The World Health Organization is again urging people to lower the amount of sugar they eat.

The Geneva-based global health agency says getting daily sugar intake to below five per cent of one's daily caloric intake would be optimal but reiterated that restricting intake to no more than 10 per cent is also good.

"We should aim for five per cent if we can ... but 10 per cent is more realistic," said Dr. Francesco Branco, head of nutrition for health and development for WHO.

The draft recommendations, which will likely be contentious, will be open for public comment for the rest of the month until March 31. Then the agency and scientific advisers will finalize the guidance.

"Sugar might become the new tobacco in terms of risk," said Branco at a news conference in Geneva on Wednesday morning.

The 5 per cent rule

  • Five per cent of sugar intake daily is about 25 grams of sugar/day for an adult.
  • That is about six to seven teaspoons.
  • A can of Coke has more than 10 teaspoons of sugar.

Branco warned about the "sugars that we don't see."

"It's sometimes in condiments, sauce added to meats, a tablespoon of ketchup has up to seven grams of sugar [and] sweetened yogurt up to six grams."

The WHO has long urged people to limit sugar calories to below 10 per cent of their daily calories, but the five per cent target is new.

To put it into context, five per cent would be about six teaspoons of sugar a day; a can of sugar-sweetened soda contains about 10 teaspoons of sugar.

Branco was particularly concerned about pop drinks and children. 

"An average serving at a fast food place of sugar-sweetened soda ... approaches 30 grams of sugar per serving," noted Branco. "That already exceeds the recommended daily serving for a child."

He emphasized that if parents can limit their child's intake to the five per cent mark, the child will have almost no tooth decay in addition to being healthier and unlikely to become overweight and obese.

Free sugars

The recommendations relate to what are called free sugars — those added by manufacturers, cooks or consumers. And they abound in prepared foods. 

They relate to all monosaccharides — things like glucose and fructose — and disaccharides such as sucrose or table sugar, as well as sugars in honey, syrups, fruit juices and fruit concentrates.

The recommendations do not relate to "intrinsic" sugars — those built into whole foods such as fruits or vegetables.

The recommendations look at limiting sugar intake in relation to lowering the risk of obesity and dental decay, two conditions scientific studies suggest are linked to excess sugar consumption.

The report, from the WHO Department of Nutrition for Health and Development, says consideration was given to also looking at the evidence related to sugar intake and two other conditions — heart disease and diabetes. But in the end the focus remained on obesity and tooth decay.

Nutritional experts have been expecting new recommendations from the WHO.

In 2004 when the WHO tried to include the 10 per cent sugar limit recommendation in its Global Strategy for Diet, Physical Activity and Health, the U.S. Congress — under pressure from the sugar industry lobby — threatened to withdraw U.S. funding for the agency. The direct reference to the 10 per cent figure was removed from the final report.

No recommendations in Canada

In Canada, the Heart and Stroke Foundation has begun a consultation process to determine if it should recommend that Canadians restrict the portion of their daily calories that come from sugar.

Health Canada does not have specific recommendations in terms of teaspoons or grams per day of sugar Canadians should consume.

'We are woefully inadequate in the evidence around sugar consumptions for Canadians. Also the role of added sugars throughout all the processed foods.'- Dr. Tom Warchawski, Childhood Obesity Foundation

According to Statistics Canada, in 2004, the average Canadian consumed 26 teaspoons of sugar per day. That works out to 40 kilograms per year —– or 20 bags. Experts say that amount should not exceed 13 teaspoons per day, if sticking to the 10 per cent benchmark.

"We are woefully inadequate in the evidence around sugar consumptions for Canadians. Also the role of added sugars throughout all the processed foods," Dr. Tom Warshawski told CBC News. Warshawski, a pediatrician, is also chair of the Childhood Obesity Foundation in Canada.

"Health Canada could not, in all fairness, have come out with more rigid guidelines because the evidence wasn't there. But the evidence is coming so now we have to grasp it, study it and come forward with meaningful recommendations for the public."

Current food labelling regulations can make it difficult for consumers who want to avoid sugar.

On Canadian nutrition labels, manufacturers are required to list ingredients in order from greatest to least volume. But many labels list multiple kinds of sweeteners with different names. For example, honey, barley malt syrup and evaporated cane juice could all be listed separately, even though the human body treats them all as sugar.

Also, sugar is measured in grams on labels, instead of more consumer-friendly teaspoons. For someone trying to keep track of intake, four grams of sugar equals one teaspoon. In a can of Coke, for example, there are more than 10 teaspoons of sugar. 

The WHO's Branco suggests that final recommendations from his organization "will have to be taken up through policymakers" in governments around the world.

"[Our recommendations] can be used to develop policies to provide healthier food in public institutions or it can be used in the context of public information campaigns but much more has to be considered."

With files from The Canadian Press