Per capita sugar consumption in Switzerland is not extreme.

study by Masood et al. [2012]. Taking into account the collective flow of sugared goods (sugar, syrup, honey), in fact the per capita sugar consumption in Switzerland was 42.3 kg in 2004 and has not changed significantly since [Swiss Farmers’ Union, 2010]. The World Health Organization [2011] also reported a sugar consumption of about 40 kg per capita per year in Switzerland. Thus, sugar consumption in Switzerland is comparable to that in other European countries like Sweden or Denmark. Comparing the DMFT levels of Denmark and Switzerland (canton of Zurich) (0.7 and 0.82, respectively), the suggestion that salt fluoridation is responsible for the low caries level in Switzerland appears to be unsubstantiated, considering there is no salt fluoridation in Denmark. Rather, we would like to stress that, besides availability of fluoride dentifrices, school and preschool educational dental public health measures as practiced in these two countries lead to low levels of caries experience. However, it should be kept in mind that caries counts may be dependent more on dentists’ treatment decisions than on preventive approaches. Hence, the regression analysis in the study by Masood et al. [2012] should be recalculated, and the respective scatterplots should also be adjusted, using the more realistic sugar consumption data of Switzerland at least. Dear Editor, The study by Masood et al. [2012] compared national income, caries prevalence and per capita sugar consumption of numerous countries. The data presented by the authors are supposed to show that the relationship between sugar consumption and caries levels is dependent on the absolute level of income of the respective country. Switzerland, next to Singapore, has been identified as the country with ‘the highest per capita sugar consumption (about 70 kg) but has a relatively low level of caries’. The authors suggest that the caries level in Switzerland might be due to the high level of salt fluoridation. The data for the per capita sugar consumption were obtained from the United Nations Food and Agricultural Organization (UNFAO). The per capita added sugar consumption was calculated by subtracting the sum of added sugar imported and produced from the total added sugar exported or used for industry. The quantity that remained had therefore ‘disappeared’ and was assumed to have been consumed. However, supply balance sheets are at risk of bias. For Switzerland, considerable export data (e.g. sweet soft drinks) are underestimated or not considered at all by the statistics as published by réservesuisse and Swiss sugar producers [Sugar companies of Aarberg and Frauenfeld, 2012], which was most likely used by the UNFAO. From a methodological point of view, it is indispensable to use reliable, available published data. It is difficult to exactly assess the per capita consumption of sugar for each nation, and the authors admit a certain lack of clear definition. We have substantiated concerns about the validity of data regarding Switzerland used in the Received: February 8, 2013 Accepted after revision: April 21, 2013 Published online: November 26, 2013