Carbohydrates and Health

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eport no significant association between either intake of sugars confectionery or sweet snacks and dental caries incidence (Leroy et al., 2005; Tamaki et al., 2009). Of the studies identified in the update search one reports an association between frequency of consumption of sugars confectionery at age one year and dental caries development at age 15 years (Alm et al., 2012). The other, in children and adolescents with cerebral palsy, found a significant association between higher frequency of sugars consumption and dental caries (Ferreira et al., 2011). Of the studies that did not adjust for tooth brushing, one indicates that the number of between-meal snacks containing more than 10% sugars is associated with two- , but not three-year dental caries increment (Wilson & Ashley, 1989). The other two studies indicate no association between sugars confectionery and snack consumption and dental caries risk. Frequency of sugars-containing foods and/or sugars confectionery consumption (servings/day or servings/week) and dental caries in mixed and permanent dentition • Association • Moderate evidence • The direction of the association indicates that higher frequency of consumption of sugars-containing foods and/or sugars in confectionery is detrimental to oral health • The association is biologically relevant Outcomes where there is insufficient evidence 10 6.65 The tables below detail the exposures and outcomes where there are two or fewer studies that meet the inclusion criteria for the review (e.g. by study duration, publication date, health of subjects, design of intervention) to draw a conclusion as per the grading system in Annex 2. A full description of the studies can be found in the relevant systematic reviews. Table 6.1: Insufficient evidence - cohort studies Risk factor/health outcome/measure Cardiovascular disease events Coronary events Stroke Incident hypertension Blood pressure Total cholesterol Exposure monosaccharides disaccharides monosaccharides disaccharides sugars rich foods sugars-sweetened beverages total sugars monosaccharides disaccharides sugars-sweetened beverages fructose sugars-sweetened beverages sugars rich foods sugars rich foods 92 10 See Annex 2 paragraph A2.21 for criteria.
Table 6.1: continued Risk factor/health outcome/measure HDL-cholesterol Body weight Weight gain Waist circumference Body fatness and fat distribution Energy intake (children) Type 2 diabetes mellitus Impaired glucose tolerance Glycaemia Insulinaemia Insulin resistance/sensitivity HbA1c Colo-rectal, colon and rectal cancer Caries in the deciduous dentition Caries in the mixed and permanent dentition Oral cancer Exposure sucrose sugars-sweetened beverages sucrose sugars rich foods sugars-sweetened beverages sucrose sugars rich foods sugars-sweetened beverages total sugars sugars rich foods sugars-sweetened beverages sugars-sweetened beverages sugars rich foods total sugars sugars-sweetened beverages total sugars sugars-sweetened beverages sugars sugars-sweetened beverages glucose fructose sugars, fructose, sucrose lactose (colon cancer only) frequency of sugars intake sweetened comforter (dummy) fruit juice frequency of sugars-sweetened beverages sugars-sweetened beverages Table 6.2: Insufficient evidence - randomised controlled trials Risk factor/health outcome/measure Vascular compliance Fasting blood lipids CRP, haptoglobin and transferrin Body weight Weight gain Energy intake Eating motivation Impaired glucose tolerance Glycosylated blood proteins Exposure sugars glucose, fructose, sucrose sugars sugars-sweetened beverages sugars-sweetened beverages sugars rich foods sugars-sweetened beverages sucrose sugars sugars 93
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Carbohydrates and Health 2015
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Published by TSO (The Stationery Of
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performed the systematic review on
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Colo-rectal health Children and ado
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5 Fibre isolates 233 Psyllium 233
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Dr David Mela Prof. Angus Walls (si
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Prof. Ian Macdonald Prof. of Metab
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Summary S.1 Carbohydrates are a ma
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Sugars and sugars-sweetened foods a
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S.21 It is recommended that dietar
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1 Introduction and methods Backgrou
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used as the primary dietary assessm
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2.3 Carbohydrates can be classifie
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β-glucans are a heterogeneous grou
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2.19 The amount of energy yielded
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Definitions used in different dieta
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2.32 In the United States ‘total
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is associated with higher incidence
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3 Dietary sources and intakes of ca
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3.12 In adults aged 19-64 years, s
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3.24 At a broad food category leve
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were also significant contributors.
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4.5 Obesity occurs when energy int
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loose stools with fast transit thro
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Risk factors and measures considere
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important in trials assessing effec
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5.18 Two cohort studies were identi
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Page 57 and 58: Fasting blood lipids 5.32 Fifty ei
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Page 63 and 64: to exclude confounding by concomita
Page 65 and 66: Fasting LDL-cholesterol 5.57 Twenty
Page 67 and 68: Fasting LDL-cholesterol:HDL-cholest
Page 69 and 70: Carbohydrate diets and C-reactive p
Page 71 and 72: not be included in a meta-analysis
Page 73 and 74: Phillips et al., 2008; Due et al.,
Page 75 and 76: concomitant weight loss on fasting
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Page 79 and 80: carbohydrates was less than 5% betw
Page 81 and 82: 5.121 The heterogeneity is above t
Page 83 and 84: Higher carbohydrate and lower fat d
Page 85 and 86: 5.138 No significant association is
Page 87 and 88: Table 5.2: Insufficient evidence -
Page 89 and 90: 5.151 The trials do provide eviden
Page 91 and 92: 6.7 No significant association is o
Page 93 and 94: al., 2006), which left an insuffici
Page 95 and 96: Sugars and energy intake • Effect
Page 97 and 98: Sucrose (g/day) and type 2 diabetes
Page 99 and 100: Sugars-sweetened beverages (ml/day)
Page 101 and 102: sugars-sweetened and non-caloricall
Page 103 and 104: 6.53 No meta-analyses have been con
Page 105: foods. Five of these adjusted their
Page 109 and 110: that met the inclusion criteria. As
Page 111 and 112: 7 Starch and starch-rich foods 7.1
Page 113 and 114: 7.11 No association was found betwe
Page 115 and 116: were combined into a meta-analysis
Page 117 and 118: 7.25 Findings from prospective coh
Page 119 and 120: 2011; Park et al., 2011; Wallstrom
Page 121 and 122: Hays et al., 2006). The data were i
Page 123 and 124: Dietary fibre and fasting insulin c
Page 125 and 126: 2007; Schatzkin et al., 2007; Wakai
Page 127 and 128: metabolic review, cardiovascular di
Page 129 and 130: Fruit fibre (g/day) and coronary ev
Page 131 and 132: (Salmeron et al., 1997a; Salmeron e
Page 133 and 134: Faecal weight and intestinal transi
Page 135 and 136: Coronary events 8.76 Eight cohort s
Page 137 and 138: Oat bran and β-glucans and fasting
Page 139 and 140: Oat bran and β-glucans and fasting
Page 141 and 142: al., 2008). The data on dietary int
Page 143 and 144: observes an increase in bowel movem
Page 145 and 146: Cereal fibre (g/day) and colo-recta
Page 147 and 148: Total cereals Cardiovascular diseas
Page 149 and 150: Whole grains (serving/day) and hype
Page 151 and 152: increases in vegetable, fruit, and
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Page 155 and 156: Table 8.1: continued Risk factor/he
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Table 8.3: Inconsistent evidence Ri
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9 Non-digestible oligosaccharides,
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Forcheron & Beylot, 2007). One tria
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trial administers 21g/day inulin co
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coffee (Walton et al., 2010). All t
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Arabinoxylan-oligosaccharides 9.33
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9.42 An effect of raw resistant sta
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1999c) or retrograde resistant star
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9.61 All three trials demonstrate
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Non-digestible oligosaccharide (fru
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9.76 Of the five trials that inves
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Table 9.2: Inconsistent evidence -
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10 Glycaemic index and glycaemic lo
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Stroke 10.10 Three cohort studies w
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10.18 No significant effect of GI i
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Glycaemic index (unit/day) and fast
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10.38 No significant effect is demo
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health review (Greenwood et al., 20
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Table 10.1: Insufficient evidence -
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11 Dietary recommendations 11.1 T
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energy compensation (degree of volu
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Dietary fibre 11.17 In 1991 COMA s
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with any adverse effects on growth
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Figure 11.4: Risk of type 2 diabete
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12 Overall summary and conclusions
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permanent dentitions. There is a la
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supplements on recurrence of colo-r
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• With the proposed reduction in
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sweet spreads, fruit juice, confect
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ANNEX 1 Cardio-metabolic, colo-rect
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frequency and age. For oral cancer,
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framework for the evaluation of evi
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• Whether the effect or associati
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Commentary on the evidence on fruct
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A3.9 There are few data from trial
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mechanism may have been acting for
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Table A4.1: Prospective cohort stud
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Randomised controlled trials A4.14
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Table A4.3: continued Study Trial d
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Table A4.3: continued Study Trial d
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TableA4.4: Risk of bias assessment
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TableA4.5: Results from prospective
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likely to progress in subjects who
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Table A4.6: continued Study Interve
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A4.37 The effect of one litre a day
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Fibre isolates ANNEX 5 A5.1 Prospe
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Constipation A5.9 Four randomised c
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Isolated gums and gelling agent sup
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a meta-analysis. Overall, the trial
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Mixed isolated gums and gelling age
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Risk factor/health outcome/measure
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IL-6 Interleukin 6 J Joule kcal Kil
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A7.4 Higher birth weight is associ
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A7.17 One cohort study observed tha
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Carbohydrate intake (% energy) and
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Summary and conclusions A7.31 This
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P P er er c c ent ent Top tw Top tw
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Table 3.2: Average daily intake of
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Table 3.13b: Total quantities consu
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Table 3.16: continued Aged 1.5 year
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Table 3.19b: Top 20 contributors to
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Table 3.19d: Top 20 contributors to
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Table 3.20a: Top 20 contributors to
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Table 3.20c: Top 20 contributors to
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Table 3.20e: Top 20 contributors to
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Table 3.21b: Top 20 contributors to
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Table 3.21d: Top 20 contributors to
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Table 3.22a: Top 20 contributors to
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Table 3.22c: Top 20 contributors to
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Table 3.22e: Top 20 contributors to
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A9.1 The meta-analysis was perform
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A9.3 The difference in sugars inta
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References Abete I, Parra D & Marti
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Asayama K, Thijs L, Brguljan-Hitij
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Beiswanger BB, Boneta AE, Jau MS, K
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