American Heart Association Recommended Sugar Intake Levels Not Science-Based

WASHINGTON — Nearly four years ago the American Heart Association (AHA) published a statement, which made recommendations for limiting sugar intake levels.

These recommendations—which propose cutting sugar consumption to historic and unrealistic lows—were not based on any scientific finding of negative health impact, a point made by the authors in the statement itself: “research tools thus far have been insufficient to confirm a direct link [between sugar and obesity].”

Unlike fat intake recommendations, which are based on scientific consensus, the AHA sugar intake recommendations are derived from mathematical formulas which lack the scientific underpinning to be used as the basis for official or unofficial quantitative recommendations.

Indeed, upon release of the statement, the American Dietetic Association confirmed: “the suggestion of 6% to 10% of energy from added sugars was not based on any scientific evidence regarding health impacts but was calculated using the Food Guide Pyramid.”

That’s not to say that scientific evidence regarding sugar intake wasn’t available—it was. But the AHA statement failed to acknowledge evidence presented by members of the medical and scientific communities, including the Institute of Medicine in 2002 and again in March 2010, and a European Food Safety Authority expert panel which stated: “Available data do not allow the setting of an UL (upper level) for total or added sugars, neither an AI (Adequate Intake) nor a recommended intake range.” These are significant scientific reviews, which the AHA apparently disregarded because they didn’t support their recommendation.

Even the lead author of the AHA statement admitted the evidence for their findings was lacking—a perspective published by the Journal of the American Medical Association following the statement’s release points out: “…some researchers emphasize the lack of scientific rigor behind the claims that sugar causes obesity and its associated adverse outcomes… Rachel K. Johnson PhD, MPH, lead author of the scientific statement, agreed that the science may lack rigor…”

The fact that no authoritative scientific body has ever set an upper intake level or daily value for sugars only, after a comprehensive analysis of the peer-reviewed published literature, should signify that obesity is more complex than the AHA statement implies. Nevertheless four years later, continued references to the AHA recommendations by major media sources give them a false aura of credibility while ignoring a 2010 Critical Reviews in Food Science and Nutrition article showing that body weights are highest in Americans consuming the lowest amounts of sugars.

The suggested limits aren’t just lacking scientific basis—they’re nearly impossible to implement in daily life. In a letter to the Wall Street Journal following the initial release of the AHA recommendations, Dr. Liz Applegate, Director of Sports Nutrition at the University of California, Davis wrote: “The AHA limits mean most of us are prohibited from having a single can of soda on a hot summer day, a slice of cake at a party, and even a third of a cup of dried cranberries as a snack.”

These recommendations would also preclude the consumption of other everyday items, such as a slice of unbuttered toast with jelly at breakfast, a mid-afternoon snack of yogurt, and a small dish of ice cream for dessert after dinner.

Nutrition advice, no matter the source, should be based only on the best available scientific evidence to preserve the confidence of American consumers. The dietary sugars advice provided by the AHA is not science-based, and may mislead consumers who believe that it is. Worse, the AHA contradicts itself by telling consumers to restrict their sugar consumption to record lows, while at the same time endorsing foods that would make it impossible to adhere to their recommendations.

Further, when the AHA attempts to alarm consumers by saying that Americans consume 22.2 teaspoons of added sugars per day, they fail to mention that in 1970 Americans were consuming a little over 25 teaspoons per day—and that was before obesity ever became a major public health issue.

Any group claiming to advocate solely on behalf of consumers and their health, including the AHA, should base its advice on the totality of the best available scientific evidence and data. Failure to do this risks misleading consumers. And going one step further to imply such advice is rooted in some sort of scientific finding, when it is not, is frankly irresponsible.