SUGAR AND HEALTH ALLEN W. KNEHANS, PHD DAVID ROSS BOYD PROFESSOR OF - - PowerPoint PPT Presentation

SUGAR AND HEALTH

ALLEN W. KNEHANS, PHD DAVID ROSS BOYD PROFESSOR OF NUTRITIONAL SCIENCES DEAN, COLLEGE OF ALLIED HEALTH OU HEALTH SCIENCES CENTER

WHAT IS SUGAR?

• Not so simple a question
• Nutritionist/Dietitian – any mono or disaccharide
• Layperson – Sucrose, a specific disaccharide
• FDA Labeling: Sugars (plural) as component of Total

Carbohydrate – All mono and disaccharides combined

WHAT ARE ADDED SUGARS?

• Added sugars are distinct from naturally occurring sugars
• Naturally occurring: dairy, fruit, 100% fruit/veggie juice, vegetables
• Added sugars: added during processing, high fructose corn syrup in many soft drinks,

include syrup and honey

• Added sugars: dairy desserts (ice cream), grain-based desserts (cake, cookies), sugar-

sweetened beverages (soft drinks, sweet tea), sweets (candies, syrups)

• Foods of Minimal Nutritional Value for federal regulations: soda water (soft drinks),

water ices (popsicles), chewing gum, some candies (hard candy, jelly beans, marshmallows, candy corn)

CONCERN ABOUT ADDED SUGARS

• Over past 30-40 years, total caloric intake has increased by 150-300

calories per day, and about half of that increase comes from sugar- sweetened beverages

• Average intake of added sugars in US is about 15% of calories, an increase
• Added sugars add no nutritional value; no vitamins, minerals, or protein, only

add calories (many get too many calories in US)

• Data from NHANES III indicate a reduced intake of calcium, vitamin A, iron,

and zinc when added sugar intake was above 25% of total energy intake

ADDED SUGARS AND HEART DISEASE

• Those consuming above 25% of calories as added sugars almost 3X greater

risk of death from heart disease

• Those above 10% of calories as added sugars have 30% greater risk
• High sugar diets lead to high blood triglyceride levels and high LDL-

cholesterol levels, both risk factors for heart disease (evidence is excellent)

ADDED SUGARS AND OBESITY

• Intake of sugar-sweetened beverages/soft drinks is associated with a higher

body weight

• Reducing sugar-sweetened beverage intake is associated with weight loss
• Given complexity of obesity, difficult to say added sugar intake causes
• besity, but significant evidence argues an association

ADDED SUGARS MAY HAVE OTHER EFFECTS

• Type 2 diabetes
• Fatty liver disease
• Increased inflammation, which increases risk of most chronic diseases including

heart disease and diabetes

RECOMMENDATIONS FOR ADDED SUGARS

• 2015-2020 Dietary Guidelines for Americans recommend that Americans limit

calories from added sugars to less than 10 percent of calories per day

• Food labeling laws require added sugars be listed on labels, being phased in
• American Heart Association (AHA) recommends a daily upper limit of about 5

teaspoons of added sugars for an average adult woman and 9 teaspoons for an average adult man

• For reference, one 12-ounce soda contains about 8 teaspoons of added sugar

POLICY APPROACHES

• Menu labeling at chain restaurants – limited effect, many saw, few used
• Improved food infrastructure – programs to increase mobile vendors of fruits and vegetables

into disadvantaged neighborhoods, no effect on intake

• Subsidies for health foods – matching funds for SNAP benefits, has increased fruit and

vegetable purchases at farmers’ markets

• Taxation of unhealthy foods/beverages – more common in Europe, successful, AMA supports
• Labeling codes at point of sale – “red-coded” soft drinks in vending machines, city-wide only

at public buildings, successful

PREVIOUS APPROACHES TO RESTRICT SNAP USE

• In 2008 US Congress rejected the restriction of buying sugar sweetened

beverages with SNAP benefits as part of 2008 Farm Bill

• Multiple states (Maine, Minnesota, New York) have attempted to restrict SNAP

benefit use but have not been approved

• Since 2010 Healthy Hunger-Free Kids Act passed, USDA has revised nutrition

standards for nearly all federal food programs to align with Dietary Guidelines for Americans, exception is SNAP

ARGUMENTS FOR/AGAINST RESTRICTION OF SNAP BENEFITS

• Feasibility – could use barcodes to designate which foods can be purchased
• Justification – SNAP participants have a lower Healthy Eating Index
• Effectiveness – participants can use own money to purchase high sugar items
• Slippery slope – if approve restricting high sugar, what is next?
• Consistency – USDA states should drink water instead of sugary drinks
• Dignity – would feel singled out
• Distrust – Beverage industry has funded “anti-hunger” centers that oppose restrictions

MY OPINIONS

• No question that consumption of high sugar foods is unhealthy
• So government funds should not go to purchase foods of minimal nutrition value

(sugar sweetened beverages primarily)

• If a waiver is not possible, then alternatives such as a food tax on high sugar foods
• r incentive program to purchase fruits and vegetables could be implemented
• Could be a combination, those who accept limits on SNAP would receive incentives

for fruits and vegetables

• A recent study found that 2/3 of SNAP participants asked would prefer this policy