e-Library of Evidence for Nutrition Actions (eLENA)


An online library of evidence-informed guidelines for nutrition interventions and single point of reference for the latest nutrition guidelines, recommendations and related information.

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Reducing consumption of sugar-sweetened beverages to reduce the risk of unhealthy weight gain in adults

Intervention | Last updated: 9 August 2023


Overweight and obesity are major risk factors for a number of noncommunicable diseases, including diabetes, cardiovascular diseases and certain types of cancer. Once considered a problem only in high income countries, overweight and obesity are now dramatically on the rise in low- and middle-income countries, particularly in urban settings.

Sugar-sweetened beverage consumption is high in many parts of the world and is suggestive of poor dietary quality, as sugar-sweetened beverages contain sugars such as sucrose or fructose, often in large amounts, which contribute to the overall energy density of diets. The calories provided by sugar-sweetened beverages have little nutritional value and may not provide the same feeling of fullness that solid food provides. As a result, total energy intake may increase which can lead to unhealthy weight gain.

WHO has developed guidance on free sugars* intake, as shown below, based on the impact of free sugars intake on weight gain and dental caries. Current evidence suggests that increasing consumption of sugar-sweetened beverages is associated with weight gain. Therefore, reducing consumption of sugar-sweetened beverages would also reduce the risk of unhealthy weight gain in adults.

* Free sugars include monosaccharides and disaccharides added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.

WHO Recommendations


WHO recommends a reduced intake of free sugars throughout the lifecourse.

In both adults and children, WHO recommends reducing the intake of free sugars to less than 10% of total energy intake.

WHO suggests a further reduction of the intake of free sugars to below 5% of total energy intake.



Evidence


Systematic reviews used to develop the guidelines


Effect on caries of restricting sugars intake: systematic review to inform WHO guidelines

Moynihan PJ, Kelly SA. Journal of Dental Research. 2014; 93(1):8-18.


Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies

Te Morenga L, Mallard S, Mann J. BMJ. 2013; 346:e7492.


Related systematic reviews


Nutritively sweetened beverage consumption and body weight: a systematic review and meta-analysis of randomized experiments

Mattes RD, Shikany JM, Kaiser KA, Allison DB. Obesity Reviews. 2011; 12(5):346-65.


Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis

Malik VS, Pan A, Willett WC, Hu FB. American Journal of Clinical Nutrition. 2013; 98(4):1084-1102.


Cost-effectiveness Learn More Alternate Text


Cost-effectiveness analyses


The impact of a tax on sugar-sweetened beverages on health and health care costs: a modelling study

Veerman JL, Sacks G, Antonopoulos N, Martin J. PLoS One. 2016; 11(4):e0151460.


Modelled cost-effectiveness of a package size cap and a kilojoule reduction intervention to reduce energy intake from sugar-sweetened beverages in Australia

Crino M, Herrera AMM, Ananthapavan J, Wu JHY, Neal B, Lee YY, et al. Nutrients. 2017; 9(9).


Cost Eeffectiveness of a sugar-sweetened beverage excise tax in the U.S.

Long MW, Gortmaker SL, Ward ZJ, Resch SC, Moodie ML, Sacks G, et al. Am J Prev Med. 2015; 49(1):112-23.


Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis

Lal A, Mantilla-Herrera AM, Veerman L, Backholer K, Sacks G, Moodie M, et al. PLoS Med. 2017; 14(6):e1002326.


Taxes and subsidies for improving diet and population health in Australia: a cost-effectiveness modelling study

Cobiac LJ, Tam K, Veerman L, Blakely T. PLoS Med. 2017; 14(2):e1002232.