by Marion Nestle

Currently browsing posts about: Sugars

Sep 9 2014

Canada’s Heart and Stroke Foundation weighs in on added sugars

Dr. Yoni Freedhoff sent me Canada’s Heart and Stroke Foundation’s  new position statement on Sugar, Heart Disease, and Stroke.

Its major recommendation is just like the one from the World Health Organization:

The Heart and Stroke Foundation recommends that an individual’s total intake of free sugars not exceed 10% of total daily calorie (energy) intake,and ideally less than 5%.

The Canadian government, the Foundation says, should:

  • Ensure clear and comprehensive nutrition labelling of the free sugars content in the Nutrition Facts table of all packaged foods, grouping all sugars together when listingingredients on product packaging, and standardized serving sizes on the Nutrition Facts table.
  • Restrict the marketing of all foods and beverages to children.
  • Educate Canadians about the risks associated with free sugars consumption through public awareness and education campaigns.

Shouldn’t we be doing that too?

As Dr. Freedhoff puts it, it’s “Amazing how forceful and sweeping public health organizations can be when they don’t need to worry about upsetting their industry partners.”

Aug 18 2014

Food Navigator on what’s happening with the nutrition label

Food Navigator—USA’s Elaine Watson just put together a special edition on the revamping of the Nutrition Facts label.  Her title: Radical overhaul or a missed opportunity?

To understand what’s happening with food labels, you can start with the FDA’s home page on its proposed revisions.  The comment period has ended.  You can read the comments that have been filed on the Nutrition and Supplement Facts panels, and those filed on the proposed changes to the standards for serving sizes.  These are fun to read; opinions, to say the least, vary.

But back to Food Navigator, which collects in various pieces on the topic in one place.  The “Radical overhaul” piece contains a summary of the major provisions.  Others in the series are also useful (I’m quoted in some of them):

Does vitamin D belong on the Nutrition Facts panel?

FDA proposals to list “added sugars” on the Nutrition Facts panel have already generated heated debate, so it’s perhaps unsurprising that its plan to include vitamin D is proving equally controversial…

Should ‘added sugars’ be listed on the Nutrition Facts panel?

A row is brewing over the merits of including ‘added sugars’ on the Nutrition Facts panel, with critics arguing that our bodies don’t distinguish between ‘naturally occurring’ and ‘added’ sugar – and neither should food labels – and supporters saying it will help consumers identify foods with more empty calories.

 Nutrition Facts overhaul is a missed opportunity for long chain omega-3s EPA and DHA, says GOED

The FDA’s overhaul of the Nutrition Facts panel misses a public health opportunity by prohibiting firms from even highlighting long chain omega-3 fatty acids EPA and DHA on the panel, says GOED.

What are the biggest contributors of added sugars to the US diet?

Check out this analysis of NHANES data to see where our added sugars are coming from plus read new comments about the ‘added sugars’ labeling proposal from Ocean Spray cranberries and others.

Former FDA commissioner: Nutrition Facts overhaul doesn’t go far enough

FDA proposals to overhaul the Nutrition Facts panel on food labels don’t got far enough, says former FDA commissioner David Kessler, M.D.

Behavioral scientists: Changing serving sizes on Nutrition Facts label could have unintended consequences

FDA proposals to change the way serving sizes are calculated to better reflect real-life eating behavior could encourage some people to eat even more unless the wording is changed, says one expert group.

Until phosphorus gets on the USDA’s radar, labeling policy won’t change: NKF

While phosphorus is an essential nutrient found naturally in some foods such as egg yolk and milk, it is increasingly added to packaged foods via a raft of phosphorus additives, and some experts believe it should be listed on the Nutrition Facts panel.

Canada’s proposed Nutrition Label changes emphasize calories, sugar

Health Canada is proposing changes to nutrition labels that would make them easier for consumers to read.

RD: There’s a health continuum for every food; what pillars do you want to stand on?

Rachel Cheatham, RD, founder of nutrition strategy consultancy FoodScape Group, talks food labeling at the IFT show.

Is your product ready for nutrition label changes?

“A 16-ounce drink and a two-ounce bag of potato chips are a single serving. If it’s bigger than that, from 200 to 400%, then you need to declare two columns of information—one for the serving size and one for the whole container.”

Proposed nutrition labels more effective than current labels: survey

Consumers find proposed labels easier to read in less time.

How much do consumers use (and understand) nutrition labels?

New research from the NPD Group is questioning how many US consumers even routinely check nutrition labels anymore.

 FDA’s proposed nutrition label changes emphasize calories, serving sizes

If approved, the new labels would place a bigger emphasis on total calories and update serving sizes, while also drawing attention to added sugars and nutrients such as Vitamin D and potassium.

CRN, NPA submit comments on FDA’s proposed changes to food, supplement labels

Both the Council for Responsible Nutrition and the Natural Products Association have submitted a comments on FDA’s proposed revisions for food and dietary supplement labels.

The FDA’s next step is to deal with the comments and issue final rules.  By when?

Eventually.  Stay tuned.

Jul 31 2014

Rep. Rosa de Lauro introduces the SWEET soda tax act!

Yesterday, the fabulous Representative Rosa DeLauro (Dem_CT) introduced the Sugar-Sweetened Beverages Tax Act of 2014 (SWEET Act).  Here’s a quick summary of the bill. The SWEET Act (you have to love the name) would put an excise tax of one cent per teaspoon of sugars (a teaspoon is about 4 grams). The bill is clearly aimed at sugary drinks, which account for about half of total sugar intake.  According to the 2010 Dietary Guidelines (page 29),

  • Sodas, energy, and sports drinks account for 35.7% of total sugars
  • Fruit drinks—a category that does not include 100% juices—account for another 10.5%.
  • Sugar-sweetened teas account for 3.5%.

The tax ought to raise about $10 billion a year, and is earmarked for programs to combat soda-related disease. It also ought to further reduce consumption of sugary drinks, as is already happening in Mexico. If you would like to endorse this legislation, contact Kelly.Horton@mail.house.gov in Representative DeLauro’s office. References

 

Jul 29 2014

Last call for comments on proposed food label: more on Added Sugars

August 1 is the deadline for filing comments on FDA’s food label proposals.

Two were released yesterday, one for and one against.

The Union of Concerned Scientists (UCS) organized a statement in support of listing added sugars signed by 280 scientists, physicians, and public health officials (including me).

The press release says:

In a letter submitted as a public comment for the agency’s first label update since 1994, the signatories point out that sugar overconsumption contributes to diabetes, cardiovascular disease and other ailments….Many food and beverage manufacturers add excessive amounts of sugar to their products, including those that they market as healthy options. In our current food environment, many people are unknowingly and unavoidably consuming excess sugar. Given our soaring rates of chronic diseases and the link between sugar and these diseases, citizens have a right to know how much sugar has been added to their foods.

People who signed the letter include many from Healthy Food Action, a national network of health professionals founded by Dr. David Wallinga.  I am a co-author of the statement with UCS staff and Dr. Robert Lustig.

In contrast, the American Society for Nutrition (ASN), an organization of nutrition scientists to which I belong, produced a strong statement against labeling added sugars.

ASN also has concerns that the inclusion of added sugars on the label may divert attention away from total calories and other important contributors to weight gain. The inclusion of added sugars on the label may confuse consumers and create the perception that naturally occurring sugars are somehow more beneficial because they are “natural” and do not have health effects similar to added sugars…There is no supporting evidence that indicates that the inclusion of added sugars on the food label will translate into the American public reducing caloric intake from added or total sugars or total energy intake…it is important to consider potential unintended consequences of  reformulation as well. When sugar is removed from a solid food product…The replacement is often fat and/or starch which could lead to a product with higher calories per serving. ASN encourages FDA to carefully consider potential adverse consequences of this proposed determination, including gaining input from food scientists…An investment in consumer education… is likely to be most productive for consumer understanding relative to added sugars, and would assure that consumers do not experience increased confusion, which they may encounter if added sugars are declared on the Nutrition Facts label.

These comments, which read as though written by sugar trade association groups, were signed by the president of ASN.  Although the statement letter gives no indication of the process by which these comments were developed, I’m told it was prepared by ASN’s public policy committee.

If so, it would help to know whether members of the committee have financial ties to the sugar industry or to food companies that use sugar in their products.

I wonder how much of the ASN membership agrees with this position on Added Sugars.   I certainly don’t.

 

Jul 17 2014

FDA’s proposed food label changes: comments on Added Sugars

The FDA is taking comments on its proposals to revamp the food label until August 1, 2014.

It has two sets of proposed changes:

Here is the first of my comments on several food label items.  Feel free to copy, edit, or file your own (see directions below).

July 16, 2014

TO:  FDA

FROM:  Marion Nestle, Professor, New York University

RE:  Nutrition Facts panel: ADDED SUGARS

1.  Retain the line for Sugars but call it Total Sugars

2.  Add a line for Added Sugars

Rationale:

  • Excessive intake of dietary sugars is well established to raise the risk of obesity and type-2 diabetes.[i]
  • Americans on average twice as much as is generally recommended.[ii]
  • The amount typically consumed comes close to the upper limit recommended by the Institute of Medicine on the basis of increased risk of nutrient deficiencies.[iii]
  • Sugars intrinsic to foods are accompanied by nutrients; added sugars are not.
  • Although there is no biochemical difference between intrinsic and added sugars, food and beverage companies know exactly how much sugar they add as part of the recipes for their products.
  • Listing the amount of added sugars on food labels would inform consumers about how much sugars are added to the foods they buy.
  • Randomized, controlled clinical trials to test the hypothesis that added sugars increase disease risk would violate ethical standards and, therefore, are impossible to conduct.

3.  Establish a Daily Reference Value for Added Sugars of 10% of total calories

Rationale:

  • Since the 1977 Dietary Goals, health officials have consistently recommended an upper limit of 10 percent of calories from added sugars.[iv]
  • The 1992 USDA Food Guide Pyramid suggested an upper limit of 6, 12, and 18 teaspoons of sugars, respectively, for daily diets of 1,600, 2,200, and 2,800 calories, respectively.  This works out to 7, 10, and 13 percent of calorie intake, respectively, for an average of 10 percent.[v]
  • By 1992, health officials in several European countries had recommended much the same.[vi]
  • The Institute of Medicine’s 2002 upper safety limit of 25% of calories was based on risk for nutrient deficiencies, not obesity and chronic disease.[vii]
  • In 2009, the American Heart Association recommended that women consume no more than 100 calories per day from added sugars (25 grams), and men no more than 150 calories per day (38 grams).  These come to 5 percent and 7.5 percent, respectively, of a 2000-calorie daily diet.[viii]
  • The 2010 Dietary Guidelines for Americans state that no more than 5 to 15 percent of calories should come from a combination of solid fats and added sugars.  This implies that added sugars should be less than 10% of calories.[ix]
  • Dr. Robert Lustig says that a “dose” of added sugars up to 50 grams a day poses little risk for metabolic or chronic disease.  This amounts to 200 sugar calories and 10% of a 2,000-calorie daily diet (he says twice that much, the amount commonly consumed by Americans, is toxic.[x]
  • The World Health Organization in 2014 said that added sugars should make up less than 10 percent of total calories per day, and less than 5 percent would be even better,[xi] based on two research reviews, one on sugars and obesity[xii]  and one on sugars and tooth decay.[xiii]
  • Added sugars as 10% of calories represents about half the amounts currently consumed and comes close to consensus.

References

[i] Te Morenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohttp://steinhardt.nyu.edu/nutrition/hort studies. BMJ 2012;345:e7492.  doi: 10.1136/bmj.e7492.

[ii] USDA.  Loss-adjusted food availability documentation.  March 11, 2014.  http://www.ers.usda.gov/data-products/food-availability-(per-capita)-data-system/loss-adjusted-food-availability-documentation.aspx#.UzlzcfldU6w.   USDA.  Food availability documentation: added sugar and sweeteners.  http://www.ers.usda.gov/data-products/food-availability-(per-capita)-data-system/food-availability-documentation.aspx#sugar.   The tables used to construct figure 3D are at: Refined Sugar, Corn Syrup, Other Sweeteners.

[iii] Institute of Medicine (IOM) of the National Academies. “Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients), Chapter 6: Dietary Carbohydrates: Sugars and Starches”, Washington, DC: National Academies Press; 2002.

[iv] U.S. Senate Committee on Nutrition and Human Needs.  Dietary Goals for the United States, December 1977.

[v] USDA.  Food Guide Pyramid, 1992.

[vi] Cannon G:  Food and Health: The Experts Agree.  London:  Consumers’ Association, 1992.

[vii] USDA.  Is intake of added sugars associated with diet quality?  Nutrition Insights, Insight 21, October 2000.

[viii] Johnson RK, Appel LJ, Brands M, et al.  Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association.  Circulation. 2009;120(11):1011-1120.  doi: 10.1161/CirculationAHA.109.192627.

[ix] USDA and USDHHS.  Dietary guidelines for Americans, 2010.  http://www.cnpp.usda.gov/dgas2010-policydocument.htm.

[x] Lustig RH.  Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease.  Hudson Street Press, 2012.

[xi] WHO.  Draft guideline: Sugars intake for adults and children, March 2014. http://www.who.int/nutrition/sugars_public_consultation/en/.

[xii] Te Morenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ 2012;345:e7492 doi: 10.1136/bmj.e7492.

[xiii] Moynihan PJ, Kelly SAM.  Effect on Caries of Restricting Sugars Intake. Systematic Review to Inform WHO Guidelines.  JDR 2014;93:8-18.  doi:10.1177/0022034513508954.

 

The FDA makes it easy to file comments. It provides:

Jun 19 2014

Corn Refiners to test the new food label

ProPolitico writes that the Corn Refiners Association (CRA) and five other industry groups have written the FDA that they intend to fund their own research on the FDA’s proposed changes to the Nutrition Facts label.

The FDA already has a research project underway.

Why would the CRA—the trade association for the makers of high fructose corn syrup—want to bother with an expensive and complicated research project like this?

In an interview, John Bode, CRA president and CEO, told Politico:

The FDA has estimated that changes to the label could cost the industry $2.3 billion, but ‘we suspect that is a very conservative number.

OK.  So one purpose of the research will be to prove that the new food label will cost industry a lot more money than the FDA estimates.

Let me take a guess here and surmise that another purpose will be to prove that listing “added sugars” on food labels “misleads” the public.

This will be industry-funded research.  No matter how well it appears to be done, it is highly likely to produce the answers the CRA wants.

Otherwise, why do it?

If you are a betting person, this one looks like a sure thing.

FDA: finish up those studies and get the results out!

Addition, June 20:  Legal analysts, one a former attorney for CSPI who now works for a law firm representing industry clients, advise against putting “added sugars” on the label.  

 

May 21 2014

Really, sugars are sugars. Some sugar is good. Less is better.

We need a break from school food issues.

I love this graphic, designed by Noelle Campbell.  It’s from an article by Rebecca Adams in the Huffington Post (I’m quoted).

sugar

 

May 2 2014

HFCS politics, continued. Endlessly.

Sometimes I have some sympathy for the makers of High Fructose Corn Syrup (HFCS).  They get such bad publicity.

The most recent example occurred at the White House during the annual Easter Egg Roll, and involved the First Lady of the United States (FLOTUS), Michelle Obama.

Meet Marc Murphy, a chef, drizzling honey over a fruit salad:

MURPHY: “Honey is a great way to sweeten things, it is sort of a natural sweetener.”

FLOTUS: “Why is honey better than sugar?”

MURPHY: “Our bodies can deal with honey…The high-fructose corn syrup is a little harder to … I don’t think our bodies know what do with that yet.”

FLOTUS: “Did you hear that?  Our bodies don’t know what to do with high-fructose corn syrup. So we don’t need it.”

OK class.  It’s time for a lesson in basic carbohydrate biochemistry.

  • The sugars in honey are glucose and fructose.
  • The sugars in HFCS are glucose and fructose.
  • Table sugar is glucose and fructose stuck together, but quickly unstuck by enzymes.

The body knows perfectly well what to do with glucose and fructose, no matter where it comes from.

Now meet John Bode, the new president of The Corn Refiners Association:

We applaud First Lady Michelle Obama’s commendable work to educate the public about nutrition and healthy diets… It is most unfortunate that she was misinformed about how the body processes caloric sweeteners, including high fructose corn syrup…Years of scientific research have shown that the body metabolizes high fructose corn syrup similar to table sugar and honey.

If you’ve been following this blog for a long time, you may recall that I have a little history with the Corn Refiners.

Bizarrely, I was caught up in their lawsuit with the Sugar Association.

And I was not particularly pleased to find several of my public comments about carbohydrate biochemistry displayed on the Corn Refiners website.  I did not want them used in support of the group’s ultimately unsuccessful proposal to change the name of HFCS to corn sugar.

I asked to have the quotes removed.  The response: “Your quotes are published and in the public domain.  If you don’t want us to use them, take us to court.”

I let that one go.

Enter John Bode, the Corn Refiners’ new president and CEO.  As it happens, I became acquainted with Mr. Bode in the late 1980s when he was Assistant Secretary of Agriculture and I was working in the Department of Health and Human Services (yes, the Reagan administration).

To my pleasant surprise, he recently wrote me “warm greetings, after many years.”  His note assured me that my request to have the quotes removed would be respected and that they would soon disappear.  And so they have, except for a couple in some archived press releases.

Score one for John Bode.

Mr. Bode has his work cut out for him.  He has to teach the world carbohydrate biochemistry, restore public acceptance of HFCS, defend against Sugar Association lawsuits, stop the Corn Refiners from being so litigious, and do some fence-mending, all at the same time.

And he must do all this in an era when everyone would be better off eating a lot less sugar of any kind, HFCS included.

 

 

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