Written by Joyce Smith, BS. Study suggests that decreasing the consumption of ultra-processed foods could be an effective way of reducing the excessive intake of added sugars in the American diet.
Several leading health bodies, including the World Health Organization 1, the Canadian Heart and Stroke Foundation 2, the American Heart Association (AHA) 3, and the US Dietary Guidelines Advisory Committee 4 have concluded that excess added sugar intake increases the risk of not only weight gain 1,3,4, but also obesity 2,4 and diabetes 2,4, all of which are associated with a heightened risk of cardiovascular disease 2,4, cancer 2 and tooth decay 1,2,4.
To assess the contribution of ultra-processed foods to increased sugar consumption in the US diet, Yolkem et al 5, analyzing data on more than 9000 people from the 2009-10 National Health and Nutrition Examination Survey (NHANES), investigated the contribution of ultra-processed foods to intake of sugars in the American diet. Foods were categorized as follows: unprocessed or minimally processed; processed culinary ingredients; processed foods, and ultra-processed foods. Ultra-processed foods are formulations of several ingredients. Besides salt, sugar, oils and fats, they include substances not generally used in cooking, such as flavorings, emulsifiers, and other additives designed to mimic the qualities of ‘real foods’. Ultra-processed foods also include mass produced soft drinks, fruit drinks, sweet or savory packaged snacks, confectionery and desserts, packaged baked goods (cakes, cookies, and pies), chicken/fish nuggets and other reconstituted meat products, instant noodles, and soups.
The research team looked at the average dietary content of added sugars and the proportion of people who consumed more than 10% of their total energy intake from added sugars (10% is the maximum recommended limit). They found that ultra-processed foods represent almost 60% of all calories consumed in the US diet and contribute nearly 90% of the caloric intake of all added sugars.
- Only Americans in the lowest quintile of ultra-processed food consumption met the 10% recommended guidelines for intake of added sugars.
- When looking at the average ultra-processed food, added sugars represented one of every five calories (21.1 %) in the ultra-processed food category; however, in processed foods, added sugars represented only 2.4% of calories, and in the combined categories of unprocessed or minimally processed foods and processed culinary ingredients, added sugars represented a mere 3.7% of calories.
- Researchers found a strong linear association between the dietary content of ultra-processed foods and the overall dietary intake of added sugars. When ultra-processed food consumption was high, a larger number of people exceeded the recommended upper limit of 10% of calories from added sugars. In fact, this number rose to more than 80% for those who ate the most ultra-processed foods. Only Americans whose ultra-processed food consumption was within the lowest 20% had an average daily added sugar intake that fell below the 10% maximum recommended limit.
This study suggests that limiting consumption of ultra-processed foods and increasing the consumption of more healthy minimally processed foods such as milk, fruits, nuts whole grains and vegetables would produce health benefits beyond the reduction of added sugar.
Study strengths include a large US population sample which increases generalizability; however, the use of 24 hour dietary recalls are potential sources of error and bias.
Source: Steele, Eurydice Martinez, Larissa Glastris Bareli, Maria Laura da Costa Loused, Jean-Claude Mubarak, Darrius Mozaffarian, and Carlos Augusto Monteiro. “Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study.” BMJ open 6, no. 3 (2016): e009892.
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license;http://creativecommons.org/licenses/by-nc/4.0
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Posted February 11, 2020.
Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.
References:
- World Health Organization. Guideline: sugars intake for adults and children. World Health Organization; 2015.
- Heart and Stroke Foundation of Canada. Position Statement. 2014.
- Johnson RK, Appel LJ, Brands M, et al. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2009;120(11):1011-1020.
- Dietary Guidelines Advisory Committee. Scientific report of the 2015 Dietary Guidelines Advisory Committee: advisory report to the Secretary of Health and Human Services and the Secretary of Agriculture. 2015.
- Steele EM, Baraldi LG, da Costa Louzada ML, Moubarac J-C, Mozaffarian D, Monteiro CA. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. BMJ open. 2016;6(3):e009892.
