Everything you thought you knew about nutrition is wrong

The terms “healthy”, “natural”, or “light” are used more for their commercial value than promoting healthy products. This makes life difficult for national health agencies, such as the FDA (US Food and Drug Administration) in the United States. I will explain why.

It was recently announced that the FDA has reversed its stance on popular fruit and nut bars KIND, and will allow them to use the word “healthy” on their nutritional labels.1

The FDA currently defines “healthy” food, and other related terms, as food that meets their dietary recommendations as well as the conditions necessary to control total fat, saturated fat, cholesterol, and other nutrients. This definition of “healthy” is consistent with prior federal dietary guidance, which placed a greater emphasis on specific dietary nutrient levels, rather than on the overall contribution of recommended food to a healthy diet. This resulted in products such as nuts, avocados, olives, and salmon being restricted from using the “healthy” label which is not consistent with the USDA guidelines currently in place in the US.

http://on.wsj.com/1TavZJ6

In fact, the 2010 Dietary Guidelines published by the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) state to emphasise whole foods and dietary patterns rather than specific nutrients like fats. This means that the FDA should revise the current use of the term “healthy”, as well as collaborate with other agencies on this issue.  What is more surprising is there is no mention by the FDA of the danger of excessive sugar intake.

The 2015 WHO guideline recommends adults and children reduce their daily intake of free sugars to less than 10%, roughly 50 grams (12 teaspoons) of their total energy intake.2 Without realising, we are eating more than this recommended intake through sugars contained naturally in some products, like fruits and potatoes. A greater contributor however, is the sugar added by manufacturers to processed foods that we consume in our breakfast cereals, flavored yogurts, sodas and/or juices, amongst others.

Artificial glucose and fructose is immediately converted to fat, and can cause a condition known as insulin resistance - considered the fundamental cause of obesity, and the underlying cause of other non-communicable diseases such as heart disease, type 2 diabetes, and even some forms of cancer. Of course, there have been some proposals to tax processed food that contains added sugars, but they have not been very effective because of fierce opposition from powerful soda, cereals, and fast food lobbyists.3

As citizens we should be able to control the amount of sugar, fats, and salt we are purchasing and consuming if we want to curb the tendency of obesity, diabetes and cancer. For this reason, HCWH Europe calls on increasing health literacy  among the general public- the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Information such as this is key to understanding the importance of nutrition and healthy dietary behaviours, as well as preventing and managing these global health concerns.4 An easy way to start, is to not only look at nutritional information, but also ingredients. If details of sugar or similar ingredients, such as saccharin, aspartame, or sucralose, (which act as a dangerous cocktail for health problems), appear on the products including quantities, it would be possible to reduce their consumption and address the potential problems linked to them.

More evidence and research is consequently required; eating healthy food requires much more than just counting calories. Awareness needs to be raised on the health impact of some ingredients, like sugars and fats, especially if they have been fully or partially processed; they need to explicitly be included in labelling. Finally, we should also pay attention to the complexity of different categories of sugars and fats, i.e. saturated fats are not the same as unsaturated fats, nor are glucose molecules the same as starch molecules. Knowing the difference, and having a greater awareness is paramount to have a good knowledge about nutrition.

After more than two decades, such indications were put into effect on 20th May when the US FDA announced changes on the nutrition facts label of packaged foods.5 Some of these changes include increasing type size for “calories”, “servings per container”, and the “serving size” declaration, and using bold type for the number of calories and the “serving size” declaration to highlight this information. Some of the most controversial points are referred to:

Fats: “Calories from Fat” is being removed because research shows the type of fat – saturated, unsaturated or trans fat - is more important than the amount supposed to be. Trans fat are still on the label, as they as supposed to be reduced, but not eliminated from foods.

Sugar: “Added sugars,” both in grams and as a percentage of daily recommendations, will be now included on the label as a way to increase consumer awareness of the quantities of added sugars on certain foods. It is difficult to meet nutrient needs while staying within calorie limits if you consume more than 10% of your total daily calories from added sugar.

This last point, of course, has not been well received by several major food associations, the Sugar Association have stated this is not only an unfairly negative light, but also an unprecedented demonstration for the FDA of the lack of scientific justification in this rulemaking process.6

For us, opening the Pandora’s box that is sugars, which have been hidden for far too long, is a huge win.


- Paola Hernández, Sustainable and Healthy Food Programme Assistant

Preview image: Uwe Hermann via Flickr cc


References:

(1) Politico Morning Agriculture (2016). 

See also:

Warning letter (KIND, LLC 3/17/15)

Citizen petition

(2) WHO (2015). WHO calls on countries to reduce sugars intake among adults and children. Geneva.

(3) Neel, D. (2012). The Sugar Dilemma. Harvard College Global Helath Review. 

(4) Carbone ET, Gibbs HD (2013) Measuring Nutrition Literacy: Problems and Potential Solutions. J Nutr Disorders Ther 3:e105. doi:10.4172/2161-0509.1000e105 

(5) FDA (2016). Changes to the Nutrition Facts Label. 

(6) Ferdman, R. (2016). Why the sugar industry hates the FDA’s new Nutrition Facts label. The Washington Post.