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Exposing hidden sugar in food

'Added sugars' alert on nutrition labelling helps people make informed food decisions

If you travel to the United States, you might notice a slight difference in the content of nutrition labels in grocery stores there.

The US Food and Drug Administration (FDA) announced in May that new nutrition facts labels will be rolled out "to reflect new scientific information, including the link between diet and chronic diseases".

One key change in the new labelling is a new category called "added sugars".

The FDA said it is including this category in labels as a sub-header under the category "total sugars", in line with recommendations from various health associations which recommend decreasing one's intake of added sugars.

Although added sugars can be part of a healthy diet, consuming added sugars makes it more difficult for people to meet their nutrient needs while staying within caloric requirements.

This is because people may hit their daily calorie limit without consuming other important foods such as those with essential vitamins, fibres and minerals.

The FDA hopes that adding this category will help consumers be aware of the amount of added sugars in their food.

Added sugar provides calories without other benefits, unlike food with natural sugars such as fruit, which also provides vitamin C, carotenoids, phytonutrients, antioxidants and fibre.

Added sugars are those that are added to food during preparation or processing, for example, white and brown sugar, and syrups, said Ms Rddhi Naidu, a dietitian from Parkway East Hospital.

This is in contrast to natural sugars which are present in foods in their natural state, such as fructose in fruit and honey, and lactose in milk.

She said that all sugars provide the same amount of calories - 4 kcal per gram. Sugar is broken down to glucose and used for energy production or stored in the body if not used. However, there are differences between natural and added sugars.

Ms Bibi Chia, principal dietitian at Raffles Diabetes and Endocrine Centre, said that food high in natural sugars tend to have a lower glycemic index when compared to food that is high in added sugars.

It is healthier to eat food with a lower glycemic index as this raises blood glucose levels by a smaller amount.

Added sugar provides calories without other benefits, unlike food with natural sugars such as fruit, which also provides vitamin C, carotenoids, phytonutrients, antioxidants and fibre.

"When we eat them as whole foods, they are beneficial," said Dr Lim Su Lin, chief dietitian at the National University Hospital.

People should be aware of whether the food they eat is high in natural or added sugars, and not just look at the total sugar content.

Another example is cereals with added dried fruit, said Ms Chia. These are high in sugar content due to the natural sugars in the fruit. However, dried fruit provides fibre and vitamins, compared to cereal sweetened with simple sugars.

Ms Naidu said: "Knowing the difference between the two types can help you identify sources of sugar in the diet and reduce consumption for weight control."

Another thing to be aware of is that sugars are extracted in concentrated form. When this is added to other foods, it will cause them to have higher calories and sugars, which can lead to a higher risk of obesity, said Dr Lim.

This can, in turn, lead to a higher risk of getting diabetes and other chronic diseases, she added.

Dr Lim said that some people mistakenly believe that fructose is healthy, since it is derived from fruit. But studies have shown that fructose as an added sugar is more unhealthy than fructose as a natural sugar. "Sugar has detrimental effects once extracted from its natural sources and taken in large amounts."

The Health Promotion Board (HPB) does not require food manufacturers to use a similar labelling format as the FDA.

Singapore is a largely importing country and imposing requirements for a standardised labelling format would not be practical, said HPB chief executive officer Zee Yoong Kang.

Nutrition labelling in different countries varies. For example, the US requires nutrient labelling for each serving of food product, while the nutrition information panel in the European Union, Australia and New Zealand is per 100g.

Only the US requires "added sugars" to be disclosed on labels, with countries like Canada and Australia encouraging voluntary labelling, said Mr Zee.

"We are closely following the development of food-labelling measures in the global landscape. At the moment, about two-thirds of retail products here have some form of nutrition labelling," he said.

The HPB "would not rule out the possibility" of making nutrition labelling a requirement here in time to come.

Nutrition labelling can be a useful tool, especially as part of a wider effort to educate consumers on making informed food decisions, said Mr Zee.

The HPB recommends that people consume no more than 10 per cent of daily dietary energy from sugars, whether added or natural.

This is equivalent to about 10 teaspoons of sugar - about 50g.

On average, women need about 1,800 calories a day, while men need about 2,200 calories in order to stay healthy, depending on factors such as age, gender, weight and activity levels.

A version of this article appeared in the print edition of The Straits Times on July 19, 2016, with the headline 'Exposing hidden sugar in food'. Print Edition | Subscribe