Exploring sugars in the foods we buy Frequently Asked Questions

Exploring sugars in the foods we buy Frequently Asked Questions Why all the recent fuss about reducing free sugars? Which foods contribute the most to free sugars intake in the UK? What s the difference between total sugars and free sugars? How can I tell how much free sugars are in the food I buy? Where do I find sugars on nutrition labels? Why are sugars from fruit juice considered free sugars but sugars from a whole piece of fruit are not? Why is there so much hidden sugar in foods we buy? I ve heard that sugar is sugar and the same whether it is in a bar of milk chocolate or in sweetcorn or in a banana? So why should I not just eat the chocolate? How can I reduce free sugars in my diet? Why all the recent fuss about reducing free sugars? Many foods and drinks that contain free sugars can be high in energy (calories) and may have few other nutrients. Having these foods or drinks too often can mean you consume more calories than you need, which can lead to weight gain and obesity, and obesity is one of the most significant current health concerns in the UK. The amount and frequency of foods and drinks with free sugars we consume can also increase our risk of dental decay. Which foods contribute the most to free sugars intake in the UK? Looking at the types of foods and drinks that contribute to free sugars in our diet may help us reduce our intake. Below we list the main sources of free sugars as reported in the most recent UK dietary survey for children (4-10 years), adolescents (11-18 years) and adults (19-64 years). TOTAL: Boys 63g/day, girls 59g/day,on average 16% sugars-sweetened drinks 13% fruit juices 4-10 year-olds: sources of free sugars* non-alcoholic beverages, 30% cereals & cereal products, 29% 12% buns, cakes, puddings 8% biscuits 5% breakfast cereals (not high fibre) 3% high fibre breakfast cereals 7% sugar confectionery 7% chocolate confectionery 7% sugar, preserves & spreads sugar, preserves & confectionery, 22% milk products, 12% 6% yogurt, fromage frais, dairy desserts 4% ice cream * intakes measured as non-milk extrinsic sugars (free sugars data not yet available for the survey); data from the National Diet and Nutrition Survey (NDNS) Rolling Programme 2008-2012. Source: Bates et al. 2014. 1

11-18 year-olds: sources of free sugars* TOTAL: Boys 84g/day, girls 64g/day, on average 29% sugars-sweetened drinks 10% fruit juice alcoholic drinks, 2% non-alcoholic drinks, 40% cereals & cereal products, 22% sugar, preserves & confectionery, 21% 8% buns, cakes, puddings 7% biscuits 4% breakfast cereals (not high fibre) 2% high fibre breakfast cereals milk products, 7% 3% yogurt, fromage frais, dairy desserts 3% ice cream 8% chocolate confectionery 8% sugar, preserves, spreads 5% sugar confectionery TOTAL: Men 68g/day, women 49g/day, on average Adults: sources of free sugars* alcoholic drinks 10% non-alcoholic drinks, 25% cereals & cereal products, 21% 9% buns, cakes, puddings 6% biscuits 3% high fibre breakfast cereals 3% other breakfast cereals milk products, 6% 16% sugars-sweetened drinks 8% fruit juice sugar, preserves & confectionery, 26% 17% sugar, preserves, spreads 7% chocolate confectionery 2% sugar confectionery * intakes measured as non-milk extrinsic sugars (free sugars data not yet available for the survey); data from the National Diet and Nutrition Survey (NDNS) Rolling Programme 2008-2012. Source: Bates et al. 2014. Pie charts from Why 5%? An explanation of SACN s recommendations about sugars and health. Source PHE 2015. Contains public sector information licensed under the Open Government Licence v2.0. 2

What s the difference between total sugars and free sugars? Free sugars Free sugars are sugars added to foods and drinks by manufacturers, cooks or consumers, and also sugars found naturally in honey, syrups and fruit juice. found for example in fruits and vegetables (fresh, frozen or dried) and in milk and products such a plain yogurt and cheese are not classed as free sugars. It is free sugars in particular that many people need to eat less of. Total sugars The total sugars value given on food labels, includes all sugars, regardless of the source. In other words, it includes those naturally present and those added to foods or drinks. In some foods and drinks, all of the sugars are free sugars. Examples include:- -sweetened beverages, fruitflavoured sweets and fruit juice. All sugars in these products are free sugars Some foods provide a mix of free sugars and naturally present sugars as they contain milk and/or fresh or dried fruit but are also sweetened with additional sugar. Examples include:- Fruit yogurt Breakfast cereals with dried fruit present naturally in milk (lactose) (not free sugars) or fruit (not free sugars) but can also have sugars added to sweeten (free sugars) present in dried fruit like raisins (not free sugars) but can also have sugars added to sweeten (free sugars) Some foods contain sugars, none of which are classed as free sugars. Examples include:- Plain yogurt, no-added sugar muesli, pack of prepared stir fry veg present naturally in milk (lactose) (not free sugars) or in dried or fresh fruit and vegetables (not free sugars) This can make it difficult to find out, at a glance, which foods contain free sugars, as the total sugars value can be misleading. 3

How can I tell how much free sugars are in the food I buy? Don t forget, the sugars we need to reduce in our diets are free sugars - those added to foods and drinks and those found in fruit juice, honey and syrups. Those naturally present in the structure of fruits and vegetables and in milk are not included in the definition of free sugars. However, by law, nutrition labels on back of packs provide information about total sugars this includes both the free sugars and naturally occurring sugars. Total sugars information on back-ofpack nutrition labels appears as of which sugars. It can be difficult to tell how much free sugars are in particular products but the ingredients list is a good place to start. that are added to products must be included in the ingredients list. Free sugars may appear in the ingredients list as sugar but other words and terms to look for include:- Cane sugar, honey, brown sugar, dextrose, fructose, sucrose, glucose, maltose, high fructose corn syrup, fruit juice concentrate, corn syrup, molasses, isoglucose, crystalline sucrose, nectars and molasses are listed in descending order of weight, so if a type of sugar appears near the beginning of the ingredients list, the product is likely to have more free sugars than one in which any sugars are at the end. For example, look at the ingredients list for this salad dressing, which has a total sugars content of 3.5g/100g. We have highlighted all the types of free sugars in the product in red. Not all the sugars are free sugars as some come from the plain yogurt and from the cheese powder, and so are not highlighted in the list:- Water, White Wine Vinegar, Cheese Stock (4%) (Cheese Powder (Cows' Milk), Glucose Syrup, Water, Yeast Extract, Salt, Flavouring, Sunflower Oil), Sugar, Cornflour, Low Yoghurt (Cows' Milk), Rapeseed Oil, Onion Powder, Salt, Worcester Sauce (Water, Sugar, Spirit Vinegar, Molasses, Onion Purée, Salt, Tamarind Paste, Clove, Ginger Purée, Garlic Purée), Garlic Powder, Chive, Concentrated Lemon Juice, Colour: Titanium Dioxide; Stabiliser: Xanthan Gum; Preservative: Potassium Sorbate; Black Pepper. For some products, such as sugars-sweetened beverages, confectionery, biscuits and sweet pastries, it is likely that most of the sugars present are free sugars. However, it is more complicated for products that have both free sugars and sugars from fruit and vegetables or milk for example a cooking sauce that contains both tomatoes and vegetables, as well as some sugars added to bring out the flavour, a sweetened fruit yogurt or a prepared rice salad with dried fruit, vegetables and a honey-based salad dressing. Finding out exactly how much of the total sugars content is free sugars may not be possible. But looking at the ingredients will help. Although this may sound complex, the main thing to concentrate on is having a healthy, balanced diet and keeping the foods that make the biggest contributions to free sugars intake to small amounts or to have them less often. As is illustrated above, these are things like sugars-sweetened drinks, chocolate and sweets, cakes and biscuits. 4

on nutrition labels In line with European legislation, you will find the amount of total sugars listed per 100g in back-ofpack nutrition labels. Some products will also have this listed per portion. Typically, major retailers and manufacturers will also show: 1. the amount of total sugars per portion on the front of pack, often with traffic light coding to indicate whether the food has a high, medium or low total sugars content per 100g; 2. a percentage of the European reference intake (RI) per portion for total sugars, which is 90g a day (based on a 2000kcal diet) for adults. By law, the packaging has to provide an ingredients list, which includes any added sugars as mentioned above. Let s look at some examples Example: Tomato-based curry sauce Tomatoes (55%), Water, Double Cream (Cows' Milk) (6%), Onions (6%), Tomato Purée, Yogurt (Cows' Milk) (3.5%), Sugar, Rapeseed Oil, Dried Onion, Creamed Coconut, Maize Starch, Coriander Leaf, Ground Cumin, Salt, Ground Coriander, Acidity Regulators: Citric Acid, Acetic Acid; Ginger Purée, Garlic Purée, Turmeric, Ground Cardamom, Chilli Powder, Ground Black Pepper, Ground Nutmeg, Ground Fenugreek, Fenugreek Leaf, Onion Purée, Ground Ginger, Ground Cumin, Paprika, Ground Cinnamon, Garlic Powder, Cumin Seeds, Ground Fennel, Ground Cloves, Black Onion Seeds Per 100g Energy 436kJ 545kJ 105kcal 131kcal Of which Saturates 6.1g 2.2g 7.6g 2.8g 10.1g 8.4g 12.6g 10.5g Protein 1.5g 1.9g Salt 0.73g 0.91g Per portion (125g) 10.5g 12% Grams of total sugars per portion % of European reference intake (RI) for total sugars provided by a portion Traffic light colour represents whether per 100g the food is low (green) medium (amber) or high (red) in total sugars tomatoes and other vegetables (NOT free sugars), plain yogurt and cream (NOT free sugars) So only some will be from sugars added during manufacturing (free sugars), sugar being the 7 th ingredient on the list 5

Example: Lasagne British Beef (26%), Cows' Milk, Cooked Free Range Egg Pasta (Durum Wheat Semolina, Water, Free Range Egg, Free Range Egg White), Tomato (12%), Onion, Tomato Purée, Red Wine, Carrot, Mushroom, Mature Cheddar Cheese (Cows' Milk) (2.5%), Cornflour, Garlic, Grated Medium Hard Cheese (Cows' Milk) (Anti Caking Agent: Potato Starch), Rapeseed Oil, Fortified British Wheat Flour (Wheat Flour, Calcium Carbonate, Iron, Niacin, Thiamin), Salt, Rosemary, Black Pepper, Nutmeg, White Pepper, Bay. Per 100g Energy 617kJ 2278kJ 148kcal 548kcal 8.6g 31.6g Of which Saturates 4.1g 15.2g 6.8g 4.0g 24.9g 14.8g Protein 7.8g 28.7 Salt 0.53g 1.94g Per portion (375g) 14.8g 16% Grams of total sugars per portion % of European reference intake (RI) for total sugars provided by a portion Traffic light colour represents whether per 100g the food is low (green) medium (amber) or high (red) in total sugars tomatoes and other vegetables (NOT free sugars), cheese (NOT free sugars) There are no free sugars in this product Total sugars are low for 100g of the food (4g) but may seem quite high per portion (14.8g). However portion size reflects this is a main meal 6

Example: Strawberry yogurt Low Yogurt (Cows' Milk), Strawberry (12%), Sugar, Strawberry Purée (4.5%), Rice Starch, Colour: Anthocyanins; Flavourings. Per 100g Energy 316kJ 474kJ 75kcal 112kcal 1.2g 1.8g Of which Saturates 0.8g 1.2g 11.2g 9.9g 16.8g 14.7g Protein 4.7g 7.1g Salt 0.13g 0.19g Per portion (150g) 14.7g 17% milk (NOT free sugars) strawberries (NOT free sugars) Only some of the total sugars present will be from the sugar added to sweeten the yogurt (free sugars) Example: Couscous salad Couscous (49%) (Durum Wheat Semolina, Water, Rapeseed Oil), Chickpeas (13%), Yellow Pepper, Sugar, Red Onion, Raisins (4.5%), Water, Apricots (3%) (Apricots, Rice Flour, Preservative: Sulphur Dioxide), Cranberries (2.5%), Rapeseed Oil, Malt Vinegar (Barley), Parsley, Honey, Coriander, Salt, Tomato Purée, Turmeric Powder, Black Pepper, Roasted Garlic Purée, Ginger Purée, Red Chilli, Cornflour, Smoked Paprika, Cinnamon Powder, Sunflower Oil, Mustard Seed, Cumin Powder, Cardamom, Pectin, Ginger Powder, Clove Powder, Nutmeg, Coriander Powder. Per 100g Per portion (115g) Energy 864kJ 993kJ 205kcal 236kcal Of which Saturates 4.9g 0.5g 5.6g 0.6g 34.5g 9.5g 39.7g 10.9g Protein 4.6g 5.3g Salt 0.5g 0.58g 10.9g 12% vegetables and dried fruit (NOT free sugars) Some will be from the sugar and honey present in the dressing (free sugars) 7

Example: Chilled soup carton Carrot and butternut squash Water, Carrots (35%), Butternut Squash (9%), Onions, Salted Butter (Milk), Tomato Paste, Honey, Salt, Ginger, Garlic, Cumin Seeds, Ground Coriander, Dried Red Chillies Per 100g Energy 116kJ 354kJ 28kcal 84kcal Of which Saturates 1.0g 0.6g 3.0g 11.4g 3.8g 3.8g 11.4g 11.4g Protein 0.5g 1.5g Salt 0.53g 1.6g Per portion (300g) 11.4g 13% vegetables (NOT free sugars) Some will be from the honey (free sugars) Example: Margherita pizza Pizza Base (Wheat Flour, Water, Rapeseed Oil, Yeast, Salt), Tomato Sauce (Water, Tomato, Tomato Purée, Cornflour, Sugar, Garlic Purée, Black Pepper), Mozzarella Cheese (19%) (from Cows' Milk), Mature Cheddar Cheese (6%) (from Cows' Milk), Red Cheddar Cheese (4%) (from Cows' Milk) (with Colour: Beta Carotene), Monterey Jack Cheese (1%) (from Cows' Milk). Per 100g Energy 1052kJ 250kcal 1619kJ 385kcal Of which Saturates 8.6g 4.7g 13.2g 7.2g 30.7g 2.3g 47.3g 3.5g Protein 11.5g 17.7g Salt 0.65g 1.01g Per portion (150g) 3.5g 4% tomatoes (NOT free sugars) cheese (NOT free sugars) Some will be from sugar added to the tomato sauce (free sugars) 8

Why are sugars from fruit juice considered free sugars but sugars from a whole piece of fruit are not? UK government definitions of sugars have typically made a distinction between sugars in fruit juice and those in the whole fruit. This is because there is little evidence that sugars naturally found within the cell structure of foods (or lactose found in milk and milk products) have adverse health effects. It has also been suggested that sugars outside their cell structure such as in fruit juice can be taken in quantities greater than in their natural form in other words we can drink a glass of juice much quicker than it would take us to eat the number of whole fruit it took to make the juice. Fruit juice and whole fruit also differ in the amount of fibre they contain most of the fibre in whole fruit is lost when the fruit is juiced. Adequate fibre intake is important for health and, on average, we should be eating far more dietary fibre than we do currently. To achieve this we should be eating more fibre-rich cereals, fruit and vegetables and limiting fruit juice intake to a small 150ml glass a day. However, fruit juice does contain useful micronutrients like vitamin C and counts as one of your 5 A DAY. Twice as much fibre in the whole fruit compared to fruit juice Why is there so much hidden sugar in foods we buy? In some cases, sugars may be found in foods that are considered savoury and where you might not expect to find them. may be added to foods like sauces, soups, cereals and ready meals for a variety of reasons, from taste to the texture or structure of food. For example, sugar is often added to tomato products in manufacturing to counter the natural acidity of the tomatoes and improve palatability. However sugars added to savoury products are usually added in fairly small amounts. When we look at the foods contributing to free sugars intake in the pie diagrams on pages 1 and 2, savoury foods do not appear to be making a significant contribution to our free sugars intakes, which mainly come from sweet foods and drinks. As to whether sugars are being hidden, it is compulsory for food companies to display the ingredients and the nutritional content of their foods and drinks and so you should always be able to find the total sugars content of the food (found in the nutrition panel on the back of the packaging and often also on front-of-pack labelling) and the ingredients list will include any sugars added to the product. So it s a good idea to check labels, and you can choose those which don t have any sugars included in the ingredients list or go for those that have a lower total sugars value (although do note that total sugars includes both free and naturally occurring sugars and so can be misleading). 9

I ve heard that sugar is sugar and the same whether it is in a bar of milk chocolate or in sweetcorn or in a banana? So why should I not just eat the chocolate? The term sugars includes a variety of different sugar molecules such as the single unit sugar, glucose, and the double unit, sucrose (made up of one glucose and one fructose molecule). These sugars vary in their structure but whether a single type, such as sucrose, is present in fruit, vegetables, cake or chocolate it has the same chemical structure and is perceived in the same way by the body a source of fuel. BUT fruits and vegetables naturally contain a range of other nutrients, such as vitamins, minerals and fibre; scientific evidence supports the varied health benefits of eating fruit and vegetables; the concentration of sugars in a bar of chocolate is far higher than in a piece of fruit or a vegetable that tastes naturally sweet; the energy (calorie) content of a bar of milk chocolate is far higher than in a piece of fruit and excess energy contributes to weight gain and risk of obesity obesity is a major health concern in the UK. per banana (100g) 81 kcal 18g sugars How can I reduce free sugars in my diet? per bar of milk chocolate (45g) 234 kcal 25g sugars We can include some foods high in free sugars in our diet now and again, but in moderation! The recommended way to reduce free sugars intake is to base main meals on fibre-rich, starchy carbohydrates (like wholegrain foods and potatoes with their skins), with plenty of fruit and vegetables, and some protein-containing foods such as lean meat, poultry, fish (including oily fish), eggs and pulses and low-fat dairy products. At the same time many of us need to reduce our consumption of foods that contain lots of free sugars, including sugar itself, confectionery, cakes, pastries and biscuits, and limit our intake of sugars-sweetened beverages by replacing some with water and lower-fat milks, diluting fruit drinks and juices or opting for no added sugars drinks. The Department of Health suggests limiting our fruit juice consumption to a small 150ml glass a day. It counts as one of your 5 A DAY, but don t forget unsweetened fruit juice also counts towards free sugars intake. Sources of fibre include vegetables, fruits, nuts, seeds, beans, pulses, oats and other wholegrains, wholemeal breads and pasta, and potatoes with skins For more information on the sources used in this text, please contact postbox@nutrition.org.uk The new adult recommendation for fibre is 30g/day Last reviewed August 2015. Next review due August 2018. 10