Lesley James, Heart & Stroke Foundation

Risky Liquid Candy
Lesley James
Wednesday, November 26
Why sugar?
► Excess
sugar consumption is associated with
heart disease, stroke, obesity, diabetes, high
blood cholesterol, cancer and dental caries.
► Sugar,
Heart Disease and
Stroke Position Statement
– released September 2014
Media highlights
Globe and Mail
National Post story also appeared in Vancouver
Sun, Ottawa Citizen, Windsor Star, The
StarPhoenix (Saskatoon), The Leader-Post
(Regina), Montreal Gazette, Edmonton Journal,
and Calgary Herald.
Front page of the Vancouver Sun
CBC syndication – all major CBC drive-home
shows across the country
Canadian Health and Lifestlye, Canadian Living
Global, CTV
Social highlights: Blogs: Marion Nestle
(Foodpolitics.com), Yoni Freedhoff
(weightymatters.com). Tweets from major media
that covered the story and Andre Picard (Globe
and Mail) and Mark Bittman (New York Times food
writer and food policy critic)
Free vs. bound sugars
► Free
sugars: all monosaccharides and
disaccharides added to foods by the
manufacturer, cook or consumer, plus sugars
naturally present in honey, syrups and fruit
Health effects of sugar
Those with 10% - 25% of total
energy from added sugar have a
30% higher risk of death from
heart disease or stroke.1
With 25% or more of calories from
added sugar the risk is nearly
Systematic review - reduced
intake of dietary free sugars
results in weight loss and
increased sugar intake is
associated with weight increase.2
Yang et al. JAMA 2014.
Morenga et al. BMJ 2012.
2 Te
Sugar consumption in Canada
Estimated Canadians
consume as much as 13% of
their total calorie intake from
added sugars.1,2
The Heart and Stroke
Foundation recommends
that an individual’s total
intake of free sugars not
exceed 10% of total daily
calorie (energy) intake, and
ideally less than 5%.
Brisbois et al. Nutrients 2014.
Srinivasan CS. Food Policy 2006.
Sugar consumption in Canada
► 10%
of total energy (calories) from free sugars
in a 2,000-calorie-a-day diet = 48 grams
(roughly 12 teaspoons) of sugar.
► 5%
of total energy = 24 grams (roughly 6
teaspoons) of sugar.
Liquid candy
► Sugar
sweetened beverage
(SSB), sugary drinks, or
sugar loaded drinks.
► These
include soda/soft
drinks, fruit drinks (punch,
cocktail), juices (including
100% fruit juice) sport drinks,
sweetened coffees and teas,
vitamin waters and energy
Health effects of sugary drinks
Just 1 serving/day increases
diabetes risk by 22%, 2 – 3 sugary
drinks/day associated with 31%
greater risk diabetes compared to
consumption at less than
Each additional serving/day
increases risk of CHD by 19% and
childhood obesity by 60%.2
180,000 deaths worldwide each
Schultz MB. JAMA 2004.
Chiuve et al. J of Nut 2012.
Singh et al. EPINAM 2013.
Sugary drink consumption
Largest contributor of sugar in
1/3 of Canadians aged 5 – 19
report daily consumption.2
Top calorie source among NA
ages 12 – 50.3
As children get older, they
consume more sugar from soft
Yang et al. JAMA Int Med 2014.
Langlois et al. Health Reports 2010.
3 Brownell et al. NEJM 2009.
4 Garriguet. Health Reports 2008.
What’s the issue?
► Canadians
are often
unaware of the amount of
sugar in beverages.
don’t feel as full
as they do if they ate the
same number of calories
from solid food.
► Drinkers
► Liquid
sugar facilitates
caloric uptake/over
Sugar backlash
► Adverse
health effects of sugar shown in media
► The consumer is more health conscious
► Sugary drink policy successes exist
Sugary drink campaigns
Public opinion
The time is right;
88 % agree that large serving sizes of sugary drinks can
lead to bad health.
94 % consider over consumption of sugary drinks to be
an important contributor to obesity among Canadians .
79 % agree that large sized sugary drinks in restaurants
and convenience stores are usually offered at little
additional cost in order to encourage people to spend
and consume more.
63 % would support a plan to eliminate large sugary
drink sizes in restaurants and large sugary fountain
drinks in convenience stores as a way to improve health.
Healthy public policy progress
Sugary drink taxes in various jurisdictions (Mexico,
Norway, France, Denmark, & Berkeley)
Warning labels in California (did not pass) and NY state
Marketing to kids restrictions (Quebec, Denmark,
Finland, Belgium, Sweden, Mexico, UK)
Portion size standardization in NYC (did not pass, but
being revived by new administration)
Procurement policies in various municipalities and
What is HSF doing?
► Recommendations
for all levels
of government, researchers,
food and beverage industry,
health professionals and
educational institutions,
workplaces and individuals to
reduce sugary consumption
► Specific
HSF policy asks and
campaigns to reduce sugary
drink consumption
Bigger portions means more sugar
7 ounces
140 calories
22g sugar
12 ounces
82 calories
38 g sugar
16 ounces
180 calories
49 g sugar
32 ounces
374 calories
102 g sugar
64 ounces
780 calories
217 g sugar
Portion size standardization
► Standardize
the portion size of sugary drink
containers in foodservice sector outlets.
Sugary drink tax
HSF recommends a manufacturer’s levy on sugary
drinks (provincial and federal).
► Levy sugary drinks would be placed on
manufacturers with revenues dedicated to
government led healthy living initiatives (school
healthy lunch programs, and subsidization of
vegetables and fruit).
Restrict marketing to kids
► Asking
provincial and federal governments to:
Restrict the commercial marketing of foods
and beverages to children.
Restrict marketing to kids
Collaboration is key to success
► We
can’t do this alone! Please join our efforts.
► www.heartandstroke.ca
Lesley James
Senior Health Policy Analyst