Dental caries and overweight and obesity in Australia and New Zealand 13
Policy initiatives in relation to sugars in Australia and New Zealand 14
Sugar labelling in Australia and New Zealand 16
Current labelling requirements in relation to sugar 16
Other labelling initiatives in Australia and New Zealand 18
Sugar labelling internationally 20
United States 20
Consumer research 22
Sugar taxes 23
Analysis of sugar policy context in Australia and New Zealand 23
Australia and New Zealand preventive health initiatives relating to sugar 25
Non-Government activities and initiatives focussing on sugar 31
Taxes on sugar or sugar-sweetened beverages 36
Petitions and campaigns for taxes on sugar/sugar-sweetened beverages in Australia and New Zealand 39
Sugarcane industry in Australia 41
Excess sugar consumption has been identified as an area of concern in Australia and New Zealand. The Australia New Zealand Ministerial Forum on Food Regulation has agreed to a program of work to investigate labelling approaches to providing information on sugars.
As part of this program of work, the Australian Government Department of Health prepared an updated policy context paper to provide Ministers with a summary of current issues and policies relating to sugars in Australia and New Zealand.
Sugar is a type of carbohydrate that occurs naturally in foods such as milk and fruit and can also be added to foods and drinks by the manufacturer or the consumer. Sugars are not only added to a product to provide sweetness, they can also be added for functional reasons. Sugars added to a food or drink by the consumer or manufacturer are commonly referred to as ‘added sugars’. Added sugars are not chemically different to sugars naturally occurring in foods such as fruit and milk, which makes it difficult to distinguish between added and naturally occurring sugars using analytical methods.
There is no universally accepted definition for ‘added sugar’. Both the Australian and New Zealand dietary guidelines recommend limiting consumption of added sugars, however, neither guideline provides a clear definition of what are added sugars.
Foods and beverages that are high in added sugars tend to be lower in micronutrients (vitamins and minerals) compared to whole or less processed foods, and can displace more nutritious foods and beverages in the diet. There is good evidence to suggest that dietary sugars may lead to overconsumption of energy, hence, contribution to overweight and obesity; however more evidence is needed to determine whether added sugar per se has a negative impact on health.
Some international agencies have developed guidelines for sugar intake:
The World Health Organization (WHO) recommendation that ‘free sugars1’ should account for less than 10% of total energy intake (approx. 50 grams/12 teaspoons) for the prevention of unhealthy weight gain and dental caries.
In 2015, the UK Scientific Advisory Committee on Nutrition (SACN) advised that the UK population’s intake of ‘free sugars’ should be less than 5% of total energy intake.
The 2015-2020 Dietary Guidelines for Americans recommend a limit for added sugar intake of less than 10% of total energy for adults and children
Researchers in Australia and New Zealand have recently analysed sugar consumption:
Over half of consumers in Australians (52%) and New Zealand adults (58%) are exceeding the WHO recommended intakes, with adolescents and young adults recording the highest sugar consumption.
The majority (81%) of free sugars consumed in Australia came from energy-dense, nutrient-poor ‘discretionary’ foods and beverages.
Sugar sweetened beverages are the major source of free sugars in Australian diets and beverages were the major source of total sugar in New Zealand children’s diets.
Australians consuming sugar sweetened beverages dropped from 43% in 1995 to 34% in 2011-12 and small non-significant reductions in sweetened beverage consumption were also observed in New Zealand adults between 1997 and 2008/09.
Conditions associated with sugar consumption
Consuming too much free/added sugar is associated with dental caries and weight gain, which in turn increases the risk of non-communicable diseases (NCDs) such as heart disease, type 2 diabetes, stroke and some cancers.
For Australians aged 18 years and over, the prevalence of overweight and obesity increased in Australia from 56.3% in 1995 to 63.4% (11.2 million people) in 2014-15. For children aged 5-17 years, the proportion who were overweight or obese increased from 20.9% in 1995 to 25.7% in 2011-12 and then remained stable to 2014-15 (27.4%).
In Australia, during the 30 year period 1989-2007, 46% of children under the age of 6 had already experienced caries.
In New Zealand, obesity rates for adults are increasing, with more than three in ten adults (32%) obese in 2015/2016, up from 27% in 2006/07. However, obesity rates in children have been stable since 2011/12 with (11%) classified as obese.
In New Zealand, despite improvements in oral health over time, dental caries remain the most prevalent chronic (and irreversible) disease
Policy initiatives in relation to sugars in Australia and New Zealand
A range of healthy eating policies, campaigns, and initiatives relating to sugar are being implemented in Australia and New Zealand.
Government activities at the national and jurisdictional level are wide ranging but many focus on reducing the consumption of sugar sweetened beverages. Examples include restricting high sugar foods (and sugary drinks) in school canteens and health care settings, plus health promotion messages through social marketing.
Non-government initiatives focus on raising consumer awareness of the added sugar content of foods and drinks, particularly sugary drinks, plus advocating for changes to food labels to allow consumers to more easily identify foods high in added sugars. There are some strong messages coming from individual anti-sugar advocates which may conflict with some of the evidence-base for sugar and confuse consumers.
Food industry initiatives focus on providing information to consumers about the sugar content of foods, and reformulating products to reduce sugar content.
Sugar Labelling in Australia and New Zealand
The Overarching Strategic Statement for the Food Regulatory System recognises that food labelling policy is complex, and to support decision making in the area of food labelling, the aims of the food regulatory system have been translated into the following risk-based issues hierarchy:
Preventive health issues include the indirect, long term impacts on health and particularly include chronic disease and overweight and obesity. Providing information on the label to assist consumers to understand the sugar content of foods and beverages may support consumers to make food choices that support prevention of obesity and chronic diseases.
Labelling of sugars on packaged food products is regulated in the Australia and New Zealand Food Standards Code (the Code):
In most cases, it is mandatory to declare sugar content per serve and per 100g (of total sugars) in a Nutrition Information Panel (NIP) and declare sugars in the statement of ingredients (in descending order of weight).
Some stakeholders consider that the NIP should distinguish between naturally occurring and added sugars to help consumers to identify foods high in added sugars. Consumer advocates also claim that the current requirements for the statement of ingredients may be misleading as added sugars may appear in the ingredients list under at least 40 different names, which can make it difficult for consumers to identify foods containing added sugars.
The Code also regulates optional aspects of sugar labelling: Percentage Daily Intake and Nutrition Content Claims (such as ‘no added sugar’, ’low sugar’ or ‘% sugar free’).
Other labelling initiatives relating to sugar that are outside of the Code include the Health Star Rating (HSR)System and Daily Intake Guide (DIG).:
The HSR algorithm is based on the balance of multiple nutrients, including sugars; it uses the total sugar content of a food, rather than added sugars. The HSR permits an optional nutrient icon where information about the energy content of a product, as well as the levels of saturated fat, sodium, and total sugars are displayed.
The scheme uses ‘thumbnails’ on the front of the package to display the amount and %DI for energy, fat, saturated fat, sugars and sodium per serve, using a serving size set by the manufacturer.
Sugar labelling internationally
Various sugar labelling options have been adopted internationally.
The United States is the only country to include added sugar in their labelling scheme. Justification for this was based on supporting consumers to identify foods containing added sugar and the need for consumers to have a consistent basis on which to compare products.
Canada initially considered labelling added sugar, however following a consultation period, it decided to focus its labelling on total sugars to avoid misconceptions added sugars are nutritionally different from naturally occurring sugars, and enforcement challenges due to the lack of a current analytical method able to distinguish between sugars and total sugars.
FSANZ has examined the available literature on consumer knowledge, attitudes and behaviours relating to sugars in foods as presented on food labelling:
Consumers report being interested in sugar.
Consumers have trouble classifying sugars as ‘natural’ or ‘added’ and perceive that ‘natural’ sugars are healthier than added sugars.
International studies indicate labelling the amount of added sugars, in additional to total sugars, may confuse consumers and cause them to overestimate the total sugar content of a product. While the layout and wording of the label can reduce the proportion of consumers who make this error, further research would be needed to determine whether this error rate could be reduced further.
Consumers in Australia and New Zealand are generally able to identify which of two products is the lower in sugar from the mandated information on food labels for sugar information. However, consumers’ motivation to reduce sugar in the diet influenced whether they would actually use the label information.
However, international research reports that when examining a single product, consumers had difficulty in determining whether a single product was high or low in sugars.
Additional contextual information on the label, such as %Daily Intake, may offer consumers further assistance in understanding food labels and making decisions about purchasing and/or consuming particular products.