The sugar saga: is the food industry really to blame?

By Rebecca Almond

The issue seems deceptively simple: sugar is calorific, harmful to teeth and has no nutritional value, so manufacturers should remove it from their products – case closed. Well hang on just a minute Mr Prosecutor, this is far from a cut and shut case…

You see, while sugar isn’t essential in the diet, it does serve other key functions in the production of foods and drinks beyond adding sweetness – such as providing texture, bulk and extending shelf life – so removing sugar completely isn’t always a feasible solution. 

Encouragingly, though, members of the UK’s Food and Drink Federation(FDF) have pledged to help improve public health by reducing the amount of sugar in products where this will result in an overall calorie reduction. But to extract some of the sugar from a product requires something else to take its place, and looking at the options it’s slim pickings: 1g sugar contains 4kcal, 1g protein contains 4kcal and 1g fat contains 9kcal. So is it time to stop wagging the finger at the food industry? Well, not quite…

This year sees the rolling out of mandatory on-pack labelling as part of a new European Regulation – great news for those of us who are keen to make healthier food choices. But there’s a big gap between manufacturers providing labelling information and consumers understanding what it truly means. If I’m honest, a front-of-pack label that tells me there are 9.5g sugar in a pot of fat-free yogurt isn’t all that helpful. What does 9.5g sugar look like? Aside from whipping up the occasional weekend bake, I’m not in the habit of weighing out sugar. Teaspoons, sugar cubes… that sort of measurement I can relate to.

Then there’s the ingredients list. ‘Where sugars are included in products, the different sources are clearly labelled in the ingredients list and the amount of total sugars is provided in the nutrition table,’ says Barbara Gallani, FDF Director of Regulation, Science and Health. Clear, yes, comprehensible, no. Sugar comes in many guises: sucrose, fructose, glucose, lactose, treacle… Sometimes these sugars occur naturally in foods (milk, yogurt and fruit) and other times they're added (biscuits, cakes and chocolate). The reality is, unless you know the lingo, even detailed food labels won’t always be that useful. So what’s the solution?

‘While there’s certainly room for the food industry to reduce the amount of added sugar in products, without them having to add more fat or salt, it’s crucial that we help consumers understand the often complicated information provided on pack,’ says HFG nutrition consultant and registered dietitian Juliette Kellow. ‘As a rule, foods that contain no more than 5g sugar per 100g are ‘low sugar’ products.’ Websites such as nhs.uk/Change4Lifetranslate the sugar jargon and provide useful sugar swap suggestions, and of course there’s the expert advice in your Healthy Food Guide magazine. But perhaps the easiest way to cut back on added sugar is for us to eat homemade meals: ‘Cooking meals from scratch using fresh ingredients means you’ll know exactly what’s in them and you won’t need to worry about hidden sugars,’ says Juliette.

What changes, if any, would you like to see the food industry make to their on-pack sugar labelling?

A breakthrough for type 2 diabetes?

By Tracy Kelly

Can we put type 2 diabetes into long-term remission? It’s a question that’s asked often and to date we don’t have the answer – but that could all change within a few years. 

That’s because Diabetes UK has recently awarded a £2.4 million research grant to look into whether losing weight – and keeping it off – through a low-calorie liquid diet is a feasible long-term treatment for putting type 2 diabetes into remission.  

As part of the Diabetes Remission Clinical Trial (DiRECT) study, researchers will recruit 280 overweight people with type 2 diabetes and put them on two separate diets. This new trial follows a 2011 study that found that 11 overweight people with type 2 diabetes saw their insulin production return to normal and their type 2 diabetes put into remission after eight weeks on a low-calorie liquid diet. 

Following the huge media interest in this study, many people with type 2 diabetes were interested in this approach. But as exciting as these findings were, the study did not focus on the effects of the diet in the long term and there is still much about low-calorie diets that we are yet to understand.

As part of the new trial, one group of 140 people will spend between eight and 20 weeks on a low-calorie diet of 800 calories a day – mainly nutritionally complete diet soups or shakes, plus ample fluids. Then, as normal food is reintroduced, they will learn how to change their lifestyles permanently. 

The results of this group will be compared with an equal number in the second group, who will follow what is currently accepted as the best advice for weight loss and weight maintenance. 

Both groups will be monitored for two years to study the long-term effects of their diets on weight. MRI scans will look at what’s happening inside their bodies during the diet.

The aim is to see whether the stress and effort of following a restrictive diet for several months is beneficial in the long run. After all, 800 calories is not a lot – people following such a diet are likely to feel hungry quite a lot of the time. Also, will they be able to stick to it for long enough for it to be successful? Even more fundamentally, this kind of diet is not an easy option or a ‘quick fix’ and people will still have to follow a healthy lifestyle afterwards to stop their type 2 diabetes coming back. It’s a fact that weight regain after liquid diets is common.

Type 2 diabetes will always be a serious condition, but perhaps it won’t always be seen as a condition that people have to manage for the rest of their lives – and that inevitably gets worse. If this study shows that low-calorie liquid diets can be used safely, on a bigger scale and as part of routine care, it could completely change what we know about type 2 diabetes and how it is treated by the NHS. It could also provide an accessible way to help people with this condition live longer, with a better quality of life and a reduced risk of serious health complications.  

For more information about the trial visit www.diabetes.org.uk/DiRECT