by Marion Nestle

Currently browsing posts about: Sugars

May 1 2015

Weekend reading: The Oxford Companion to Sugar and Sweets

Darra Goldstein, editor.  The Oxford Companion to Sugar and Sweets.  Oxford University Press, 2015.

Full disclosure: I have two entries in this book, one with Daniel Bowman Simon.

  • Simon DB, Nestle M.  Soda lobbies.  In: Goldstein D.  The Oxford Companion to Sugar and Sweets.  Oxford University Press, 2015:681-682.
  • Nestle M.  Soda.  In: Goldstein D.  The Oxford Companion to Sugar and Sweets.  Oxford University Press, 2015:623-624.

With that out of the way, I can only think that the editors of this book, Darra Goldstein and Michael Krondl, must have had the best time pulling this together.

The encyclopedia starts with an elegant introduction by Sidney Mintz, author of Sweetness and Power, the one book that tops everyone’s list of must reads in food studies.

The remaining 800 pages or so are devoted to entries by 265 authors on matters as diverse or arcane as dulce de leche, nanbangashi (“southern barbarian sweets”), syllabub, and whoopie pie (look them up).  I especially like the Appendixes: lists of films featuring sugar and chocolate, songs about sugar and candy (often as a metaphor), and museums.

The illustrations are lavish, especially the two sets of gorgeous color inserts.  Subtlety: The Marvelous Sugar Baby, alas, is gone from the Domino Sugar Factory in Brooklyn, but it lives on here.  For that alone….

Apr 20 2015

Sugar politics: never a dull moment

Here are two more items on the endless disputes over sugar intake.

1.  The IOM’s 25% of calories from sugar “recommendation”

I was surprised to see the Institute of Medicine’s upper limit of sugar safety cited in a JAMA commentary on sugars and heart disease. The authors disagreed with the conclusions of a study by Yang et al. in JAMA Internal Medicine:

Most US adults consume more added sugar than is recommended for a healthy diet. We observed a significant relationship between added sugar consumption and increased risk for CVD mortality.

The authors of the commentary say:

The relationship between added sugar intake and CVD mortality remains unresolved. The study by Yang et al1 does not support implementation of health policies limiting sugar intake because a relatively small fraction of the total population ingests excessive amounts of sugar by the IOM criteria….Laws attempting to limit excess sugar intake have been passed and overturned on legal grounds. Aside from the legal questions, there is insufficient scientific evidence to support pursuit of policies limiting sugar intake.

They then go on to say:

The Institute of Medicine (IOM) recommendation is that less than 25% of total kilocalories come from added sugar.

Oops.  The IOM made no such recommendation.

Instead, the IOM said 25% of calories was the upper limit of safe sugar intake for nutrient deficiencies.  The risk of nutrient deficiencies increases above that percentage.  That IOM report said nothing about the relationship of sugar quantity to risk of chronic diseases.

Most health authorities recommend no more than 10% of calories from added sugars as a means to reduce the risk of obesity, diabetes, and heart disease.

Most research shows that chronic disease risks increase with increasing sugar intake.

 2.  What is the FDA doing about “Added Sugars” on food labels?

According to all sources, the FDA is still working on what to do about Added Sugars on the new Nutrition Facts panel.  It is engaged in two studies of this question.

It says the added sugars study is complete and the data are being analyzed.  It says the format study is in the works.

The FDA was criticized for proposing added sugars on the label without having done the research first.  Apparently, the White House Office of Management and Budget took 9 months to approve the FDA’s proposal to do the sugar research.  The approval came after the FDA issued its label proposal.

The bottom line on sugar: Less is better.

Apr 14 2015

Sugar politics: the sagas never end

I’ve been collecting items on sugars.  Here are the first two.  Two more will come later this week.

1.  The American Academy of Pediatrics Council on Nutrition has new guidance on sugars in schools.

Although access to junk foods remains an issue in schools, the Council blames the problem on students, parents, and staff.  It advises:

A positive emphasis on nutritional value, variety,appropriate portion, and encouragement for a steady improvement in quality will be a more effective approach for improving nutrition and health than simply advocating for the elimination of added sugars.

Really?  Evidence, please.

I ask because Kellogg could not be happier with this approach.  A little sugar, it says, may help kids eat more nutritious foods.

Surely it’s not a coincidence that one of the authors discloses receiving support from the National Dairy Council and the American Dairy Association, and the other receives support from the Nestle Nutrition Institute.

In any case, we aren’t talking about a little sugar in schools.  We are talking about candy, cupcakes, and drinks brought in for birthdays, treats, and after school celebrations.

2.  Sugar in the Trans Pacific Partnership (TPP)

This, you will of course recall, is the controversial multinational trade agreement currently under negotiation (see my previous post on this topic).

Japan wants to keep its tariff on sugar.

It now appears that the Japanese sugar industry gave a 1 million yen donation to a political group that supports Minister of Agriculture Koya Nishikawa, just before he became involved in the TPP talks in 2013.

As one commentator put it, considering Nishikawa’s central role in the TPP negotiations,

his receipt of a donation from an industry group brings his morals as a politician into question. Nishikawa stated that he returned the donation in light of his capacity as agricultural minister, but this is unlikely to resolve the situation…In March 2013, it was announced that the Japan Sugar Refiners’ Association would receive 1.3 billion yen in subsidies under a Ministry of Agriculture, Forestry and Fisheries’ project.

At the very least, this situation looks like blatant conflict of interest.

Apr 6 2015

Is SmartCandy smart policy?

I was surprised by FoodNavigator-USA’s story about “SmartCandy,”—a “vitamin-infused snack.

smart candy

Could the name and contents of this candy be violating the FDA’s “jelly bean” rule?

The “jelly bean” rule refers to FDA’s fortification policy,* which aims to discourage food and beverage makers from adding vitamins to “foods of minimal nutritional value” (a.k.a. junk foods) so they can be marketed as healthy.

The policy is explicit.  The FDA does not consider it appropriate to add nutrients to candies and beverages.

Here’s what the article says about what’s in it:

Smartcandy is formulated with a blend of Vitamin A for eye health, three B vitamins to support converting sugar and carbohydrates into sustained energy, and vitamin C for immunity. The trans fat-, high-fructose corn syrup-free candies come in four varieties: sweet and sour gummies; and Froot, a proprietary snack with a candy shell and a layer of yogurt encasing a strawberry or orange center.

Here’s the Nutrition Facts label (thanks to a reader for sending).

Here’s what the website says Orange Froot candy can do:

This is the visionary leader of the snacking world, it’s the one they listen to and admire. He can make a three point shot with his eyes closed, build the best fort you’ve ever seen, or solve an algebra question like it was a nursery rhyme, this flavor packed snack will push you to achieve anything!

If SmartCandy can get away with this, won’t Coca-Cola and Pepsi be next?

Candy is candy and has an place in kids’s diets—occasionally.  But a health food that makes kids do better in school?  I’d like to see the evidence for that.

FDA: take a look please.

*Thanks to Michael Jacobson for forwarding.

Update, April 13: The New York State Attorney General has filed a complaint.

Mar 11 2015

Study documents sugar industry influence on dental research in the 1960s and 1970s

A new study in PLoS Medicine provides documentary evidence of sugar industry manipulation of research on dental caries in the 1960s and 1970s.

The paper is a formal presentation of an article in Mother Jones (which I wrote about in a previous post).

The researchers are at UCSF, which sent out a press release:

A newly discovered cache of industry documents reveals that the sugar industry worked closely with the National Institutes of Health in the 1960s and ‘70s to develop a federal research program focused on approaches other than sugar reduction to prevent tooth decay in American children.

The archive of 319 industry documents, which were uncovered in a public collection at the University of Illinois, revealed that a sugar industry trade organization representing 30 international members had accepted the fact that sugar caused tooth decay as early as 1950, and adopted a strategy aimed at identifying alternative approaches to reducing tooth decay.

These approaches, as the article explains, involved encouraging the NIH to do research on mitigating or preventing tooth decay, which is fine in theory, but in practice distracted the dental research community from trying to discourage sugar consumption.

The analysis showed that in the late 1960s and early 1970s, the sugar industry funded research in collaboration with allied food industries on enzymes to break up dental plaque and a vaccine against tooth decay. It also shows they cultivated relationships with the NIDR and that a sugar industry expert panel overlapped by all but one member with the NIDR panel that influenced the priorities for the NIH tooth decay program. The majority of the research priorities and initial projects largely failed to produce results on a large scale, the authors found.

Understandably, the Sugar Association is not pleased.  Here is what the Sugar Association told Time Magazine:

It is challenging for the current Sugar Association staff to comment directly on documents and events that allegedly occurred before and during Richard Nixon’s presidency, given the staff has changed entirely since the 1970s. However, we are confused as to the relevance of attempts to dredge up history when decades of modern science has provided answers regarding the role of diet in the pathogenesis of dental caries… A combined approach of reducing the amount of time sugars and starches are in the mouth, drinking fluoridated water, and brushing and flossing teeth, is the most effective way to reduce dental caries.

As Stan Glantz pointed out in his blog post, “This sounds similar to the statement from Brown and Williamson Tobacco put out in 1995 in response to our first papers based on tobacco industry documents.”

Distracting researchers from focusing on underlying causes is a strategy perfected by the tobacco industry and copied widely by other industries making potentially harmful products, as shown clearly in the just released film, Merchants of Doubt (a must-see).

Mar 10 2015

World Health Organization: Eat less sugar

The World Health Organization (WHO) has finally officially released its recommendations for sugar intake.  I say “officially,” because I posted an earlier version these guidelines late in January.

The new—and official—WHO guideline, “Sugar intake for adult and children,” makes these recommendations for adults and children:

  • For general health, Reduce daily intake of free sugars to less than 10% of total energy intake.
  • For additional health benefits: Reduce daily intake to below 5% or roughly 25 grams (6 teaspoons) per day.

This recommendation is based on a scientific review as well as comments by groups such as Center for Science in the Public Interest.

The British advocacy group, Action on Sugar, is disappointed in the recommendations, thinks they don’t go far enough, and suspects that heavy food industry lobbying was at work.

There is absolutely NO nutritional requirement for free sugars in our diets, therefore AoS is disappointed that the 5% recommendation is conditional. The WHO used the GRADE[Grading of Recommendations Assessment, Development and Evaluation] system for evaluating the evidence which is useful for drug trials, but is not appropriate for the links between diet and health. This has allowed the food industry to sow the seeds of doubt amongst the WHO, who have failed to come up with the strong recommendation that is so vitally needed, especially for children.

On the other hand, the food industry says the recommendations are misleading and based on weak evidence.

The US Sugar Association [said]…Such a claim is serious, and requires high-quality data, particularly given the potential for consumer confusion and the likelihood that the economic impact to developing countries will be severe. There was a need for extensive debate, especially before the 5% value was included in official recommendations, said the European Committee of Sugar Manufacturers (CEFS). “Especially because the data this value is based on was deemed to be of very low quality by both WHO and the dental health review authors,” it said…. The sugar industry said that sugar in isolation could not be blamed for obesity and asked people to focus on what the WHO defined as the primary cause of obesity: an imbalance between calories and activity.

The WHO recommendations are similar to those issued for decades by national health agencies.  The last time WHO tried to issue the 10% of calories advice in 2003, it got clobbered by lobbyists.

This time, lobbyists didn’t succeed.  This is progress.

Tomorrow: more on sugar lobbying.

 

Feb 13 2015

Sugar politics: The BMJ’s series “Spinning a web of influence”

BMJ (formerly the British Medical Journal) has just released an editorial and four papers on ties between the sugar industry and public health scientists who advise the government on health policy.  Some health policies involve recommendations about intake of sugars.

The BMJ press release explains

Recipients of research funding from sugar and other related industries include members of the Scientific Advisory Committee on Nutrition (SACN), which is currently updating official advice on carbohydrates consumption, and researchers working for the Medical Research Council’s Human Nutrition Research unit (HNR).  HNR scientists have received research funding and funding in kinds from companies including Coca-Cola, Mars, Nestlé, Sainsbury’s, the Institute of Brewing and Distilling, Weight Watchers International and others…Of the 40 scientists affiliated with SACN between 2001 and 2012, only 13 have had no interests to declare.

This, of course, is no different than what we see here.  Food and beverage companies support food and nutrition research as well as professional societies, and conflicts of interest are rampant.

Even so, these well documented studies are alarming and worth serious attention.  And be sure to look at the map.

MedPage has a nice summary (I’m quoted).

The furor over these articles

Jan 28 2015

WHO versus noncommunicable (chronic) disease: where’s the sugar target?

The World Health Organization (WHO) released two reports within the last week aimed at preventing noncommunicable diseases.  Although the second is all about reducing sugar intake, the first report is about everything but.

1.  The Global Status Report on Noncommunicable Diseases, 2014.* 

The WHO press release points out that the report calls for:

more action to be taken to curb the epidemic, particularly in low- and middle-income countries, where deaths due to NCDs are overtaking those from infectious diseases. Almost three quarters of all NCD deaths (28 million), and 82% of the 16 million premature deaths, occur in low- and middle-income countries.

How?  By working to achieve 9 targets:

  • Target 1: A 25% relative reduction in risk of premature mortality from CVDs, cancer, diabetes, chronic respiratory diseases.
  • Target 2: At least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context.
  • Target 3: A 10% relative reduction in prevalence of insufficient physical activity.
  • Target 4: A 30% relative reduction in mean population intake of salt/sodium.
  • Target 5: A 30% relative reduction in prevalence of current tobacco use in persons aged 15+ years.
  • Target 6: A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure, according to national circumstances.
  • Target 7: Halt the rise in diabetes and obesity.
  • Target 8: At least 50% of eligible people receive drug therapy and counselling (including glycaemic control) to prevent heart attacks and strokes.
  • Target 9: An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major NCDs in both public and private facilities.

Don’t dietary sugars have something to do with diabetes and obesity?  How come no specific target?  This is especially odd in light of the second report.

2. Guideline: Sugars Intake for Adults and Children [see updated, revised publication released March 2015]

The WHO makes three recommendations about intake of added (“free”) sugars:

  • A reduced intake of free sugars throughout the lifecourse (strong recommendation).
  • Reducing the intake of free sugars to less than 10% of total energy intake (strong recommendation).
  • A further reduction of the intake of free sugars to below 5% of total energy intake (conditional recommendation)

Why no target for sugar reduction to 10% of energy  in the first report?

The omission is glaring.  Could politics be involved?  It’s hard to think of any other explanation.

WHO needs to speak with one voice on NCD targets, guidelines, and recommendations.

* Along with the NCD target report, WHO also released:

**Thanks to Dr. Karen Sokal-Gutierrez for alerting me to the lack of a sugar target.

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