The BMJ-BRIT MED J published an article titled “Dietary Sugar Consumption and Health: Umbrella Review” by the research team of Professor Qiang Wei and et al in its April 5, 2023 issue. Employing the evidence-based medicine method of umbrella review, the study revealed the harmful association between dietary sugar consumption and 45 diseases, such as prostate cancer, diabetes and hypertension. The article proposed the best control range of dietary sugar consumption according to the research conclusions, providing the latest and highest level of evidence-based information for health organizations around the world to formulate more accurate and comprehensive sugar control policies. Dr. Yin Huang, chief physician Zeyu Chen, Dr. Bo Chen and Dr. Jinze Li of theDepartment of Urology/Institute of Urology, West China Hospital,are the co first authors of the paper. Prof. Qiang Wei, Associate Professor Dehong Cao and Associate Professor Liangren Liu from the Department of Urology, West China Hospital are the co corresponding authors of the paper.
Excessive dietary sugar consumption can have a negative impact on health. The World Health Organization (WHO) and other health organizations recommend controlling the intake of free or added sugars to within 10% of the total daily energy consumption. However, it is necessary to evaluate the quality of existing evidence before developing an accurate and comprehensive sugar control policy. Therefore, researchers evaluated the quality of evidence on dietary sugar consumption and health outcomes using umbrella reviews of existing meta-analyses.
Map of outcomes associated with dietary sugar consumption
The umbrella reviews covered 73 meta-analyses (including 67 observational study and 6 randomized controlled trials), reviewing 83 health-related outcomes. Researchers conducted a comprehensive evaluation of the quality of existing evidence and made recommendations based on the AMSTAR score, evidence classification criteria (class I-IV), and GRADE grading (high, moderate, low, very low).
Evidence classification criteria (class I-IV）
Generally speaking,high dietary sugar consumption is generally more harmful than beneficial for health, especially in cardiometabolic disease.
Significant dose-response relations between dietary sugar consumption and multiple health outcomes
“--- Significant harmful associations between dietary sugar consumption and 18 endocrine/metabolic outcomes, 10 cardiovascular outcomes, seven cancer outcomes, and 10 other outcomes (neuropsychiatric, dental, hepatic, osteal, and allergic) were detected. Moderate quality evidence suggested that the highest versus lowest dietary sugar consumption was associated with increased body weight (sugar sweetened beverages) (class IV evidence) and ectopic fatty accumulation (added sugars) (class IV evidence). Low quality evidence indicated that each serving/week increment of sugar sweetened beverage consumption was associated with a 4% higher risk of gout (class III evidence) and each 250 mL/day increment of sugar sweetened beverage consumption was associated with a 17% and 4% higher risk of coronary heart disease (class II evidence) and all cause mortality (class III evidence), respectively. In addition, low quality evidence suggested that every 25 g/day increment of fructose consumption was associated with a 22% higher risk of pancreatic cancer (class III evidence).” (Results)
This study was funded by the National Natural Science Foundation of China (grant number 82000721) and Program from the Department of Science and Technology of Sichuan Province (grant number 2020YJ0054).
https://www.bmj.com/content/381/bmj-2022-071609
