Dietary sugar consumption and health: umbrella review
- Study type
- Meta-analysis
- Design
- Umbrella review of existing meta-analyses; registered in PROSPERO (CRD42022300982)
- Sample size
- 73 meta-analyses and 83 health outcomes from 8601 unique articles
- Source
- BMJ · 2023
In plain words
This research brought together and reviewed the results of many earlier studies on sugar intake. The results show that eating a lot of sugar, especially sugary drinks, is linked to weight gain, heart disease, gout and a higher risk of death, and that fructose intake is linked to a higher risk of pancreatic cancer. The researchers suggest keeping added sugars below 25 grams a day and sugary drinks to less than one serving a week. These findings show links and do not necessarily prove that sugar alone causes these problems.
Key results
Treatment arms and regimens
Comparison of highest versus lowest dietary sugar intake, or per-unit increase in intake (for example per serving per week or per 250 mL per day of sugar-sweetened beverages, and per 25 g per day of fructose). More details in the full text.
Source of the regimen details: Abstract of the paper
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Study population
Systematic reviews and meta-analyses of randomised controlled trials, cohort, case-control or cross-sectional studies that examined the effect of dietary sugar intake on any health outcome in humans free of acute or chronic disease.
Endpoints
Assessment of the quality of evidence, potential biases and validity of all available studies on dietary sugar intake and health outcomes. Details of primary and secondary outcomes are not given in the abstract.
Safety and side effects
Not an interventional study and has no data on treatment adverse events; harmful outcomes associated with sugar intake are given in the results.
Clinical significance and place in guidelines
This umbrella review shows that high dietary sugar intake is generally more harmful than beneficial for health, especially for cardiometabolic disease. The authors recommend reducing free or added sugars to below 25 g per day and limiting sugar-sweetened beverages to less than one serving per week. In the cancer field, the only finding highlighted in the abstract is the association of fructose with pancreatic cancer, with low-quality evidence. The place of these recommendations in formal guidelines should be checked separately.
Limitations
Most outcomes came from meta-analyses of observational studies (74 of 83 outcomes), and only 9 outcomes came from meta-analyses of randomised trials. According to the abstract, the evidence for the strongest findings was only of moderate or low quality, including the association with pancreatic cancer (low quality, class III). The associations should therefore not be regarded as definitively causal. Other limitations should be checked in the full text.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.