BEVERAGES. Risks and opportunities: the science. Sigrid Gibson. Director, Sig- Nurture Ltd. Nutrition Consultants

Transcription

1 BEVERAGES Risks and opportunities: the science Sigrid Gibson Director, Sig- Nurture Ltd. Nutrition Consultants

2 OTHER ingredients BEVERAGES HEALTHY OR UNHEALTHY? SUGAR(S) & OBESITY JUICES AND 5- A- DAY DIET QUALITY

3 Fact or myth? Only water hydrates you Soft drinks are the major source of sugar in the diet Soft drinks cause obesity and diabetes Low calorie beverages make you crave sweet foods Free sugars are worse than other sugars for tooth decay Fruit juice discourages fruit intake

4 Hydration: Are we getting enough liquid? EFSA adequate intake 2L for women 2.5L for men Median UK intakes are 2-2.5L US Reference intake is 3.2/ 3.7L

5 Hydration: Are we getting enough liquid? We don t really know!- some people are under- hydrated, some of the time elderly people heavy labourers workers with limited access to loos Thirst is our regulator of dehydration but not overconsumption

6 All beverages hydrate some better than water 2 SD above mean for water control Ronald J Maughan et al. Am J Clin Nutr 2016;;103: by American Society for Nutrition

7 Amount and types of beverages consumed according to day of the week (mean g/d). Gibson, S., & Shirreffs, S. M. (2013). Beverage consumption habits 24/7 among British adults: association with total water intake and energy intake. Nutrition Journal, 12,

8 OTHER ingredients BEVERAGES HEALTHY OR UNHEALTHY? SUGAR(S) & OBESITY JUICES AND 5- A- DAY DIET QUALITY

9

10 Sugar Reduction The evidence for action 1. In adults, when consuming an unrestricted daily diet, increasing the percentage of total energy from sugar leads to increases in energy intake 2. Higher consumption of sugar and sugar containing foods and drinks is associated with a greater risk of dental caries 3. Consumption of sugar sweetened drinks, compared to non- sugar sweetened drinks, results in greater weight gain and increases in body mass index in children and adolescents due to increased energy consumption 4. Greater consumption of sugar sweetened drinks is associated with increased risk of type 2 diabetes

11 Most up to date systematic review and meta- analysis Confirms lower body weight when Low calorie/energy sweeteners replaced sugar in foods and beverages Low energy beverage studies also showed reduced BW

12 Body weight reduction when consuming Low calorie beverages vs. Sugar- sweetened beverages (Rogers et al. 2015)

13 Headline versus Study. New York Daily News - Diet soda is a gateway drug. Drinkers of the no- calorie beverages are more likely to gorge on sugary, salty and fatty treats like cookies, French fries and pastries than people who drink regular soda, says a new study from the University of Illinois.

14 Beverage consumption in relation to discretionary food intake and diet quality among US adults 2003 to 2012 Ruopeng, An 2015 JADA Discretionary foods Diet beverages consumers ate 69 kcals more, of which 49 kcal was DF SSB consumers ate 226kcal more of which 30kcal was DF Coffee drinkers ate 108kcal more of which 60kcal was DF NO CHANGE IN HEALTHY EATING SCORE WITH DIET BEVERAGES

15 OTHER ingredients BEVERAGES HEALTHY OR UNHEALTHY? SUGAR(S) & OBESITY JUICES AND 5- A- DAY DIET QUALITY

16 Consumption of low calorie beverages is associated with energy and nutrient intakes and diet quality Gibson, Horgan et al. (2016, Nutrients) Recent UK data (NDNS ) Detailed 4- day dietary records 1590 adolescents (16+) and adults Classified into one of four groups DRINK SUGAR SWEETENED BEVERAGES? NO YES DRINK LOW CALORIE BEVERAGES? NO YES NO YES No soft drinks (NC) LCB only SSB only No soft drinks SSB LCB Both Both LCB and SSB (BB)

17 Results Energy intake P< LCB and NC had significantly lower energy intakes than SSB and BB (difference of ~ 250kcal) Free sugars* (NMES) significantly lower in LCB and NC vs. SSB & BB (9% vs. 14% of energy from NMES) P< Gibson et al. (2016, Nutrients)

18 Compared with SSB consumers, adults drinking Low calorie beverages ate more fruit and vegetables and fish, and no more sugary foods Beverage group mean consumption (g/d) no soft drinks (NC) LCB only SSB only Both (BB) Total beverages Meat And Meat Products Fish Fruit Vegetables Sugary foods (total) (Gibson et al, Nutrients, 2016)

19 CHOICE trial Does LCB intake affect dietary consumption patterns? Overweight adults substituted caloric beverages with either water or LCB for 6months Both intervention groups showed beneficial changes in energy intakes and dietary patterns. Consuming LCBs, compared with water, did not increase preferences for sweet foods and beverages Piernas, Tate et al. 2013

20 OTHER ingredients BEVERAGES HEALTHY OR UNHEALTHY? SUGAR(S) & OBESITY JUICES AND 5- A- DAY DIET QUALITY

21 Fruit Juice Crowe- White et al Crit Rev Food Sci Nutr Impact of 100% Fruit Juice Consumption on Diet and Weight Status of Children: An Evidence- based Review 22 studies Evidence did not support an association between 100% FJ consumption and weight/adiposity Children consuming 100% FJ have higher intake and adequacy of dietary fiber, vitamin C, magnesium, and potassium(8 studies)

22 Fruit Juice and 5 a DAY in UK 42% consumed FJ during the survey. Average intake was 58g/d (139g/d among consumers) But 35% of consumers drank more than 150ml/day. Consumers had higher energy and sugar intakes (13.6 vs. 11.1) than non-consumers. Intakes of potassium, folate, and vitamin C were significantly higher among FJ consumers for whom FJ provided more than 10% of folate and potassium and half their vitamin C. Gibson et al., in preparation

23 61% of teenagers and 34% of adults consume less than 3 portions of fruit and vegetables a day How to help these? Data extracted from NDNS Gibson et al., unpublished

24 Fruit juice contributes to fruit and vegetable consumption Gibson & Ruxton, unpublished

25 FJ consumers are less at risk of missing F&V targets Teenagers P<0.001 (Chi- Square) More likely to achieve 5 a day Less likely to have <3 a day

26 FJ consumers are less at risk of missing F&V targets P<0.001 (Chi- Square) More likely to achieve 5 a day Less likely to have <3 a day

27 Industry response to sugar targets Reformulation New product launches Gradual reduction in some brands Pack size changes (250ml) Promotion Focus on low/no sugar Price incentives Work with cinemas & fast food chains Cals 7% Labelling: FOP energy and sugars

28 OTHER ingredients BEVERAGES HEALTHY OR UNHEALTHY? SUGAR(S) & OBESITY JUICES AND 5- A- DAY DIET QUALITY

29 Other risks/opportunities

30 Caffeine EFSA opinion (2015) mg per day is considered safe for adults (200mg for pregnant/lactating women). Not enough evidence for a safe limit in children and adolescents. 200mg = approx. 2 cups of coffee (huge variation according to type) or 6 cans of Cola or 4 cans of diet cola or 4 cups of tea. Energy drinks can contain around 80 mg in 250ml. 12 th April EFSA approved 4 health claims for caffeine: endurance performance, endurance capacity, alertness, concentration

31 How much caffeine is in your drinks?

32 Unauthorised health claims? Helps with weight loss Super charges your immune system Increases energy and endurance Enhances mood and memory Stimulates metabolism Naturally detoxfies

33 OTHER ingredients Caffeine within limits Sweeteners all approved JUICES AND 5- A- DAY Small amounts OK BEVERAGES HEALTHY OR UNHEALTHY? SSB if overconsumed might encourage excess ENERGY intake and OBESITY Low calorie alternatives help manage intake DIET QUALITY Depends on beverage and food choice We all need to drink...