Search results: sugar policy

This week, I’m going to be posting items about sugar politics.

Item on sugars #1:

Funny thing.  I was not invited to this event, but someone who was invited passed along the invitation.  You too will be sad you weren’t invited.

I am contacting you at the request of Dr. Courtney Gaine, VP of Scientific Affairs from The Sugar Association, regarding an invitational roundtable on The Role of Sugars in Supporting a Nutrient-dense Diet for Toddlers, 12 to 24 Months.  It will be sponsored by the University of Colorado, Anschutz Medical Campus, Department of Pediatrics, chaired by Dr. Ronald Kleinman from Harvard Medical School, co-chaired by Dr. Frank Greer from the University of Wisconsin School of Medicine, and facilitated by Sylvia Rowe.  The roundtable is supported by an unrestricted educational grant from the Association….

Roundtable Objectives

• Provide a forum to discuss the science and research voids on the role of sugars as a strategy that may help parents successfully transition their older infants and toddlers (12 to 24 months) from complementary infant foods to consuming a variety of nutrient-dense foods from the family table.
• Generate potential research ideas and questions on this topic for future guidance on the feeding of young children, including birth to 24 months, which is scheduled for integration into the 2020 Dietary Guidelines for Americans.
• Create the impetus to extend this research to public-private partnerships with industry, academy and the government.

Proposed Topic Areas 

• The roundtable has been tentatively divided into these 5 topic areas: 1) transitional toddler feeding and nutrition policy; 2) physiology; 3) sugars in toddler feeding practices; 4) parent-feeding strategies: emerging science; and 5) the research path forward….

Honorarium 

The Sugar Association will reimburse you for all reasonable travel expenses, plus a $2,000 honorarium for your review of abstracts and presentations, which you will receive in mid-October, and your participation in the 1 ½ day roundtable.

This requires some translation.  I may be over-interpreting here, but as I see it, the Sugar Association is paying academics $2000 to implicitly endorse:

• Promoting the use of sugar as a way to get toddlers to eat healthier foods.
• Making sure the 2020 dietary guidelines say nothing about the need for kids to eat less sugar (we don’t even have the guidelines for 2015 yet).
• Making sure that government agencies don’t advise or set policies to encourage eating less sugar.

Sigh.

While I was visiting Cuba, formerly the largest supplier of sugar to the United States and now blocked from selling anything to us, I missed several stories about sugar.  It’s time to catch up with them.

• The Mexican Nutritional Health Alliance announces a 6% reduction in purchase of sugary beverages since implementation of the peso-per-liter tax.
• Johns Hopkins issued a case study on Mexico’s soda tax, explaining why it worked.
• The New York City Department of Health and Mental Hygiene has a new advertising campaign on the health risks of sugary drinks for children.  You can view the ads here.
• Canada has decided against requiring labeling of added sugars, but instead plans to institute a Daily Value for total sugars of 100 grams and to group all sugars on the ingredient list.  Note: 100 grams is 20% of total calories for people on 2000-calorie diets, and is twice what is recommended by most health authorities these days.
• The Washington Post says it’s great to get rid of trans fats, but what about sugars?
• The Washington Post also discusses the war between the Corn Refiners (makers of high fructose corn syrup) and sugar trade associations, this time over federal protections of the sugar industry.  I’ve discussed sugar policy in previous posts (see this one, for example).

On this last item the Post explains:

While other crop subsidies have withered, Washington’s taste for sugar has been constant. The sugar program, which has existed in various forms since the 1930s, uses an elaborate system of import quotas, price floors and taxpayer-backed loans to prop up domestic growers, which number fewer than 4,500.

Sugar’s protected status is largely explained by the sophistication and clout of a small but wealthy interest group that includes beet farmers in the Upper Midwest, cane growers in the South and the politically connected Fanjul family of Florida, who control a substantial part of the world sugar market.

Attempts to get rid of the sugar program have been constant, at least since the 1970s when I first started teaching about it, but to no avail.  Why not?  Because outrageous as the program is, it only costs the average American $10 per year—not enough to generate widespread opposition, apparently.

The bottom line on all this: eating less sugar is always a good idea.

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

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.

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.

 

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.

• Sugar: spinning a web of influence
• Sugar’s web of influence 2: Biasing the science
• Sugar’s web of influence 3: Why the responsibility deal is a “dead duck” for sugar reduction
• Sugar’s web of influence 4: Mars and company: sweet heroes or villains?
• Map showing links between public health scientists and the sugar industry ​

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

The furor over these articles

• UK scientists object to the accusations
• Responses to the BMJ
• BBC commentary on the dispute
• Susan Jebb responds
• The Obesity Society’s Position Opposing Ad Hominem Attacks (its term for articles like those in the BMJ)

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.

 

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

It has two sets of proposed changes:

• Nutrition and Supplement Facts Labels
• Serving Sizes

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:

• All necessary information in one place.
• A short guide and checklist
• Nutrition and Supplement Facts Label: Docket FDA-2012-N-1210  Comment here now
• Serving Sizes: Docket FDA-2004-N-0258  Comment here now

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].

• http://www.law360.com/articles/481315/lifeway-accused-of-masking-smoothies-sugar-content?article_related_content=1.
• http://www.law360.com/articles/524647/cane-juice-labeling-suit-tossed-pending-fda-decision.
• http://www.law360.com/articles/474011/late-july-faces-false-ad-suit-over-evaporated-cane-juice-?article_related_content=1. 

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).