‘Added sugars’ label may prompt industry reformulation, save lives

USA - Cost-Effectiveness of the US Food and Drug Administration Added Sugar Labeling Policy for Improving Diet and Health

Abstract

BACKGROUND: Excess added sugars, particularly from sugar-sweetened beverages, are a major risk factor for cardiometabolic diseases including cardiovascular disease and type 2 diabetes mellitus. In 2016, the US Food and Drug Administration mandated the labeling of added sugar content on all packaged foods and beverages. Yet, the potential health impacts and costeffectiveness of this policy remain unclear. 

METHODS: A validated microsimulation model (US IMPACT Food Policy model ) was used to estimate cardiovascular disease and type 2 diabetes mellitus cases averted, quality-adjusted life-years, policy costs, health care, informal care, and lost productivity (health-related) savings and cost-effectiveness of 2 policy scenarios: (1) implementation of the US Food and Drug Administration added sugar labeling policy (sugar label), and (2) further accounting for corresponding industry reformulation (sugar label+reformulation). The model used nationally representative demographic and dietary intake data from the National Health and Nutrition Examination Survey, disease data from the Centers for Disease Control and Prevention Wonder Database, policy effects and diet-disease effects from meta-analyses, and policy and health-related costs from established sources. Probabilistic sensitivity analysis accounted for model parameter uncertainties and population heterogeneity. 

RESULTS: Between 2018 and 2037, the sugar label would prevent 354400 cardiovascular disease (95% uncertainty interval, 167000–673500) and 599300 (302400–957400) diabetes mellitus cases, gain 727000 (401300– 1138000) quality-adjusted life-years, and save $31 billion (15.7–54.5) in net healthcare costs or $61.9 billion (33.1–103.3) societal costs (incorporating reduced lost productivity and informal care costs). For the sugar label+reformulation scenario, corresponding gains were 708800 (369200– 1252000) cardiovascular disease cases, 1.2 million (0.7–1.7) diabetes mellitus cases, 1.3 million (0.8–1.9) quality-adjusted life-years, and $57.6 billion (31.9–92.4) and $113.2 billion (67.3–175.2), respectively. Both scenarios were estimated with >80% probability to be cost saving by 2023. 

CONCLUSIONS: Implementing the US Food and Drug Administration added sugar labeling policy could generate substantial health gains and cost savings for the US population

https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.118.036751

A new Nutrition Facts label that highlights the amount of added sugars in food could prevent nearly 1 million cases of heart disease and type 2 diabetes, suggests a new study published in the journal Circulation. If consumers had access to this new label, their food choices could prevent more than 350,000 cases of heart disease and nearly 600,000 cases of type 2 diabetes over the next two decades, researchers predicted using a computer model.

The new label, first proposed by the U.S. Food and Drug Administration (FDA) in May 2016, adds a new line under the “total carbohydrate” category that details the amount of sugar that has been added on top of the sugars already contained in a food product. Added sugars account for more than 15% of Americans' total daily calories, exceeding the recommended level of less than 10%, the researchers said in background notes.

The researchers used an already validated model that considers a variety of information—including demographics, risk factors, dietary habits, and diseases—to project the impact of the revised Nutrition Facts label on consumers’ food choices, their long-term health, and the economic cost of heart disease and type 2 diabetes.

According to the researchers, the most striking finding from the study came when they predicted what might happen if the food industry responded to the new label by reducing the amount of added sugars in products. Even a partial industry response could result in about 700,000 fewer cases of heart disease and 1.2 million fewer cases of type 2 diabetes over the next 20 years, the model shows.

“The industry should be part of the solution,” said Renata Micha, associate research professor at the Tufts University School of Nutrition Science and Policy. “We saw when we did account for even a modest industry reformulation, maximum health and economic gain can be achieved.”

The FDA has delayed implementation of the label until 2020.

Yue Huang

, 

Chris Kypridemos

, 

Junxiu Liu

, 

Yujin Lee

, 

Jonathan Pearson-Stuttard

, 

Brendan Collins

, 

Piotr Bandosz

, 

Simon Capewell

, 

Laurie Whitsel

, 

Parke Wilde

, 

Dariush Mozaffarian

, 

Martin O'Flaherty

, and 

Renata Micha

AMA seeks warning labels for foods with high added sugar content

California voters overwhelmingly approved a measure (Proposition 12) on November 6 that requires stricter animal During the 2018 American Medical Association (AMA) Interim Meeting, held November 8–13, delegates adopted a new policy aimed at increasing consumer awareness of the amount of added sugars, as well as the type of allergens, in food products. Specifically, the AMA is urging the U.S. Food and Drug Administration (FDA) to develop front-of-package warning labels for foods that are high in added sugars based on the established recommended daily value. The policy also encourages the FDA to limit the amount of added sugars allowed to be included in food products that also make claims about health or nutrient content on the front of their packages.

According to the AMA, many front-of-package food labels that make health claims about a particular nutrient are often placed on products that contain added sugars that are above the daily recommended value as outlined in the 2015–2020 U.S. Dietary Guidelines for Americans. The association believes that these nutrient claims may lead consumers to think a product is healthy despite the product’s level of added sugar.

Under the new policy, the AMA is also encouraging food manufacturers to pursue more obvious packaging distinctions between products that contain the most common food allergens identified in the Food Allergen Labeling and Consumer Protection Act and products that do not contain these allergens.

“The AMA believes that food packaging should include more transparent information about the contents within our food, so the healthy choice can be the easy choice for consumers,” said Albert J. Osbahr, III, a member of the AMA board of trustees. “When consumers have access to the amount of sugar they are consuming, they may choose foods with less sugar—which can help prevent debilitating chronic medical conditions, such as type 2 diabetes and heart disease which affect millions of Americans.”

The AMA has existing policy to ensure Americans better understand the actual amount of sugar contained in the foods they consume, including policy in support of the FDA’s decision to include added sugars on nutrition labels.

LINK: https://www.ama-assn.org/ama-advocates-transparency-food-labeling-and-packaging

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Artificial sweeteners may not raise glucose levels

There is well-documented research on the health risks of sugar consumption in terms of child and adult obesity, but studies are ongoing to provide conclusive evidence that non-nutritive sweeteners offer benefits toward weight management or other health benefits. Among the concerns is whether non-nutritive sweeteners raise glycemia—the glucose level in the blood. In a paper published in the European Journal of Clinical Nutrition, researchers at the University of Illinois (U of I) analyzed current research on four of the most popular non-nutritive sweeteners to find a conclusive answer.

They wanted to examine the glycemic response specifically to the non-nutritive sweeteners, so they only included studies in which participants had fasted before consuming the sweeteners. In addition, the sweeteners could not have been consumed as part of another beverage or food in the study. In total, the researchers’ analysis included 29 trials, with a total of 741 participants. The sweeteners represented in the studies included aspartame, saccharine, steviosides, and sucralose. The meta-analysis tracked blood glucose levels over 210 minutes after the consumption of a non-nutritive sweetener.

They found that these sweeteners—overall and at various time points—didn’t raise glucose levels. While they did see a decline in glycemia for some participants (depending on additional characteristics such as diabetic state, age, etc.), they believe this is most likely because of the prolonged fasting, not because of the sweetener consumption.

“It has been assumed in the literature for a long time that non-nutritive sweetener consumption wouldn’t affect your fasting blood glucose levels, but there’s never been a meta-analysis to determine if this is actually true,” said Alexander Nichol, co-author of the study and master’s student in the Dept. of Food Science and Human Nutrition at U of I. “I see it all the time in research papers where people will mention that non-nutritive sweeteners don’t affect blood glucose levels, and now we hope our study can be used as a reliable reference.”

Study: https://www.nature.com/articles/s41430-018-0170-6.epdf?author_access_token=4oG0UFx1g-HheoyVzuza5dRgN0jAjWel9jnR3ZoTv0NRZMPNohRYr2gUVeeVGDfp_7Qc1O9QihNk5JPbfcIgIpPp-_GKE5irZjKL4bs8Mg6OfjHB8Xk2iVvSdSe3WwmMGWBQSEQ7euQ9SEedbhi8ww%3D%3D

23-5-2018

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