When reviewing questions and supporting evidence at the public meeting, the Committee will refer to studies in the scientific literature. These questions and citations are part of the Committee’s deliberative process and are considered draft material under consideration. The information provided here relates to the topics discussed at this meeting and do not represent all of the questions or literature the Committee may consider as it completes its work. Final questions, details of the literature searches, and final literature that contributed to the Committee’s conclusions will be available in the Committee’s final report and/or on www.DietaryGuidelines.gov and www.NEL.gov.

Added Sugars Working Group

Added Sugars

What is the relationship between added sugars and risk of cardiovascular disease?

NEL Systematic Review

  1. Aeberli I,Gerber PA,Hochuli M,Kohler S,Haile SR,Gouni-Berthold I,Berthold HK,Spinas GA,Berneis K. Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. Am J Clin Nutr. 2011;94(2):479-85. PMID:21677052. http://www.ncbi.nlm.nih.gov/pubmed/21677052.
  2. Aeberli I,Hochuli M,Gerber PA,Sze L,Murer SB,Tappy L,Spinas GA,Berneis K. Moderate amounts of fructose consumption impair insulin sensitivity in healthy young men: a randomized controlled trial. Diabetes Care. 2013;36(1):150-6. PMID:22933433. http://www.ncbi.nlm.nih.gov/pubmed/22933433.
  3. Barrio-Lopez MT,Martinez-Gonzalez MA,Fernandez-Montero A,Beunza JJ,Zazpe I,Bes-Rastrollo M. Prospective study of changes in sugar-sweetened beverage consumption and the incidence of the metabolic syndrome and its components: the SUN cohort. Br J Nutr. 2013;110(9):1722-31. PMID:23534417. http://www.ncbi.nlm.nih.gov/pubmed/23534417.
  4. Bernstein AM,de Koning L,Flint AJ,Rexrode KM,Willett WC. Soda consumption and the risk of stroke in men and women. Am J Clin Nutr. 2012;95(5):1190-9. PMID:22492378. http://www.ncbi.nlm.nih.gov/pubmed/22492378.
  5. Black RN,Spence M,McMahon RO,Cuskelly GJ,Ennis CN,McCance DR,Young IS,Bell PM,Hunter SJ. Effect of eucaloric high- and low-sucrose diets with identical macronutrient profile on insulin resistance and vascular risk: a randomized controlled trial. Diabetes. 2006;55(12):3566-72. PMID:17130505. http://www.ncbi.nlm.nih.gov/pubmed/17130505.
  6. Chen L,Caballero B,Mitchell DC,Loria C,Lin PH,Champagne CM,Elmer PJ,Ard JD,Batch BC,Anderson CA,Appel LJ. Reducing consumption of sugar-sweetened beverages is associated with reduced blood pressure: a prospective study among United States adults. Circulation. 2010;121(22):2398-406. PMID:20497980. http://www.ncbi.nlm.nih.gov/pubmed/20497980.
  7. Cohen L,Curhan G,Forman J. Association of sweetened beverage intake with incident hypertension. J Gen Intern Med. 2012;27(9):1127-34. PMID:22539069. http://www.ncbi.nlm.nih.gov/pubmed/22539069.
  8. de Koning L,Malik VS,Kellogg MD,Rimm EB,Willett WC,Hu FB. Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men. Circulation. 2012;125(14):1735-41, s1. PMID:22412070. http://www.ncbi.nlm.nih.gov/pubmed/22412070.
  9. Dhingra R,Sullivan L,Jacques PF,Wang TJ,Fox CS,Meigs JB,D'Agostino RB,Gaziano JM,Vasan RS. Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation. 2007;116(5):480-8. PMID:17646581. http://www.ncbi.nlm.nih.gov/pubmed/17646581.
  10. Duffey KJ,Gordon-Larsen P,Steffen LM, Jr. Jacobs DR,Popkin BM. Drinking caloric beverages increases the risk of adverse cardiometabolic outcomes in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr. 2010;92(4):954-9. PMID:20702604. http://www.ncbi.nlm.nih.gov/pubmed/20702604.
  11. Eshak ES,Iso H,Kokubo Y,Saito I,Yamagishi K,Inoue M,Tsugane S. Soft drink intake in relation to incident ischemic heart disease, stroke, and stroke subtypes in Japanese men and women: the Japan Public Health Centre-based study cohort I. Am J Clin Nutr. 2012;96(6):1390-7. PMID:23076619. http://www.ncbi.nlm.nih.gov/pubmed/23076619.
  12. Faeh D,Minehira K,Schwarz JM,Periasamy R,Park S,Tappy L. Effect of fructose overfeeding and fish oil administration on hepatic de novo lipogenesis and insulin sensitivity in healthy men. Diabetes. 2005;54(7):1907-13. PMID:15983189. http://www.ncbi.nlm.nih.gov/pubmed/15983189.
  13. Fung TT,Malik V,Rexrode KM,Manson JE,Willett WC,Hu FB. Sweetened beverage consumption and risk of coronary heart disease in women. Am J Clin Nutr. 2009;89(4):1037-42. PMID:19211821. http://www.ncbi.nlm.nih.gov/pubmed/19211821.
  14. Larsson SC,Akesson A,Wolk A. Sweetened beverage consumption is associated with increased risk of stroke in women and men. J Nutr. 2014;144(6):856-60. PMID:24717367. http://www.ncbi.nlm.nih.gov/pubmed/24717367.
  15. Le KA,Ith M,Kreis R,Faeh D,Bortolotti M,Tran C,Boesch C,Tappy L. Fructose overconsumption causes dyslipidemia and ectopic lipid deposition in healthy subjects with and without a family history of type 2 diabetes. Am J Clin Nutr. 2009;89(6):1760-5. PMID:19403641. http://www.ncbi.nlm.nih.gov/pubmed/19403641.
  16. Lewis AS,McCourt HJ,Ennis CN,Bell PM,Courtney CH,McKinley MC,Young IS,Hunter SJ. Comparison of 5% versus 15% sucrose intakes as part of a eucaloric diet in overweight and obese subjects: effects on insulin sensitivity, glucose metabolism, vascular compliance, body composition and lipid profile. A randomised controlled trial. Metabolism. 2013;62(5):694-702. PMID:23363580. http://www.ncbi.nlm.nih.gov/pubmed/23363580.
  17. Lowndes J,Sinnett S,Pardo S,Nguyen VT,Melanson KJ,Yu Z,Lowther BE,Rippe JM. The effect of normally consumed amounts of sucrose or high fructose corn syrup on lipid profiles, body composition and related parameters in overweight/obese subjects. Nutrients. 2014;6(3):1128-44. PMID:24642950. http://www.ncbi.nlm.nih.gov/pubmed/24642950 (“a”).
  18. Lowndes J,Sinnett S,Yu Z,Rippe J. The Effects of Fructose-Containing Sugars on Weight, Body Composition and Cardiometabolic Risk Factors When Consumed at up to the 90th Percentile Population Consumption Level for Fructose. Nutrients. 2014;6(8):3153-68. PMID:25111121. http://www.ncbi.nlm.nih.gov/pubmed/25111121 (“b”).
  19. Maersk M,Belza A,Stodkilde-Jorgensen H,Ringgaard S,Chabanova E,Thomsen H,Pedersen SB,Astrup A,Richelsen B. Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. Am J Clin Nutr. 2012;95(2):283-9. PMID:22205311. http://www.ncbi.nlm.nih.gov/pubmed/22205311.
  20. Raben A,Vasilaras TH,Moller AC,Astrup A. Sucrose compared with artificial sweeteners: different effects on ad libitum food intake and body weight after 10 wk of supplementation in overweight subjects. Am J Clin Nutr. 2002;76(4):721-9. PMID:12324283. http://www.ncbi.nlm.nih.gov/pubmed/12324283.
  21. Tasevska N,Park Y,Jiao L,Hollenbeck A,Subar AF,Potischman N. Sugars and risk of mortality in the NIH-AARP Diet and Health Study. Am J Clin Nutr. 2014;99(5):1077-88. PMID:24552754. http://www.ncbi.nlm.nih.gov/pubmed/24552754.
  22. Yang Q,Zhang Z,Gregg EW,Flanders WD,Merritt R,Hu FB. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med. 2014;174(4):516-24. PMID:24493081. http://www.ncbi.nlm.nih.gov/pubmed/24493081.
  23. Yu Z,Lowndes J,Rippe J. High-fructose corn syrup and sucrose have equivalent effects on energy-regulating hormones at normal human consumption levels. Nutr Res. 2013;33(12):1043-52. PMID:24267044. http://www.ncbi.nlm.nih.gov/pubmed/24267044.

What is the relationship between added sugars and body weight or risk of obesity?

Existing Reports

  1. Malik VS, Pan A, Willett WC, Hu FB. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr. 2013;98(4):1084-102. PMID: 23966427. http://www.ncbi.nlm.nih.gov/pubmed/23966427.
  2. Te Morenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. Bmj. 2013;346:e7492. PMID: 23321486. http://www.ncbi.nlm.nih.gov/pubmed/23321486.

What is the relationship between added sugars and risk of type 2 diabetes?

Existing Reports

  1. Greenwood DC, Threapleton DE, Evans CE, Cleghorn CL, Nykjaer C, Woodhead C, et al. Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose-response meta-analysis of prospective studies. Br J Nutr. 2014:1-10. PMID: 24932880. http://www.ncbi.nlm.nih.gov/pubmed/24932880.
  2. InterAct Consortium, Romaguera D, Norat T, Wark PA, Vergnaud AC, Schulze MB, van Woudenbergh GJ, Drogan D, Amiano P, Molina-Montes E, Sánchez MJ, Balkau B, Barricarte A, Beulens JW, Clavel-Chapelon F, Crispim SP, Fagherazzi G, Franks PW,Grote VA, Huybrechts I, Key TJ, Khaw KT, Nilsson P, Overvad K, Palli D, Panico S, Quirós JR, Rolandsson O, Sacerdote C, Sieri S, Slimani N, Spijkerman AM, Tjonneland A, Tormo MJ, Tumino R, van den Berg SW, Wermeling PR, Zamara-Ros R, Feskens EJ, Langenberg C, Sharp SJ, Foroughi NG, Riboli E, Wareham NJ. Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct. Diabetologia. 2013 Jul;56(7):1520-30. doi:10.1007/s00125-013-2899-8. Epub 2013 Apr PubMed PMID: 23620057. http://www.ncbi.nlm.nih.gov/pubmed/23620057.
  3. Malik VS, Popkin BM, Bray GA, Despres JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33(11):2477-83. PMID: 20693348. http://www.ncbi.nlm.nih.gov/pubmed/20693348.
  4. Sonestedt E, Overby NC, Laaksonen DE, Birgisdottir BE. Does high sugar consumption exacerbate cardiometabolic risk factors and increase the risk of type 2 diabetes and cardiovascular disease? Food Nutr Res. 2012;56. PMID: 22855643. http://www.ncbi.nlm.nih.gov/pubmed/22855643.
  5. Xi B, Li S, Liu Z, Tian H, Yin X, Huai P, et al. Intake of fruit juice and incidence of type 2 diabetes: a systematic review and meta-analysis. PLoS One. 2014;9(3):e93471. PMID: 24682091. http://www.ncbi.nlm.nih.gov/pubmed/24682091.

What is the relationship between added sugars and dental caries?

Existing Reports

  1. Moynihan PJ, Kelly SA. Effect on caries of restricting sugars intake: systematic review to inform WHO guidelines. Journal of dental research. 2014;93(1):8-18. PMID: 24323509. http://www.ncbi.nlm.nih.gov/pubmed/24323509.

Low-Calorie Sweeteners

What is the relationship between low-calorie sweeteners and body weight or risk of obesity?

Existing Reports

  1. Brown RJ, de Banate MA, Rother KI. Artificial sweeteners: a systematic review of metabolic effects in youth. Int J Pediatr Obes. 2010;5(4):305-12. PMID: 20078374. http://www.ncbi.nlm.nih.gov/pubmed/20078374.
  2. Miller PE, Perez V. Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies. Am J Clin Nutr. 2014;100(3):765-77. PMID: 24944060. http://www.ncbi.nlm.nih.gov/pubmed/24944060.
  3. Wiebe N, Padwal R, Field C, Marks S, Jacobs R, Tonelli M. A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes.BMC Med. 2011;9:123. PMID: 22093544. http://www.ncbi.nlm.nih.gov/pubmed/22093544.

What is the relationship between low-calorie sweeteners and risk of type 2 diabetes?

Existing Reports

  1. Greenwood DC, Threapleton DE, Evans CE, Cleghorn CL, Nykjaer C, Woodhead C, et al. Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose-response meta-analysis of prospective studies. Br J Nutr. 2014:1-10. PMID: 24932880. http://www.ncbi.nlm.nih.gov/pubmed/24932880.
  2. InterAct Consortium, Romaguera D, Norat T, Wark PA, Vergnaud AC, Schulze MB, van Woudenbergh GJ, Drogan D, Amiano P, Molina-Montes E, Sánchez MJ, Balkau B, Barricarte A, Beulens JW, Clavel-Chapelon F, Crispim SP, Fagherazzi G, Franks PW,Grote VA, Huybrechts I, Key TJ, Khaw KT, Nilsson P, Overvad K, Palli D, Panico S, Quirós JR, Rolandsson O, Sacerdote C, Sieri S, Slimani N, Spijkerman AM, Tjonneland A, Tormo MJ, Tumino R, van den Berg SW, Wermeling PR, Zamara-Ros R, Feskens EJ, Langenberg C, Sharp SJ, Foroughi NG, Riboli E, Wareham NJ. Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct. Diabetologia. 2013 Jul;56(7):1520-30. doi:10.1007/s00125-013-2899-8. Epub 2013 Apr PubMed PMID: 23620057. http://www.ncbi.nlm.nih.gov/pubmed/23620057.