The ABCs of Sweeteners in Schools: A Science-Based Discussion Tami Ross, RD, LD, CDE Lexington, KY tarossrd@insightbb.com Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 1 www.schoolnutrition.org Learning Objectives At the conclusion of the session, attendees will be able to: 1) Demonstrate a keen understanding of the research on sweeteners & how this applies to children’s diets . 2) Integrate the latest consumer insights regarding parents’ perceptions & attitudes towards sweeteners into long-range planning for the development of food & beverages that meet state-mandated legislation. Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 2 www.schoolnutrition.org Types of Sweeteners Nutritive Sweeteners Low Calorie Sweeteners (LCS) Blends Polyols (Sugar Alcohols) Other Sweeteners Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 3 www.schoolnutrition.org ABC’s of Sweeteners About the sweetener Benefits of the sweetener Concerns & Consensus on safety & use of the sweetener Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 4 www.schoolnutrition.org Choices, Choices & More Choices… Safety Uses Mouth feel Taste Cost Calories Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 5 www.schoolnutrition.org Obesity is a calorie imbalance issue – no single food or ingredient is the sole cause OR sole solution Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 6 www.schoolnutrition.org Source: 2005 Dietary Guidelines for Americans Nutritive Sweeteners of Interest Sucrose (sugar) Fructose High fructose corn syrup (HFCS) Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 7 www.schoolnutrition.org Sugar – About, Benefits, Consensus Disaccharide – glucose + fructose 1 tsp table sugar = 15 calories Often sweetener of choice – tabletop, home use Individual consumption often higher than realized More costly than other nutritive sweetening options Benefits: Wide range of uses Consensus: Can be part of a healthy diet in moderation 8 Sources: AHA, 2010 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. www.schoolnutrition.org Fructose – About, Benefits & Consensus Naturally occurring - fruits, vegetables, honey, sucrose ~ same calories as sugar Free flowing crystalline sweetener Can be substituted for sugar in wide variety foods & beverages Benefits: Texture & flavor enhancement Clear, light mouth feel – similar to sugar Increased sweetness over sugar (~1 ½ x sweeter) Potential for calorie reduction – less needed to achieve sweetness Potential for cost saving Consensus: Can be part of healthy diet in moderation Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 9 www.schoolnutrition.org High Fructose Corn Syrup (HFCS) – About & Benefits • Fructose & HFCS are different sweeteners Similar to sucrose (sugar) in many respects – sweetness & calories comparable Blend of fructose & glucose Enzymatic processing of corn syrup Many “viral” urban myths Scientific perspective lost in the debate Benefits: Less expensive than sugar Useful beyond sweetening - Enhances flavor, stability, moistness, browning Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 10 www.schoolnutrition.org HFCS - Consensus Meets FDA’s requirements for use of the term “natural” Can fit in a healthy diet in moderation Metabolized like sucrose Melanson, et al. Nutrition. 23(2)(2007) Recent short term study – HFCS not metabolized differently in the body from sucrose No evidence HFCS is uniquely responsible for obesity American Medical Association (2008) concluded – No scientific proof HFCS is a cause of obesity compared to other caloric sweeteners Research continues Source: www.ers.usda.gov Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 11 www.schoolnutrition.org FDA Approved Low Calorie Sweeteners (LCS) Acesulfame Potassium (Ace K) Aspartame Neotame Saccharin Stevia (steviol glycoside extracts) - GRAS Sucralose Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 12 www.schoolnutrition.org Low-Calorie Sweeteners by Definition Ingredients added to foods or beverages to impart sweetness without adding a significant amount of calories Aliases: artificial sweeteners intense / high intensity sweeteners no-calorie sweeteners non-nutritive sweeteners sugar replacers / replacements sugar substitutes Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 13 www.schoolnutrition.org The LCS Difference Calories & Sugar… LCS may help consumers meet “Dietary Guidelines for Americans” recommendations to reduce sugar intake - particularly to decrease use of sugar-sweetened foods & beverages to reduce caloric intake & help with weight control Source: HHS and USDA, 2005 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 14 www.schoolnutrition.org FDA Approval Process Extensive safety testing and review process FDA considers short and long-term toxicity, carcinogenicity, reproductive toxicity studies Basic questions for review: How & where is the additive (sweetener) made & who makes it? What will it do as a food ingredient? How will it be consumed? Who (adults, children, pregnant women) will consume it? How much will each group consume? Has it been shown to be safe and without adverse effects? Sources: ADA, 2004; FDA, 2007; IFIC, 2006; 21 CFR 171; IFIC, 2000 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 15 www.schoolnutrition.org Acceptable Daily Intake (ADI) The amount of sweetener that can be safely consumed daily over a lifetime, without risk Set by FDA (mg/kg body weight/day) Conservative estimate - 1/100 maximum level at which no adverse effects are observed Sources: Nabors, 2007; ADA, 2004; IFIC, 1996 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 16 www.schoolnutrition.org Approved LCS Acceptable Daily Intakes Low-calorie sweetener ADI (mg/kg body weight/day) Acesulfame Potassium (Ace-K) 15 Aspartame 50 Neotame 18 Saccharin 15 Sucralose 5 Sources: ADA, 2004; Kroger, 2006 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 17 www.schoolnutrition.org ADI Equivalents To reach the ADI for aspartame a 50 pound (23 kg) child would have to consume daily: 6 12-oz. cans diet soda; OR 14 4-oz. servings sugar-free gelatin; OR 32 packets tabletop sweetener (e.g., Equal, NutraSweet) Source: CCC, 2005 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 18 www.schoolnutrition.org Estimated Daily Intake (EDI) vs. ADI Research shows EDI of LCS are far below the ADI Ace-K: Aspartame: Neotame: Saccharin: Sucralose: EDI = 20% of ADI for adults EDI = 6% of ADI in general adult pop. EDI = 0.2% of ADI EDI = 12% of ADI EDI = 32% of ADI for adults & children >2 yo Sources: ADA, 2004; Kroger, 2006; Renwick, 2006; IFIC, 2000 , ADA EAL 2006 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 19 www.schoolnutrition.org Saccharin – About & Benefits Oldest - discovered in 1878 300 times sweeter than sugar Not metabolized; calorie-free Heat stable Used as a tabletop sweetener & in foods/beverages Brand names: Sweet ‘N Low®, Sweet Twin®. Sugar Twin® Sources: ADA, 2004; FDA, 2006; Kroger, 2006; Henkel, 2006 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 20 www.schoolnutrition.org Saccharin – Consensus on Safety Studies in 1970’s - linked high doses of saccharin over lifetime of exposure to bladder cancer in laboratory rats Relevance of rat studies to humans Mechanism by which saccharin causes bladder cancer in rats found to be irrelevant to humans, based on physiological differences between the two species Human studies show no evidence that saccharin causes cancer Dec 21, 2000 – warning label removed Authoritative organizations (ADA, ACS, AMA) - agree that saccharin use is safe Sources: Henkel, 2006; Kroger, 2006; ADA, 2004; NCI, 2006; IFIC. 2000; FDA, 2006 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 21 www.schoolnutrition.org Get the facts… National Cancer Institute Fact Sheet – Artificial Sweeteners and Cancer: Questions and Answers http://www.nci.nih.gov/cancertopics/factshe et/Risk/artificial-sweeteners#2 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 22 www.schoolnutrition.org Aspartame – About & Benefits 1981 – Initial approval by FDA 160-220 times sweeter than sugar Made of 2 amino acids: Aspartic acid + phenylalanine Metabolized as protein (4 kcal/g) Minimal caloric contribution due to small amount needed Unstable when exposed to high heat - not recommended for baking Phenylketonuria (PKU) - should not consume Warning on labels of products containing aspartame Brand names: NutraSweet®, Equal® Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 23 www.schoolnutrition.org Aspartame – Consensus on Safety National Toxicology Program and National Cancer Institute determined no clear link between aspartame use & brain cancer, following suggestions of 1996 epidemiological analysis. 2006 - European Food Safety Authority (EFSA) reaffirms safety April 2007 – FDA reaffirms safety September 2007 - Expert panel confirms safety of aspartame in Critical Reviews in Toxicology report Based on an extensive scientific literature review No evidence that aspartame is carcinogenic Sources: EFSA, 2006; Soffritti, et al, 2007; FDA, 2006 & 2007; Magnuson, et al, 2007; NIC 2006 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 24 www.schoolnutrition.org American Dietetic Association Evidence Analysis on LCS Considered published, peer-reviewed, human data only Similar conclusions regarding benefits No convincing evidence of harm Strength of evidence for safety conclusions differ slightly primarily due to lack of toxicology testing performed on human subjects Continued monitoring recommended due to limited human data on safety Sources: ADA, 2004; FDA, 2007, ADA EAL 2006 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 25 www.schoolnutrition.org What’s the Evidence? ADA Evidence Analysis Library http://www.adaevidencelibrary.com/ Overall strength of the available supporting evidence: Grade I - Good Grade II - Fair Grade III - Limited Grade IV – Expert Opinion Grace V – Not assignable NOTE: Non-nutritive sweeteners (NNS) is term used in ADA EAL Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 26 www.schoolnutrition.org What’s the Evidence? Adverse effects associated with aspartame Consensus: Children – Limited evidence suggests that aspartame consumption is not associated with detrimental effect on blood methanol, eye problems, acne, blood pressure, seizure disorder, or ADD in children. [Grade III – Limited # studies] General population - Aspartame consumption is not associated with adverse effects in the general population. Studies have found no evidence of an effect of aspartame on a wide range of adverse effects including hypersensitivity reactions, elevated blood methanol or formate levels, blood cancers or brain cancers. Neurological changes tested included cognitive functions, seizures, headaches and changes in memory or mood. [Grade I] Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 27 www.schoolnutrition.org Source: ADA EAL 2006, 2008 What’s the Evidence? Adverse effects associated with aspartame Consensus: Several studies report that in healthy adults & children (as well as those considered to have “sugar sensitivity” or behavioral disorders), aspartame intake of 10-60 mg/kg body weight (ADI 50 mg/kg body weight) for periods of 1 day to 12 weeks have not been shown to have any significant effect on behavior, cognitive function, or mood. [Grade II] Further studies are needed using larger intakes of NNS over longer time periods Source: ADA EAL 2006, 2008 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 28 www.schoolnutrition.org “Aspartame toxin” theory unwrapped… Aspartame is completely broken down to phenylalanine, aspartic acid & methanol – the amounts are much less than those from common foods/beverages: • 1 svg skim milk vs same svg size aspartame-sweetened beverage • Milk has 6-9x more phenylalanine; 13x more aspartic acid • 1 svg tomato juice vs same svg size aspartame-sweetened beverage • Juice has 4-6x more methanol Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 29 www.schoolnutrition.org Acesulfame Potassium (Ace-K) – About, Benefits, Consensus on Safety 1988 – Initial approval by FDA 200 times sweeter than sugar Combination of an organic acid & potassium Not metabolized; calorie-free Heat stable Brand names: Sunett®, Sweet One® CONSENSUS: SAFE No human health problems reported Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 30 www.schoolnutrition.org Sources: ADA, 2004; Kroger. 2006 Sucralose – About, Benefits, Consensus on Safety 1998 - Initial FDA approval 600 times sweeter than sugar Derived from sugar Cost savings Not metabolized; calorie-free Heat stable Brand name: Splenda® CONSENSUS: SAFE Sources: ADA, 2004; FDA, 2006; Kroger, 2006 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 31 www.schoolnutrition.org Neotame – About,Benefits, Consensus on Safety 2002 – FDA approved as general purpose sweetener; newest LCS ~7,000- 8,000 times sweeter than sugar Contains derivative of two amino acids Aspartic acid + phenylalanine PKU alert not required • Rapidly metabolized and excreted; calorie-free More heat stable than aspartame in baked goods CONSENSUS: SAFE Sources: ADA, 2004; FDA, 2006; Kroger, 2006 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 32 www.schoolnutrition.org Stevia Sweeteners – About & Benefits December 2008- Highly purified stevia sweeteners received GRAS status from FDA Derived from the stevia plant leaves - a South American shrub Also known as stevioside, steviol glycosides, Stevia rebaudiana Used as tabletop sweetener & in foods / beverages 250-300 times sweeter than sugar Not metabolized; calorie-free Heat stable; suitable for baking Licorice flavor Familiar Brand names: Purevia, Sun Crystals, Truvia, OnlySweet, Others… Sources: Food & Chemical Toxicology 2008, 2009; JECFA 2008 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 33 www.schoolnutrition.org Stevia Sweeteners – Consensus on Safety Extensive research shows that stevia sweeteners are safe for human consumption Food & Chemical Toxicology, July 2008 Vol. 46, supplement 7S 12 studies dedicated to safety Sources: JECFA, 2008; Food & Chemical Toxicology 2008, 2009 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 34 www.schoolnutrition.org Low Calorie Sweetener (LCS) Blends Long history of safe use Potential advantages: Improve quality of sweet taste Add versatility to products Lengthen shelf-life Reduce already safe levels of intake for each LCS Common blends in U.S.: Aspartame + saccharin (fountain soft drinks) Aspartame + Ace-K (many foods & beverages) Sucralose + Ace-K (many beverages) Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 35 www.schoolnutrition.org Sources: Kroger 2006; IFIC 2000 Low Calorie Sweeteners – Consensus on Safety American Dietetic Association – Position Statement on the Use of Nutritive and Nonnutritive Sweeteners (2004) Considered all evidence in vitro, animal, & human data, & regulatory safety assessments (broader range of data than EAL) Similar conclusions drawn in ADA EAL & Position Statement LCS safe within context of federal nutrition recommendations & individual health goals. Sources: ADA, 2004; ADA EAL 2006 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 36 www.schoolnutrition.org What about low calorie sweeteners & appetite, energy balance & weight? Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 37 www.schoolnutrition.org What’s the Evidence? Effect of NNS on appetite (acesulfame-K, aspartame, neotame, saccharin, sucralose) Consensus: Adults – Taken together, the results of (mostly short-term) studies indicate that NNS do not affect appetite in adults. [Grade I; Grade I for aspartame alone] Children – There are not enough studies in children to draw a conclusion. Further research is needed. As for aspartame alone, limited evidence suggests it does not affect appetite or food intake in children. [Grade III; Grade III for aspartame alone] Sources: ADA EAL 2006, 2008 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 38 www.schoolnutrition.org What’s the Evidence? Effect of NNS on food intake (acesulfame-K, aspartame, neotame, saccharin, sucralose) Consensus: Adults – NNS do not increase food intake. Modest energy savings can result if NNS replace sugar-sweetened products in a form that is also lower energy. [Grade II; Grade I for aspartame alone] Children – NNS do not increase food intake. Short-term studies suggest that modest energy savings can result if NNS replace sugar-sweetened products in a form that is also lower energy. Long-term studies need to assess if use of NNS in children help to balance energy intakes with expenditures. [Grade II; Grade III for aspartame alone] Sources: ADA EAL 2006, 2008 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 39 www.schoolnutrition.org The latest word… Mattes & Popkin, Am J Clin Nutr 89:1-14, 2009 Critical review of literature suggests addition of NNS to non-energyyielding products may increase appetite – not observed when NNS ingested with other energy sources. Anton, et al. Appetite Mar 2010 New human trial - Tested the effect of stevia, aspartame, & sucrose on food intake, satiety, & after meal glucose and insulin levels First study to directly test stevia on these parameters Conclusion: LCS sweetened beverages did not lead to eating more & no significant differences in hunger or satiety Brain imaging (Smeets, Netherlands) LCS & sugar sweetened beverage both activated sensory pleasure center Only sugar activated brain region sensing calories Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 40 www.schoolnutrition.org What’s the Evidence? Effect of NNS on energy balance (acesulfame-K, aspartame, neotame, saccharin, sucralose) Consensus: Adults - Using NNS in either a calorie-restricted or ad libitum diet will affect overall energy balance only if the NNS are substituted for higher calorie food or beverages. [Grade II] •Use of aspartame by individuals consuming a reduced calories diet may be associated with increased weight loss. In some cases aspartame did not affect weight loss. [Grade I] Children – Studies do not support that the use of NNS causes weight gain among children & adolescents. If non-caloric beverages including NNS are substituted for sugar-sweetened beverages, there is the potential for energy savings. [Grade III] Source: ADA EAL 2006, 2008 Phelan, et al. International Journal of Obesity, 7/28/09 LCS beverages may be important weight control strategy among weight loss maintainers Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 41 www.schoolnutrition.org Impact of LCS on Weight Control America on the Move program provides an example of potential weight loss usage Source: Rodearmel, et al, 2007 42 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. www.schoolnutrition.org Impact of LCS on Weight Control LCS + sensible diet + physical activity = weight loss Decreased body weight Decreased body mass index (BMI) Calorie Balance is Key! Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 43 www.schoolnutrition.org Top 5 Takeaways: Low Calorie Sweeteners 1) LCS are safe within ADI. 2) LCS use is a choice. No one has to use them. 3) LCS can help with weight management, but is not a magic bullet. Children need adequate calories for growth. 4) Sugar-free does not mean calorie-free or fat-free! 5) Rely only on reputable sources for information (FDA, IFIC) IFIC guidelines for evaluating Web site credibility: http://ific.org/f Source: ADA, 2004 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 44 www.schoolnutrition.org Common Polyols Erythritol Hydrogenated Starch Hydrolysates (HSH) Isomalt Lactitol Maltitol Mannitol Sorbitol Xylitol Most names end in “-ol” Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 45 www.schoolnutrition.org Polyols – About & Benefits Sugar-free sweeteners - replace sugar in foods cup for cup Products containing these - can be labeled “sugar-free” Potential Benefits: About half the calories of sugar – due to incomplete digestion & absorption Do not promote tooth decay Safe for use by people with diabetes Potential Drawback: Laxative effect – especially in children Sources: Kroger, 2006; ADA, 2004; Steagall and Nabors, 2007; caloriecontrol.org Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 46 www.schoolnutrition.org Polyols – Consensus on Safety Regulated as food additives OR GRAS (generally recognized as safe) - sorbitol Source: Kroger, 2006 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 47 www.schoolnutrition.org Other Sweeteners Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 48 www.schoolnutrition.org For more information on sweeteners… American Dietetic Association http://www.eatright.org Calorie Control Council www.caloriecontrol.org Food and Drug Administration http://www.fda.gov International Food Information Council http://www.ific.org PubMed http://www.pubmed.gov Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 49 www.schoolnutrition.org 3 Key Take Aways 1) Sweetener choice is an individual preference. Choose the best fit. 2) All things in moderation. 3) Current evidence supports that these sweeteners are safe for use. Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 50 www.schoolnutrition.org Parents’ Attitudes Toward Sweetening and Sweeteners Dave Tuchler | Tate & Lyle | July 12, 2010 | Dallas, TX Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 51 www.schoolnutrition.org www.schoolnutrition.org A Global Supplier of Renewable Food Ingredients • Transform corn and sugar to value-added ingredients • $6 billion global sales • 5,700 employees • London-based • US HQ: Decatur, IL • Serve food, beverage, pharmaceutical, cosmetic, paper and building industries Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 52 www.schoolnutrition.org A Global Supplier of Renewable Food Ingredients FOOD STARCHES Used by food and drink producers to add texture and body and to enhance mouthfeel CORN SWEETENERS Used in soft drinks and foods to provide sweetness, mouthfeel and energy ACIDULANTS Used to enhance flavor and preserve a wide range of foods, beverages and pharmaceuticals SUGAR & SYRUPS For food and beverage ingredient use; also a strong retail presence in the UK SPLENDA® Sucralose A no-calorie high-intensity sweetener used in over 4,000 foods and beverages worldwide SPLENDA® and the SPLENDA® logo are trademarks of McNeil Nutritionals, LLC Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 53 www.schoolnutrition.org Tate & Lyle’s Approach Caloric Balance Equation • • Value-added, full-service (R&D, quality, customer service) Fact driven – Regular global consumer research – 16 major studies since 2004 – Focus: sweetener attitudes, moms, trends • Good health driven by moderation, balance in calories, and exercise CALORIES IN CALORIES OUT Food Beverages Body Functions Physical Activity Caloric balance is like a scale. To remain in balance and maintain your body weight, the calories consumed (from foods) must be balanced by the calories used (in normal body functions, daily activities, and exercise).* *Source: Centers for Disease Control and Prevention Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 54 www.schoolnutrition.org More Calories In - And The Mix is Changing 1970-2000: • Calories per capita among school-aged children remained relatively constant from 1970 until the mid-1980s, then increased • Energy increase is derived largely from carbohydrates Source: Food Consumption Data System, Economic Research Service, U.S. Department of Agriculture Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 55 www.schoolnutrition.org Fewer Calories Out • 45% of high school children had insufficient or no physical activity in 2003* • In 2005, 28.4% of children had daily participation in school PE in 2005, vs. 41.6% in 1991** • Since 2000, over 100 million video game consoles were sold in the US*** • In 2001, only 13% of children walked or biked to school, vs. 41% in 1969**** • 10.2 million bikes sold in the US in 2009, down from 15.2 million in 1973***** HAPPY FLABBY *Centers for Disease Control, Youth Risk Behavior Surveillance, May 2004 **Centers for Disease Control ***NPD Group ****Robert Wood Johnson Foundation, August 2008 *****National Bicycle Dealers Assn Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 56 www.schoolnutrition.org If You’re Not Sure, Kids’ Habits Have Changed That Much in 20 Years Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 57 www.schoolnutrition.org School Nutrition Directors are on the Front Line, and Under Extreme Pressure Pressing Issues Identified by SN Directors Top Tier Middle Tier SNA 2007 Trends Report 58 District Level National Level Funding 51% Funding 62% Cost of food/food preparation 49% Childhood obesity 51% Local school wellness policy implementation Cost of food/food preparation Childhood obesity Employee recruitment /retention Local school wellness policy implementation Food safety/HACCP Food safety/HACCP State or local nutrition policies Employee recruitment /retention Customer satisfaction State or local nutrition policies Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. www.schoolnutrition.org Some Great Progress Has Been Made - But not with overall milk consumption “There has been an 88% decrease in total calories contained in all* beverages shipped to schools since 2004.” Milk Consumption *Unfortunately, this does not include milk. Milk consumption has been steadily declining. Source: USDA Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 59 www.schoolnutrition.org Milk is Key to Children’s Nutrition - And flavored milk is the key to milk consumption • Milk is critical to nutrition – Important source of key nutrients for school-aged kids* – 8 oz milk is a required offering in all NSLP and SBP meals • Flavored milk drives the entire school milk category – 66% of all milk served in schools** – When flavored milk is removed, overall milk consumption declines and a lot of milk is wasted*** • Milk processors have developed lower sugar/calorie chocolate milk options – But acceptance is far from universal *Source: USDA, Dietary Guidelines for Americans, 2005 **Source: USDA, School Nutrition Dietary Assessment Studies I and III, 2005 ***Source: Murphy, Douglass, Johnson - Journal of the American Dietetic Assn, 2008 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 60 www.schoolnutrition.org Excellent Low-fat Flavored Milks Exist - But is it possible to further lower calories and sugar? Full-Calorie vs. Low-Fat Chocolate Milk Typical Full-Calorie Chocolate Milk Typical Low-Fat Chocolate Milk Calories Per Serving (8oz) 240 150-170 Sugar Per Serving 27 grams 24-27 grams Fat Per Serving 8 grams 2.5 grams Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 61 www.schoolnutrition.org Additional Low-fat Milk Options Exist - All are real products, commercially available now Other Low-Fat Milk Options Typical Full-calorie Chocolate Milk Typical Low-Fat Chocolate Milk Option A Option B Option C Calories Per Serving (8oz) 240 150-170 160 140 110 Sugar per serving 27 grams 25-27 grams 25 grams 19 grams 12 grams Fat per serving 8 grams 2.5 grams 2.5 grams 2.5 grams 2.5 grams Sweetener(s) Sugar or HFCS Sugar or HFCS Sucrose, Fructose HFCS, Sucralose Sucralose Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 62 www.schoolnutrition.org Realistic Solutions Must Meet Key Targets Meet nutrition requirements Cost effective Tastes good Suitable for kids 5-18 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 63 www.schoolnutrition.org What Do Moms Think? • “I always avoid…” • “I will not give my child…” • “All good Moms reject…” • Anecdotal evidence • “It’s from the internet, it must be true” • Focus Group Syndrome • Opinion without context Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 64 64 www.schoolnutrition.org Tate & Lyle Consistently Tracks These Attitudes Summary of proprietary Tate & Lyle consumer insights research • • • • • • • • • • • • • • • • 2004/05 – Overall Health & Wellness Attitudes – Quantitative (US, UK, France, Germany) 2005 – Attitudes – Dairy – US – Qualitative 2005 – Moms & Kids – Perceptions/Attitudes – Qual. 2005 – SPLENDA® Logo – perceptions (US) – Quant. 2006 – Health, Sweetening Attitudes (Canada) – Qual. 2006 - Health, Sweetening Attitudes – Hispanics (US) – Qual. 2006 – Sugar Blending – perceptions/appeal (US) - Qual/Quant. 2007 – Sugar Blending – how to communicate blending (US) - Qual. 2007 - European Sweetening Attitudes – Quant. (UK, Germany, France, Italy, Spain, Russia) 2007/08 – Overall Health & Wellness Attitudes (China) – Qual/Quant. 2008 – Sweeteners/ Logo – perceptions (US) – Quant. (4000) - diabetic, ethnic, parents/children, category-specific detail 2008 – SPLENDA® Logo – on-package perceptions (Mexico) – Quant. 2009 – Sweeteners/ Logo/Natural – perceptions (US) – Qual/Quant. (1087) 2010 – SPLENDA® Logo /sweetener perceptions (Australia) 2010 – European Sweetening Attitudes – Quant. (UK, Germany, France, Italy, Spain) (5000) 2010 – Sweeteners and Sweetening habits (US) – Quantitative (3000) Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 65 www.schoolnutrition.org Consumers Think Some Products Contain Too Much Sugar “I think products often contain too much sugar” Parents Strongly Agree 6% 10% 26% 33% 25% Somewhat Agree Neither agree nor disagree 58% Base = 329 Somewhat disagree Strongly disagree Adults 5% 8% Base = 758 26% 31% 30% 61% Source: Illuminas US Online Study September 2009 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 66 www.schoolnutrition.org Not All Sweeteners Are Created Equal - Most well known sweeteners are familiar 60-90% of Americans Which, if any, of the following have you heard of?* 50%+ Awareness *Aided Awareness Base = 1087 Source: Illuminas US Online Study September 2009 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 67 www.schoolnutrition.org Sweeteners Have Fans & Detractors Some more positive, some more negative, some polarizing, some not Most Comfortable 15% or more felt ‘Least Comfortable’ Which would you be most (least) comfortable with being used as ingredients in the food and drinks you consume? Choose up to three. Not highly controversial Felt Least Comfortable Base = 1087 Source: Illuminas US Online Study September 2009 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 68 www.schoolnutrition.org Majority of Consumers are NOT Negative about HFCS or Fructose On a scale of 1 to 5, where 1 is ‘not at all comfortable’ and 5 is ‘extremely comfortable,’ please indicate how comfortable you are with the following sweetening ingredients being used in the food and drink products you consume. Comfort Level with High Fructose Corn Syrup 17% 15% 29% 24% 15% Extremely comfortable Somewhat comfortable 32% Total Uncomfortable 68% Total Comfortable/Not Uncomfortable Neither comfortable Or uncomfortable Comfort Level with Fructose 11% 14% 25% Total Uncomfortable Base= Total Sample (1004) 35% 26% 75% Total Comfortable/Not Uncomfortable Source: Illuminas US Online Study May 2009 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 69 www.schoolnutrition.org 14% Somewhat uncomfortable Extremely uncomfortable Appeal of Sweeteners Must be Measured in Context of Benefits I’d like to see the amount of sugar in food and drink products for my child reduced through the replacement of some sugar with a nocalorie sweetener, provided it doesn’t change the taste. 72% Age of Oldest Child in Household of Parents of Children 3-15 Accept Use of No-Calorie Sweeteners to Reduce Sugar % Neutral/Somewhat or Strongly Agree Age 3-5 66% Base = 416 Age 6-8 78% Base = 260 Age 9-12 75% Base = 269 Age 9-12 74% Base = 260 Source: Illuminas US Online Study January 2008 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 70 www.schoolnutrition.org *For this question, non-acceptance is indicated by disagree rating – neutral classified as ‘no objection’ 80% Of Parents Accept The Use of Sucralose To Reduce Sugar Levels For Their Children As you may be aware, sucralose provides sweetness but has no calories. How appealing is it to replace some of the sugar with a small amount of sucralose in the food and drink products you buy for consumption by your oldest child under 16? 2009 Very appealing 12% 8% 35% 24% 80% Appeal/Accept Base = 329 Consistent with 2007 measurement 18% Somewhat appealing Neither appealing nor unappealing Somewhat unappealing Not at all appealing Source: Illuminas US Online Study September 2009 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 71 www.schoolnutrition.org The Chocolate Milk Test Which version of chocolate milk would you prefer for your oldest child aged under 16? Moms evaluated labels of two chocolate milk options for their kids - Their preferences may surprise you Source: Illuminas US Online Study January 2008 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 72 www.schoolnutrition.org 70% of Parents Preferred a Sucralose Reduced Sugar Chocolate Milk Over a Typical Low-Fat Milk • Even 54% of HIS Rejecters chose the Sucralose version! • What people say is often different from what they do 15% Selected Source: Illuminas US Online Study January 2008 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 73 www.schoolnutrition.org 70% Selected Appeal was strong across all children’s age groups Of those with a preference Total Parents Which version of chocolate milk would you prefer for your oldest child aged under 16? With Sucralose 70% 82% Preference for reduced calorie milk 78% 78% Age 3-5 Base = 386 Without Sucralose 15% 82% Age 6-8 Base = 228 No preference 9% 80% Age 9-12 Base = 232 Neither 6% Base = Parents who expressed a preference Base = 1205 Source: Illuminas US Online Study January 2008 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 74 www.schoolnutrition.org 90% Age 13-15 Base = 241 The Driver Was Calorie/Sugar Reduction You said that you prefer Option B [with sucralose] of the chocolate milk for your child. Why do you feel this way? 34% No/les s c alories 32% No/les s s ugar 13% Healthy/Nutritious 10% No/les s fat 70% No/les s s odium/c arbs 3% C ontains protein 3% C ontains s kim milk/other ingredients 3% G ood/s ame tas te Base = 1205 Base = 831 Source: Illuminas US Online Study January 2008 Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 75 www.schoolnutrition.org 1% Sweeteners Have Been Used in Kids’ Products for Years Case Study: Hawaiian Punch - An Iconic Brand • Excellent acceptance since Sept 2005 reformulation • Calories per serving decreased to 80, from original 120 Change Sept 05 ANNUAL SALES • Reduced nutritive sweeteners through use of small amount of sucralose HAWAIIAN PUNCH FRUIT JUICY RED DRINK 128 OZ 1480064608 Source: IRI Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 76 www.schoolnutrition.org Summary • Schools have tremendous influence over kids’ health • Driving milk consumption is important – And flavored milk drives overall milk consumption • Options exist that can help in the goal of further reducing calories – And a wide variety of sweeteners is acceptable to parents • The growing obesity problem requires courage in challenging conventional wisdom, to deliver solutions that make a difference – Chocolate milk is an excellent opportunity Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. 77 www.schoolnutrition.org