Bad Sugars, Good Sugars: From Hearsay & Hype to Sound Science

Susan Mitchell, PhD, RD, LD/N, FAND Founder and President

Practicalories Inc.

BAD SUGARS, GOOD SUGARS: FROM HEARSAY & HYPE

TO SOUND SCIENCE

Florida Dietetic Association Annual Business Meeting & Symposium July 15, 2013

Twenty years in the media communicating evidence-based health messages

Featured Contributor for Growing Bolder Media: Growing Bolder TV and Radio, Growing Bolder Magazine & Growing Bolder.com

Continuing education for health professionals

Member of the Corn Refiners Association RD Network

SUSAN MITCHELL, PHD, RD/LDN, FAND MEDIA CONSULTANT: NUTRITION & HEALTH

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The Commentary that Started It All

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SOCIAL MEDIA BUZZ AND CONSUMER CONFUSION

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Added Sugars, Particularly HFCS: The Current Social Media Villains

A Quick Google Search: Health Professionals, Media Professionals & the Public are bombarded with misinformation on ADDED sugars

Hype Includes: Added sugars, especially HFCS, are THE cause of various health issues including obesity and HFCS is toxic

HFCS is metabolized differently than other nutritive sweeteners & is not as natural as sucrose/other added sugars

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What Do You Think Consumers Are Thinking?

Is the media coloring your perception of consumer attitudes?

“Is Sugar Toxic?” (4/01/12)

“Sounding the alarms against sugar”

(4/14/12) “Health advocates go sour on sugar: ‘Sugar is

killing us’” (6/08/12)

“Soft drinks: Public Enemy No.1 in Obesity

Fight?” (4/27/12)

“Sugar Should Be Regulated As Toxin, Researchers Say”

(2/01/12)

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7 Source: 6/11/13 https://www.facebook.com/BanOfHFCS 7

Hype: Avoid HFCS at All Costs

8 Source: Accessed 6/10/13 http://www.womansday.com/health-fitness/nutrition/is-high-fructose-corn-syrup-bad-for-you#slide-4 8

OTHER SOURCES AMPLIFYING THE MESSAGE

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Product Marketing

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Books

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Dr. Mark Kern, PhD, RD, CSSD, a professor at San Diego State University, was commissioned by the Corn Refiners Association to use evidence-based scientific analysis to critically analyze and challenge the major claims made in "Fat Chance.”

Find the Review: SweetenerStudies.com/Resources

Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity and Disease, By: Dr. Robert Lustig

Fructose & Obesity: • No Scientific evidence to support the idea that fructose causes obesity or

metabolic syndrome when consumed in typical amounts. • Dr. Lustig’s assertion that excessive fructose is converted to fat by the body,

thereby uniquely contributing to obesity & metabolic syndrome is unsubstantiated.

“A Calorie Is Not A Calorie” • Dr. Lustig’s point of view on energy balance is opposed to leading government

& scientific sources on health & nutrition, including NIH & AND. • Calorie recommendations ignore the complexity of

determining individual calorie requirements, which depend on a variety of factors, including but not limited to age, gender & physical activity.

THAT BUZZ YOU HEARD? CHANCES ARE IT’S MANUFACTURED

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That Buzz You Heard? Chances Are It’s Manufactured

• 61% of identifiable Very High Volume posters may be “suspicious,” i.e. content farms, trolls, and bots.

• 44% originated with Facebook accounts that are opened and closed just to generate buzz.

A small number of posters create a disproportionate amount of content.

Source: “Dissecting “Buzz” - It’s not what you think it is. A detailed analysis of social media “buzz” around controversial topics” (2012) By Katie Delahaye Paine & Heather Fysh, KDPaine & Partners. 13

That engagement you saw? Probably not what you think

• Low volume posters represent the majority of all posts but are not very engaged in the topic.

• Moderate Volume Posters are more engaged.

• Moderate Volume Posters tended to get involved in a particular discussion on a specific forum or site; i.e., Final Gear or Body Building.

Many relevant conversations are taking place on Reddit and other smaller networks.

Source: “Dissecting “Buzz” - It’s not what you think it is. A detailed analysis of social media “buzz” around controversial topics” (2012) By Katie Delahaye Paine & Heather Fysh, KDPaine & Partners. 14

Most People Post One Comment, Then Move On

Poster Volume

Posts per 12 months

Very-low volume

1 - 2

Low-volume 3 - 12

Moderate 13 - 24

High-volume 25 - 60

Very-high volume

61+

Source: “Dissecting “Buzz” - It’s not what you think it is. A detailed analysis of social media “buzz” around controversial topics” (2012) By Katie Delahaye Paine & Heather Fysh, KDPaine & Partners. 15

Social Media Buzz… A True Picture?

• Consumers are more concerned with total added sugars than with any specific type of caloric sweetener.

• Social media contributes to confusion about true consumer sentiment.

• Social media buzz alone does not portray a full or true picture of the consumer.

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CONSUMER ATTITUDES TOWARD NUTRITIVE SWEETENERS & HFCS

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Research Focused on Moms, The Primary Shopper

• Conducted by Mintel Research Consultancy • October 2012 • Base Size: 2,400 respondents • Female • 18-44 years old (6 of 10 respondents) • Children under 18 years old in HH • Annual income range: $35k - $85k • Education: Bachelors or advanced degree

Sample weighted by age and education prior to analysis. 75% of primary shoppers being women is within range of other studies. 18

What Are Consumers Demanding? Less Added Sugar.

3%

3%

3%

3%

4%

5%

8%

10%

17%

21%

22%

Sodium

Red meat

Processed/packaged foods

High fructose corn syrup

Fast food

Carbohydrates/white foods

Soda/carbonated beverages

Salt/Sodium

Fats/oils, hydrogenated fats

Sugar, added sugar

Not avoiding or purposefully consuming less…

In the last six months, have there been any particular foods, beverages, or specific ingredients that you and your family are trying to consume less of or avoid? (UNAIDED)

Source: Mintel 2012; N = 2,400 Q3. In the last six months, have there been any particular foods, beverages, or specific ingredients that you and your family are trying to consume less of or avoid? (multiple responses accepted) * “HFCS” Includes HFCS and corn syrup

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Primary Shoppers Don’t Look for HFCS on the Label

Hardly Ever 15%

Never 12%

Regularly 48%

Occasionally 30%

Source: Mintel 2012; N = 2,173 Q2. When you read labels, what information are you looking for? (multiple responses accepted) * “HFCS” Includes HFCS and corn syrup

38%

30% 28% 24%

13%

5% 5% 4% 4% 4%

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A LOOK AT THE EVIDENCE-BASED SCIENCE

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22 Source: Melanson, Zukley, Lowndes, Nguyen, Angelopoulos, Rippe. 2007.Effects of high-fructose corn syrup and sucrose consumption on circulating glucose, insulin, leptin, and ghrelin and on appetite in normal-weight woman. Nutrition 23(2):103-112.

Sugar vs. HFCS Research Methods • 30 women consumed identical meals for one day with sweetened

beverage each • Half drank beverage sweetened with sugar and half with HFCS • Measured blood levels of glucose, insulin, appetite hormones and

triglycerides Results • No significant difference between the two sweetener were seen in fasting

plasma glucose, insulin, and ghrelin (P>0.05). Conclusions These short-term result suggest that, when fructose is consumed in the form of HFCS, the measured metabolism responses do not differ from sucrose in lean women

Weight Loss Research Methods • Overweight or obese individuals fed 4 hypocaloric diets • Contained levels of sucrose or HFCS typically consumed by adults in

US Results • All four hypocaloric groups: reductions observed in all measures

including body mass, BMI,% body fat, waist circumference and fat mass

• Reductions in the exercise only group for body mass, BMI and waist circumference

Conclusions Similar decreases in weight and indices of adiposity observed

23 Source: Lowndes, Kawiecki, Pardo, Nguyen, Melanson, Yu, Rippe. 2012. The effects of four hypocaloric diets containing different levels of sucrose or high fructose corn syrup on weight loss and related parameters. Nutrition Journal 11:55 23

Nutritive Sweeteners & Liver Fat Methods • For 10 weeks, 64 individuals consumed low-fat milk sweetened with either HFCS or

sucrose; the added sugar matched consumption levels of fructose in the 25th, 50th, and 90th percentiles of the population.

• The fat content of the liver was measured with unenhanced computed tomography imaging, and the fat content of muscle was assessed with magnetic resonance imaging.

Results • When the 6 HFCS and sucrose groups were averaged, there was no change over

the course of 10 weeks in the fat content of the liver, vastus lateralis muscle, or gluteus maximus muscle.

• Group assignment did not affect the result (interaction > 0.05). Conclusions These data suggest that when fructose is consumed as part of a typical diet in normally consumed sweeteners, such as sucrose or HFCS, ectopic fat storage in the liver or muscles is not promoted.

24 Source: Bravo, S., Lowndes, J., Sinnett, S., Fullterton, Z. and Rippe, J. 2013. Consumption of sucrose and high fructose corn syrup does not increase liver fat or ectopic fat deposition in muscles. Applied Physiology, Nutrition, and Metabolism. 38(999): 681-688 24

Fructose & Exercise Evaluated the effects of exercise on circulating lipids in healthy subjects fed a weight-maintenance, high-fructose diet.

Methods Eight healthy males were studied on three occasions after 4 days of …

1. A diet low in fructose and no exercise, 2. A diet with 30% fructose and no exercise, or 3. A diet with 30% fructose and moderate aerobic exercise.

Conclusions The data concluded that even with high intakes of fructose, exercise completely prevented fructose-induced alterations of lipid metabolism.

25 Source: Egli, L., et al. 2013. Exercise prevents fructose-induced hypertriglyceridemia in healthy young subjects. Diabetes. 25

Key Take Away Messages

• Internet hype is powerful and it’s difficult for someone to know myth versus fact.

• RDs know the evidence-based science and facts.

• Utilize the AND Evidence-Based Library

• Help patients/clients understand added sugars and how to read labels. Share how to choose sugars by the company they keep.

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Thank You!

Additional Resources

www.SweetSurprise.com www.SweetenerStudies.com

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Susan Mitchell, PhD, RD, LD/N, FADA Email: [email protected]

Website: susanmitchell.org