Editorial by Drs. Tom Wolever and John Sievenpiper "Revised food labeling in North America: the blind leading the blind?"
Earlier this year the US Food and Drug Administration (FDA) proposed several changes to the US Nutrition Facts panel, including the declaration of “Added Sugars”. In July 2014, Health Canada made a similar proposal to provide consumers with more information about “added sugars” on food packages.
In a recent editorial “Revised food labeling in North America: the blind leading the blind?” published in the European Journal of Clinical Nutrition, Toronto medical doctors and professors Tom Wolever and John Sievenpiper voice their concern “that the rationale for declaring added sugars is based on popular misconceptions rather than high-quality evidence and may do harm”.
The authors caution that consumer perceptions such as “consuming added sugars can cause people to consume less nutrient-rich foods and increase the energy intake and that added sugars are ‘empty calories’”, are “oversimplifications” and “not supported by high-quality evidence”.
In fact, as indicated by Wolever and Sievenpiper:
- A recent WHO-sponsored meta-analysis showed that reducing intake of energy from added sugars reduced excess body fat in adults, but not in children, and no difference was seen where added sugars isocalorically replaced other carbohydrate sources;
- The CARMEN study (the largest and longest trial to use an ad libitum design to assess the effect of sugars on weight gain) found that participants on a high-sugar diet lost significantly more weight than those on the control (higher fat) diet, suggesting that people can lose weight on an energy-reduced diet even if it is high in simple sugars;
- A UK survey showed that people with intakes of added sugars between 10-13% energy tended to have higher intakes of nutrients such as calcium, iron and folate compared to those with the lowest (5% energy) and highest (22%) intakes.
The authors emphasize that as physicians with an interest in nutrition, they “are not going to tell people to eat more sugar”; however, they argue that “driving out added sugars could detract from public health”. Because sugars are often added to make nutritious and/or high-fibre foods more palatable (examples provided include yogurt, breakfast cereals, canned beans), “undue avoidance of foods containing added sugars could have the deleterious effect of reducing intakes of certain nutrients”.
This reiterates Registered Dietitian and professor Joanne Slavin’s views in the American Journal of Clinical Nutrition editorial “Two more pieces to the 1000-piece carbohydrate puzzle” that states while “added sugars have become the nutrition villain du jour… we must be clear that added sugars provide 4 kcal/g just like any other digestible carbohydrate and are no more likely to cause weight gain than any other calorie source”.
She emphasizes that food should be “eaten and enjoyed”. Because people eat food not nutrients, rather than “nutritional nitpicking” one nutrient such as added sugars, dietary guidance should focus on whole foods and overall eating patterns.
To read the full editorials: