Abstract
Objectives: Implementing public health measures is necessary to decrease sugars intake, which is associated with increased risk of noncommunicable diseases. Our scoping review aimed to identify the types of measures implemented and evaluated to decrease sugars intake in the population and to assess their impact. Methods: Following a review of systematic reviews (SRs) published in 2018, we systematically searched new SR (May 2017–October 2020) in electronic databases. We also searched the measures implemented in Europe in the NOURISHING database. Two researchers selected the reviews, extracted and analysed the data. Results: We included 15 SRs assessing economic tools (n = 5), product reformulation and labels/claims (n = 5), and educational/environmental interventions (n = 7). Economic tools, product reformulation and environmental measures were effective to reduce sugar intake or weight outcomes, while labels, education and interventions combining educational and environmental measures found mixed effects. The most frequently implemented measures in Europe were public awareness, nutritional education, and labels. Conclusion: Among measures to reduce sugar intake in the population, economic tools, product reformulation, and environmental interventions were the most effective, but not the more frequently implemented in Europe.
Highlights
The frequent consumption of excessive dietary sugars, especially sugar-sweetened beverages (SSBs) is a risk factor for unbalanced diet, weight gain, and an increased risk of noncommunicable diseases including type 2 diabetes [1, 2], cardiovascular disease mortality [3], and dental caries [4, 5]
According to the World Health Organization (WHO), the term “free sugars” includes all “monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates” [5]
The 15 systematic reviews (SRs) included in this scoping review assessed the effect of the following interventions on sugar intake: 1) Economical tools: five SRs addressed this question i.e., two SRs focusing only on SSB [15], one only on foods with addedsugar [16] and two included both [17]
Summary
The frequent consumption of excessive dietary sugars, especially sugar-sweetened beverages (SSBs) is a risk factor for unbalanced diet, weight gain, and an increased risk of noncommunicable diseases including type 2 diabetes [1, 2], cardiovascular disease mortality [3], and dental caries [4, 5]. The WHO strongly recommend that intake of free sugars should not exceed 10% of total energy intake, and a conditional recommendation states that it should not exceed 5% [5]. This represents a Measures to Reduce Sugar Intake maximum intake of 50 g/day, ideally 25 g/day, for a person consuming 2,000 calories. In a review comparing total sugars (naturally present and added in food and drink) in several European countries, the mean intake ranged from 76 g/day in Spain to 117 g/day in the Netherlands [7]. In a Swiss survey, the mean intake of total sugars reached 107 g/day (11% of total energy intake), and only 8% of the population followed the WHO recommendation of less than 5% of total energy intake [8]
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