Dietary sugar consumption and health: umbrella review

Yin Huang ¹, Zeyu Chen ¹, Bo Chen ¹, Jinze Li ¹, Xiang Yuan ², Jin Li ¹, Wen Wang ³, Tingting Dai ⁴, Hongying Chen ⁵, Yan Wang ⁵, Ruyi Wang ¹, Puze Wang ¹, Jianbing Guo ¹, Qiang Dong ¹, Chengfei Liu ^6,^{✉ Introduction}As an important component of the human diet, sugars have been shown to be harmfully associated with a variety of risk factors for decades, mainly including obesity,¹ ² ³ diabetes,⁴ ⁵ ⁶ cardiovascular disease,⁷ ⁸ ⁹ ¹⁰ hyperuricaemia,¹¹ gout,¹¹ ¹² ¹³ ectopic fatty accumulation,¹⁴ ¹⁵ ¹⁶ dental caries,¹⁷ and some cancers.¹⁸ ¹⁹ ²⁰ ²¹ According to the latest report of the World Health Organization and the Food and Agriculture Organization of the United Nations, sugars include monosaccharides, disaccharides, polyols, and free sugars, of which free sugars are identified as all monosaccharides and disaccharides added to foods by the manufacturer, cook, or consumer and sugars naturally present in honey, syrups, and fruit juices.³ ²² In addition, another important group of sugars, added sugars, has been proposed in the Dietary Guidelines for Americans and has been defined as all monosaccharides and disaccharides used in processed and prepared foods and drinks and sugars added to foods but not naturally occurring sugars such as in fruits and fruit juices (table 1).²³

, Classification of dietary sugars³ ²³

Class	Principal components
Monosaccharides	Glucose, fructose, galactose
Disaccharides	Sucrose, lactose, maltose, trehalose
Polyols	Sorbitol, mannitol, lactitol, xylitol, erythritol, isomalt, maltitol
Free sugars	All monosaccharides and disaccharides added to foods by the manufacturer, cook, or consumer; sugars naturally present in honey, syrups, and fruit juices
Added sugars	All monosaccharides and disaccharides used in processed and prepared foods and drinks; sugars added to foods but not naturally occurring sugars such as in fruits and fruit juices