Dispelling nutrition myths, ranting, and occasionally, raving


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Is a spoonful of sugar the way to get the vegetables to go down?

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When I saw this article: “Sugar, salt or sweeteners may be key to getting children to eat greens” last week in the Nutrition Resource Centre “News in Brief” email I knew that I had to read more. I mean, were the authors really suggesting that we should add sugar to veggies to get infants and toddlers to eat them? Or was this just a case of a misleading or misinterpreted press release? I found a copy of the full article: Mary Poppins was right: Adding small amounts of sugar or salt reduces the bitterness of vegetables and set about reading.

One thing that struck me right away was that this study was done with adults, no infants or toddlers, or children of any age were involved in the research. Adult participants were provided with puréed vegetables (broccoli, kale, and spinach) with varying concentrations of added sugar. They were asked to rate them on various attributes, and most importantly, they were asked to indicate whether or not they liked or disliked each sample. I was surprised that the conclusion would be drawn that adding sugar to green vegetables is a reasonable means to encourage infants to eat them (I’m saying infants because these were puréed veggies and as such are really only suitable for babies just starting to eat solid foods) based on ratings by adults. After all, adults have very different palates than infants and have very different relationships with food that have been shaped over decades. To me it seems inappropriate to conclude that because adults preferred sugar sweetened veggies that infants will as well. The authors themselves also state that, “It should be noted that infants and toddlers are also not merely small adults”. However, they also use the analogy of adults beginning coffee consumption with added sugar and gradually weaning off the sugar as justification for proposing adding sugar to vegetables when the World Health Organization, among many other bodies, is currently encouraging reduced consumption of added sugars.

The second thing I wondered about was precisely how much sugar was added to each serving of vegetables. The news article, and much of the journal article, references 1% and 2% concentrations but what did that translate to in teaspoons or grams? It sounds pretty innocuous, right? 1% or 2% is hardly anything. Well, in actuality the 1% was equivalent to the addition of 1/2 teaspoon per serving and the 2% was equivalent to 1 teaspoon per serving. Not an insignificant amount when you’re talking about toddlers who are generally only consuming a tablespoon or two of a food in a serving. Interestingly, the researchers asked parents how comfortable they would be offering their babies vegetables with added sugar in amounts of 8 calories, 16 calories, 1/2 teaspoon, or 1 teaspoon. The 8 calories = 1/2 teaspoon = 1% concentration. The 16 calories = 1 teaspoon = 2% concentration. Essentially asking: how can we frame this added sugar to make it more palatable to parents who are trying to feed their children healthy diets?

Despite the general conclusion that adding sugar to vegetables may encourage young children to eat them, even the ratings by adults were not overwhelmingly improved by the added sugar. For broccoli and kale purées both 1% and 2% sugar increased overall liking. For spinach the 2% sugar (but not the 1%) increased overall liking. For broccoli and spinach the sugar increased the ratings of liking from disliked to liked. However, for kale, even at the highest sugar level ratings never rose above the midpoint (i.e. neither like nor dislike). So, these adults did not like any of the green vegetables to begin with (at least not in puréed form) but after adding higher quantities of sugar they liked the spinach, and even with the smaller quantity of added sugar they liked the broccoli. But neither amount of sugar was enough to get them to like the kale. Would babies have different initial reactions to these vegetables? Would the addition of sugar cause them to change these reactions? I don’t know and I don’t think anyone can say based on the results of this study alone.

Just for fun, I took a look at the funding sources for the study after I finished reading it. Can you guess what one of the funding organizations was? If you guess the Sugar Association you’d be correct. I think this explains a lot because honestly I was a bit baffled as to why anyone would be looking into adding sugar to get babies to eat vegetables and why such tenuous conclusions would be drawn and publicized based on the actual findings. But who other than the Sugar Association would think that we need to encourage babies to eat more sugar?

I think a better analogy than the sugar sweetened coffee for this research would be the argument that chocolate milk is a good way to get kids to drink milk or that baking apples into a pie is a good way to encourage fruit consumption. In some ways it’s even worse because infants are at the mercy of their caregivers when it comes to what foods are offered to them and encouraging a preference for only sweet foods at such a young impressionable age could have long lasting implications for their food choices and health throughout their lives.

 

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Grocery Store Lessons: Liberte Baby Yoghurt

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Baby yoghurt isn’t a new product. I had thought about blogging about it a while ago and then forgot and then thought that it had been discontinued. Unfortunately, that wasn’t the case. File this one under ridiculous unnecessary products that you never need to buy.

There is no reason that a baby needs yoghurt with added sugar. And that’s what this product is. It’s a series of yoghurts with 6% milk fat. You’re supposed to start them on the plain (with a mere teaspoon of sugar per 75 gram package). Ingredients: whole milk, cream, cane sugar, milk protein concentrate, bacterial cultures, and vitamin D. Then you can progress to the yoghurts at “step 2”; banana or strawberry.

The banana and strawberry both have 7 grams (just under two teaspoons of sugar) per 75 gram serving.

Ingredients in the banana: whole milk, fruit preparation (banana puree [i.e. flavoured sugar], cane sugar, water, tapioca starch, pectin, natural flavour, lemon juice concentrate), cream, cane sugar, milk protein, concentrate, bacterial cultures, and vitamin D.

Ingredients in the strawberry: whole milk, fruit preparation (strawberry pureecane sugar, water, rice starch, natural flavour, carrot juice concentrate, cranberry juice concentrate, lemon juice concentrate), cream, cane sugar, milk protein concentrate, bacterial cultures, vitamin D.

Babies don’t need sweetened yoghurt. Just because many adults need sugary flavoured yoghurts doesn’t mean that babies do. Their tastebuds are much more sensitive than ours and they’re also learning what they like (and dislike). There’s no need for us to impose our preferences and sweet teeth on them. Lots of babies enjoy the tangy taste of plain full-fat yoghurt.

Parents don’t need to shell out the extra cash for smaller servings of plain yoghurt for their babies. Save your cash and get unsweetened plain yoghurt for your baby.


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Grocery store lessons: a tale of two pasta sauces

Further to all of my discussion about sugar in food and nutrition labels I wanted to share with you the following nutrition facts label that has me stumped:

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Apologies for the poor photo quality. Hopefully you’re able to see that the nutrition facts panel indicates that there’s no sugar in this pasta sauce. That’s grand and all, no one wants a sugary tomato sauce. It’s also puzzling because tomatoes (and many other vegetables) naturally contain sugar. So how does one end up with zero grams of sugar in a 1/2 cup serving?

Compare this to another pasta sauce:

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This second sauce, despite having no added sugar, still contains 6 grams of sugar per serving. This is much more the norm  than the sauce in the first photo.

I know that people are trying to cut back on sugar. That’s great. But this is another example of why you might want to pay more attention to the ingredients in a food than to the nutrition facts panel. These are very similar products but tell rather different stories when it comes to sugar content. One supposedly contains no sugar, while the other contains about one and a half teaspoons in a serving. Even if you’re trying to cut back on sugar there’s really no point in getting riled up about a little bit of sugar naturally occurring from vegetables.


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What the WHO sugar recommendations look like

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It was all over the news last week: the World Health Organization has released draft guidelines on sugar intake. These guidelines recommend a further reduction in added sugar intake from less than 10% of total daily calories to less than 5% of total daily calories. They state that this would be roughly 6 teaspoons of sugar a day for the average person. But what does this really look like?

Let’s look at the “average” person first. The “average” sedentary Canadian woman (31-50 years of age) needs roughly 1, 800 calories per day (1). Honestly, that sounds like rather a lot to me. I’m shorter than the average Canadian woman but far more active; my job is very physical and I’m currently training for the Boston Marathon and that’s about all I need in a day. Anyway… Let’s pretend that Health Canada isn’t over estimating our caloric needs. That would mean that the average Canadian woman should aim to have no more than 90 calories a day from added sugars. Knowing that one gram of sugar contains about 4 calories that means that this Average Woman would be permitted 22.5 grams of added sugar a day, or 5.63 teaspoons.

The Average Man (same age range) needs about 2, 350 calories a day. That would mean that he could have 117.5 of those calories from added sugar, or 29.38 grams, or 7.34 teaspoons.

Now, just to be clear, even though your body doesn’t distinguish between added sugar, refined sugar, unrefined sugar, naturally occurring sugar, yada yada, the WHO is only referring to added sugars. Lest you think that the food industry can get tricky and use pureed fruit or fruit juice concentrate to sweeten foods and get around these counting as “added sugars” these have been included in the definition of added sugar.

Just as most of the sodium in our diets is hidden in processed and packaged foods, so is much of the sugar. It’s not going to be as simple as eliminating the teaspoon of sugar in your cup of tea. Although, if you’re one of those people who adds two sugars to your coffee, once you’ve had two cups you’re creeping up on that limit.

How easy is it to reach that limit? Here are a few common “foods” and their respective sugar contents:

A small (16oz) Coke contains 41.4 g of sugar or 10.35 teaspoons (2).

A medium DQ Blizzard contains 74 g of sugar or 18.5 teaspoons (3).

A vanilla latte at Starbucks has 35 g of sugar or 8.75 teaspoons (4).

A 3/4 cup serving of Liberte 2% Coconut Greek Yoghourt contains 19 g of sugar or 4.75 teaspoons (reference: the tub in my fridge).

Two slices of Dempster’s 12 Grain Bread contain 6 g of sugar or 1.5 teaspoons (5).

Check out this infographic for more.

To be fair, some of these sugars will be naturally occurring. But… How are we as consumers to know how much of the sugar is naturally occurring and how much is added? And does it really matter? Unless we are eating diets that consist solely of unprocessed foods it’s going to be damn near impossible for any of us to know precisely how much sugar in a food is added and how much is naturally occurring. Unless food labels start changing to indicated added and naturally occurring sugars it’s going to be a bit of a guessing game. Personally, I think it would be better if we focussed less on individual nutrients and focussed more on overall diet. Recommending limits on processed and fast food and encouraging increasing consumption of home cooked meals and minimally processed foods would be easier to follow. The way these recommendations are framed they just steer people in developed countries toward foods sweetened with non-nutritive sweeteners and allow the food industry to market nutritionally-void foods as healthy choices by replacing sugar with other things. They also make things like fruit juice perfectly acceptable even though they are essentially just liquid candy.

If you’re interested in contributing to the draft guidelines you can download the complete document here and send your comments in by March 31st.


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Sugar: Not such a sweet heart

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A study was published in JAMA Internal Medicine last week that got everyone all worked up! In case you somehow missed it, sugar is the latest white food to be blamed for obesity. While this study didn’t look at obesity it still added a whole whack (that’s a real unit of measurement, right?) of fuel to the fire of those railing against sugar.

The study looked at the data from NHANES a huge long-term US health and nutrition study and concluded that those who are consuming diets with more than 25% of calories from added sugars are significantly more likely to perish from heart disease than are those who are consuming less than 25% of their daily calories from added sugars.

Of course, there are the usual caveats with this sort of research. They relied on food frequency questionnaires which are notoriously inaccurate and put much of the research based on them in question. A little aside: I used to work as an interviewer for a large Canadian statistical agency and I wouldn’t trust any of the nutrition information we collected. I mean, vegetable intake was determined by asking questions such as “how often do you eat carrots?”. I think we asked about consumption of three kinds of vegetables (including potatoes which were meant to exclude fried and potato chips) and “other vegetables” to determine total vegetable intake. People could answer on a daily, weekly, or monthly basis. Interviewees often seemed confused about hot to answer the questions and I often wondered to myself what people were eating when, based on their answers, they seemed to eat one carrot a month and a slice of bread everyday. Anyway… let’s put aside the fact that these studies are flawed. Let’s pretend that we do actually know how many calories people are consuming every day from sugar. Can we be sure that the increase in heart disease is attributable to sugar consumption? Perhaps it’s due to displacement of other foods. If someone is consuming 25% of their daily calories from sugar that either means that they’re consuming an excessive number of calories and obtaining adequate quantities of required nutrients, they’re consuming excess calories but not meeting nutrient requirements, or they’re consuming reasonable amounts of calories and not meeting nutrient requirements. Odds are, if they’re getting too much sugar, they’re getting too little of a number of essential vitamins and minerals.

I don’t think that we should be obtaining 25% of our daily calories from added sugar. While the “safe” amount of sugar is still up for debate, the previously suggested maximum of 10% of daily calories from the WHO seems reasonable and achievable. I don’t think that we should be rushing out and lobbying the food industry for sugar to be removed from everything. I certainly don’t think that this research lends any support to the case for sugar causing obesity. I think that we should take it as a caution and aim to be more conscious of the sugars we’re consuming on a daily basis.