What Do Government Agencies Consider in the Debate Over Added Sugars?(1)(2)(3)

The place of sugars in the U.S. diet is vigorously debated with much attention on added sugars, those added during processing or preparation of foodstuffs, particularly as they relate to obesity. Federal government agencies have different responsibilities related to the food supply including research, food safety, nutrition assistance, and labeling; therefore, the interpretation of evidence differs depending on the role of the agency. Some common references for government agency positions are the dietary reference intakes and the Dietary Guidelines for Americans, which together form the foundation for much of federal nutrition policy. Sugar consumption has increased in proportion to intake of other nutrients since 1980, when obesity began to increase substantially. Median intake of added sugars is ∼12% of energy, whereas total sugar intake is ∼22% of energy. Although there are differences in the way in which individual monosaccharides are metabolized, they are rarely consumed alone. A key issue related to obesity is likely the increased number of eating occasions and portion size for many indulgent foods; grain-based snacks have become the largest source of energy in the U.S. diet. There are currently insufficient data to justify a decision on regulation or taxation of sugar-containing foods and the like because the approach must be weighed against personal freedoms; the list of foods associated with obesity includes many commonly eaten items, and it is not likely that they are all causally related. Government should consider the totality of the evidence including the strength of the relationship of sugar intake with various health outcomes.