The UN Food and Agriculture Organization (FAO) and the World Health Organization (WHO) released a controversial report on diet and its impact on disease in Rome yesterday, despite severe lobbying from the US Sugar Association.
The report aims to provide for a global strategy to combat the growing burden of chronic diseases and is the result of a two-year long Joint FAO/WHO Expert Consultation.
The two organisations claim the report contains the best currently available scientific evidence on the relationship of diet, nutrition and physical activity to chronic diseases, however the food industry, and in particular, sugar manufacturers, have raised strong objections to some of the recommendations, since the release of a draft copy last month.
The report which reveals how the burden of chronic diseases is rapidly increasing, accounting for around 59 per cent of total deaths in 2001, concludes that a diet low in saturated fats, sugars and salt, and high in vegetables and fruits, together with regular physical activity, will have a major impact on combating this high toll of death and disease.
More specifically it recommends limiting fat to between 15 and 30 per cent of total daily energy intake, and saturated fats to less than 10 per cent. And in the most controversial point, carbohydrates should provide the bulk of energy requirements (from 55 -75 per cent of daily intake) with free sugars remaining beneath 10 per cent.
The US Sugar Association argues that the report is not based on the "preponderance of current science", but rather on only 11 scientific references - one of which is almost 30 years old. It also cites research published by the US National Academy of Sciences (the 2002 Dietary Reference Intakes Report) suggesting that the limit should be 25 per cent of sugars in the diet, rather than less than 10 per cent, and says the report also ignores the 2001 publication of the USDA's Current Knowledge of the Health Effects of Sugar Intake.
In a report earlier this week UK newspaper The Guardian compared the group's agressive lobbying tactics to those of the tobacco industry in recent years. It said that the sugar industry was even threatening to 'bring WHO to its knees by asking Congress to stop funding the body unless it scraps the guidelines'. Meanwhile the UK food and drink industry voice, the Food and Drink Federation (FDF), has also expressed its concern that the report contains "many sweeping statements, which were not clearly based on scientific evidence".
"It was in general over-prescriptive; unworkable in its severity; and contained too many negative messages," said the FDF in a statement. The association continued that these negative messages "based on restriction rather than educated choice" would be counterproductive in achieving healthier lifestyles.
The FAO/WHO report, which also urged that salt intake be limited and fruit and vegetables increased, involved a group of 30 independent experts with a global perspective, who worked with around 30 of their peers to review evidence on nutrition.
"We have known for a long time that foods high in saturated fats, sugars, and salt, are unhealthy; that we are, globally, increasing our intake of energy-dense, nutritionally poor food as our lives become increasingly sedentary," said Dr Gro Harlem Brundtland, director-general of WHO. "And that these factors - together with tobacco use - are the leading causes of the great surge we have seen in the incidence of chronic diseases. What is new, is that we are laying down the foundation for a global policy response."
Brundtland added that she will be meeting next month with senior executives from a number of major food and beverage companies, and also with representatives of the key professional and consumer NGOs. Their input will be considered in developing the Global Strategy, to be finalised for the WHO Executive Board in January 2004.
The report will have significant repercussions for consumer information and food labeling and also has important consequences for agricultural production and processing methods.
FAO Director-General Jacques Diouf said the report "contains a number of very interesting recommendations. They require FAO to examine trends in consumption patterns to assess how these dietary trends would need to be altered in response to the recommendations and how the food and agricultural sectors worldwide can adjust to these needs".
The report will be presented, together with FAO's response to its findings, to the Organisation's governing bodies as soon as possible. This would include an analysis of the impact of the recommendations on consumers and farmers in developing countries, many of whom are poor and undernourished.
Dr Brundtland concluded: "The work we are embarked upon could lead to one of the largest positive shifts in population health ever undertaken."