: Research shows that eating less added sugar is generally better for our health, but there isn’t a magic number or percentage of calories where that risk drops substantially. In other words, there’s no study that says that getting 9 percent of our daily calories from added sugar is safe, but 10 percent is not. So the committee used, for lack of a better term, the process of elimination to determine how much of the average US diet could realistically be composed of added sugars. The 10 percent limit they arrived at is based on the percent of daily calories that would be “left over” once all other dietary needs were met—meaning a person could still eat a healthy amount and variety of foods like fruits, vegetables, whole grains, etc., while getting up to 10 percent of their calories from added sugar.
The thing is, a 10 percent limit doesn’t actually meet the average person’s needs. In reality, the maximum percentage of calories a person could get from added sugar ranges from 3 percent to 8 percent, depending on how many calories that person needs per day. And if you look at what the average person needs (rather than the upper limit of 10 percent, which would really only work for someone who eats a lot of calories), you actually get a number between 5 and 6 percent. Voila!
Why didn’t the committee reach this conclusion five years ago? It’s not clear, but it could have something to do with the industries that would stand to lose profits if people ate less sugar. According to our research, Coca-Cola and PepsiCo and their industry lobby group, the American Beverage Association, spent a combined $23.8 million lobbying Congress in the two years preceding the 2015-2020 Dietary Guidelines. Meanwhile, leading health organizations such as the American Heart Association and the World Health Organization have touted the health benefits of further limiting added sugar below 10 percent for years.
How could less sugar lead to better health?
In 2019, we sought to answer this very question by estimating the health benefits of eating less added sugar, based on research showing the relationship between sugar-sweetened beverage intake and type 2 diabetes.
Sugar-sweetened beverages make up almost half of all the added sugars consumed in the US, accounting for nearly 150 calories eaten by the average person each day. To put that into context, that means the average eight-year-old is getting one out of every 10 calories from sugar-sweetened beverages. And an ever-growing body of research shows that added sugar intake is harmful to our health in many ways—including increasing our risk of developing type 2 diabetes. Studies show that the risk of type 2 diabetes, a metabolic disorder affecting close to 30 million people in the US, increases by between 13 and 21 percent for each additional serving of sugar-sweetened beverages each day.
Our analysis found that, if adults in the US who drink sugar-sweetened beverages were consuming just one fewer serving each day (containing 27 grams of sugar, or about 5 percent of total daily calories), this could save nearly 19,000 lives and decrease medical costs by $16 billion each year from type 2 diabetes alone. In addition, it would recoup about $6 billion in productivity costs that would otherwise be lost due to illness and premature death.
When will we see final guidelines?
The federal agencies issuing the 2020-2025 Dietary Guidelines are still anticipating that the final guidelines will be released by the end of 2020 (and I definitely can’t imagine there are any current events that might slow them down).
Ideally, the final guidelines will closely follow the recommendations issued in the scientific report. But as history as shown, the recommendations made by the scientific committee don’t always make it into the final guidelines—and when that happens, it’s generally not for the right (read: scientific) reasons. That’s where we come in.
Beginning in mid-July, the committee’s full scientific report will be publicly available, and the public will have the opportunity to weight in by providing comments. There will also be an opportunity to provide oral comments directly to the committee during a virtual meeting on August 11, 2020.