Carbohydrates and Health

Definitions used in different dietary recommendations
2.23 The classification of carbohydrate components in dietary recommendations
may vary between different authorities. The terms carbohydrate and starch have
distinct chemical definitions that do not differ between different organisations.
There is diversity of opinion regarding the measurement of dietary components
defined on the basis of functionality rather than chemical composition (Englyst
et al., 2007). The classification used to define sugars and dietary fibre in dietary
recommendations varies between different authorities and these differences are
considered below.
Sugars
2.24 While the term ‘sugars’ refers to monosaccharides and disaccharides, various terms
are used to define the types of sugars described in dietary recommendations. A
summary of the different definitions for sugars is given in Table 2.2.
2.25 In the UK, dietary reference values have been provided for ‘non-milk extrinsic
sugars’. Intrinsic sugars are those naturally incorporated into the cellular structure
of foods; extrinsic sugars are those sugars not contained within the cellular
structure of a food. The extrinsic sugars in milk and milk products (i.e. lactose)
were deemed to be exempt from the classification of sugars in relation to the
dietary reference value (COMA, 1991). Non-milk extrinsic sugars include sugars
added to foods, e.g. sucrose, glucose and fructose, and sugars naturally present in
fruit juices, e.g. glucose and fructose.
2.26 The 2002 FAO/WHO Expert Consultation defined the term ‘free sugars’ as all
monosaccharides and disaccharides added to foods by the manufacturer, cook
or consumer, plus sugars naturally present in honey, syrups and fruit juices (WHO,
2003). In 2015, the term was elaborated to ‘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, 2015).
2.27 In the United States, dietary reference intakes are set for ‘added sugars’, which
are defined as sugars and syrups that are added to foods during processing and
preparation. Added sugars do not include naturally occurring sugars such as
lactose in milk or fructose in fruits (Institute of Medicine, 2005).
2.28 The European Food Safety Authority (EFSA) defines sugars as total sugars, including
both endogenous (sugars naturally present in foods such as fruit, vegetables,
cereals and lactose in milk products) and added sugars (EFSA, 2009). The term
‘added sugars’ refers to sucrose, fructose, glucose, starch hydrolysates (glucose
syrup, high-fructose syrup, isoglucose) and other isolated sugar preparations used
as such, or added during food preparation and manufacturing.
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