I am a consultant to various food and beverage companies though all thoughts and opinions are my own.
It seems like every day the media reports on a new study about sugar, high fructose corn syrup or a new proposed policy restricting the consumption of caloric sweeteners. Are these policies based on credible science? Or are they designed to be quick fixes to a problem, fueled by misinformation and misunderstanding?
Published on March 6, a new textbook entitled Fructose, High Fructose Corn Syrup, Sucrose and Health and edited by James Rippe, MD, examines the most current science surrounding different caloric sweeteners and their effects on health. One chapter, “Crystalizing Global Sugar Policy: Public Health Promise or Perception,” co-authored by Dr. Roger Clemens, discusses how countries around the world are addressing the issue.
Sugar sweetened beverages (SSB) are a common policy target. In a discussion with Dr. Clemens about the available scientific evidence on the relationship between SSBs and obesity, he shared a story from his time serving on the 2010 Dietary Guidelines Advisory Committee (DGAC). The DGAC concluded that the evidence is limited and when equal-calorie substitutions are made for SSBs, there is no change in weight gain, meaning that ultimately, the amount of calories consumed affects weight gain, not the source of calories. Dr. Clemens described it as a shocking revelation, “People don’t want to dig in to really identify the cause [of obesity]. SSBs are low hanging fruit for consumer groups and regulatory agencies. If they can blame an ingredient for the lack of change and behavior then that is the direction they will go.”
Yet, despite the lack of evidence, much time and energy continue to be devoted to attempting to curb added sugar intake through policy and taxation. Dr. Clemens says both consumerism and the media are driving forces behind these policy changes. “Consumerism clearly dictates policy as opposed to scientific evidence….news outlets translate association to cause and then social media goes viral with everyone catching on to the cause.”
These issues aren’t just limited to the United States. The World Health Organization (WHO) recently released proposed guidelines for sugar consumption. The guidelines propose cutting sugar intake from an already low 10 percent to 5 percent of daily caloric intake. Dr. Clemens feels that this is misguided, not to mention an unrealistic target, “It is clear that organizations [like WHO], rather than looking at the evidence and identifying the cause of obesity, they just blame it on sugar. Importantly, the 5 percent target is based on weak evidence relative to potential improvement of dental health, and not associated with weight management. They show the evidence that supports their position and gloss over that which shows inconsistencies. We are on a collision course, wanting people to eat more fruits [and vegetables] and telling people to curb their innate sugar intake at the same time, which doesn’t make sense.”
In the United States, taxation as a method to control public intakes of sugar is a commonly proposed approach despite limited consumer support. Outside of the United States, only six countries in the European Union have moved forward with a SSB tax. According to Dr. Clemens, “The other countries have realized it doesn’t work and there are many issues to manage such taxation.”
There is some computer modeling in Clemens’ textbook chapter that suggests a SSB consumption tax may result in a marginal decrease in consumption and a slight increase in beverages like juice and milk. When asked about what value this substitution might have, Clemens replied that it is mainly one of perception. A reduction of 100 calories a day from any energy source would promote better health. “The bottom line is we aren’t doing a good job of educating. People don’t want to make tough decisions; they want to have their cake and eat it too. We need to figure out how to educate the consumer so that the consumer understands and takes control of his or her diet.”
Potential unintended consequences of taxing SSBs and other foods with added sugars, such as a greater burden on the socioeconomically disadvantaged, is another concern. Dr. Clemens adds that “the majority of people think sugar is only in foods to provide flavor. Sugar has other functions in the food supply providing texture and mouthfeel to foods, fermentation, inhibition of bacterial growth and protection against deterioration of antioxidants.” Using less sugar or cutting it out of foods completely is not as easy or beneficial as one might think.
The science does not support solely blaming sugar, caloric sweeteners or any single ingredient for the obesity epidemic that is now a global concern. By continuing to focus on taxing or regulating sugar rather than on educating and empowering consumers to make better choices, we’re missing the opportunity to develop meaningful solutions. Instead, we should be relying on scientific evidence to bridge the gap between consumer perception and changes that will truly improve health. The 2015 Dietary Guidelines for Americans are in development and represent an opportunity to achieve this, provided the recommendations reflect the scientific evidence.