Summary

> Because sugary beverages are implicated in the global obesity crisis, major soda manufacturers have recently employed elaborate, expensive, multinational corporate social responsibility (CSR) campaigns.

> These campaigns echo the tobacco industry's use of CSR as a means to focus responsibility on consumers rather than on the corporation, bolster the companies' and their products' popularity, and to prevent regulation.

> In response to health concerns about their products, soda companies appear to have launched comprehensive CSR initiatives sooner than did tobacco companies.

> Unlike tobacco CSR campaigns, soda company CSR campaigns explicitly aim to increase sales, including among young people.

> As they did with tobacco, public health advocates need to counter industry CSR with strong denormalization campaigns to educate the public and policymakers about the effects of soda CSR campaigns and the social ills caused by sugary beverages.

> Sugar consumption is linked to a rise in non-communicable disease

> Sugar’s effects on the body can be similar to those of alcohol

> Regulation could include tax, limiting sales during school hours and placing age limits on purchase.

The classic exposé on the dangers of sugar, with a new introduction by Robert H. Lustig, the bestselling author of Fat Chance

Scientist John Yudkin was the first to sound the alarm about the excess of sugar in the diet of modern Americans. His classic exposé, Pure, White, and Deadly, clearly and engagingly describes how sugar is damaging our bodies, why we eat so much of it, and what we can do to stop. He explores the ins and out of sugar, from the different types—is brown sugar really better than white?—to how it is hidden inside our everyday foods, and how it is damaging our health.

In 1972, Yudkin was mostly ignored by the health industry and media, but the events of the last forty years have proven him spectacularly right. Yudkin’s insights are even more important and relevant now, with today’s record levels of obesity, than when they were first published. Brought up-to-date by childhood obesity expert Dr. Robert H. Lustig, this emphatic treatise on the hidden dangers of sugar is essential reading for anyone concerned about their health, the health of their children, and the wellbeing of modern society.

A PDF of the original version is available here: http://www.sheldonsblo...

Objective: Using data from many countries in the world combined with in-depth U.S. dietary data, we explored trends in caloric sweetener intake, the role of urbanization and income changes in explaining these trends, and the contribution of specific foods to these changes.

Research Methods and Procedures: Food disappearance data from 103 countries in 1962 and 127 in 2000 were coupled with urbanization and gross national income per capita data in pooled regression analysis to examine associations between these factors and caloric sweetener intake. Three nationally representative surveys from 1977 to 1978, 1989 to 1991, and 1994 to 1996 plus 1998 are used to examine caloric sweetener intake trends in the United States and the foods responsible for these changes.

Results: Increased consumption of caloric sweetener is one element in the world's dietary changes, represented by a 74-kcal/d increase between 1962 and 2000. Urbanization and income growth represent 82% of the change. U.S. data show an 83-kcal/d increase of caloric sweetener consumed—a 22% increase in the proportion of energy from caloric sweetener. Of this increase, 80% comes from sugared beverages; restaurant and fast food sources are represented in greater proportions.

Discussion: Caloric sweetener use has increased considerably around the world. Beverage intake seems to be a major contributor.

The evidence considered in this report endorses a dietary pattern concerning carbohydrates that is based on whole grains, pulses (e.g. kidney beans, haricot beans, lentils), potatoes, vegetables and fruits, but limiting the amounts consumed of table sugar and rich sources of free sugars, such as preserves and sweet spreads, fruit juice, confectionery, biscuits, buns and cakes. The report also provides evidence that sugars sweetened beverages should be consumed in minimal (i.e. infrequently and in small) amounts.

The National Diet and Nutrition Survey shows that, as a whole, the population consumes more than the recommended amount of sugars and the intakes of fibre are below current advice. With the proposed increase of the dietary reference value for fibre and the reduction of the dietary reference value for free sugars, the difference between recommendations and the population’s intake would become even greater for both. In order to address this imbalance, there needs to be a change in the population’s diet so that people derive a greater proportion of dietary energy from carbohydrate-rich foods that are low in free sugars and high in dietary fibre.

Citerank: (13) 348691A healthier dietEncourage people to eat a healthier diet – and to be more health-discerning about when, how often, and what to eat.565CA4D9, 351718Consuming too much sugarMany people are eating more sugar than they should. Current intakes of sugar for all population groups exceed recommendations set by the Committee on Medical Aspects of Food Policy (COMA) for the UK in 1991 (which recommended that, on a population basis, no more than 10% of the average total energy intake should be consumed as sugar). Energy dense diets, such as those that are high in sugar, can lead to an excess calorie intake (which, if sustained, leads to weight gain and obesity).555CD992, 352400Many individuals are consuming more energy than they are expendingPublic Health England estimates that the average man in England is consuming around 300 calories a day more than they would need were they a healthy body weight.555CD992, 352457Public Health Responsibility DealThe Public Health Responsibility Deal aims to tap into the potential for businesses and other influential organisations to make a significant contribution to improving public health by helping us to create this environment. The Responsibility Deal embodies the Government’s ambition for a more collaborative approach to tackling the challenges caused by our lifestyle choices.62C78C9A, 352522Calorie consumptionPublic Health England estimates that the average man in England is consuming around 300 calories a day more than they would need were they a healthy body weight.555CD992, 368236SugarDefinitions of sugar vary. For the purposes of the PHE paper cited, the term ‘sugar’ includes all sugars outside the cellular structure in foods and drinks excluding those naturally present in dairy products. This includes sugar added to foods, plus the sugar in fruit juice and honey. It does not include the sugars naturally present in intact fruit and vegetables or dairy products.82AECCD8, 399669A healthier dietEncourage people to eat a healthier diet – and to be more health-discerning about when, how often, and what to eat.565CA4D9, 399705Public Health Responsibility DealThe Public Health Responsibility Deal aims to tap into the potential for businesses and other influential organisations to make a significant contribution to improving public health by helping us to create this environment. The Responsibility Deal embodies the Government’s ambition for a more collaborative approach to tackling the challenges caused by our lifestyle choices.62C78C9A, 399891Many individuals are consuming more energy than they are expendingPublic Health England estimates that the average man in England is consuming around 300 calories a day more than they would need were they a healthy body weight.555CD992, 399909Calorie consumptionPublic Health England estimates that the average man in England is consuming around 300 calories a day more than they would need were they a healthy body weight.555CD992, 399934Consuming too much sugarMany people are eating more sugar than they should. Current intakes of sugar for all population groups exceed recommendations set by the Committee on Medical Aspects of Food Policy (COMA) for the UK in 1991 (which recommended that, on a population basis, no more than 10% of the average total energy intake should be consumed as sugar). Energy dense diets, such as those that are high in sugar, can lead to an excess calorie intake (which, if sustained, leads to weight gain and obesity).555CD992, 399946The addictiveness of sugarSome companies are harnessing the addictiveness of sugar for commercial benefit and to the detriment of public health. Emerging science on the addictiveness and toxicity of sugar, especially when combined with the known addictive properties of caffeine found in many sugary beverages, points to a large-scale public health threat similar to addictiveness and harmful impacts of tobacco products.62C78C9A, 399960SugarDefinitions of sugar vary. For the purposes of the PHE paper cited, the term ‘sugar’ includes all sugars outside the cellular structure in foods and drinks excluding those naturally present in dairy products. This includes sugar added to foods, plus the sugar in fruit juice and honey. It does not include the sugars naturally present in intact fruit and vegetables or dairy products.82AECCD8

Eating too much sugar is bad for us. This paper outlines the steps PHE will take to help families and individuals to reduce their sugar intake and how we study possible initiatives to further reduce sugar consumption. This will allow us to meet the Department of Health’s request that we provide them draft recommendations in spring 2015 to inform the government’s thinking on sugar in the diet.

We will do this work in the light of the Scientific Advisory Committee on Nutrition’s report on carbohydrates, which has been published in draft form and will be finalised by the end of the year. People eat more sugar than they should.

Current intakes of sugar for all population groups exceed recommendations set by the Committee on Medical Aspects of Food Policy (COMA) for the UK in 19911. Its recommendation is that on a population basis, no more than 10% of the average total energy intake should be consumed as sugar.

More than two-thirds of adults and, by the time they leave primary school, one in three children are carrying excess weight. Improving diet and specifically rebalancing calorie intake must be a top priority. Evidence shows diet and obesity related diseases including cardiovascular disease and some cancers cost the NHS alone at least 11 billion pounds per year, and are major contributors to health inequality, with the most deprived being most at risk.

People’s health would benefit if average sugar intakes in England were reduced. Sugar increases the risk of consuming too many calories, which, if sustained, causes weight gain and obesity. This document outlines how PHE will prepare evidence and advice for government. We also set out the actions we are undertaking now, and those we will take in the near future to help reduce sugar intake.

Our work plan builds on our expertise and experience in diet, obesity and marketing and on conversations with stakeholders including academics, consumer groups and industry representatives.

Our Plans include:

> immediately launch a digital marketing package to help families and individuals reduce their sugar intakes followed by a focused national behaviour change campaign on sugar reduction in January 2015

> a refresh of the “5 a day” campaign, including a reconsideration of our advice on fruit juice and smoothies and an assessment of how “5 a day” might apply to composite dishes (such as ready meals)

> advice to government departments, industry, non-governmental organisations and others regarding any necessary revisions to nutrition messaging in light of SACN’s finalised advice on carbohydrates and health (expected in late 2014/early 2015). Further work to revise our key dietary messaging and improvement tools, such as the “eatwell plate”, advice on catering and Change4Life messaging may follow

> evidence reviews and further analysis to allow in-depth consideration of the possible initiatives we have already identified as key areas for future discussion. These include advertising of foods to children, fiscal measures that relate to sugar-sweetened drinks, the role of the food industry, food procurement across the public sector, and education and training

> supporting the Department of Health in its work with the food and drink industry.

SugarScience.org is designed as an authoritative source for the scientific evidence about sugar and its impact on health. Developed by a team of health scientists from the University of California, San Francisco (UCSF), the site reflects an exhaustive review of more than 8,000 scientific papers that have been published to date, with a focus on the areas where the science is strongest – specifically, on diabetes, heart disease and liver disease. The goal of SugarScience is to take this information out of medical journals and make it available to the public, to help individuals and communities make healthy choices.