Guidelines Dietary - Eat For Health

Other conditions• Dental caries: The relationship between sucrose and dental caries was first documented more than a centuryago 772 and has been confirmed in numerous studies since then. 773 Historically, the prevalence of dental carieshas increased when dietary patterns have changed to include more added sugars and foods containing refinedstarches. New evidence supports past findings and suggests that high or frequent consumption of added sugars,particularly for infants and young children, is associated with increased risk of dental caries (Grade C; EvidenceReport, Section 14.2). 774-778 The evidence also suggests that dental caries are related to sugar-sweetened drinks(Grade C; Evidence Report, Section 15.4). 774,776• Caries are associated with national per capita yearly sucrose consumption, with very few caries in childrenconsuming 10kg/year (about 30g/day) or less. A steep increase may occur from 15kg/year upwards. 88• The sugars contained in the cellular structure of foods, such as the intrinsic sugars of fresh fruit and vegetables,have been found to have little cariogenic potential, whereas foods high in added sugars are most damagingto teeth. 779• Bone strength: Evidence suggests an association between consumption of soft drinks and increased riskof reduced bone strength (Grade C; Evidence Report, Section 15.3). 650-653 Cola drinks (sugar-sweetened anddiet varieties), but not other carbonated drinks, are associated with significantly lower bone mineral density inwomen, but not in men. 653 In young men, significant adverse changes in indices of bone remodelling and boneresorption markers occurred when cola drinks were added to a low-calcium diet, compared with adding milk. 650A systematic review reported an inverse relationship between soft drink consumption and milk intake. 195Guideline 3• It appears that soft drink consumption is associated with some problems related to bone health, but, with theexception of some limited evidence related to cola drinks, it remains unclear whether soft drinks exert a directeffect or reflect an inverse relationship with milk consumption.• Attention deficit hyperactivity disorder (ADHD): There is no evidence that added sugars are involved in theaetiology of ADHD. 7803.3.3 How limiting intake of foods and drinks containing added sugars may improvehealth outcomesDental caries: Important factors for development of caries include the bacterium Streptococcus mutans, dietarysugars and a susceptible tooth surface. Fermentable carbohydrates (both sugars and starches) are a substratefor bacteria such as S. mutans and S. sobrinus, which increase the acid-producing potential of dental plaque. 781Dietary sugars other than sucrose (e.g. glucose and lactose) can also induce caries, although these sugars areless cariogenic than sucrose because, in addition to being converted to acid metabolites, sucrose is uniquelyused for extracellular polysaccharide synthesis.Oral hygiene, dental care, fluoridated water supplies, the type of food and salivary function are also important.The more frequently foods containing added sugars are consumed, the greater the risk of caries, since frequentconsumption does not allow remineralisation of the teeth. 782 The duration of exposure depends on how longsugary foods stay in the mouth and the number of eating occasions. On the basis of the scientific evidence,advice on sugar intake for preventing dental caries should include frequency of intake as well as the amount.The acidity of sweetened drinks is also relevant to dental erosion, a major factor in dental decay. 657 This appliesequally to sugar-sweetened or diet soft drinks, since their acidity is comparable.Excess weight: Many foods containing added sugars (e.g. soft drinks, confectionery, cakes and biscuits) areenergy-dense but nutrient-poor. The association between sugar-sweetened drinks and weight gain appears tobe related to the reduced effect on satiety of sugars in a liquid medium. Past studies found that compensationfor energy from sugar-sweetened drinks is less complete than that for energy in solid form. 783 Newer evidencesupports this failure to compensate by reducing energy intake from other foods or drinks. 762 Sugar-sweeteneddrinks therefore add to total energy intake. 78478EAT FOR HEALTH – australian dietary guidelinesNational Health and Medical Research Council