Reply to RJ Kaplan

Cancer Research Center of Hawaii
University of Hawaii
1236 Lauhala Street, Suite 407
Honolulu, HI 96813
E-mail: suzanne{at}crch.hawaii.edu
Department of Nutrition and Food Sciences
University of Vermont
Burlington, VT 05405
E-mail: rachel.johnson{at}uvm.edu

Dear Sir:

Kaplan is correct in noting that 1-d intakes should be adjusted for day-to-day variation before assessment of the proportion of a population with usual intakes below a cutoff. In our review of the data on intakes of sugars in the United States (1), we should have noted that the Institute of Medicine report that we cited (2) reported unadjusted 1-d intakes, and therefore the values in Table 2 of our review represent the proportion of the population with intakes of >25% of energy from added sugars on a single day. The numbers would indeed be somewhat smaller if they had been adjusted to reflect usual intake. However, we believe that our points are still valid: a substantial proportion (20–30%) of children and adolescents aged 9–18 y exceed this recommended ceiling of added sugars intake on any given day, and further examination of the dietary patterns of such persons would be worthwhile.

REFERENCES

1. Murphy SP, Johnson RK. The scientific basis of recent US guidance on sugars intake. Am J Clin Nutr 2003;78(suppl):827S–33S.
2. Institute of Medicine. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. Washington, DC: National Academy Press, 2002.