Currently browsing posts about: Sugars

Earlier this week I received a 3-page, single-spaced letter—plus 4 pages of charts and figures–from Andrew Briscoe III, the President and CEO of the Sugar Association.

I opened it with some trepidation because the last letter I got from the Sugar Association threatened to sue me (to read it, click here and scroll down to the Controversies section).

Whew.  This one merely expresses general concerns about:

the misinformation reported on added sugars consumption and the overstatement of added sugars contribution to increased caloric intakes.  Americans do not consume 25 percent of their calories from added sugars. We write to provide you with accurate data….

I don’t think I ever said that the average American consumes 25% of calories from sugars (although some surely do) but I have complained that the Institute of Medicine’s “safe” level of intake of sugars is 25% of calories.  This is higher than public health recommendations to restrict sugars to 10% of calories or less.  It is meant as an upper limit, but is often interpreted as a license to eat this much.

One quarter of daily calories from sugars is too high for something that provides no additional nutritional value.

The letter concludes:

The Sugar Association is committed to ensuring that all advice consumers receive regarding sugar intake is based on the best available scientific evidence and related data.  The American consumer will be better served by dietary advice that is science-based, practical and accurate, no matter the issue.

Can’t argue with that.  But as with all matters concerning nutrition, the issue is which science you choose to cite and how you interpret it.

Mr. Briscoe uses the term sugars, plural, because sucrose, HFCS, syrups, honey, and other such things are all sugars.

How much do Americans actually consume?  Mr. Briscoe was kind enough to provide USDA tables that address this question.  These describe the availability of sugars in the food supply, not necessarily what people are actually eating.

My interpretation of the tables is that they say:

• Sugars comprise 17% of total calorie availability.
• Adjusted for waste, the availability of sugars is about 27.5 teaspoons per day per capita (meaning everyone:  men, women, and tiny babies).
• Translating this into calories: 27.5 teaspoons x 4 grams per teaspoon x 4 calories per gram = 440 calories per day per capita.
• On a 2000 calorie diet, that’s 22% of total energy intake, although it will be lower for people who take in more calories.

The CDC has just released a summary of intake of added sugars among children and adolescents, in calories per day.

At 4 calories a gram, 400 calories is 100 grams or 3.5 ounces.  Can these calories contribute to weight gain or other health problems?

You bet.

As Mark Bittman put it in his New York Times column this week,

Let me state the obvious: there is no nutritional need for foods with added sugar.

All of this is part of the bigger question: How do we regulate the consumption of dangerous foods? As a nation, we’ve accepted the need to limit the marketing and availability of tobacco and alcohol. The first is dangerous in any quantity, and the second becomes dangerous when overconsumed.

And added sweeteners, experts increasingly argue, have more in common with these substances than with fruit.

No wonder the Sugar Association uses its own interpretation of the science to suggest that current levels of intake are benign and that no level of intake poses a risk.  Mr. Briscoe’s letter says:

No authoritative scientific body that has conducted a major systematic review of the scientific literature has a found a public health need to set an Upper Level (UL) for total or added sugars intake.  Every comprehensive review of the scientific literature concludes that, with the exception of dental caries, no causal link can be established between the intake of sugars and lifestyle diseases, including obesity.

I’m glad he mentioned dental caries.  Karen Sokal, a physician in California, has been tracking the onset of tooth decay among children in Latin America who are now consuming sodas and candy on a daily basis.  She writes:

Mark Bittman’s excellent editorial, “Regulating our Sugar Habit,” (Feb 27) concludes that eating too much sugar has become “the biggest public health challenge facing the developed world.”  Indeed, it poses a big health challenge for the entire world, especially developing countries.

In my 30 years of global health work, I have seen an explosion in the marketing and consumption of non-nutritious foods and beverages followed by a dramatic rise in childhood tooth decay and obesity. Quarterly business reports praise the food and beverage industry’s increased profits based on increased sales in “emerging markets.” The NY Times article on Kellogg’s purchase of Pringles (Feb 12) stated, “The snack business is growing faster and has greater appeal internationally,” which analysts noted “appears somewhat out of sync with the trends toward better-for-you snacking.”

Governmental regulations to ensure the production and marketing of healthful food and beverages must be applied worldwide and protect the health of the world’s most vulnerable populations.

Indeed, they must.  The Sugar Association has much to answer for in its opposition to public health recommendations to eat less sugar.

Nature, the prestigious science magazine from Great Britain, has just published a commentary with a provocative title–The toxic truth about sugar—and an even more provocative subtitle: Added sweeteners pose dangers to health that justify controlling them like alcohol.

The authors, Robert Lustig, Laura Schmidt and Claire Brindis, are researchers at the University of California medical center in San Francisco (UCSF).

They argue that although tobacco, alcohol and diet are critically important behavioral risk factors in chronic disease, only two of them—tobacco and alcohol—are regulated by governments to protect public health.

Now, they say, it’s time to regulate sugar.  By sugar, they mean sugars plural: sucrose as well as high fructose corn syrup (HFCS).  Both are about half fructose.

Their rationale?

• Consumption of sugars has tripled over the last 50 years.
• Many people consume as much as 500 calories a day from sugars (average per capita availability in the U.S. is about 400 calories a day)
• High intake of fructose-containing sugars induce metabolic syndrome (high blood pressure, insulin resistance), diabetes, and liver damage.
• Sugars have the potential for abuse.
• Sugars have negative effects on society (mediated via obesity).
• Too much of a good thing can be toxic.

Therefore, they argue, societies should intervene and consider the kinds of policies that have proven effective for control of tobacco and alcohol:

• Taxes
• Distribution controls
• Age limits
• Bans from schools
• Licensing requirements
• Zoning ordinances
• Bans on TV commercials
• Labeling added sugars
• Removal of fructose from GRAS status

In a statement that greatly underestimates the situation, they say:

We recognize that societal interven­tion to reduce the supply and demand for sugar faces an uphill political battle against a powerful sugar lobby, and will require active engagement from all stakeholders.

But, they conclude:

These simple measures — which have all been on the battleground of American politics — are now taken for granted as essential tools for our public health and well-being. It’s time to turn our attention to sugar.

What is one to make of this?  Sugar is a delight, nobody is worried about the fructose in fruit or carrots, and diets can be plenty healthy with a little sugar sprinkled here and there.

The issue is quantity.  Sugars are not a problem, or not nearly as much of a problem, for people who balance calorie intake with expenditure.

Scientists can argue endlessly about whether obesity is a cause or an effect of metabolic dysfunction, but most people would be healthier if they ate less sugar.

The bottom line?  As Corinna Hawkes, the author of numerous reports on worldwide food marketing, wrote me this morning, “there are plenty of reasons for people to consume less sugar without having to worry about whether it’s toxic or not!”

The Environmental Working Group (EWG) is getting interested in childhood obesity.  It released a report on sugars in kids’ breakfast cereals.

The report shows—no surprise—that kids’ cereals are really cookies in disguise, typically 40% -50% sugars by weight.   Kellogg’s Honey Smacks topped the list at 55%.

Michele Simon’s analysis of the report notes that these levels don’t even meet Kellogg’s commitment to responsible marketing, a pledge to “apply science-based Kellogg Global Nutrient Criteria to all products currently marketed to children.”

I’ve been reading reports like this since the 1970s when Center for Science in the Public Interest published them at regular intervals.  Not much has changed.

Courtesy of Kellogg, I have a collection of copies of Froot Loop boxes dating back to the year in which this cereal was first introduced.  I thought it would be interesting to check the sugar content.

Froot Loops, Sugar content, grams per ounce

In 2005, Kellogg tried a version with 1/3 the sugar—10 grams—but it didn’t sell and quickly disappeared.

Companies are trying to reduce the sugars by a little, but this seems to be the best they can do.  It’s not enough.

As the EWG press release explains, some cereals are better than others.   It notes that I recommend:

• Cereals with a short ingredient list (of additives other than vitamins and minerals).
• Cereals high in fiber.
• Cereals with little or no added sugars (added sugars are ingredients such as honey, molasses, fruit juice concentrate, brown sugar, corn sweetener, sucrose, lactose, glucose, high-fructose corn syrup and malt syrup).
• Even better, try fresh fruit and homemade oatmeal.

The increasingly absurd fight between the Sugar Association and the Corn Refiners Association over what to call High Fructose Corn Syrup (HFCS) seems never to end.

Trade associations representing growers of sugar cane and sugar beets (sucrose–the white stuff on the table) have gone to court to charge that corporate members of the Corn Refiners Association (HFCS) are behind a “conspiracy” deliberately designed to “deceive the public.”  Why?  Because—in an equally absurd move—they want to change the name of HFCS to corn sugar. 

The sucrose-growers lawsuit argues Corn Refiners conspired to engage in false advertising as part of a $50 million campaign to promote HFCS by changing its name to “corn sugar,” thereby implying that HFCS is equivalent to “real” sugar from cane and beet plants.

Oh please.  Sucrose is glucose and fructose linked together.  HFCS is glucose and fructose separated.  Both are sugars (note: plural).  Sucrose is extracted from sugar beets and cane in a series of boiling, extracting, and cleaning steps.  HFCS does the same from corn, but uses one more enzyme so is somewhat less “natural,” but so what?

Both are sugars and empty calories, and everyone would be better off eating less of both.

What’s really at issue here is the encroachment of HFCS into sucrose territory.  Americans used to eat much more sucrose than HFCS.  Now we consume about 60 pounds of each of them a year—way too much of either.

My opinion: the name change is frivolous and so is the lawsuit. 

Both are a waste of time and distract from the real message: eat less sugar(s).

The public relations firm for the Sugar Association, Levick Strategic Communications, sent me a press release celebrating the victory of sugar producers against corn refiners over the question of whether high fructose corn syrup (HFCS) can be renamed “corn sugar.”

A federal judge ruled that the case brought by the Sugar Association against the Corn Refiners can proceed to trial. If you want the details, see the  judge’s “order denying in part and granting in part defendents’ motion to dismiss”, and “order granting defendents’ motion to strike.”

I cannot even begin to tell you how funny I think all this is.

The Sugar Association represents growers of sugar beets and cane.  They produce table sugar—sucrose—a double sugar composed of glucose and fructose linked together.  In the body, sucrose is quickly split to glucose and fructose.

The Corn Refiners represent processors of corn (obviously).  They produce HFCS, a syrup made of glucose and fructose.

From a biological standpoint, glucose and fructose are the same no matter where they come from.  Biochemically, sucrose, glucose, and fructose are all sugars.

HFCS used to be a lot cheaper than sucrose, but what with all the corn used for ethanol, the price gap has narrowed.  As a result, and because HFCS has gotten a bad reputation, companies are dropping it in favor of sucrose.  The Corn Refiners are upset about that and think a name change would help.

The Sugar Association thinks it’s just great that HFCS has a bad reputation and does not want table sugar to be confused with corn sugar.

Both of these trade associations are acting totally in self-interest.  Neither cares at all about public health.  The lawsuit is entirely about corporate profits, not public welfare.

The Sugar Association is famous for protecting a system of quotas and tariffs that transfers money from American consumers to the coffers of sugar producers.  Its aggressive actions in its own self interest are legendary (see, for example, its threatening letter to me when Food Politics came out—this and my reply are posted at the end of the About section).

And I’ve written previously about the Corn Refiners’ consistently bad self-interested behavior.

Both trade associations behave with appalling disregard for the public.

In this case, the public interest is clear: everyone would be healthier eating less table sugar and HFCS.

 I worry a lot about the ability of the FDA to set limits on the excess marketing practices of food companies.  The latest cause for worry is the seemingly trivial fuss over what to call High Fructose Corn Syrup (HFCS).

HFCS is not especially high in fructose (its fructose content is about the same as that of table sugar) but the term has gotten a bad reputation and food companies have begun to replace this sweetener with table sugar.

The Corn Refiners Association, the trade association that protects the interests of the makers of HFCS thinks it can solve that problem by getting the FDA to allow a name change from HFCS to “corn sugar” (see my previous comments on this issue).  The FDA has this request under consideration. 

In the meantime, the Corn Refiners are using “corn sugar” in advertisements on two websites, cornsugar.com and sweetsurprise.com.

Last week, the Associated Press (AP) reported that the FDA is taking a dim view of this behavior.   In a letter seen by the AP (but which I cannot find on the FDA website), the FDA has asked the Corn Refiners to cease and desist using “corn sugar” until the term receives regulatory approval.  

According to the AP account, which I have been unable to verify, the FDA:

Has no regulatory control over the corn association’s advertising because it is not selling a product but promoting an industry. The federal agency can prosecute companies that incorrectly label ingredients and [FDA official Barbara] Schneeman wrote that the FDA may launch enforcement action against food companies listing high fructose corn syrup as “corn sugar.”

The AP also said that internal FDA documents “indicate high-level skepticism” over the proposed name change. 

This, no doubt, is because “corn sugar” already exists as a regulatory term for dextrose which, in turn, is another name for the sugar, glucose, derived from corn. 

The AP says:

Michael Taylor, the FDA’s deputy commissioner for foods, wrote in an internal email that a previous attempt by the corn industry to change the name of high fructose corn syrup to just “corn syrup” was misleading, could have robbed consumers of important information and would invite ridicule.  “It would be affirmatively misleading to change the name of the ingredient after all this time, especially in light of the controversy surrounding it,” Taylor told colleagues in an email dated March 15, 2010.

Changing the name of HFCS to corn sugar is about marketing, not public health. If the FDA decides to approve the change, it will not alter the fact that about 60 pounds each of HFCS and table sugar are available per capita per year, and that Americans would be a lot healthier consuming a lot less of either one.

I’ve just turned in the copy-edited manuscript of Why Calories Count: From Science to Politics (pub date March 2012) and now have time to catch up on some questions:

Q. I was recently given to read a book titled “The China Study” which is based on research conducted in 1970’s in China by Dr. Colin Campbell. His main conclusion is that eating dairy and meat causes cancer. His resolution is that a plant-based diet (i.e. vegan) is the (only?) healthy diet for humans. This book has made strong enough of a point to convince several of my friends to “convert” to a vegan diet in order to save their health. Could you share some comments on the validity of the research and conclusions this book presents with regards to detrimental effects of dairy and meat on human health?

A. Campbell makes a forceful argument based on his interpretation of the research and on case studies of people whose diseases resolved when they became vegans. And yes I’ve seen Dr. Campbell’s new movie, Forks over Knives. The first half is a terrific introduction to how the current food environment promotes unhealthy eating.  The second half promotes Dr. Campbell’s ideas about the hazards of meat and dairy foods.

Whether you agree with these ideas or not, the film is well done and worth a look.

Some scientists, however, interpret the research as demonstrating that people are healthier when they eat dairy foods.  For example, the enormous consensus report on diet and cancer risk from the American Institute for Cancer Research and the World Cancer Research Fund concluded in 2007 that eating lots of red meat and processed meat is convincingly associated with an increased risk of colorectal cancer (but no others).

On the other hand, they found dairy foods to be associated with a decrease in the risk of colorectal cancer.  They found limited and less convincing evidence that dairy foods might decrease the risk of bladder cancer but increase the risk of prostate cancer.

How to make sense of this?  These are two food groups in the diets of people who consume many kinds of foods and who do many things that might increase or decrease cancer risk.  Given this complexity, one food or food group seems unlikely to have that much influence on cancer when considered in the context of everything else people eat and do.

Nutrition research, as I am fond of saying, is difficult to do and requires interpretation. Intelligent people can interpret the studies differently depending on their point of view.

The new Dietary Guidelines say to cut down on saturated fats. Those are most plentiful in meat and dairy foods (plant foods have them, but in smaller amounts). Pretty much everyone agrees that plant-based diets promote health/  But whether they have to be 100% plant-based is highly debatable.

The new USDA MyPlate food guide suggests piling plant foods—fruit, vegetables, and grains—on 75% of your plate so the argument is really about what goes on the remaining 25%, what USDA calls the  “Protein” section. You can put beans in that quarter if you don’t want to eat red meat, poultry, or fish.

Q. I’d love to hear your take on the recent walnut flap [accusations that the FDA now considers walnuts to be drugs].  I suspect walnuts got caught with such offenders as Pom, Froot Loops, and Juicy-Juice, but I’d love to find out what the FDA actually said about this. For some odd reason I don’t believe the article is presenting the whole truth.

A. This is a health claims issue. The FDA is not saying walnuts are drugs. It is saying that Diamond Walnut is claiming walnuts as drugs on package labels. How so?

The labels say the omega-3 fatty acids in walnuts may help lower cholesterol; protect against heart disease, stroke and some cancers (e.g. breast cancer); inhibit tumor growth; ease arthritis and other inflammatory diseases; and even fight depression and other mental illnesses. These are disease claims for which the FDA requires scientific substantiation.

The company’s petition did not provide that substantiation so the FDA issued a warning letter. In general, you should be skeptical any time you see a nutritional factor advertised for its ability to prevent or treat such a broad range of problems.

Q. A question about sugar and how it is counted: My books say: 4 g = 1 teaspoon = 15 calories. My Illy Caffe says 10 g of sugar, but 50 calories. Ingredients: coffee, sugar, potassium bicarbonate, potassium citrate. If the drink is 50 calories, shouldn’t it say 12 g or more for the sugar listing?

A. Sugar should be the only ingredient that has calories in this coffee but I’ve seen calorie lists that say 5 calories per gram for sugars. Food companies have some leeway in the way they compute calories. Illy may be using a method that gives 5 rather than 4. But the difference between 40 and 50 is hardly measurable and I wouldn’t worry about amounts this small, annoying as imprecise figures may seem.

Philip Brasher of the Des Moines Register reports: the Western Sugar Cooperative has just filed suit against the Corn Refiners and corn processors to stop them for falsely advertising HFCS as “corn sugar.”

Oh please.  Western Sugar is trying to claim that HFCS is not sugar, when it most definitely is.  To sugar associations, which represent cane and beet producers, sugar means sucrose (the white stuff on the table).

When the Sugar Association threatened to sue me for saying that soft drinks had sugar and nothing else (when they also contained HFCS), I patiently explained the biochemistry.  If you would like to read what they said, I’ve posted the threatening letter and my response at the bottom of this link. Here’s the biochemistry:

• Sucrose: a double sugar of 50% glucose and 50% fructose linked together
• HFCS: a syrup of about 45% glucose and 55% fructose, separated

The 5% differences are biologically insignificant and the body can’t tell them apart.

I never heard from the Sugar Association again, but I try to to remember to say sugars, plural.

Whether the FDA should allow the defendants to change the name of HFCS to Corn Sugar is a matter of some debate (see previous posts and comments on them).  The FDA will make its decision in due course.

In the meantime, this lawsuit is about marketing competition among sources of sugars (plural).  It has nothing to do with health.