SIOI Policy on Sugar Intake: Limiting Free Sugars from Earliest Days of Life to Prevent Caries, Specific Non-Communicable Diseases, and Tumors

PURPOSE The Italian Society of Paediatric Dentistry (SIOI) is committed to encouraging the different health professionals taking care of children (e.g., paediatric dental practitioners, paediatricians, gynecologists, obstetricians, dental hygienists, and dieticians) to educate parents (up to the period of pregnancy) and caregivers to limit their children's consumption of cariogenic sugars. The purpose of this SIOI policy is to provide quality communication and information, based on the most updated scientific evidence, on the amount of free sugars (those classified as cariogenic) that can be consumed daily in the diet during the first two years of life, and then from childhood throughout life. This Policy communication aims to reduce the prevalence and severity of caries in both childhood and adulthood and, in addition, to prevent the occurrence of other specific non-communicable diseases (NCDs) that share the risk factor of excessive free sugar intake with caries. NCDs related to free sugar intake are obesity, type 2 diabetes mellitus (T2DM), non-alcoholic fatty liver disease (NAFLD), cardiovascular disease (CVD), hypertension, as well as some cancers and all-cause mortality. METHODS This policy is based on the most updated and methodologically valid evidence, drawing from data found in systematic reviews (with or without meta-analysis) as well as guidelines and policies (or any official statements/documents) promulgated by the most relevant international scientific societies in this field. The references collection was carried out by searching the PubMed (R)/MEDLINE electronic database using the following keyword terms: sugar, monosaccharide, disaccharide, sucrose, lactose, galactose, fructose, glucose, maltose, sweetened beverage, sweet food, dessert, snack, candy, cookies, chewing gum, chocolate, dairy products, fruit juice, honey, syrup, and molasses. Only studies and statements/documents written in English, available in their full text, and published within the last 10 years were included in this policy. No restrictions were adopted on the age, gender, and provenience of study participants. The interpretation of the literature findings and the subsequent formulation of policy recommendations were based on the consensus of a multidisciplinary expert panel of researchers and clinicians working in this field.