Review article – Sweet Symposium Webinar

By:  Dr Deborah Nolan-Clark and Dr Elizabeth Neale, Landmark Nutrition

The ‘Sweet Symposium: a spotlight on fructose and sugar-sweetened beverage trends,’ webinar provides a unique opportunity for nutrition professionals to learn about the evidence base surrounding fructose, sugar sweetened beverage intakes and consumer insights relating to nutrition messages. 

 

Health effects of fructose – Dr John Sievenpiper

The symposium commenced with an excellent presentation on the health effects of fructose from Dr John Sievenpiper, from the University of Toronto, Canada. Mindful of the recent public health interest in fructose Dr Sievenpiper opened the symposium highlighting the importance of considering the strength of evidence when examining and drawing conclusions about the health effects of fructose.  Though media hype tends to follow studies reporting ecological data, this data may be informative from a hypothesis generating perspective but should not be the basis for clinical practice recommendations. Data from the results of higher quality data, such as meta-analyses of randomised controlled trials (RCTs), indicate that fructose intake is not related to the risk of type 2 diabetes but may increase the risk of gout. 

Dr Sievenpiper also stressed the importance of controlling for energy intake in trial design in order to isolate the effects of nutrients. In RCTs whereby fructose was provided in an isocaloric substitution setting, no harmful effects of fructose intake were evident. In contrast, hypercaloric trials (whereby fructose is providing energy in excess of requirements) report adverse effects on body weight, serum lipids and liver function. Because these effects are consistent with those seen from an excess energy intake in general, it is difficult to draw conclusions about the effect of fructose as an isolated nutrient. 

Overall, Dr Sievenpiper’s presentation illustrates the need to consider the whole diet rather than a single nutrient to ensure the most successful interventions.  Given the attention that is often afforded to outspoken individuals presenting lower quality data relating to a single nutrient without consideration of the whole diet, nutrition professionals must improve their engagement with both the media and consumers to ensure that messages provided are based on the best available evidence. 

 

Beverage habits of consumers – Dr Gina Levy

In the next presentation Dr Gina Levy, reported 15-year sales data relating to water-based beverages and how beverage habits change according to life-stage and household structure. This data was as an objective alternative to self-reported dietary survey data (which may be subject to under-reporting or memory bias). This is an interesting approach and may be particularly informative to dietitians seeking to understand which demographic groups may particularly benefit from guidance relating to intakes of sugar sweetened beverages. It may also help inform demographic targets for communication strategies aiming to implement change in this area. 

Overall sales data suggests that intakes of sugar sweetened water based beverages are decreasing with a concomitant increase in non-sugar sweetened beverages (such as diet soft drinks or plain bottled water). This shift in behaviour may reflect the growing public awareness of obesity and the need to reduce overall energy intake. 

The finding that lower income households purchased the lowest volume share of carbonated soft drinks was surprising given that higher intakes of such beverages in individuals with a lower socio-economic status have been reported in the literature. Whether this finding is consistent with the soon to be released results from the Australian Health Survey (which includes self-reported dietary intake data) will be particularly interesting. 

 

Nutrition information sources of consumers – Dr Rebecca Huntley

The third presenter was Dr Rebecca Huntley, Executive Director of the Mind and Mood Report, highlighted that consumers are still confused about nutrition, with mixed messages relating to ‘good’ and ‘bad’ foods still prevalent in the media. As a result, Australian consumers struggle with knowing who to trust.  

Dr Huntley also presented quantitative data from the Food-Health Report, a longitudinal study involving 3000 Australians. Whilst, a large proportion of study participants reported that health care professionals were their most trusted source of nutrition information, food labels and packaging were the most frequently used source of this information. These findings highlight the need for nutrition professionals to engage with the food industry to ensure that health messages on food labels and packaging represent the best available evidence. Such collaboration may increase the consistency of nutrition messages communicated by both packaging and health professionals and inspire greater consumer confidence as a result. 

 

Summary

The symposium was concluded with a panel discussion involving key nutrition experts. The need to reorient nutrition education from negative messages focussed on avoiding nutrients or food components to those relating to positive foods and dietary patterns which can be enjoyed was discussed. 

Overall, the symposium provided insights of relevance to nutrition professionals in relation to fructose and water-based beverage consumption. More broadly, it demonstrated the importance of using high quality data to draw conclusions about food health relationships and the need to consider whole dietary patterns and positive nutrition messages to most effectively engage consumers.  

 

Disclosure

At the time of this review, Deborah and Elizabeth do not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and have no relevant affiliations.