Search results: added sugar

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300% in recent years, and their presence in food products is easily cloaked from consumers because of FDA’s arcane and outdated food labeling requirements.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.

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.

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.

As I mentioned yesterday, the American Beverage Association represents the interests of soft drink companies that use sugars and artificial sweeteners in their products.  Its goal: to make you think both are just fine for your health.

Today, let’s take a look at a related, but different trade association, this one The Sugar Association.  Its goal: to make you not worry about sugars and to think that they are better for you than artificial sweeteners.

Here, for example, is a press release from this Association from this past summer: New Research Shows Large Majority of Consumers Understand Real Sugar Comes from Plants & That it Can Be Part of a Healthy Diet; Data reveals significant shift in perceptions of sugar and artificial sweeteners.

And here is its infographic showing data on public suspicions of artificial sweeteners.

Now, we have a new campaign from The Sugar Association: The Campaign for Sweetener Transparency.

More than 10,000 consumers across the United States have joined the fight for sweeping reform of the government’s labeling regulations covering the use of alternative sweeteners in packaged food by signing an online petition urging the U.S. Food & Drug Administration (FDA) to require food companies to place clear, complete and accurate information on food labels…it’s virtually impossible for shoppers to know what alternative sweeteners are in which packaged foods because the FDA only requires food companies to list the chemical names of sugar substitutes on food ingredient labels. So, consumers only see names like Xylitol, Hydrogenated Starch Hydrolysates, Saccharin, Acesulfame Potassium, Neotame, Isomalt and Lactitol on ingredients lists without even knowing what they are and why they are used.

The Sugar Association wants artificial sweeteners clearly labeled so customers will switch to products that have sugars instead.

• Products containing artificial sweeteners fall in the category of ultra-processed—foods that should be avoided or eaten in small amounts.
• Products containing added sugars also should be avoided or eaten in small amounts.

That’s why this campaign is about market share, not health.

For a basic guide to what to do about sugars, see this resource guide from Hunter’s Food Policy Center.

Berkeley, California, ever at the cutting edge of public health nutrition policy, is banning junk food from checkout counters and aisles.

The new policy will require retailers larger than 2,500 square feet to stock healthy food at the register and in areas where customers wait in line, instead of items like chips, soda and candy. It forbids food items with 5 grams of added sugars and 200 milligrams of sodium, chewing gum and mints with added sugars, and beverages with added sugars or artificial sweeteners. In Berkeley, the policy will affect stores like Safeway, Monterey Market, Whole Foods and Berkeley Bowl.

As a result of efforts like these—public health campaigns, soda taxes, and other initiatives—heavy consumption of sugary drinks (more than 500 calories/day) is declining.

According to a recent study, the percentage of children who drink more than 500 calories worth of soft drinks a day declined from 11% to 3%  from 2003 to 2016, and the percentage of adult heavy consumers declined from 13% to 9%.

This trend is in the right direction.

The COVID-19 pandemic has pointed out how the higher risk of complications and death among members of minority groups.  The reasons are fairly well established.  Members of minority groups are more likely to:

• Be overweight
• Have diet-related risk factors: hypertension, type-2 diabetes, multiple metabolic problens
• Live in high-pollution areas
• Have asthma
• Suffer from the daily stress of discrimination
• Lack sick leave benefits
• Have poor health care

The .latest report from Rudd Center on Food and Obesity Policy, Sugary Drinks FACTS 2020, highlights how sellers of sugary drinks target their products to minority populations.  The press release says that the report found:

• In 2018, companies spent $84 million to advertise regular soda, sports drinks, and energy drinks on Spanish-language TV, an increase of 8% versus 2013 and 80% versus 2010.
• Sports drink brands disproportionately advertised on Spanish-language TV, dedicating 21% of their TV advertising budgets to Spanish-language TV, compared to 10% on average for all sugary drinks.
• Compared to White children and teens, Black children saw 2.1 times as many sugary drink ads and Black teens saw 2.3 times as many. Black youth exposure was particularly high for sports drinks, regular soda, and energy drinks.

Click here for the full report. 

• Sugary Drink FACTS 2020 Supplement: Examples of social media campaigns targeted to teens and Hispanic and Black youth
• Sugary Drink FACTS 2020 Appendix Tables
• Sugary Drink FACTS 2020 report summary

The report’s main finding:

CNN has an excellent account of this, in which I am quoted.

Experts say soda companies have also taken a page out of the tobacco industry’s marketing playbook, by providing funding for many Black communities and endeavors “in ways that don’t look like advertising, like funding playgrounds in minority neighborhoods, minority community groups, and sponsorship of Black and Hispanic sports figures,” said Marion Nestle, who also authored “Eat, Drink, Vote: An Illustrated Guide to Food Politics.”  “These work,” Nestle said. “Minority kids identify soda brands with sports figures, and minority community groups find it hard to oppose soda company marketing when the companies have been so generous.”

“The great irony of Ramon Laguarta’s promises to counter PepsiCo’s conscious or unconscious racist practices in the company, its business, and communities is that none of them addresses targeted marketing,” said Nestle.

“The best thing Pepsi could do to improve the health of its customers would be to stop advertising and marketing to children and teenagers, especially those of color,” Nestle added.

You may think, as I do, that everyone would be better off eating less sugar, but that’s not how The Sugar Association sees it.  This trade association for sugar producers funds research to demonstrate that eating sugar is a good thing and not harmful.

Here’s what The Sugar Association says:

The Sugar Association is committed to transparent engagement with researchers, external partners and consumers to address knowledge gaps and support independent, peer-reviewed science. Recent literature suggests this framework, rooted in transparency and communication and reflected in our Operating Principles, leads to increased public confidence in industry-funded research,* a goal the organization is working to achieve.

The asterisk refers to Achieving a transparent, actionable framework for public-private partnerships for food and nutrition research, a consensus report written by, among others, representatives of the International Life Sciences Institute, a well known front group for the food industry, and other organizations with ties to food companies.

The Sugar Association lists some of its recent publications [you can’t make this stuff up]:

• Bakke AJ, Stubbs CA, McDowell EH, Moding KJ, Johnson SL, Hayes JE. Mary Poppins was right: Adding small amounts of sugar or salt reduces the bitterness of vegetables. Appetite. 2018. doi: 10.1016/j.appet.2018.03.015. [Mary Poppins was talking about medicine, not vegetables: “Just a spoonful of sugar helps the medicine go down, In a most delightful way.”]
• Bailey RL, Fulgoni VL, Cowan AE, Gaine PC. Sources of Added Sugars in Young Children, Adolescents, and Adults with Low and High Intakes of Added Sugars. Nutrients. 2018;10(1):102.

Nutrition Today Supplement: Sweet Taste Perception and Feeding Toddlers. March/April 2017 – Volume 52 [The Sugar Association funded the conference that resulted in this supplement, which it also funded].

• Dwyer JT. Good Nutrition in Toddlers. Nutrition Today. 2017;52(2):S1-S2.5.
• Bailey RL, Barr SI. Introduction: Sweet Taste Perception and Feeding Toddlers. Nutrition Today. 2017;52(2):S3-S5.
• Achterberg C. A Perspective: Toddler Feeding, Science, and Nutrition Policy. Nutrition Today. 2017;52(2):S6-S13.
• Kleinman RE, Greer F, Cowart BJ, et al. Roundtable Proceedings: The Role of Innate Sweet Taste Perception in Supporting a Nutrient-Dense Diet for Toddlers, 12 to 24 Months Old. Nutrition Today. 2017;52(2):S14-S24. [Kleinman is co-chair of the 2020 Dietary Guidelines Advisory Committee]
• Murray RD. Influences on the Initial Dietary Pattern Among Children From Birth to 24 Months. Nutrition Today. 2017;52(2):S25-S29.Johnson SL, Hayes JE. Developmental Readiness, Caregiver and Child Feeding Behaviors, and Sensory Science as a Framework for Feeding Young Children. Nutrition Today. 2017;52(2):S30-S40.
• Hayes JE, Johnson SL. Sensory Aspects of Bitter and Sweet Tastes During Early Childhood.Nutrition Today. 2017;52(2):S41-S51.
• Moshfegh AJ, Rhodes DG, Goldman JD, Clemens JC. Characterizing the Dietary Landscape of Children, 12 to 35 Months Old. Nutrition Today. 2017;52(2):S52-S59.
• Welsh JA, Figueroa J. Intake of Added Sugars During the Early Toddler Period. Nutrition Today. 2017;52(2):S60-68.
• Palmer CA. Oral and Dental Health Considerations in Feeding Toddlers. Nutrition Today. 2017;52(2):S69-S75.

Last week was a big one for comments about sugars.  I’m traveling this week but here’s a quick round-up.

• Julia Belluz of Vox explains what sugar is about (I’m quoted) and displays a great graphic of where it hides in food (here’s an excerpt).
  
• Gary Taubes, author of The Case Against Sugar, summarizes how the sugar industry attempted to manipulate research on the effects of fat v. sugar and heart disease risk.
• Yoni Freedhoff counters with a somewhat different perspective on Taubes’ interpretations and the sugar story.
• A Canadian study shows that two-thirds of packaged foods sold in Canada have added sugar.
• Canada’s new food label is causing a fuss over the sugar listing because it (a) does not distinguish between intrinsic and added sugars, and (b) sets 100 grams per day as the standard amount.  Looks like the Canadian sugar lobby won this one.