Currently browsing posts about: Sugars

I mentioned yesterday that whenever something comes out saying that “everything you thought you knew about nutrition is wrong,” it’s a sign that some skepticism may be in order.

Here is another example: The article on the “sugar conspiracy“ by Ian Leslie published in The Guardian.  This strongly criticizes the work of Ancel Keys, whose work was largely but by no means exclusively responsible for the diet-heart hypothesis linking excessive intake of animal fats to heart disease risk.

I love conspiracy theories as much as anyone else and appreciated how the author made his case for this one.  My sense of his article was that it had grains of truth (Gary Taubes and Cristin Kearns, for example, report that Keys had funding from the sugar industry).  But the overall thrust of the article seemed excessively hyperbolic and based on selective picking of the data (cherry-picking).

Going through the piece line by line to identify errors and misinterpretations was not something I thought worth the trouble.

Fortunately, someone else did.

Katherine Docimo Pett, a master’s degree candidate in biochemical and molecular nutrition at Tufts University, who blogs as Nutrition Wonk, sent me her detailed critique of the paper.  She explains:

So I decided to look into the Seven Countries Study and I found a number of occasions where “The Sugar Conspiracy” misinterprets the evidence.  So buckle yourselves up, conspiracy theorists, because in this post, I’m going to cover the history of the diet-heart hypothesis – namely The Seven Countries Study and the subsequent research mentioned in “The Sugar Conspiracy.”

If you can wade through her lengthy analysis, you will be hard pressed to disagree with her conclusion:

In “The Sugar Conspiracy,” the author makes a lot of assumptions about intent, the usefulness of epidemiology, and even the conclusions of papers.  However, upon closer inspection, a lot of his evidence doesn’t hold up under scrutiny.

The idea that Keys claimed in his Seven Countries Study that correlation proved causation is false.  Keys just said that cholesterol is a mediator for heart disease and that saturated fat raises cholesterol, both of which later turned out to be true.  The Menotti “reanalysis” did not find that sugar is more closely correlated with heart disease than fat, and even if it did, it is a simple regression – it controlled for zero confounders, way fewer than were controlled for in the original Seven Countries Study.  Finally, there is plenty of evidence to suggest that substituting saturated fatty foods in favor of unsaturated fats is a good idea [Clarification: she must mean substituting unsaturated for saturated].

It is absolutely worthwhile to debate the merits of all scientific findings or even the merits of an entire field, like epidemiology.  Scientists, even nutrition scientists, do this all the time.  The problem, though, is that if basic facts are actually based on misinformation, you can’t build a real case for or against anything.

Amen.

Footnote: Sarah Tracy, an historian at the University of Oklahoma, has been working on a biography of Ancel Keys for quite some time.  I can’t wait for her to get it done (she probably can’t either), as it is likely to give us a thoughtful, balanced account of the significance of his work.

The USDA has just done a write up on a study it funded in collaboration with the National Honey Board:  Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals.

This was one of the 12 industry-negative studies I posted to my collection of 168 industry-funded studies from March 2015 to March 2016.

The USDA article explains:

Controversy exists over whether all sweeteners produce the same metabolic effects in consumers despite the sweeteners’ chemical similarities. A study conducted by U.S. Department of Agriculture (USDA) researchers indicates that consuming lower amounts of added sugars is a more effective approach to health than finding a sugar that is more neutral in terms of its health effects…Volunteers [consuming honey, white cane sugar, or HFCS] did not show any differences in blood sugar levels based on the dietary sugar source. In addition, blood levels of triglyceride, an indicator of blood fat concentrations (a marker for heart disease risk), increased in response to all three sugars tested.

White cane sugar is 50% glucose and 50% fructose, linked together (but quickly separated in the body).  Honey and High Fructose Corn Syrup are glucose and fructose, already separated, but with slightly higher percentages of fructose.  Biochemically, they are not all that different.

So the results of this study, disappointing as they may have been to the Honey Board, were predictable on the basis of basic sugar biochemistry.

One of the newsletters I subscribe to, BeverageDaily.com, has a special edition—a collection of its articles—on what the industry is doing to address its biggest problem: reducing sugar.

What is the beverage industry doing to cut calories?

Health and wellness is at the forefront of consumers’ minds, and sugar gets plenty of bad press. Obesity is as big a concern as ever, and soft drinks are in the firing line.

What is the beverage industry doing to reduce calories? How are market leaders reformulating and revamping their portfolios; and what healthier brands are appearing?

From alternative sweeteners to packaging sizes, we look at what the industry is doing to cut calories – and how well these initiatives are working.

From reformulation to nutritional labeling, the non-alcoholic beverage industry has adopted a variety of strategies to reduce the calorie content of drinks. We look at how different strategies from around the world are being implemented. .. Read

• UK sugar tax: comment and analysis: The UK government has announced a sugar tax on sugar-sweetened beverages, which will come into effect in April 2018. From public health officials to think tanks, we take a look at some of the comments and analysis following the announcement.  .. Read
• Stevia’s star keeps rising: MintelThe use of stevia in non-alcoholic beverage launches increased 487% between 2011 and 2015, according to figures from Mintel, with carbonates and RTD iced tea in particular turning to the natural sweetener. .. Read
• Canadian beverage company launches calorie-free organic energy water: Natural energy beverage company, Guru, has launched a sugar-free, zero-calorie organic energy water in Canada… Read
• Scientists find way to make sweetest sweetener taste sweeter: Japanese researchers have devised a method to make one of the sweetest natural sweeteners even sweeter in a development that will be seen as a breakthrough at a time when consumers are moving away from sugar… Read

You can see why the industry has a problem.  Sugar tastes good.  These other things not so much.

Thanks to a reader for sending these items from a journal that I don’t usually come across.  These bring the casually collected total since last March to 145 studies favorable to the sponsor versus 12 that are not.

Consuming the daily recommended amounts of dairy products would reduce the prevalence of inadequate micronutrient intakes in the United States: diet modeling study based on NHANES 2007–2010.  Erin E Quann, Victor L Fulgoni III and Nancy Auestad. Nutrition Journal 2015; 14:90 DOI: 10.1186/s12937-015-0057-5

• Conclusion: Increasing dairy food consumption to recommended amounts is one practical dietary change that could significantly improve the population’s adequacy for certain vitamins and minerals that are currently under-consumed, as well as have a positive impact on health.
• Funding: The study and the writing of the manuscript were supported by Dairy Management Inc.

Association of lunch meat consumption with nutrient intake, diet quality and health risk factors in U.S. children and adults: NHANES 2007–201Sanjiv Agarwal, Victor L. Fulgoni III and Eric P. Berg. Nutrition Journal. 2015;14:128.  DOI: 10.1186/s12937-015-011f8-9

• Conclusions: The results of this study may provide insight into how to better utilize lunch meats in the diets of U.S. children and adults.
• Funding: The present study was funded by North American Meat Institute.

A review and meta-analysis of prospective studies of red and processed meat, meat cooking methods, heme iron, heterocyclic amines and prostate cancer.  Lauren C. Bylsma and Dominik D. Alexander.  Nutrition Journal. 2015;14:125. DOI: 10.1186/s12937-015-0111-3

• Conclusion: Dose-response analyses did not reveal significant patterns of associations between red or processed meat and prostate cancer….although we observed a weak positive summary estimate for processed meats.
• Funding: This work was supported in part by the National Cattlemen’s Beef Association (NCBA), a contractor to the Beef Checkoff. NCBA did not contribute to the writing, analysis, interpretation of the research findings, or the decision to publish…LCB and DDA are employees of EpidStat Institute. EpidStat received partial funding from the National Cattlemen’s Beef Association (NCBA), a contractor to the Beef Checkoff, for work related to this manuscript. The conceptualization, writing, analysis, and interpretation of research findings was performed independently.

Are restrictive guidelines for added sugars science based?  Jennifer Erickson and Joanne Slavin.  Nutrition Journal. 2015;14:124.  DOI: 10.1186/s12937-015-0114-0

• Conclusion: However, there is currently no evidence stating that added sugar is more harmful than excess calories from any other food source. The addition of restrictive added sugar recommendations may not be the most effective intervention in the treatment and prevention of obesity and other health concerns.
• Disclosure: Jennifer Erickson, is a PhD student in Nutrition at the University of Minnesota working with Dr. Joanne Slavin. Joanne Slavin is a professor in the Department of Food Science and Nutrition, University of Minnesota.  In the past 5 years, she has given 150 scientific presentations in 13 countries. Many of these meetings received sponsorship from companies and associations with an interest in carbohydrates and nutritive sweeteners…Her research funding for the past 5 years has included grants from General Mills, Inc., Tate and Lyle, Nestle Health Sciences, Kellogg Company, USA Rice, USA Pears, Minnesota Beef Council, Minnesota Cultivated Wild Rice Council, Barilla Company, USDA, American Egg Board, American Pulse Association, MNDrive Global Food Ventures, International Life Science Institute (ILSI), and the Mushroom Council. She serves on the scientific advisory board for Tate and Lyle, Kerry Ingredients, Atkins Nutritionals, Midwest Dairy Association and the Alliance for Potato Research and Education (APRE). She holds a 1/3 interest in the Slavin Sisters Farm LLC, a 119 acre farm in Walworth, WI.

Cow’s milk-based beverage consumption in 1- to 4-year-olds and allergic manifestations: an RCT.  M. V. Pontes, T. C. M. Ribeiro, H. Ribeiro, A. P. de Mattos, I. R. Almeida, V. M. Leal, G. N. Cabral, S. Stolz, W. Zhuang and D. M. F. Scalabrin.  Nutrition Journal. 2016;15:19.  DOI: 10.1186/s12937-016-0138-0

• Conclusion: A cow’s milk-based beverage containing DHA, PDX/GOS, and yeast β-glucan, and supplemented with micronutrients, including zinc, vitamin A and iron, when consumed 3 times/day for 28 weeks by healthy 1- to 4-year-old children was associated with fewer episodes of allergic manifestations in the skin and the respiratory tract.
• Funding: This study was funded by Mead Johnson Nutrition…The study products were provided by Mead Johnson Nutrition. Dr. Scalabrin, S. Stolz, and W. Zhuang work in Clinical Research, Department of Medical Affairs at Mead Johnson Nutrition. All of the remaining authors have no financial relationships to disclose.

Whole grain consumption trends and associations with body weight measures in the United States: results from the cross sectional National Health and Nutrition Examination Survey 2001–2012.  Ann M. Albertson, Marla Reicks, Nandan Joshi and Carolyn K. Gugger.  Nutrition Journal 2016;15:8.  DOI: 10.1186/s12937-016-0126-4

• Conclusions: The data from the current study suggest that greater whole grain consumption is associated with better intakes of nutrients and healthier body weight in children and adults. Continued efforts to promote increased intake of whole grain foods are warranted.
• Competing interests:  Marla Reicks received an unrestricted gift from the General Mills Bell Institute of Health and Nutrition during the manuscript preparation to support research at the University of Minnesota.  Carolyn Gugger and Nandan Joshi are current employees and stockholders of General Mills, Inc.  Ann Albertson was an employee of General Mills, Inc during the conception, analysis and initial preparation of the manuscript. She is currently retired from General Mills.
• Non-financial competing interests: General Mills, Inc is a global consumer foods company that manufactures and sells products across a broad variety of food categories, including grain-based foods. General Mills product portfolio includes ready-to-eat cereals, cereal bars, baked goods, flour, and salty snacks that may contain whole grain.

I’m indebted to Maria Godoy of NPR’s The Salt for pointing out where in the new 2015 Dietary Guidelines you can find advice about cutting down on sugary drinks.  As she puts it, this is easy to miss.

Here’s my wonky analysis.

In my post about the 2015 Dietary Guidelines, I noted that they are unambiguous about the need to reduce added sugars to 10% or less of calories.  But what they say about cutting down on sugary drinks—the leading source of sugars in US diets—is buried deep in the text.  Fortunately, Deborah Noble of slowfoodfast.com has performed a great public service by producing the 2015 Dietary Guidelines in a searchable pdf format.Here’s where to find advice about cutting down on sugary drinks:

The Executive Summary: See under “Cross-Cutting Topics of Public Health Importance:”

Similarly, added sugars should be reduced in the diet and not replaced with low-calorie sweeteners, but rather with healthy options, such as water in place of sugar-sweetened beverages.

Figure 2-10 explains:

The major source of added sugars in typical U.S. diets is beverages, which include soft drinks, fruit drinks, sweetened coffee and tea, energy drinks, alcoholic beverages, and flavored waters.

Reading the Figure tells you that beverages comprise a whopping 47% of added sugars (closer to half if you add in sweetened milks, teas, and coffees).  The text following the Figure says:

Shift to reduce added sugars consumption to less than 10 percent of calories per day: Individuals have many potential options for reducing the intake of added sugars. Strategies include choosing beverages with no added sugars, such as water, in place of sugar-sweetened beverages, reducing portions of sugar-sweetened beverages, drinking these beverages less often, and selecting beverages low in added sugars.

Strategies?  How about just saying: “Cut down on sugary drinks” or “Drink water instead of sugary drinks.”

Figure ES-1 in the Executive Summary illustrates the 2015-2020 Dietary Guidelines for Americans at a Glance.  All it says is:

Limit calories from added sugars…Consume an eating pattern low in added sugars…Cut back on food and beverages higher in these components to amounts that fit within healthy eating patterns.

Figure 3.2 shows Implementation of the Guidelines through MyPlate: “Drink and eat less…added sugars,” but nothing about sugary drinks.

This circumspection is weird.  Clear, straightforward advice to cut down on sugary beverages has plenty of historical precedent.

Both Figures ES-1 and 3.2 are most certainly derived from a USDA graphic on the MyPlate website (dated January 2016).  This says flat out:

Drink water instead of sugary drinks.

This statement, in turn, derives from:

• The precepts issued with the 2010 Dietary Guidelines in January 2011
• The statements issued with the MyPlate graphic in June 2011

• The USDA’s May 2012 tip for making better beverage choices.

The 2015 DGAC (Dietary Guidelines Advisory Committee) repeatedly urged limits on consumption of sugar-sweetened beverages.  Statements like this one, for example, appear throughout the document:

To decrease dietary intake from added sugars, the U.S. population should reduce consumption of sugar-sweetened beverages.

Why did the USDA and HHS writing committee choose to waffle about his point?

This cannot be an accident.  It must be deliberate.  And it can have only one explanation: politics.

After all the talk yesterday about the Dietary Guidelines’ advice to cut down on sugar, and our sadness at the passing of Sidney Mintz who wrote Sweetness and Power, it’s good to consider just why we like sugar so much.  Oxford University Press has an encyclopedia on Sugar and Sweets.  But this weekend, for a short and sweet reminder, consider this contribution to the genre.

Andrew F. Smith.  Sugar: A Global History. Reaktion Books, 2015.

This is one of Andy Smith’s entries in Reaktion’s Edible series of small, brief, lavishly illustrated books devoted to a single food or beverage.

Andy discussed the genesis of this book in an e-mail memorial to Sidney Mintz.

Sid Mintz had an influence on my professional life as well. In the early 1980s I decided to use sugar as a vehicle to write a history of the world.  It was going to be a three volume work: one volume on Southeast Asia/India and the ancient world; one on the Middle East/Mediterranean in the Middle Ages/Renaissance; and one on the Americas and the modern world. I acquired and located thousands of potential books/articles and these were likely just a small portion of the material I assumed would be necessary to examine.

I continued plugging away until Sid published Sweetness and Power (1985), I assumed publishers would not be interested in another book on sugar history, so I decided to wait a couple years for it to go out of print before I resumed work on my sugar project.  So in the interim I decided to write a book on the history of the tomato, which was published in 1994. Then one topic led to another and sugar ended up on the shelve…

When I dined with Sid in 2001, I told him my sugar story, and asked him if he’d take his book out of print so I could write a sugar book. He laughed, and told me what I knew to be true– the topic of sugar history was big enough for many books.

I finally got around to writing Sugar: A Global History, which was published last spring. Rather than the three volume extravaganza I had planned, it ended up one of the shortest books I’ve ever written.

Maybe, but lots of that information got into it, wonderfully written, and beautiful to behold.

Jason Huffman, Helena Bottemiller Evich, and Jenny Hopkinson of Politico Pro Agriculture have published their end-of-year assessment of game-changing events in food and agriculture policy last year.  Here’s their list:

• Avian flu blew up the U.S. egg industry.
• The Trans-Pacific Partnership deal got done.
• The battle over the Dietary Guidelines turned even nastier.
• The FDA banned most uses of trans fat.
• The FDA said a genetically engineered fish is safe to eat.
• The EPA released its final Waters of the U.S. rule, inciting the wrath of multiple industries, states and lawmakers.
• A federal judge sent peanut company executives to jail for decades for their part in a giant salmonella outbreak.
• The FDA released major rules to promote the safety of produce and imports.
• The FDA doubled down on added sugars on food labels, proposing daily values for the listings.

I’ve discussed most of these on this site (all except Waters of the US).

I can’t wait to see what this year brings—more of the same, for sure, but what else?  Stay tuned.

I laughed when I first saw the Cheerios box advertising Protein.  Protein is hardly an issue in U.S. diets—most Americans consume twice what they need—so this is clearly a marketing ploy.

Center for Science in the Public Interest (CSPI), however, was less amused.  Its scientists did the math and compared the protein to the amount in regular Cheerios.  They also looked at serving sizes.

• Cheerios Protein: Protein 7 grams, Serving Size 55 grams
• Cheerios regular: Protein 3 grams, Serving Size 28 grams

Hmm.  Not much difference, is there?

CSPI filed a formal complaint.

General Mills falsely and misleadingly markets Cheerios Protein to children and adults as a high protein, healthful alternative to Cheerios. In fact, Cheerios Protein has only a smidgen more protein per serving than Cheerios, or 4 grams, which is only 5% of the average American daily protein intake. Most of that 4 grams is attributable to differences in serving sizes: Cheerios Protein has a bigger, 55 gram serving size, whereas Cheerios uses a 27 gram serving size. Two hundred calories’ worth of Cheerios Protein has a mere 7/10th of a gram more of protein than 200 calories’ worth of Cheerios.

Even worse, they looked at sugars.

• Cheerios Protein: 17 grams sugars
• Cheerios regular: 1 gram

As CSPI puts it:

Rather than protein, the principal ingredient that distinguishes Cheerios Protein from Cheerios is sugar. Cheerios Protein has 17 times as much sugar per serving, as Cheerios, which General Mills does not prominently disclose. 8. General Mills charges a price premium for Cheerios Protein.

Oops.

Buzzfeed has a good discussion of this.

Caveat emptor (I seem to be saying this a lot lately).