Laura Shumow, MHS
Director of Scientific and Regulatory Affairs
• Major association representing the U.S. confectionery
industry – small and large companies since 1884
• Education and leadership in manufacturing, technical
research, public relations, retailing practices,
government relations, and statistical analyses
• Committed to science-based evidence and educational
resources to convey role of candy as a treat in a healthy
lifestyle
2
• Earliest confections date back to
antiquity
• Cocoa used by Mayans >2000
years ago
• Celebratory food often given as a
gift and part of holidays/traditions
3
Studies of more than 15,000 U.S. adults and 11,000
children and adolescents from NHANES data showed no
association between candy intake with:
– increased weight/body mass index
– risk factors for heart disease (blood pressure, blood lipids, etc)
– Risk factors for diabetes/metabolic syndrome (glucose levels,
CRP, etc)
O'Neil CE, Fulgoni VL, Nicklas TA. Association of Candy Consumption with Body Weight Measures, Risk Factors for Cardiovascular Disease, and Diet Quality in U.S. Adults:
NHANES 1999-2004. Nutrition Research, 2011. 31(2):122-130.
O'Neil CE, Fulgoni VL, Nicklas TA. Association of Candy Consumption with Body Weight Measures, Other Health Risk Factors for Cardiovascular Disease and Diet Quality in U.S.
Children and Adolescents: NHANES 1999-2004. Food Nutr Res. 2011;55. doi: 10.3402/fnr.v55i0.5794
• A 2012 study of >1,000 healthy people published in
Archives of Internal Medicine showed men and women
who ate chocolate more frequently had a lower BMI
than those who ate chocolate less often.
• In 2013, a Nutrition Journal publication showed that
frequency of total candy consumed by adults was not
associated with risk of obesity/overweight, blood
pressure, blood cholesterol levels or markers of insulin
resistance
Golomb et al. Association between More Frequent Chocolate Consumption and Lower Body Mass Index. Arch Intern Med.
2012;172(6):519-521
Murphy et al. Body weight status and cardiovascular risk factors in adults by frequency of candy consumption. Nutr J. 2013; 12 (1):
53.
The objective of this study was to determine whether
candy consumption in childhood was predictive of the
presence of adverse levels of CVRF, including
weight/adiposity measures, in young adulthood.
O’Neil CE, Nicklas TA, Liu Y, Berenson GS. Candy consumption in childhood is not predictive of weight, adiposity measures, or cardiovascular risk factors
in young adults: The Bogalusa Heart Study. Journal of Human Nutrition and Dietetics. 2013. (E-pub before print).
Study Methodology
 Candy (g/d) consumption at baseline and from the first follow-up survey was
obtained from one day 24-hr dietary recall
 Candy consumption from the second follow-up was obtained via a food
frequency questionnaire.
 Separate linear mixed models were used to detect relationships between candy
at baseline and health biomarkers at follow-up.
Effect of candy consumption on cardiovascular risk
factors (n=355)
Candy Baseline
CVRF at Follow-up
Candy Follow-up
β±SE
std β
P-value
β±SE
std β
P-value
BMI (kg/m2)*
0.005±0.006
0.04
0.329
-0.004±0.009
-0.02
0.608
Weight (kg)*
0.013±0.016
0.03
0.410
-0.020±0.025
-0.03
0.413
Systolic BP (mm Hg)**
0.005±0.012
0.02
0.674
-0.006±0.020
-0.01
0.776
Diastolic BP (mm Hg)**
-0.018±0.011
-0.09
0.108
0.006±0.018
0.02
0.732
Total Cholesterol (mg/dL)**
0.062±0.039
0.08
0.116
-0.067±0.063
-0.05
0.288
LDL-C (mg/dL) **
0.025±0.036
0.04
0.495
-0.005±0.058
0.00
0.935
HDL-C (mg/dL)**
0.017± 0.015
0.06
0.262
0.000±0.024
0.00
0.993
Triglycerides (mg/dL)**
0.133±0.082
0.10
0.106
-0.245±0.133
-0.10
0.066
Glucose (mg/dL)**
0.025±0.019
0.11
0.191
0.034±0.039
0.07
0.382
Insulin (µU/mL) **
0.047±0.026
0.18
0.081
0.031±0.058
0.05
0.591
*Adjusted for, baseline DV, age, gender, race, gender * race, total energy, candy consumed at follow-up, smoking status, and alcohol, and length of
follow-up.
**Adjusted for baseline DV, age, gender, race, gender*race, total energy, BMI, smoking status, and alcohol, and length of follow-up.
Abbreviations: β = beta coefficient; SE = Standard Error
Conclusions & Implications
• Levels of candy consumption reported by this study
population were not predictive of CVRF.
• Consumption of nutrient dense foods consistent with
dietary recommendations are important, but foods
like candy can be added to the diet, in modest
amounts, without potential adverse long term health
consequences.
• More studies are need to confirm these results.
Percent consumers of candy and per capita intake of candy among
Americans ages 2 years and older
Population Group
Parameter
Candy consumers, %
Candy containing chocolate
Candy not containing chocolate
Total candy
Per capita candy intake, g
Candy containing chocolate
Candy not containing chocolate
Total candy
2+ y 2-18 y
19+ y
15.0
12.6
22.8
13.2
21.3
29.6
15.6
9.8
20.6
5.7
4.3
10.0
4.7
7.2
11.9
6.1
3.4
9.4
Source: What We Eat in America, National Health and Nutrition Examination Survey 2007-2010, day 1 dietary recalls.
n=17,571 individuals ages 2 years and older, n=6,090 individuals ages 2-18 years, and n=11,481 individuals ages 19
years and older; breastfeeding children were excluded from the sample. Candy categories (candy containing
chocolate, candy not containing chocolate) correspond to the What We Eat in America food categories; chewing gum
was excluded from this analysis.
Per capita contributions of candy to total energy, fat and sugar intakes
Population Group
Parameter
2+ y
2-18 y
19+ y
Total energy intake, kcal
2075
1907
2128
Energy intake from candy, kcal
45.2
51.6
43.2
% of energy intake from candy
2.2
2.7
2.0
Total fat intake, g
77.6
69.9
80.0
Fat intake from candy, g
1.6
1.5
1.7
% of fat intake from candy
2.1
2.1
2.1
Total saturated fat intake, g
25.9
24.5
26.4
Saturated fat intake from candy, g
0.8
0.8
0.8
% of saturated fat intake from candy
3.2
3.2
3.2
Total sugars intake, g
120
127
117
Sugars intake from candy, g
5.7
6.7
5.3
% of sugars intake from candy
4.7
5.3
4.5
Total added sugars intake, tsp
18.5
19.1
18.3
Added sugars intake from candy, tsp
1.2
1.3
1.1
% of added sugars intake from candy
6.4
7.0
6.3
Source: What We Eat in America, National Health and Nutrition Examination Survey 2007-2010, day 1 dietary recalls. n=17,571 individuals ages 2 years and older, n=6,090 individuals ages 2-18 years, and n=11,481
individuals ages 19 years and older; breastfeeding children were excluded from the sample. Estimates reflect intake from all candy other than chewing gum; candy as defined by the candy categories in the What We
Eat in America food categories (i.e., candy containing chocolate and candy not containing chocolate).
• Research suggests that forbidding
certain foods may be
counterproductive
• Dieting and restrained eating may
lead to overeating and poor body
weight control in children and adults
• It is more productive to promote
moderation rather than restriction
15
• Penn State study evaluating the effects of
parental practices regarding candy
– Preliminary results show that parental restriction of
candy is associated with children’s lower selfregulatory control
– Studying strategies to promote consumption of candy
in moderation
• Trial on the impact of chocolate restriction on
consumption at Purdue in adults
• Individual tactics - mindfulness, distraction
techniques
• Package size, food environment
• Parental tactics – “limit setting” as opposed to
restriction
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