Search results: sugar

The latest review of sugars and health has created quite a stir.

• The study:  Dietary sugar consumption and health: umbrella review.  BMJ 2023; 381 doi: https://doi.org/10.1136/bmj-2022-071609 (Published 05 April 2023).
• Method:  The authors evaluated 73 meta-analyses that included 8601 studies, most of them observational (meaning they indicate associations but not necessarily causation).
• Findings: Significant harmful associations between dietary sugar consumption and 18 endocrine/metabolic outcomes, 10 cardiovascular outcomes, seven cancer outcomes, and 10 other outcomes (neuropsychiatric, dental, hepatic, osteal, and allergic) were detected.
• Implications: Low-quality evidence linked each additional serving of a sugar-sweetened beverage per week with a 4% higher risk of gout. Each extra cup per day of a sugar-sweetened drink was associated with a 17% and a 4% higher risk of coronary heart disease and all-cause mortality, respectively.
• Recommendations: (1) Reduce the consumption of free sugars or added sugars to below 25 g/day (this translates to about 6 teaspoons daily). (2) Limit sugar-sweetened beverages to less than 1 a week.

Here’s the headline about the stir:

Experts recommend 6-teapsoon limit to added sugar following BMJ review, industry weighs in:  Recently published research in The BMJ is providing fresh concerns about sugar consumption levels, as some industry stakeholders disagree with the conclusion and CPG brand look to innovate in the low- and no-sugar space…. Read more

And one of the quotes from an industry representative:

…This is a review of existing evidence, and even a well-executed systematic review is only as good as the studies that are inputted. Essentially, garbage in equals garbage out, and it is known that added sugars literature suffers from significant variability when it comes to definitions, intake measurements and control of energy and other diet and lifestyle variables.

Comment: The six-teaspoon recommendation is consistent with World Health Organization guidelines to reduce daily intake of free sugar to less than 10% of their total energy intake, and preferably 5 percent.  The authors admit the evidence is not strong.  But there’s just so much of it, and it’s not going away.

When it comes to sugars, less is better, alas.

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In February, the USDA proposed rules for sugars in school meals.  These meant:

Flavored milks would be limited to no more than 10 grams of added sugars per 8 fluid ounces for milk served with school lunch or breakfast. For flavored milk sold outside of the meal (as a competitive beverage for middle and high school students), the limit would be 15 grams of added sugars per 12 fluid ounces.

The International Dairy Foods Association says it can and will do this as part of an effort “to preserve flavored milk options as part of the National School Lunch and Breakfast programs. USDA currently has proposed one option to provide only unflavored milk for school-aged children grades K-8.”

Among milk options available in schools, low-fat flavored milk is the most-consumed beverage for students regardless of grade, IDFA says. Flavored milk products such as chocolate milk offered in schools today contain an average of just 8.2 grams of added sugar per serving.

The Sugar Association, no surprise, supports continued use of sugary milk in schools—for its own particular reason.

As the ‘Healthy School Milk Commitment’ moves forward, it is important that alternative sweeteners are not encouraged or deployed as a frontline sugar reduction strategy for flavored milk served in schools.

The use of low- and no- calorie sweeteners in products intended primarily for both children and adults has increased by 300% in recent years, and their presence in food products is easily cloaked from consumers because of FDA’s arcane and outdated food labeling requirements.

As the health effects of sugar substitutes on children are not adequately studied, we should proceed cautiously when it comes to initiatives that incentivize the use of these ingredients.

We support flavored milk products, which provide important nutrients and are always a fan-favorite among school students in our nation’s schools, and caution against the use of sugar substitutes to meet sugar reduction commitments in the milk consumed by our nation’s school children.

That is a new argument (to me, at least).  Here are some old ones (with my comments):

• Chocolate milk has lots of nutrients (it also has lots of sugar).
• Kids won’t drink plain milk (they will, actually)
• Kids won’t get those nutrients if they don’t drink milk (they can get them from other foods).

But New York City has a handout on why plain milk is preferable.  It’s worth a look.

I was sent a note from the University of California Research Consortium on Beverages and Health about its new fact sheets on sugar-sweetened beverages done in collaboration with the American Heart Association.  The Consortium includes faculty who work on some aspect of sugar science on all ten UC campuses.

Factsheets and Infographics on the UC Research Consortium on Beverages and Health webpage:

• Factsheet: What Are Sugary Drinks?
• Factsheet: 7 Reasons to Skip Sugary Drinks.
• Factsheet: Health Harms of Sugary Drinks.
• Factsheet: The Heavy Environmental Impact of Sugary Drinks.
• Factsheet: Sugary Drinks and COVID.
• Factsheet: How Four Cities in California Are Using Sugary Drink Tax Revenues. UC Research Consortium on Beverages and Health.

They also can be accessed from UC’s Nutrition Policy Institute publications page.

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For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

It’s hard to know what to make of the new products heading for the market.

Here’s one.

The rapper Calvin Cordozar Broadus Jr (aka Snoop Dog) is planning to introduce a new breakfast cereal (When?  Sometime soon).

Just what we need.  Another sugary cereal targeting kids.

If a Nutrition Facts label is available, I couldn’t find it online, but I’m guessing 30-40% sugar, and full of color and flavor additives, and super ultra-processed.

But it’s gluten-free and some of the sales revenues will go to support Door of Hope, which advocates for homeless families.

Despite the do-good aura, it’s not what nutritionists recommend, alas.  Well maybe as an occasional treat.

Will Kellogg complain about copyright infringement?  This is clearly a Froot Loops copycat, only with marshmallows—more marshmallows, no less.

Sigh.

At the request of Congress, the USDA’s Food and Nutrition Service (FNS) has just released “Added Sugars in School Meals and Competitive Foods.”  The report itself is at this link.

The idea was to find out whether schools were meeting the 10% standard: meals and snacks were not to exceed 10% of calories from added sugars.

Note: the 10% is meant to be a ceiling, not a floor.

The report’s Key Findings

• Practically all—92%—of school breakfasts had 10% or more of calories from added sugars.
• The majority of schools—69%—served lunches with 10% percent or more calories from added sugars.
• The main source of added sugars in school meals is flavored (e.g., chocolate) fat-free milk; this contributed 29% of the added sugars in breakfasts and 47% in lunches.
• Of the 10 most popular a la carte food items available at breakfast, 6 exceeded the 10% maximum for added sugars.
• Of the 10 most popular a la carte food items available at lunch, four exceeded the 10% maximum.

Mind you, this says nothing about sweet snacks and candy used as rewards, treats, snacks, or celebrations in classrooms.

But if you want to know why nutritionists like me would like to see chocolate milk mostly kept out of schools, here’s why.

We have Healthy Food America and the University of Washington, the UCONN Rudd Center for Food Policy & Health, and the Public Health Law Center at Mitchell Hamline School of Law to thank for this guide to tax legislation that will promote health and racial equity.

The report:

• Reviews tax laws proposed and achieved in the US
• Summarizes the experience of advocates and policymakers
• Examines approaches used in alcohol, tobacco, and cannabis taxes
• Recommends how to draft legislation to promote equity

The full report: Investing Sweetened Beverage Tax Revenues to Advance Equity: Recommendations for Drafting Legislation

The brief report is here.

An infographic provides a quick overview.

Other supporting materials are available on the Healthy Food America website.

Want to give this a try?  Here’s how.

Here’s a good one for my collection:

The Study: TRENDS IN ADDED SUGARS INTAKE AND SOURCES AMONG U.S. CHILDREN, ADOLESCENTS AND TEENS USING NHANES 2001-2018.  Laurie Ricciuto,Victor L. Fulgoni III, P. Courtney Gaine, Maria O. Scott, Loretta DiFrancesco. The Journal of Nutrition, Volume 152, Issue 2, February 2022, Pages 568–578, https://doi.org/10.1093/jn/nxab395 

• Background: Over the past 2 decades, there has been an increased emphasis on added sugars intake in the Dietary Guidelines for Americans (DGA), which has been accompanied by policies and interventions aimed at reducing intake, particularly among children, adolescents, and teens.
  Objectives: The present study provides a comprehensive time-trends analysis of added sugars intakes and contributing sources in the diets of US children, adolescents, and teens …focusing on variations according to sociodemographic factors.
• Methods: Data from 9 consecutive 2-year cycles of the NHANES were combined…Trends were also examined on subsamples stratified by sex, race and ethnicity…income (household poverty income ratio), food assistance, physical activity level, and body weight status.
• Results: From 2001–2018, added sugars intakes decreased significantly…mainly due to significant declines in added sugars from sweetened beverages.
• Conclusions: Declines in added sugars intakes were observed among children, adolescents, and teens…Despite these declines, intakes remain above the DGA recommendation; thus, continued monitoring is warranted.
• Support: The funding for this research was provided by The Sugar Association, Inc. The views expressed in the manuscript are those of the authors and do not necessarily reflect the position or policy of The Sugar Association, Inc. The Sugar Association, Inc. had no restrictions regarding publication.
• Author Disclosures: LR and LD as independent consultants provide nutrition and regulatory consulting to various food manufacturers, commodity groups and health organizations. VLF III as Vice President of Nutrition Impact, LLC conducts NHANES analyses for numerous members of the food, beverage and dietary supplement industry. PCG and MOS are employed by The Sugar Association, Inc.

Here’s a report from the World Health Organization on the effects of taxing sugar-sweetened beverages.

The study:

Consumption of SSBs is associated with increased risk of overweight and obesity (5), cardiovascular events (6), hypertension (7) and diabetes (8). There is now substantial evidence that SSB taxes can both discourage consumption and encourage reformulation (9,10). SSB taxes have also been found to have positive impacts on population weight and to potentially have greater health benefits among lower socioeconomic populations (11,12)….This study takes a policy analysis lens to studying SSB tax adoption and implementation in the WHO European Region. The focus was on the politicoeconomic and stakeholder dynamics in cross-sectoral policy-making, as well as considering adaptation in policy design.

https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/publications/2022/sugar-sweetened-beverage-taxes-in-the-who-european-region-success-through-lessons-learned-and-challenges-faced-2022

https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/publications/2022/sugar-sweetened-beverage-taxes-in-the-who-european-region-success-through-lessons-learned-and-challenges-faced-2022

• Be adapted to a country’s legislative, fiscal, economic and health context.
• Be designed and implemented through collaboration between finance and health policy-makers.
• Take revenues into consideration.
• Expect opposition from industry.

On this last point, the report says:

SSB taxes were strongly opposed by actors in the food and beverage industry in all the study countries, before and after  implementation. Industry made strong public statements regarding the negative economic impact that the tax would have on industry, particularly in relation to employment. In Finland, France, Hungary, Ireland and Portugal, they also argued that the tax would be regressive and, therefore, have a negative impact on consumers. In Belgium, Finland, France and Hungary (notably, these were earlier taxes), industry actors raised concerns that the tax singled out beverages and/or the beverage industry for differential taxation. Industry actors also presented a range of arguments regarding the taxes being ineffective and poorly designed.

Soda tax advocates need strategies to counter this opposition.  Plenty are available.  See the toolkit at Healthy Food America, for example.