Are diets high in non‐milk extrinsic sugars conducive to obesity? An analysis from the Dietary and Nutritional Survey of British Adults

S.A. Gibson

doi:10.1046/j.1365-277X.1996.00463.x

S.A. Gibson

Abstract

Restriction of dietary sugars is often advocated for weight control, alongside a reduced fat and energy intake. This project examined data from the Dietary and Nutritional Survey of British Adults (Gregory et al., 1990) to evaluate the associations between non-milk extrinsic (NME) sugars (as a percentage of food energy) and body mass index (BMI), energy intake and percentage energy from fat. The influence of dieting and potential under reporting on these relationships was also explored. BMI was inversely associated with percentage energy from NME sugars. The relationship was weak, but did not appear to be a mere artifact of dieting and/or under reporting. The well-recognized reciprocal relationship between sugars energy and fat energy was also seen with saturated, monounsaturated and polyunsaturated fatty acids, but not with trans fatty acids. As a result of the sugar : fat see-saw effect only 2% of men and women met the current dietary targets for both fat and NME sugars, suggesting that these may be incompatible on a practical level. These analyses suggest that high (NME) sugar diets appear to be weakly related to leanness rather than obesity, although the relationship is weaker than the inverse association between sugars and fat. It is hypothesized that overweight and diet-restrained individuals often choose to restrict NME sugars: a strategy which can result in a higher (proportional) fat diet and weight gain. Emphasis on reducing NME sugars intakes may be counterproductive to attempts to reduce proportional fat intake and body weight.

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Journal of Hum an Nutrition and Dietetics (1996), 9, 283–292

Are diets high in non-milk extrinsic

sugars conducive to obesity? An

analysis from the Dietary and

Nutritional Survey of British Adults

S. A. Gibson

21 Orchard Road, Burpham , Guildford, Surrey, UK

Restriction of dietary sugars is often advocated for weight control, alongside a

reduced fat and energy intake. This project examined data from the Dietary and

Nutritional Survey of British Adults (Gregory et al., 1990) to evaluate the

associations between non-milk extrinsic (NME) sugars (as a percentage of food

energy) and body mass index (BMI), energy intake and percentage energy from

fat. The influence of dieting and potential under reporting on these relationships

was also explored. BMI was inversely associated with percentage energy from

NME sugars. The relationship was weak, but did not appear to be a mere artifact

of dieting and/or under reporting. The well-recognized reciprocal relationship

between sugars energy and fat energy was also seen with saturated,

monounsaturated and polyunsaturated fatty acids, but not with trans fatty acids.

As a result of the sugar : fat see-saw effect only 2% of men and women met the

current dietary targets for both fat and NME sugars, suggesting that these may be

incompatible on a practical level. These analyses suggest that high (NME) sugar

diets appear to be weakly related to leanness rather than obesity, although the

relationship is weaker than the inverse association between sugars and fat. It is

hypothesized that overweight and diet-restrained individuals often choose to

restrict NME sugars: a strategy which can result in a higher (proportional) fat diet

and weight gain. Emphasis on reducing NME sugars intakes may be

counterproductive to attempts to reduce proportional fat intake and body weight.

Key words: BMI, obesity, adult dietary survey, non-milk extrinsic sugars, fat, dieting.

Introduction

non-milk extrinsic (NME) sugars, have been

seen as predisposing to overweight by

Obesity is poised to become the most significant

encouraging over-consumption, and their

nutritional problem for the next century. The

restriction is advocated in those who are, or

prevalence of obesity (defined as a body mass

who may become, obese (DHSS, 1989;DoH, 1994).

index (BMI) over 30) is currently estimated at

There is, however, mounting evidence to

13% of men and 15% of women in England

challenge the rationale for NME sugars

(Breeze et al., 1994). Although the aetiology is

restriction. Cross-sectional studies have shown

complex, it is axiomatic that obesity arises from

that there is no evidence of a positive

a previous excess of energy intake over

association between intakes of total or NME

expenditure. Dietary fat, and to a lesser extent

sugars (adjusted for energy) and BMI. Instead,

an inverse relationship is normally found

(Richardson, 1972; Fehily et al., 1984; Gibson,

1993; Bolton-Smith & Woodward, 1994). This

Correspondence: Sigrid Gibson, 21 Orchard

Road, Burpham, Guildford, Surrey, GU4 7JH, UK.

may be partly attributable to sugar avoidance

 1996 Blackwell Science Ltd

283

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Are diets high in non‐milk extrinsic sugars conducive to obesity? An analysis from the Dietary and Nutritional Survey of British Adults

S.A. Gibson