The examples and perspective in this article deal primarily with the United States and do not represent a worldwide view of the subject.(January 2024) |
This article needs to be updated. The reason given is: The most recent given information in this article is from 2016, and the future tense for "US nutritional labelling changes" indicates newer information is needed.(January 2024) |
Sugar is heavily marketed both by sugar producers and the producers of sugary drinks and foods. Apart from direct marketing methods such as messaging on packaging, television ads, advergames, and product placement in setting like blogs, industry has worked to steer coverage of sugar-related health information in popular media, including news media and social media. [1] [2] [3]
Sugar refiners and manufacturers of sugary foods and drinks have also sought to influence medical research and public health recommendations. [4] [5] The results of research on the health effects of sugary food and drink differ significantly, depending on whether the researcher has financial ties to the food and drink industry. [6] [7] [8] The authors of a 2016 review [6] of funding bias concluded that "This industry seems to be manipulating contemporary scientific processes to create controversy and advance their business interests at the expense of the public's health".
In the early 1950s, sugar was marketed as a healthy substance that would help curb hunger and provide an energy boost. [9] More recent methods are necessarily less direct. Methods of marketing sugary products include: [10]
Sugar refiners and manufacturers of sugary foods and drinks have sought to influence medical research and public health recommendations, [4] [5] with substantial spending documented from the 1960s to 2016. [11] [12] [13] [14] The results of research on the health effects of sugary food and drink differ significantly, depending on whether the researcher has financial ties to the food and drink industry. [6] [7] [8] The authors of a 2016 review [6] of funding bias concluded that "This industry seems to be manipulating contemporary scientific processes to create controversy and advance their business interests at the expense of the public's health". A 2013 review concluded that "unhealthy commodity industries should have no role in the formation of national or international NCD [ non-communicable disease ] policy". [15]
There have been similar efforts to steer coverage of sugar-related health information in popular media, including news media and social media. [1] [2] [3]
The Sugar Research Foundation, a trade association for the sugar industry, conceived, funded, and participated in an influential 1967 medical review. It was called "SRF Funds Project 226", and published as "Dietary Fats, Carbohydrates and Atherosclerotic Vascular Disease". [16] [11] While this took place in 1965–1967, it was documented in a 2016 JAMA Internal Medicine publication [11] which reviewed industry documents. Among the researchers who put their names to the 1967 review, David Mark Hegsted went on to write national nutrition guidelines, and Fredrick J. Stare was head of Harvard University's nutrition department. [17] Rules surrounding conflicts of interest in academic publishing were laxer then, helping the payment to go undeclared. Taking into account "other recent analyses of sugar industry documents", the 2016 review concludes that such actions were part of a wider industry-sponsored research program in the 1960s and 1970s. It also concludes that "Policymaking committees should consider giving less weight to food industry–funded studies". [11]
Immediately afterwards, the same Sugar Research Foundation funded a study comparing sugar-fed and starch-fed rats. "SRF Funds Project 259: Dietary Carbohydrate and Blood Lipids in Germ-Free Rats" was funded from 1967 until 1971, when, after reporting preliminary results to the funders, it did not have its funding renewed. The research was never published. [18] [19]
The U.S. National Institute of Dental Research's 1971 National Caries Program was lobbied by the sugar industry, which substantially influenced the types of research the caries program called for. Research on food cariogenicity that could have harmed the sugar industry was omitted from funding priorities. The NIDR's public health task force on caries and an industry task force on caries had almost exactly the same members. The NIDR copied 78% of the industry groups' report into their own, with portions being copied verbatim. [12]
After the WHO recommended cutting sugar consumption to less than 10% of daily energy intake in 1990, the International Life Sciences Institute gained accreditation as a research organization the WHO and FAO. The institute was founded by parties including Coca-Cola, PepsiCo and General Foods. Phillip James, head of the International Obesity Taskforce, considered that this accreditation increased industry influence over world health guidelines. [20]
The development of official European dietary guidelines [21] was influenced by European sugar industry groups, who in 2000 threatened to block the report if a recommendation to limit sugar consumption to less than 10% of daily energy intake were not removed. The medical experts felt forced change the recommendation, to one that sugar should not be eaten more than four times a day. [22]
Industry groups also criticized the evidence behind the World Health Organization 2003 recommended limit on free sugar consumption (again, to less than 10% of daily energy intake). [23] The US sugar industry additionally lobbied the US Congress to cut funding to the WHO. [24] [22]
When the WHO updated the recommendations, a decade later in 2013, it commissioned two reviews, and found support for both the earlier recommendation and a new, stricter one, half as high as the old limit. [25] This also met with industry opposition. The WHO began requiring anyone submitting formal comments on the proposal to fill out a conflict-of-interest form. [26]
In 2011, the competing Corn Refiners Association (which makes sugar syrups [a] ) and the Sugar Association became involved in a lawsuit against one another, which continued as of 2015. [28] In the course of this lawsuit, numerous internal documents were made public. These revealed funding of over $10 million to James Rippe for health research and media outreach, and a combined $4 million to Citizens for Health and Center for Consumer Freedom, which publicly opposed one another's views on the healthiness of the rival products without acknowledging their funding (such shilling is legal in the US following the Citizens United ruling). [2] [29] [27]
In 2015, it was reported that Coca-Cola had paid millions to promote controversial health messages related to sweet drinks, ranging from academic research to social media posts, since 2008. The money went to researchers, dietitians, health experts, research organizations, and professional associations, among others. [1] [8]
Following this media attention, Coca-Cola released information on almost $120 million U.S. dollars given out to medical, health and community organizations between 2010 and 2015. [30] These include $29 million for academic research; the largest donation was $7.5 million to Louisiana State University's Pennington Biomedical Research Center. [31] Coca-Cola has now announced that it will "pull back" (reporter's phrasing) from funding health experts and obesity research, in order to improve its transparency. [31]
Sugar is added to ingredients lists under dozens of different names, [32] which, where ingredients lists are in order from largest to smallest quantity, can let sugars appear spuriously lower on the ingredients list. [33]
In 2016, the FDA enacted new requirements for US nutrition labels, which include calorie count in larger type and a separate line for added sugars. [34] By July 2018 most manufacturers will need to use the new label.
The new FDA requirements were initially proposed in 2014, they met with strong opposition from sugar and sugary food producers. Industry claimed the new rule lacked any scientific justification. [34] Many specific companies also wrote letters requesting certain products to be exempt from the rule. The head of Ocean Spray Cranberries wrote a letter to the FDA explaining that cranberries without sugar are "unpalatable" and claimed that they needed to be an exception to the bill. The American Beverage Association wanted the measurement on the back of their labels to be in grams instead of teaspoons, saying that teaspoon measurements would carry a negative connotation that misrepresents the factual nature of nutritional information.[ citation needed ]
The changes had bipartisan support; George W. Bush supported the FDA in its request for the legislation, and, after it was enacted under Barack Obama, said that the government had "got this right". [34] [35]
A community campaign in Howard County, Maryland, used the media to influence the attitudes and behaviors about the relationship between sugary drinks and obesity. The "Howard County Unsweetened" campaign used social media, television ads, in-person marketing, and community organizations to encourage people to drink less sugary drinks, and promoted water as a substitute. [36] [37] This campaign was modeled after a study done in Portland, Oregon that found community based interventions were successful in influencing consumers likelihood of purchasing sugary drinks in supermarkets. Researchers associated sugary drinks with obesity, heart disease, and diabetes to influence the attitudes of the consumers and the purchasing behaviors of consumers. [38]
Sugar taxes have been used to reduce the consumption of sugary drinks, often in combination with public information campaigns.
A 2010 study of a sugar taxes in the US found that they decreased consumption of taxed drinks, but increased the consumption of untaxed high-calorie drinks, removing the benefit. [39]
In Mexico, sugary drink consumption dropped after a public health campaign including a sugar tax came in in 2014, and dropped further a year later. [40] [41] A 2015 tax in Berkeley, California, had a similar effect, [42] [43] although overall grocery spending did not decline. [44] In 2016, the far larger city of Philadelphia brought in a sugar tax to fund children's programs. [45] [46]
In Chile, a law implemented in 2016, was the first national regulation to jointly mandate front-of-package warning labels, restrict child-directed marketing, and ban sales in schools of all foods and beverages containing added sugars, sodium, or saturated fats that exceed set nutrient or calorie thresholds. A study later confirmed that purchases of high-in beverages significantly declined following implementation of Chile's Law of Food Labeling and Advertising; these reductions were larger than those observed from single, standalone policies, including sugar-sweetened-beverage taxes previously implemented in Latin America. [47]
A soft drink is any water-based flavored drink, usually but not necessarily carbonated, and typically including added sweetener. Flavors used can be natural or artificial. The sweetener may be a sugar, high-fructose corn syrup, fruit juice, a sugar substitute, or some combination of these. Soft drinks may also contain caffeine, colorings, preservatives and other ingredients.
Sugar is the generic name for sweet-tasting, soluble carbohydrates, many of which are used in food. Simple sugars, also called monosaccharides, include glucose, fructose, and galactose. Compound sugars, also called disaccharides or double sugars, are molecules made of two bonded monosaccharides; common examples are sucrose, lactose, and maltose. White sugar is a refined form of sucrose. In the body, compound sugars are hydrolysed into simple sugars.
Diet or light beverages are generally sugar-free, artificially sweetened beverages with few or no calories. They are marketed for diabetics and other people who want to reduce their sugar and/or caloric intake.
A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate fibre and food energy.
High-fructose corn syrup (HFCS), also known as glucose–fructose, isoglucose and glucose–fructose syrup, is a sweetener made from corn starch. As in the production of conventional corn syrup, the starch is broken down into glucose by enzymes. To make HFCS, the corn syrup is further processed by D-xylose isomerase to convert some of its glucose into fructose. HFCS was first marketed in the early 1970s by the Clinton Corn Processing Company, together with the Japanese Agency of Industrial Science and Technology, where the enzyme was discovered in 1965.
A fat tax is a tax or surcharge that is placed upon fattening food, beverages or on overweight individuals. It is considered an example of Pigovian taxation. A fat tax aims to discourage unhealthy diets and offset the economic costs of obesity.
Diet plays an important role in the genesis of obesity. Personal choices, food advertising, social customs and cultural influences, as well as food availability and pricing all play a role in determining what and how much an individual eats.
A sugary drink tax, soda tax, or sweetened beverage tax (SBT) is a tax or surcharge designed to reduce consumption of sweetened beverages by making them more expensive to purchase. Drinks covered under a soda tax often include carbonated soft drinks, sports drinks and energy drinks. Fruit juices without added sugar are usually excluded, despite similar sugar content, though there is some debate on including them.
Funding bias, also known as sponsorship bias, funding outcome bias, funding publication bias, and funding effect, refers to the tendency of a scientific study to support the interests of the study's financial sponsor. This phenomenon is recognized sufficiently that researchers undertake studies to examine bias in past published studies. Funding bias has been associated, in particular, with research into chemical toxicity, tobacco, and pharmaceutical drugs. It is an instance of experimenter's bias.
Robert H. Lustig is an American pediatric endocrinologist. He is professor emeritus of pediatrics in the division of endocrinology at the University of California, San Francisco (UCSF), where he specialized in neuroendocrinology and childhood obesity. He is also director of UCSF's WATCH program, and president and co-founder of the non-profit Institute for Responsible Nutrition.
White hat bias (WHB) is a purported "bias leading to the distortion of information in the service of what may be perceived to be righteous ends", which consist of both cherry picking the evidence and publication bias. Public health researchers David Allison and Mark Cope first discussed this bias in a 2010 paper and explained the motivation behind it in terms of "righteous zeal, indignation toward certain aspects of industry", and other factors.
Added sugars or free sugars are sugar carbohydrates added to food and beverages at some point before their consumption. These include added carbohydrates, and more broadly, sugars naturally present in honey, syrup, fruit juices and fruit juice concentrates. They can take multiple chemical forms, including sucrose, glucose (dextrose), and fructose.
Sugar-sweetened beverages (SSB) are beverages with added sugar. They have been described as "liquid candy". Added sugars include brown sugar, corn sweetener, corn syrup, dextrose, fructose, high fructose corn syrup, honey, invert sugar, lactose, malt syrup, maltose, molasses, raw sugar, sucrose, trehalose, and turbinado sugar. Naturally occurring sugars, such as those in fruit or milk, are not considered to be added sugars. Free sugars include monosaccharides and disaccharides added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.
Coming Together is a 2-minute ad created and distributed by the Coca-Cola Company and launched on the night of January 14, 2013, on several cable networks.
Barry Michael Popkin is an American nutrition and obesity researcher at the Carolina Population Center and the W.R. Kenan Jr. Distinguished Professor of Nutrition at the University of North Carolina at Chapel Hill School of Public Health, where he is the director of the Global Food Research Program. He developed the concept of "nutrition transition". He is the author of over 650 journal articles and a book, The World is Fat, translated into a dozen languages.
Y. Claire Wang is an associate professor at Columbia University's Mailman School of Public Health. Her research focuses on obesity prevention strategies and techniques, such as soda taxes, and how effective they may be in reducing the economic costs of obesity.
The Australian paradox is an observation of diverging trends in sugar consumption and obesity rates in Australia. The term was first used in a 2011 study published in Nutrients by Professor Jennie Brand-Miller, in which she and co-author Dr. Alan Barclay reported that, in Australia, "a substantial decline in refined sugars intake occurred over the same timeframe that obesity has increased."
The sugar industry subsumes the production, processing and marketing of sugars. Globally, about 80% of sugar is extracted from sugar cane, grown predominantly in the tropics, and 20% from sugar beet, grown mostly in temperate climate in North America or Europe.
The Sugar Association is a trade association for the sugar industry of the United States. Its members include nearly 142,000 growers, processors and refiners of sugar beet and sugarcane plants.
Dean-David Schillinger is an American general internist and former Chief of the University of California San Francisco (UCSF) Division of General Internal Medicine at San Francisco General Hospital (SFGH). In 2006, he founded the UCSF Center for Vulnerable Populations, whose mission is to advance health in poor communities. His research focuses on health communication for vulnerable populations, and the prevention and control of type 2 diabetes.
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