by Marion Nestle

Currently browsing posts about: Sugars

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.

 

 

Apr 8 2014

Evaporated cane juice: Sugar by any other name…

This question came in from Lourdes, a reader:

Would you please comment on these cases and the decisions regarding the issue [evaporated cane juice, apparently].

Happy to.

Evaporated cane juice is the food industry’s latest attempt to convince you that crystallizing sugar by this particular method will make you think it is:

  • Natural and healthy.
  • Better for you than table sugar.
  • Much better for you than high fructose corn syrup (HFCS).

Maybe, but it’s still sugar.

Pushed by food companies to let “evaporated cane juice” be used on food labels, the FDA in 2009 issued one of those non-binding guidance documents it loves to do.

Over the past few years the term “evaporated cane juice” has started to appear as an ingredient on food labels, most commonly to declare the presence of sweeteners derived from sugar cane syrup. However, FDA’s current policy is that sweeteners derived from sugar cane syrup should not be declared as “evaporated cane juice” because that term falsely suggests that the sweeteners are juice…. FDA considers such representations to be false and misleading…because they fail to reveal the basic nature of the food and its characterizing properties (i.e., that the ingredients are sugars or syrups) as required by 21 CFR 102.5.

The FDA opened the matter up to public comment last month.  In the meantime, evaporated cane juice is in the courts, where more and more food regulation seems to be taking place days except that judges are balking.

It’s a perfect Catch 22: The courts won’t rule until the FDA issues regulations.  The FDA won’t issue regulations while the matter is in the courts.

The bottom line?  As NPR puts it, “Sugar by any other name tastes just as sweet — and has just as many calories.”

To repeat: Evaporated cane juice is sugar.  Cane sugar is sugar.  All forms of sugar have calories, even when Kale flavored (thanks to Jill Richardson for sending this along).

20140407_185435

Mar 19 2014

Is saturated fat a problem? Food for debate.

What is a poor eater to do?

The latest meta-analysis of the effects of saturated fat on heart disease finds—none.

This study, reported in the Annals of Internal Medicine (doi: 10.7326/M13-1788), examined the results of

  • 32 observational studies involving 530 525 participants
  • 17 observational studies involving 25 721 participants
  • 27 randomized controlled trials involving 103 052 participants

The result?

Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats. 

This meta-analysis follows an editorial in a Mayo Clinic publication (http://dx.doi.org/10.1016/j.mayocp.2013.11.006) by authors who argue that saturated fat is not the problem.  Carbohydrates (e.g., sugars) are the problem.  The authors argue:

  • Effects of saturated fat on blood cholesterol are weak and transient.
  • Meta-analyses have found a lack of an association between heart disease mortality and saturated fat intake.
  • Stroke studies find that patients with stroke had eaten less saturated fat.
  • Long-term studies find that people with the highest dairy consumption have the lowest mortality risk, and also low diabetes and heart disease.
  • Dietary trials find trivial or no benefit at all from decreasing saturated fat and/or increasing intake of polyunsaturated fat.

On this basis, they say that advice to reduce intake of saturated fat is irrational.

The New York Times asked several experts for comment on the meta-analysis, among them Dr. Frank Hu of Harvard:

The single macronutrient approach is outdated…I think future dietary guidelines will put more and more emphasis on real food rather than giving an absolute upper limit or cutoff point for certain macronutrients…people should try to eat foods that are typical of the Mediterranean diet, like nuts, fish, avocado, high-fiber grains and olive oil.

Dr. Hu was referring to a large clinical trial (not included in the meta-analysis), which concluded that a diet with more nuts and extra virgin olive oil reduced heart attacks and strokes when compared with a lower fat diet with more starches.

The Times story contained a reminder that the American Heart Association issued dietary guidelines last year to “restrict saturated fat to as little as 5 percent of their daily calories, or roughly two tablespoons of butter or two ounces of Cheddar cheese for the typical person eating about 2,000 calories a day.”

How to make sense of this?

I vote with Frank Hu that dietary advice should focus on food, not nutrients.

Focusing on one or another nutrient—fat, saturated fat, cholesterol, or sugar—takes foods out of their caloric as well as dietary context.

My guess: If you balance food intake with physical activity and are not overeating, the specific proportion of fat, carbohydrate, and protein won’t matter nearly as much.

While the arguments about fat v. sugar go on and on:  Eat your veggies, vary the foods you eat, don’t gorge, and enjoy what you eat.

Mar 6 2014

WHO tries added sugar guideline again: 10% of daily calories!

While I’m on the topic of sugars (see yesterday’s post), the World Health Organization (WHO) has just called for public comment on proposed new guidelines for intake of “free” (added) sugars:

  • Added sugar intake should be less than 10% of total calories per day (50 grams for a 2000 calorie-a-day diet)
  • Intake below 5% of calories would confer additional benefits (25 grams)

Although the announcement casually mentions that the draft guidelines reaffirm a previous WHO sugar guideline from 2002, it just as casually fails to mention what happened to that guideline.

I, however, have perfect recall, particularly because I wrote about these events in the Afterword to the 2013 edition of Food Politics:

In the early 2000s, the World Health Organization (WHO) began work on a global strategy to reduce risk factors for chronic disease, obesity among them. In 2003, it published a research report that advised restricting intake of “free” (added) sugars to 10% or less of daily calories. Although this percentage was similar to that embedded in the USDA’s 1992 Pyramid (7–13% of calories, depending on total intake), sugar industry groups strenuously objected, enlisted senators from sugar-growing states to pressure the DHHS secretary to withdraw funding from WHO, and induced the DHHS chief counsel to send a critique of the report to WHO that had essentially been written by industry lobbyists. When released in 2004, WHO’s Global Strategy on Diet, Physical Activity, and Health omitted any mention of the background report or the 10% sugar recommendation.

“Strenuously objected” vastly understates what happened.

Why was the sugar industry so concerned?  One 12-ounce Coke or Pepsi contains about 40 grams of sugars.  Have one, and you’ve just about done your added sugars for the day.

WHO must either think that the research basis of the 10% sugar guideline is much stronger now (see references below), or that the political landscape has shifted so far in the direction of reducing sugar intake that governments will ignore industry groups this time.

I’m not so sure.  I think WHO needs all the help it can get with this one.

Submit comments here.  Now!

References

Reports commissioned by WHO

What happened to the previous guideline

Feb 12 2014

Sugar v. HFCS: How I got involved in this lawsuit

Eric Lipton of the New York Times, who wrote Monday’s revelation of how the National Restaurant Association funds front groups to fight a raise in the minimum wage, has just topped that story.

Today, he writes an enlightening account of the legal battles between sugar and HFCS trade associations over marketing issues, in which I seem to have played a part.  The story quotes me:

Marion Nestle, a New York University professor and nutrition expert named in several documents [scroll down to "Using Marion Nestle"] as someone whom corn industry executives sought to influence, said the role both industries played was unfortunate.

“It is a plague on both of their houses,” she said, adding that she felt manipulated by the corn refiners industry, which used her statements to defend its products. “It is a disgusting performance neither should be proud of.”

Mr. Lipton sent me two of the documents last night (letters from Audrae Erickson of the Corn Refiners Association to Larry Hobbs of the Institute of Beverage Technologists, and to J. Justin Wilson of Rick Berman’s public relations arm of the Center for Consumer Freedom).

Here’s my recollection of how I ended up in this lawsuit:

Yes, I argue that the science shows that sucrose (table sugar) and high fructose corn syrup (HFCS) contain the same sugars—glucose and fructose—and do much the same things in the body.  I think everyone would be better off eating a lot less of either.  I repeated this in many blog posts over the years.

Sometime in 2010, Christopher Speed, then director of food and nutrition sciences at Ogilvy Public Relations, asked if I would meet with his client, Audrae Erickson, president of the Corn Refiners Association (CRA).  I agreed, provided the CRA make a contribution to the NYU library’s food studies collection for cataloging expenses.  This turned out to be $1,500.  We met.

Shortly after that, my statements about the equivalence of sucrose and HFCS appeared on the Corn Refiners’ website.

I asked to have the comments removed.

Ms. Erickson’s response?  My comments were public and if I wanted them removed I could take the CRA to court.

That ended our correspondence.

From Mr. Lipton’s account I learned for the first time of the CRA’s involvement with the Center for Consumer Freedom (see previous blog posts).

This explains what had been a great mystery.  The Center for Consumer Freedom has not exactly been my great fan.  It features me under ActivistCash, and usually has rather unpleasant things to say about my work and opinions.

But with respect to my opinions about sucrose v. HFCS, its comments were quite complimentary.  I should have realized that CRA was paying the Center, via Berman, to do this.

I was also fascinated to learn:

  • The CRA spent $30 million since 2008 on public relations.
  • Of that, $10 million funded research by James Rippe to prove HFCS is no different from sucrose (something you would learn from any basic biochemistry textbook).
  • Mr. Rippe got a $41,000 monthly retainer from the CRA.

Clearly, I should have asked for a lot bigger donation to our library.

Thanks Eric Lipton, for terrific investigative reporting.  Please do more of these.

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