Risk assessment of nutrients: There must be a threshold for their effects

Area of Science:

• Nutritional Science
• Risk Assessment
• Public Health Nutrition

Background:

• Nutrient effects are dose-dependent, a crucial factor often overlooked in risk assessments.
• Recent European Food Safety Authority (EFSA) 2022 conclusions on added and free sugars recommend intake
• as low as possible,
• potentially misinterpreting dose-response relationships.

Purpose of the Study:

• To critically evaluate the EFSA's 2022 conclusion regarding added and free sugars intake.
• To determine if a threshold exists for adverse effects of sugar consumption.
• To assess the adequacy of current data for setting tolerable upper intake levels for sugars.

Main Methods:

• Analysis of randomized controlled trials (RCTs) cited by EFSA, focusing on surrogate endpoints like fasting glucose and triglycerides.
• Examination of dose-response data from RCTs to identify potential threshold effects.
• Review of existing scientific literature on sugar intake and adverse health outcomes.

Main Results:

• RCTs used by EFSA showed no adverse effects on fasting glucose or triglycerides at intake levels as low as 10 energy%.
• This suggests an observable threshold exists for adverse effects of sugars on these specific endpoints.
• The data reviewed indicates a lack of definitive evidence to establish a tolerable upper intake level for dietary sugars.

Conclusions:

• EFSA's conclusion to minimize added sugar intake may not be fully supported by the evidence presented, as threshold effects are apparent.
• Current data is insufficient to set a definitive upper limit for added sugars.
• More robust research is required to accurately identify the threshold for adverse effects of sugar intake.