The role of dietary sugars in health: molecular composition or just calories?

J Clin Nutr 2019; // —

Philip Prinz Eur —

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  • To conduct a review highlighting current literature to discuss the question of whether dietary sugars per se have an unfavorable health effect or if it is just the amount of calories that matters in the development of noncommunicable diseases (NCDs) and obesity.


  • There has been a public debate about dietary sugar intake and its role in the development of obesity and NCDs, including type 2 diabetes (T2D), cardiovascular diseases (CVDs), and cancer.


  • The methods used to conduct this review were not discussed in detail in this publication.


  • All in all, the results from prospective cohort studies and controlled intervention trials indicate that SSBs contribute to the development of T2D by adding excessive calories to the diet resulting in a positive energy balance, but no effects on parameters of glycemic control were seen under isocaloric conditions.
  • A review of multiple systematic reviews and meta-analyses found that the isocaloric exchange of fructose for other carbohydrates in clinical trials decreased diastolic blood pressure and mean arterial blood pressure without affecting systolic blood pressure. Additionally, hypercaloric fructose intake did not affect overall mean arterial blood pressure in feeding trials compared with other carbohydrates.
  • There is very little evidence that dietary sugars are associated with different types of cancer.


  • Current scientific evidence does not support the conclusion that dietary sugars themselves are detrimental to human health and the cause of obesity as well as NCDs.
  • Data from human studies clearly shows that it is the excess amount of calories, also consumed in form of dietary sugars, which promote obesity and with that favor NCDs.
  • All energy-containing beverages, including SSBs as well as fruit juices, should be seen in the same way in their effects on health due to their similar amount of calories and sugar content.
  • For sucrose, further research is needed in order to evaluate the relevance of its molecular composition, especially in comparison with other macronutrients.

Points to Consider:

  • It is well known that obesity is a major risk factor for CVDs. Therefore, nutritional recommendations to prevent CVDs should focus on tackling obesity and reducing calorie intake rather than focusing on the reduced intake of a single nutrient.
  • Current recommendations clearly point to a healthier lifestyle in order to reduce the risk of cancer by reducing body weight. To reduce the risk of cancer, a healthy lifestyle with a moderate body weight is essential.