The World Health Organization (WHO) recommends that the maximum sugar intake for adults and children throughout the life course should not exceed 10% of their total daily energy intake. However, it published a guideline in 2015 recommending a further decrease of 5%, which is more beneficial in reducing the risk of non-communicable diseases.

In the light of scientific evidence showing an association between the excessive consumption of sugars and a range of health problems, including dental caries and overweight, the European Food Safety Authority (EFSA) recommends that population intake levels and dietary patterns for sugar follow the WHO guidelines.

According the 2011 Study of Nutrition and Cardiovascular Risk in Spain (ENRICA), which used a sample of over 11,000 men and women over the age of 18, the current average sugar intake among Spanish adults is 94.3 g (100.5 g in men and 88.2 g in women). Sugar therefore accounts for 16.7% of total energy intake in men and 18.8% in women, far above the WHO recommended level.

Based on this evidence, the European Commission and the Member States in the High Level Group on Nutrition and Physical Activity (HLG) launched the EU Framework for National Initiatives on Selected Nutrients in 2011. The document promoted food reformulation policy lines for fat, sugars and calorie content, similar to the provisions of the framework for salt reduction (2008), to serve as a reference and a tool for national reformulation actions taken by European countries. As a further development to this framework, Annex I on saturated fat was established in 2012, and Annex II on added sugars was passed in 2015.

The NAOS Strategy is part of the expert working groups created within the framework of the HLG to address reformulation with a common European effort and participates periodically in video conferences or physical meetings on the subject with other Member States, the European Commission, the food industry and other sectors, consumer representatives and other related actors and sectors.

Although within Spain, AECOSAN, through the NAOS Strategy, had already been working for years with different sectors on the voluntary reduction of salt and fat, this line of action is now being reinforced based on the new Annex II on added sugars. This involves establishing new voluntary agreements with manufacturers and the distribution, catering and other sectors in order to efficiently achieve the gradual reformulation of certain foods and drinks. This reformulation must include the reduction not only of added sugars, but also of salt, fat and calories, through different reduction targets and strategies,  providing consumers with a greater number of reformulated products and making healthy options more accessible, as in other European countries. This will incentivise innovation, impacting public health at the population level.