Political Context of the World Health Organization: Sugar Industry Threatens to Scupper the WHO

The Sugar Association, representing the U.S. sugar industry, is highly critical of a WHO report on guidelines for healthy eating, which suggests that sugar should account for no more than 10 percent of a healthy diet. The association has demanded that Congress end its funding of the World Health Organization unless the WHO withdraws the guidelines, and the association and six other big food industry groups have also asked the U.S. Secretary of Health and Human Services to use his influence to get the WHO report withdrawn. The WHO strongly rejects the sugar lobby's criticisms.

Natural sweeteners in a human diet

Sweeteners, both natural and artificial, play an important role in a human diet as well as are of great importance to the food industry and dieticians. Many people associate sweet taste with sucrose, which is commonly known as table sugar. However, there are many sweet substances that food manufacturers add to food products because none of them is ideal for all applications. Besides sucrose there are also other sugars such as glucose and fructose that originate both from natural sources such as fruits and honey or from added sugars. Among sweeteners there are also compounds which have a sweet taste and contain no calories or those which sweetness is so intense so can be used at very low concentrations, thus, their impact on the total caloric value of the product is negligible. They can be classified due to their origin (natural or synthetic agents), the technological function (sweeteners and fillers), texture (powders and syrups), and nutritional value (caloric and non-caloric). Natural sweetening substances include carbohydrates, sugar alcohols, thaumatin and stevia. Besides providing well tasting foods, they might have an impact on products' texture, color, preservation and caloric value. Sugar alcohols, which belong to carbohydrates, are both natural sugar substitutes and food additives. They are becoming more and more popular among consumers mainly due to their lower caloric values and glycemic indexes as well as anticariogenic effects. Sugar alcohols are often combined with other sweeteners to enhance food products' sweetness. Stevia, which is 200 times sweeter than sucrose, is a non caloric substance whereas thaumatin, a sweet protein, provides 4 kcal/g but characterizes with sweetness about 2000 times higher than sucrose (on a weight basis).

Recommended school policies are associated with student sugary drink and fruit and vegetable intake

OBJECTIVE

To examine the association between 8 recommended school obesity-related policies and student behaviors and weight in a cohort of Minnesota schools.

METHOD

Existing surveillance surveys were used to examine the relationship between school policies to promote healthy eating and physical activity and student weight, diet, and activity behaviors from 2002 to 2006 among students (n=18,881) in a cohort of 37 Minnesota junior-senior high and high schools using fixed effects linear regression models.

RESULTS

Each additional recommended policy was associated with a significant decrease in consumption of sugary drinks and an increase in consumption of fruits and vegetables. There were no associations with weekly hours of sedentary activities, days per week of vigorous activity, or body mass index percentile.

CONCLUSION

Students attending schools that added recommended policies to promote healthy eating showed improved dietary behaviors, independent of secular trends compared with students in schools that did not add recommended policies.

Position of the Academy of Nutrition and Dietetics: use of nutritive and nonnutritive sweeteners

It is the position of the Academy of Nutrition and Dietetics that consumers can safely enjoy a range of nutritive sweeteners and nonnutritive sweeteners (NNS) when consumed within an eating plan that is guided by current federal nutrition recommendations, such as the Dietary Guidelines for Americans and the Dietary Reference Intakes, as well as individual health goals and personal preference. A preference for sweet taste is innate and sweeteners can increase the pleasure of eating. Nutritive sweeteners contain carbohydrate and provide energy. They occur naturally in foods or may be added in food processing or by consumers before consumption. Higher intake of added sugars is associated with higher energy intake and lower diet quality, which can increase the risk for obesity, prediabetes, type 2 diabetes, and cardiovascular disease. On average, adults in the United States consume 14.6% of energy from added sugars. Polyols (also referred to as sugar alcohols) add sweetness with less energy and may reduce risk for dental caries. Foods containing polyols and/or no added sugars can, within food labeling guidelines, be labeled as sugar-free. NNS are those that sweeten with minimal or no carbohydrate or energy. They are regulated by the Food and Drug Administration as food additives or generally recognized as safe. The Food and Drug Administration approval process includes determination of probable intake, cumulative effect from all uses, and toxicology studies in animals. Seven NNS are approved for use in the United States: acesulfame K, aspartame, luo han guo fruit extract, neotame, saccharin, stevia, and sucralose. They have different functional properties that may affect perceived taste or use in different food applications. All NNS approved for use in the United States are determined to be safe.

Food sources of added sweeteners in the diets of Americans

OBJECTIVE

To identify food sources of added sweeteners in the US diet.

DESIGN

A descriptive study using data from the US Department of Agriculture (USDA) 1994-1996 Continuing Survey of Food Intakes by Individuals. Each subject provided one 24-hour dietary recall. Intake of added sweeteners was calculated using the USDA Food Guide Pyramid servings database.

SUBJECTS/SETTING

A national sample of noninstitutionalized persons aged 2 years and older (N = 15,010).

STATISTICAL ANALYSES

Mean intakes of added sweeteners from all food sources and from specific food categories; percentage contribution of added sweeteners to total energy intake; and percentage contribution of each food category to total intake of added sweeteners. All analyses were conducted for the total sample and for 12 age-gender groups.

RESULTS

During 1994 to 1996, Americans aged 2 years and older consumed the equivalent of 82 g carbohydrate per day from added sweeteners, which accounted for 16% of total energy intake. In absolute terms, adolescent males consumed the most; as a percentage of energy, male and female adolescents had the highest intakes (averaging 20% of total energy from added sweeteners). The largest source of added sweeteners was regular soft drinks, which accounted for one third of intake. Other sources were table sugars, syrups, and sweets; sweetened grains; regular fruitades/drinks; and milk products.

APPLICATIONS/CONCLUSIONS

Intakes of added sweeteners exceed levels compatible with meeting current dietary recommendations. Knowing food sources of added sweeteners for the overall population and for specific age-gender groups can help dietitians provide appropriate nutrition education.

Summary of the symposium establishing the safety of fat and macronutrient substitutes presented at the 33rd annual meeting of the Society of Toxicology, San Diego, California, March 13-17, 1994

Macronutrient substitutes (MNS) are food ingredients designed to replace the organoleptic and/or functional properties of macronutrients such as fats or sugars in processed foods. Because they may be consumed in large quantities daily, traditional methods of safety evaluation are inappropriate. Conventional safety factors cannot be used in extrapolating animal data to humans due to the limitations of administering very large doses of MNS to animals. The proper evaluation of the safety of MNS involves appropriate studies in animals and humans including comparative biodispositional studies, genotoxicity and cytotoxicity studies, reproductive and developmental studies, mechanistic studies, digestive and fermentation studies, nutritional studies, and studies involving humans with special focus on gastrointestinal function. Guidelines for the proper conduct of human studies were presented and these include the use of competent investigators and IRB-approved protocols and the use of adequate numbers of healthy male and female volunteers. Postmarketing surveillance is the final step in the safety evaluation process for macronutrient substitutes. It was concluded that MNS should be evaluated on a case-by-case basis.

Perspective on the 1986 Food and Drug Administration assessment of the safety of carbohydrate sweeteners: uniform definitions and recommendations for future assessments

Carbohydrate sweeteners in the diet, which are sources of added sugars, have recently undergone changes that vary considerably among countries. The major driving force for these changes is a technological development that permits conversion of corn and other starches to sweeteners. Major changes in the type of sweeteners used in the United States began in the mid-1970s. In 1986 the US Food and Drug Administration comprehensively evaluated exposures and potential health effects of sugars contained in carbohydrate sweeteners. A UK Department of Health report followed in 1989. An overview of issues is provided, terminologies used to describe sugars and sweeteners are defined, the findings of the US and UK reports are reviewed, trends in the availability of added and naturally occurring sugars are evaluated, and recommendations for future assessment of sugars are discussed. The potential problem of underreporting of food intakes in national food consumption surveys is also reviewed.

[Psychophysics of sweet taste. I. Goals and methods of investigation]

With a view to the solution of problems concerned with the consumer's acceptance of foods in which saccharose had been substituted, a discussion is opened on psychologic and physiologic aspects of the measurability of sensory stimulus-sensation relations. The classic method for measuring taste is the determination of the taste discrimination threshold which is also termed least discernible difference. In the lat years, the discrimination threshold has been determined and calculated mainly as the mean concentration (stimulus) difference resulting from the distribution of the tasters according to their efficiency (probit analysis). In contrast, the new method, which is described in detail, is based on the dependence of the probability of a perception of difference upon the intensity which is linear and represents the initial course of a stimulus-response curve. Differences in efficiency in the group of tasters, which is assumed to be homogeneous, are included in the variance of difference frequencies found. The control of the course of the test by sequential analysis and the binomial weighting of the probabilities obtained allow to perform calculations of the discrimination threshold which are largely free from systematic errors; this discrimination threshold is defined as the concentration difference that engenders the arbitrarily defined alternative probability of Pa = 0.75. To minimize the risk of overrating the measurement result, it is suggested to calculate in addition, on the basis of the binomial distribution, the confidence limits of the discrimination threshold. Furthermore, the constant stimulus method for determining the perception of two stimulus intensities of different sweetening agents is adapted, as to performance and calculation, to the new aspects in discrimination threshold determination.

Fructose: comparison with sucrose as sweetener in four products

The relative sweetness and acceptability of sucrose and fructose were determined at various levels in sugar cookies, white cake, vanilla pudding, and lemonade. Because of the reported increased sweetness of fructose and greater tolerance in individuals with diabetes mellitus for fructose, the study was designed to investigate its potential as an alternative sweetener. Results indicate that sucrose was both preferred and considered sweeter than fructose in sugar cookies, white cake, and vanilla pudding; however, the reverse was true in lemonade. On the basis of these results, the authors do not recommend the substitution of fructose for sucrose.