Thursday, October 13, 2016

If Health Canada Won't List Free Sugars, These Frustrated Researchers Will

Today's guest post comes from PhD candidate and RD Jodi Bernstein. The post covers her, and her supervisor Dr. Mary L'Abbe, the University of Toronto's Earle W. McHenry Professor and Chair Department of Nutritional Sciences', continued push for Health Canada to require free sugars to be included on Canada's nutrition fact panels.
The World Health Organization recommends that we limit free sugar intakes to a maximum 10% of calories a day. But there are many factors that hinder our ability to abide by these guidelines, far more than support it. First of all, it’s pretty difficult to picture what 10% of calories looks like. Sure I can tell you that for the average adult it’s about 50g or 12 teaspoons, but would that really help you all that much? Most of the free sugar we eat is coming from inside candies and sweets, cereal, beverages, and baked goods, so we can’t easily see how much free sugar is in the food. To abide by the World Health Organization’s recommendations, free sugar needs it to be included on the nutrition facts table.

The United States is planning to include the amount of added sugar (similar to free sugar) on their food label. But here in Canada, the latest proposal to change the nutrition label did not include free sugar on the label. In fact, we discussed the importance of including added sugar on Canada’s nutrition label in a previous blog post on Weighty Matters.

But in the meantime, we weren’t about to just sit around and wait. In light of this difficult predicament we took it upon ourselves to calculate the free sugar content of over 15,000 Canadian packaged foods and beverages, published it for open-access use, and found some interesting results along the way. Using the University of Toronto’s Food Label database, which has nutritional and ingredient information, we calculated the amount of free sugar in each product using a 6-step algorithm tailored for just this purpose. Here’s what we found:
  1. A lot of foods have free sugar in them. Sixty-five percent to be exact. That means its probably harder to find a packaged food that doesn’t contain free sugars, although the proportion was a lot lower in certain food groups like vegetables, nuts and seeds, dairy products and cereals and grains and highest in desserts, sugars and sweets, and bakery products.
  2. Free sugar accounts for 62% of total sugar. Although this was much higher for sweets, bakery products, desserts, and beverages and much lower for fruits and vegetables.
  3. There is a wide range of free sugar in a food category. This means two things: 1) when choosing a product, there may be a similar one that has less free sugar available; and 2) successful reformulation is possible. Having similar items, some with less free sugar, acts as proof showing that, yes, this food can be made with less free sugar and consumers will still buy it!
  4. There are 152 ways to say “free sugar” in the Ingredient List. It’s no wonder free sugar is considered a “hidden” source of calories. For instance, ‘table sugar’ was listed 40+ ways including all dehydrated, dried, granulated, concentrated, refined, coarse, evaporated, solid, powdered, and liquid variants of cane juice, sugar, and sucrose.
  5. 1/5 of total calories come from free sugar. Of course this ranged between food groups, with the highest at 70% of calories coming from free sugar in beverages. Consuming foods that have more than 10% of calories from free sugar increases the likelihood of exceeding dietary recommendations.
We are hopeful that these results will support of interventions and policies (including labelling free sugar on the nutrition label!) to limit excess free sugar consumption. The detailed information we provided in this study can be used as a benchmark to monitor changes in free sugar contents overtime, identify areas and targets to focus reformulation efforts, direct educational messages, and can be linked to national nutrition surveys to evaluate free sugar consumption and monitor associated health outcomes.

Jodi Bernstein is a Registered Dietitian and has a Master’s in Public Health, specializing in community nutrition. She is currently a PhD Candidate in the Department of Nutritional Sciences at the University of Toronto. Her thesis focuses on sugars in the Canadian food environment.

Most recently, Jodi has developed an algorithm to estimate the free sugars contents of Canadian food and beverages. Results have since been used to populate One Sweet App, a mobile app that allows users to track their free sugars intakes and compare this to guidelines from the World Health Organization.


Dr. Mary L’Abbé is the Earle W. McHenry Professor and Chair of the Department of Nutritional Sciences, Faculty of Medicine, at the University of Toronto, where she leads a research group on Food and Nutrition Policy for Population Health. Dr. L’Abbé is an expert in public health nutrition, nutrition policy, and food and nutrition regulations, with a long career in in mineral nutrition research. Her research examines the nutritional quality of the Canadian food supply, food intake patterns, and consumer research on food choices related to obesity and chronic disease.

Dr. L’Abbé a member of several committees of the WHO including the Nutrition Guidance Expert Advisory Group on Diet and Health and the Global Coordinating Mechanism for NCDs; the former which recently released the WHO Guidelines on Sugars. Dr. L’Abbé was co-chair of the Canadian Trans Fat Task Force, led the Trans Fat Monitoring Program and served as Chair and vice-Chair of the Canadian Sodium Working Group. Before joining the University of Toronto, Dr. L’Abbe was Director, Bureau of Nutritional Sciences at Health Canada. Dr. L’Abbé holds a PhD in nutrition from McGill University and has authored over 180 peer-reviewed scientific publications, book chapters and government reports.