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Response to review by Te Morenga et al. in BMJ

January 2013

Sugar Nutrition UK welcomes the opportunity to respond to the article by Te Morenga et al. in the British Medical Journal, and the accompanying editorial by Willett and Ludwig.

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January 2013

Response to review by Te Morenga et al. in BMJ


Sugar Nutrition UK welcomes the opportunity to respond to the article by Te Morenga et al. in the British Medical Journal, and the accompanying editorial by Willett and Ludwig.

Both the review and editorial highlight that, in studies where the caloric content of the test diet was the same as that of the controls (through the substitution of sugar with a different carbohydrate) there was no evidence of any effect of sugar consumption on body weight. This is an important finding and confirms that it is the over consumption of calories that results in weight gain, and is not specific to sugar. This is also in agreement with the conclusions of reviews by Expert Committees, including EFSA, IoM, WHO and UK Department of Health. The review by Te Morenga and colleagues provides further evidence to support the work of the UK food industry, in respect to the Government’s Responsibility Deal pledge to reduce calories.

The editorial article states that the ‘current intake of added sugars in the United States and United Kingdom is about 15% of total energy. Thus a limit of 10% could be viewed as a realistic practical goal’. This could be misleading to those not familiar with the UK intakes and recommendations. In the UK the latest data from the Government’s dietary survey shows that the average intake of non-milk extrinsic sugars (NMES) is currently 12.3% of food energy, and this has been declining over the last decade. The UK recommendation is set at 11% of food energy, and therefore intakes are already close to this figure.

The review states that there was possible publication bias in the ad libitum studies. This is an issue that has previously been noted in a paper on 'White hat bias' in the International Journal of Obesity by Cope and Allison, in which they state that in the published scientific literature there is evidence of "a bias sufficient to misguide readers" in the area of soft drinks.



  • Te Morenga et al. (2012) Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ 345:e7492
  • European Food Safety Authority (2010) Scientific Opinion on dietary reference values for carbohydrates and dietary fibre. The EFSA Journal 8(3):1462
  • World Health Organisation and Food and Agriculture Organization (2003) Diet, nutrition and the prevention of chronic diseases. Report of a Joint FAO/WHO Expert Consultation. WHO Technical Report Series 916. WHO Geneva, Switzerland
  • Institute of Medicine of the National Academies (2002) Dietary Reference Intakes for Energy, Carbohydrate,Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (Macronutrients). The National Academies Press, Washington
  • Department of Health (1989) Dietary Sugars and Human Health. Committee on Medical Aspects of Food Policy. Report on Health and Social Subjects No. 37. HMSO, London
  • Henderson et al. (2003) The National Diet and Nutrition Survey: Adults Aged 19 to 64 years. Vol. 2: Energy, Protein, Carbohydrate, Fat and Alcohol Intake. HMSO, London
  • Department of Health (2012) The National Diet and Nutrition Survey: Headline Results from Years 1,2 and 3 (combined) of the rolling programme 2008-11.
  • Cope and Allison (2010) White hat bias: examples of its prevalence in obesity research and a call for renewed commitment to faithfulness in research reporting. Int J Obes (London) 34(1): 84-8


  • non-milk extrinsic sugars (NMES) - includes table sugar, sugars added to food and drinks and those present in fruit juices and honey.
  • White hat bias - 'bias leading to distortion of information in the service of what may be perceived to be righteous ends' (Cope & Allison, 2010)



For more information and media requests please email media@sugarnutrition.org.uk

Sugar Nutrition UK is an association principally funded by UK sugar manufacturers and is involved in promoting nutrition research and raising awareness among academics, health professionals, the media and the public about sugars and their role in health.



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