Sugar: Not So "Simple" Anymore

Sugar. How did this simple carbohydrate become a substance that generates such complex conversations and polarizing opinions?

The increasing debate over sugars seems to have no plateau in sight. At issue is whether sugars uniquely contributes to poor health beyond overconsumption. This topic is hotly debated among the scientific, regulatory, and advocacy communities.

As health professionals, we are well-aware of the poor health status of our nation—how could we not be? It seems to be the lead story on the nightly news, well, nightly. This begs the question: what could be causing this? Many, including a recently released documentary, “Fed Up,” (read our scientific analysis of the film here) would have you believe it’s sugar. Nothing else, just sugar. Limit the consumption of it, avoid it entirely, problem solved. The path to good health is apparently “simple”—that is, avoid simple carbohydrates.

If only anything were that simple.

You may be surprised to know that a significant amount of well-done research has been conducted on the impact of sugars on health. You may also be surprised to know that the balance of this research is not as conclusive as some would have you believe. Unfortunately, the conclusions that are typically reported by the media are sensational and not reflective of the body of scientific evidence, but I get it—sometimes good science doesn’t sell. “Dog bites man” doesn’t make for a good headline.

Opinions, however, do sell—and they sell at an alarming pace. Just ask Dr. Oz. Perhaps that explains the growing public sentiment surrounding sugars, where opinions seem to spread faster than facts. The IFIC Foundation’s annual Food & Health Survey has documented this growing trend toward blaming sugar as the source of calories most responsible for weight gain. In our 2014 survey, 40 percent of respondents said that sugars and carbohydrates were most responsible for weight gain, compared to 29 percent who said all sources contribute equally; 15 percent weren’t sure.

The sugars debate has more recently focused on “added” versus “natural” sugars. Dr. John Sievenpiper has eloquently stated many times that the debate on sugars is “high in opinion, low in data.” His research (and that of authoritative bodies) has shown that weight is more about total calories than it is about grams of sugars, “added” or not. The 2010 Dietary Guidelines for Americans state, “Added sugars are no more likely to contribute to weight gain than any other source of calories in an eating pattern that is within calorie limits.”

The U.S. Food and Drug Administration (FDA) recognizes “the lack of a physiological distinction between added and naturally occurring sugars.” The concern over sugars should not be about consumption, per se, but overconsumption.

Still, there are those who contend that sugars (regardless of consumption levels) are uniquely responsible for poor health, particularly added sugars. Because of this, the FDA is currently assessing whether “added sugars” should be declared on the Nutrition Facts Panel (NFP)—the thought being that labeling “added sugars” will alert consumers to their presence and, thus, motivate consumers to modify purchasing behavior.

Whether you agree with this premise, it’s an interesting one, so we at the IFIC Foundation recently investigated consumer understanding of the NFP and sugars in general, how the proposed shift in “added sugars” labeling might affect purchasing behavior, and why that effect if it indeed exists would occur. Here are some tidbits about what we’ve found:

  • The ability for consumers to accurately identify the total amount of sugars in a product is significantly higher when an “Added Sugars” line is not presented on the NFP.
     
  • Consumer understanding that amounts of sugars in an “Added Sugars” line would be included within a total amount indicated on a “Sugars” line or “Total Sugars” line was significantly higher on NFPs with a “Total Sugars” line. That is to say, many consumers had a tendency to add the “Added Sugars” line to the overall amount of sugars, producing an erroneously higher total.
     
  • Most consumers perceive that products with an “Added Sugars” declaration have a higher sugars content than is actually present. This misperception affects purchasing behavior.
     
  • There is confusion among consumers regarding what “Added Sugars” are. Some believed added sugars could even be low-calorie sweeteners.

Check back for more details on our NFP consumer research project. We’ll be looking forward to sharing those soon! In the meantime, read our latest publication on this issue. (Flip to page 14.)

UPDATE: IFIC Foundation's NFP consumer research project has been published online as an article in press by the Journal of the Academy of Nutrition and Dietetics. Look for it in a hard-copy issue later in 2015! Source: http://www.andjrnl.org/article/S2212-2672(15)00505-5/fulltext

Kris Sollid, RD, is director, nutrients, at IFIC and the IFIC Foundation. Marianne Smith Edge, MS, RD, LD, FADA, senior vice president, nutrition and food safety at IFIC and the IFIC Foundation, also contributed to this story.

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