Abstract
BackgroundTo review studies undertaken in South Africa (SA) which included sugar intake associated with dental caries, non-communicable diseases, diabetes, obesity and/or micronutrient dilution, since the food-based dietary guideline: “Use foods and drinks that contain sugar sparingly and not between meals” was promulgated by the Department of Health (DOH) in 2002.MethodsThree databases (PubMed, Cochrane Library, and ScienceDirect), and SA Journal of Clinical Nutrition (SAJCN), DOH and SA Medical Research Council (SAMRC) websites were searched for SA studies on sugar intake published between 2000 and January 2012. Studies were included in the review if they evaluated the following: sugar intake and dental caries; sugar intake and non-communicable diseases; sugar and diabetes; sugar and obesity and/or sugar and micronutrient dilution.ResultsThe initial search led to 12 articles in PubMed, 0 in Cochrane, 35 in ScienceDirect, 5 in the SAJCN and 3 reports from DOH/SAMRC. However, after reading the abstracts only 7 articles from PubMed, 4 from SAJCN and 3 reports were retained for use as being relevant to the current review. Hand searching of reference lists of SAJCN articles produced two more articles. Intake of sugar appears to be increasing steadily across the South African (SA) population. Children typically consume about 50 g per day, rising to as much as 100 g per day in adolescents. This represents about 10% of dietary energy, possibly as much as 20%. It has been firmly established that sugar plays a major role in development of dental caries. Furthermore, a few studies have shown that sugar has a diluting effect on the micronutrient content of the diet which lowers the intake of micronutrients. Data from numerous systematic reviews have shown that dietary sugar increases the risk for development of both obesity and type 2 diabetes. Risk for development of these conditions appears to be especially strong when sugar is consumed as sugar-sweetened beverages.ConclusionBased on the evidence provided the current DOH food-based dietary guideline on sugar intake should remain as is.
Highlights
To review studies undertaken in South Africa (SA) which included sugar intake associated with dental caries, non-communicable diseases, diabetes, obesity and/or micronutrient dilution, since the food-based dietary guideline: “Use foods and drinks that contain sugar sparingly and not between meals” was promulgated by the Department of Health (DOH) in 2002
The initial search led to 12 articles in PubMed, 0 in Cochrane, 35 in ScienceDirect, 5 in the SA Journal of Clinical Nutrition (SAJCN) and 3 reports from Department of Health/SA Medical Research Council (SAMRC) (Table 2)
After reading the abstracts only 7 articles from PubMed [1,5,6,7,8,9,10], 4 from SAJCN [11,12,13,14] and 3 reports [4,15,16] were retained for use in the manuscript as being relevant to the current review
Summary
In the current paper the authors reviewed new evidence published from 2000 up to January 2012, in order to reevaluate the appropriateness of the “sugar” guideline. There were two facts which hampered this assessment: first, there were no national dietary data for adult South Africans, and, secondly, the most recent national dental data were from 1999–2002 [3,4]. In order to find recent data on sugar intake in South Africa a review was undertaken and the following databases were searched for original research studies (descriptive or other) in SA since 2000 using the search terms: sugar AND dental caries AND South Africa; sugar AND noncommunicable diseases AND South Africa; sugar AND obesity AND South Africa; sugar AND diabetes AND South Africa; sugar AND micronutrient dilution AND South Africa. PubMed, Cochrane Library, and ScienceDirect were searched as well as the website of the local nutrition journal- South African Journal of Clinical Nutrition (SAJCN). Sugar or sucrose, refers to “added sugar “which refers to all mono-and disaccharides added to foods and drinks in preparation and cooking
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