Sugar Association response to “Sugar and sugars: Myths and realities”

Abstract

To the Editors: Continuing education is vital for dietetics professionals. A primary education resource for dietitians is the Journal of the American Dietetic Association. Educational programs based on anything less than objective, evidence-based information damage professional dietitians whose practices depend on their integrity, as well as up-to-date science. Beginning with its headline, the Journal Commentary entitled “Sugar and sugars: Myths and realities” ((1)Coulston A.M. Johnson R.K. Sugar and sugars myths and realities.J Am Diet Assoc. 2002; 102: 351-353Google Scholar) fails to meet the standards of objectivity and impartiality long championed by the American Dietetic Association. Exactness of terminology is a cornerstone of constructive education. Economic “consumption” numbers reflect nothing more than the total amount of a product available for all uses. Intentionally eliminating the term “economic” when premeditatedly misreporting food supply numbers as human consumption is misleading. Economic supply data will never equal human consumption. Reporting economic supply numbers as human intake is as fictitious as equating gross salary (availability) and take-home pay (intake). Second, citation of primary sources is the gold standard of science publication. If this standard had been respected, the estimated 1999 supply of sweeteners would have been reported correctly as 153 pounds per capita ((2)US Department of Agriculture. Sugar and sweetener situation and outlook yearbook. Economic Research Service. 2001;231:54.Google Scholar). Additionally, adherence to professional integrity requires the reporting of the nearly 3-pound-per-person decrease in sweetener supply between 1999 and 2000. Third, critical analysis is mandatory when any scientist cites a published article in support of a hypothesis. In the study ((3)Ludwig D.S. Peterson K.E. Gortmaker S.L. Relation between consumption of sugar-sweetened drinks and childhood obesity a prospective, observational analysis.Lancet. 2001; 357: 505-508Google Scholar) cited in support of the sugar and childhood obesity hypothesis, critical analysis shows that no more than 1.1 to 1.5 pounds of the reported 21.2-pound weight gain can be attributed to the sugar-sweetened drinks category. Obesity results when total caloric intake habitually exceeds caloric expenditure ((4)Mardis A.L. Current knowledge of the health effects of sugar intake.Fam Econ Nutr Rev. 2001; 13: 87-91Google Scholar). Fourth, unabridged paraphrasing of the published literature is a fundamental tenet of scientific integrity. Implying the authors of the cited literature review ((5)Parks E.J. Hellerstein M.K. Carbohydrate-induced hypertriacylglycerolemia historical perspective and review of biological mechanisms.Am J Clin Nutr. 2000; 71: 412-433Google Scholar) conclude high-carbohydrate diets give rise to atherogenic dyslipidemias is deceptive. The authors ((5)Parks E.J. Hellerstein M.K. Carbohydrate-induced hypertriacylglycerolemia historical perspective and review of biological mechanisms.Am J Clin Nutr. 2000; 71: 412-433Google Scholar) state unequivocally that this media-popularized view is not backed up by the rigorous data only long-term clinical studies can provide. Finally and most importantly, linking the professional statement of a premier health organization with an unrelated personal opinion is deceitful. Citing the American Heart Association statement ((6)Grundy S.M. Benjamin I.J. Burke G.L. Chait A. Eckel R.H. Howard B.V. Mitch W. Smith Jr, S.C. Sowers J.R. Diabetes and cardiovascular disease a statement for healthcare professionals from the American Heart Association.Circulation. 1999; 100: 1134-1146Google Scholar) as corroborating the sugars-and-obesity premise is unfounded. In fact, the term “added sugars” appears nowhere in the AHA document ((6)Grundy S.M. Benjamin I.J. Burke G.L. Chait A. Eckel R.H. Howard B.V. Mitch W. Smith Jr, S.C. Sowers J.R. Diabetes and cardiovascular disease a statement for healthcare professionals from the American Heart Association.Circulation. 1999; 100: 1134-1146Google Scholar). Additionally, this opinion is further refuted by a recently published literature review ((4)Mardis A.L. Current knowledge of the health effects of sugar intake.Fam Econ Nutr Rev. 2001; 13: 87-91Google Scholar). Today's savvy consumers will trust dietary recommendations only if the cornerstones of intellectual honesty and scientific integrity are preserved as the foundation in the continuing education of dietetics professionals.