The following article was published originally in the August/September 2014 issue of Sugar Producer magazine (click here to view, turn to p. 14) and is republished here with permission:
According to a popular song from Mary Poppins, “A spoonful of sugar makes the medicine go down in a most delightful way.” But in today’s environment “a spoonful of sugar” is viewed as the villain for medical intervention.
How did a simple carbohydrate that once was often viewed by Europeans as having medicinal properties until the 16th century become the source that generates such complex conversations and polarizing opinions?
In a recent invited commentary by Dr. David Allison in the British Journal of Medicine, Allison describes how H. Willoughby Gardner around the turn of the 1900s, categorized sugar “as a nutritional necessity that increased the health and vigour of populations.” With the rising cost of health care and the documented obesity epidemic that exists in the U.S. and around the globe, the “halo effect” surrounding sugar has long since been extinguished.
We cannot deny the reality of the poor health status of many Americans and the need to find long-term solutions to the health problems facing our nation. Chronic disease prevalence is of great concern and many health professionals and organizations have focused their full attention on obesity. Although a definitive cause has yet to be determined, recent headlines in the media, popular press books, and now a documentary called “Fed Up” would have one believe that a single dietary nutrient (sugar) is responsible for obesity. Others take the view that obesity is the result of a complex combination of varying social, genetic and environmental factors.
More than most other dietary components or lifestyle factors, sugars have been studied to determine whether an association with obesity exists. While scientific evidence to date doesn’t support a causal link between sugar intake and obesity, much remains unknown. Science is evolving, and answers for many important questions about the role of sugars in health continue to be investigated, especially during the 2015 Dietary Guidelines Advisory Committee (DGAC) ongoing deliberations.
Since the development of the Dietary Guidelines for Americans (DGAs) in the late 1970s, the avoidance of “too much sugar (and sodium)” has been advocated. The guidelines were simple and the focus was on advice for maintenance of good health for the average American. However, the 2010 DGAs changed direction, and the focus was directed toward guidelines for “an overweight and obese population”—hence the changing tone of viewing nutrient recommendations and guidance through the obesity lens. The 2015 DGAC has prioritized added sugars and sugar-sweetened beverages for their impact on public health.
In the recent March 14 meeting of the DGAC, John Ruff, former president of the Institute of Food Technologists, was invited to discuss the food-science aspect of reducing sugar in the food supply. It was noted that the challenge of reducing sugars is more complex than reducing sodium.
“We innately enjoy sweetness from birth, but don’t like or dislike salt,” Ruff said.
Challenges and unintended consequences of over-focusing on sugars reduction may include impact on other macronutrient consumption and less palatability of nutrient-dense foods, Ruff noted.
In addition to the focus on sugar from the 2015 DGAC, the proposed new Nutrition Fact Panel (NFP) revisions by the FDA highlights this nutrient by recommending the inclusion of “added sugars” on the NFP.
What does this mean to the consumer? More consumer attention to the avoidance of sugar or more confusion about “natural” vs. “added?” Will consumers focus on sugar avoidance rather than look at the total calories on a package?
In the IFIC Foundation annual Food and Health Survey, the question, “What do you think causes weight gain?” is asked to gain consumers’ understanding. Since 2012, 20 to 21 percent of consumers say that calories from sugar are the most likely source of calories to cause weight gain. However, 29 to 30 percent believe calories from all sources have the same impact on weight gain.
The important issue when it comes to sugar—as with any other nutrient—is calories. It’s important that we be aware of how many calories we consume from different sources of nutrients within a balanced diet. According to USDA ERS Food Availability data, 2,089 calories per capita per day were available in the U.S. in 1977. In 2010, 2,538 calories were available in the U.S. per capita per day, an increase of 21.5 percent. In other words, Americans are eating more calories, but they are not eating significantly more calories from sugars than they did in 1977. Regardless of source, the overconsumption of calories has contributed to rising obesity rates, a risk factor for Type 2 diabetes and cardiovascular disease.
Nutrition experts agree that the current approaches to addressing chronic diseases aren’t working very well. But they say the solutions will need to go beyond regulating one aspect of the food supply.
“Regulating nutrients is a slippery slope,” said Dr. David Katz, co-founder of the Yale Prevention Center. “The focus should be on the overall nutritional quality of foods, not just one nutrient.”
The convergence of science and opinion makes for great discussion and the opportunity to hear unique perspectives, ultimately creating a venue where conversation can occur, a place where voices (including the voice of science) can be heard. With the goal of amplifying the voice of science, the IFIC Foundation and noted food science and nutrition expert Dr. Marilyn D. Schorin authored “The Science of Sugars”—a four-part, peer-reviewed series examining many aspects of the relationships between sugars and health. The review also summarizes the nutrition and policy recommendations of the scientific community. The reviews were published in Nutrition Today in 2012 and can be accessed on the IFIC Foundation website at www.foodinsight.org by conducting a search for “The Science of Sugars.”
Check out the 2015 Dietary Guidelines for Americans Resource Page
Editor’s note: Smith Edge is senior vice president, nutrition & food safety for the International Food Information Council in Washington, D.C. She is responsible for directing the overall nutrition and food safety strategic initiatives of the organization, group facilitation and external collaborations. She also serves as IFIC’s spokesperson on various nutrition, food safety and health issues.