The Limits of Sugar Guidelines

A firestorm recently erupted over a paper in the Annals of Internal Medicine that found official advice limiting sugar in diets to be based on “low” or “very low” quality evidence. Because a food-industry group had funded the study, a slew of critics accused the authors of distorting the science to undermine nutrition guidelines and make sugar seem less harmful than it actually is. One prominent nutrition professor called the paper “shameful.” “It was really an attempt to undermine the scientific process,” said another.

Lost in this torrent of criticism was any significant discussion of the science itself. Regardless of its funding source, was the paper correct in saying that there is insufficient evidence to recommend limiting sugar? And do official guidelines even matter, since we pretty much know that sugar is bad for us?

The paper examined a dozen guidelines on sugar passed by governments around the world since 2002, including the Dietary Guidelines for Americans, which last year recommended limiting sugar intake to 10 percent of calories. One would assume that such advice is based on an ample body of rigorous research. But the study, which included all the papers listed in the various guidelines’ bibliographies themselves, claimed that reviews to date