Issue 4 / 10 February 2014

RESEARCH showing high consumption of added sugar more than doubles the risk of cardiovascular mortality has prompted Australian experts to renew calls for labelling reform to help curb sugar consumption.

Leading nutritionist Dr Rosemary Stanton said labelling reform was needed to compel food manufacturers to disclose the percentage of added-sugar in their products, rather than just list total sugars.

“The body of research basically shows that it’s only added sugar that’s the problem … but the food industry has resisted putting added sugar on the label”, Dr Stanton said. “We need something to alert people to how much they are actually consuming, because I don’t think they really know.”

Dr Stanton was commenting after US researchers found that adults who consumed 17%–21% of daily calories from added sugars had a 38% higher risk of cardiovascular disease (CVD) mortality, compared with those whose diet comprised 8% of calories from added sugars. (1)

The prospective cohort study of more than 31 000 people, published in JAMA Internal Medicine, also found that the risk of CVD mortality was more than double for those whose daily calorie intake was more than 21% from added sugar compared with those with less than 8% from added sugar.

An accompanying editorial said the study underscored “the appropriateness of evidence-based sugar regulations, specifically SSBs [sugar-sweetened beverages] taxation”. (2)

Dr Stanton said while in Australia the goods and services tax was applied to junk foods, this was not sufficient to moderate consumption of these foods.

“So many of the sugary foods are very cheap — you can buy a packet of six doughnuts for much less than you pay to buy six apples, for example. So we do need more taxes on these foods … if we could also have subsidies on things like fruit and vegetables”, Dr Stanton told MJA InSight.

She said fresh food subsidies were important to soften the blow for lower socioeconomic groups, pointing to Australian research published last week that found that the most disadvantaged groups in the Greater Western Sydney region experienced the greatest inequality in affordability of a healthy and sustainable diet. (3)

Professor Peter Clifton, professor of nutrition at the University of SA, agreed that a tax on SSBs might reduce consumption, but a labelling initiative alerting consumers to the health risks of these products may be more effective.

“No one needs to drink SSBs at all, so I don’t have any problem with the concept of taxation”, he said.

“This government is certainly not going to do anything in terms of legislation or control, but I think maybe labelling, like cigarette labelling, might have an effect on people’s behaviour more than the cost. Putting a label on [soft drinks] saying that ‘excessive sugar has been associated with heart disease and type 2 diabetes’ — that will surprise a few people.”

However, Professor Clifton was less concerned about singling out the added sugar content in labelling.

“I don’t think there is a difference in a sense between total sugar and added sugar and most of the sugar that we consume is going to be added sugar, unless we’re big fruit consumers, which we’re generally not.”

Professor Clifton said there had already been a change of behaviour in relation to SSBs. “There has already been … a significant reduction in sugar intake from this source by about 25% over the past 14 years — one in three soft drinks are now sugar-free.”

He said the US finding that a higher percentage intake of added sugar significantly increased the risk of CVD mortality meant some dietary guidelines would need to be revised.

“Most dietary guidelines say not to have more than 20% of your energy from sugar, so there will need to be some revision of some guidelines to lower them”, he said.

Dr Stanton said the 2013 Australian Dietary Guidelines, which she was involved in drafting, strengthened the wording around sugar consumption advising consumers to “limit intake of foods and drinks containing added sugars”. (4)

However, she said this latest data built the case to strengthen the wording even further. “With the majority of adults now overweight, I certainly think the stronger wording of 'limit' was justified and I would support something along the lines of ‘avoid sugar-sweetened drinks and limit intake of all foods with added sugar’.”

The federal Health Minister Peter Dutton was approached for comment, but was unavailable.


1. JAMA Int Med 2014; Online 3 February
2. JAMA Int Med 2014; Online 3 February
3. ANZ J Pub Health 2014; 38: 7-12
4. NHMRC 2013; Australian Dietary Guidelines

5 thoughts on “Health cost of spoonfuls of sugar

  1. Sue Ieraci says:

    ”Anonymous” – no form of sugar is ”toxic” – it is the excess of consumption that can be harmful – particularly where it leads to obesity and insulin resistence. There is also no good evidence that artifical sweeteners are harmful – they can be used sensibly if one wants a sweetened coffee, for example. There IS a real disadvantage to the consumption of large amounts of artifically-sweetened drinks, though, in that one becomes sweetness-habituated, which can lead to poor dietary choices. There are so many popular myths, fads and misconceptions in the area of food and diet at the moment – Rosemary Stanton has the patience of a saint to keep adding rational input in the face of so much abuse of her profession.

  2. Rosemary Stanton says:

    High fructose corn syrup is not used in Australia.

  3. Keith Bower says:

    If only the sugar mentioned in food labeling was from cane sugar!  ‘Sugar’ is now often the insideous result of the use of High Fructose Corn Syrup, which is the heart attack, cancer and other diseases killer of the future (and probably now).  HFCS is toxic and is usually from genetically modified sources. Also, banning the use of Aspartame and similar products would ensure greater safety for people who rely on it for ‘sweetening’ soft drinks and other ‘foods’, by restricting the toxins related to it from entering the body.  These toxic sweeteners are the real killers as their ‘sugar’ rating is much higher than the humble (and much maligned) cane sugar.  You could also take a good look at margarines and hydrogenated fats as probably reasons for many people’s ill health.


  4. Clare Harris says:

    If people stopped buying (and therefore consuming) processed frankenfoods, the entire problem would be eliminated. Sounds too hard for some I know, but a drastic elimination of premade foods, canned, packaged, frozen etc, and a replcement with fresh foods, home cooked would substantially reduce the amount of unnecessary added chemicals we take into our bodies. Ultmately we are responsible for what we eat…………


  5. Rosemary Stanton says:

    After two years of deliberations and eventual agreement, food industry, government and public health and consumer representatives developed a Health Star Rating system to appear prominently on the front of food labels. The Star Rating was based on a value derived from the content of sugars, salt and saturated fat in the product with some positive points being taken into account in the rating. Sugars, saturated fat, sodium and the food’s kilojoule content were also to be displayed on the fornt of the pack for easy reference.

    Health ministers approved the final package in December 2013. On Wednesday Feb 5, a stand-alone website appeared and public health and consumer groups applauded. By next morning, the website had been taken down. Who ordered this and why?

    The Australian Food and Grocery Council has been stating its lack of favour for the scheme even though their representatives had been part of the process that had eventually achieved agreement. 

    It’s increasingly difficult when we can’t make life a bit easier for shoppers to make healthier choices that fit with current research.


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