The FDA must reduce added sweeteners in food and drink

US

The American diet is full of added sugars. We all expect to find a lot of added sugars in sweets like candy, soda, pastries, and ice cream. But you may be shocked to learn that so-called healthier items like yogurts, protein bars, and granola can also include a sugar overload.

All these added sugars can add up, leading us to eat far too much. The Dietary Guidelines for Americans, which gives advice on eating and drinking to promote health, recommends no more than 12 teaspoons of added sugar per day for a 2,000-calorie diet yet most consume about 17 teaspoons. That is why the Food and Drug Administration convened a first-of-its kind meeting on added sugars last month. And that is also why Mayor Adams recently signed The Sweet Truth Act, historic legislation that will require warnings on all menu items at chain restaurants that contain more than a day’s worth of added sugars.

The dangers of eating too many sugary foods and drinks are well-known and include increased risks of weight gaintype 2 diabetes, hypertension, stroke, heart disease, and tooth decay. In addition, when we eat foods that have a lot of added sugars and few nutrients, we may leave less room in our diets for nutrient-dense foods like fruits and vegetables, beans, nuts, and whole grains — foods that our bodies need to stay healthy.

In the United States, sugary drinks are the largest sources of added sugars. Sweetened bakery products like cakes and cookies, candy, sweetened ready-to-eat cereals, and other desserts are the next largest sources of added sugars. As a nation, we are making little progress on the U.S. Department of Health and Human Services Healthy People 2030 goal to reduce the mean percentage of calories from added sugars consumed. Currently, added sugars continue to contribute 13% of total daily calories based on national nutrition survey data from 2017-2020.

Because approximately 72% of daily added sugars come from foods and beverages purchased in stores, it is important that everyone has the information they need right as they make their shopping decisions. A good first step in this direction has already been completed. Since 2020, the FDA has required packaged food and drink companies to list added sugars on the Nutrition Facts label.

However, studies have found that few people regularly use the labels and there are big differences in label usage across different groups. A study of American adults found that only 40% of people use the Nutrition Facts labels always or most of the time. It also found that people with a college degree or higher and those from families with a higher income were more likely to regularly read the labels, highlighting a potential equity issue in relying on labeling to address overconsumption of added sugars.

In April, the Center for Science in the Public Interest and the New York City Department of Health and Mental Hygiene jointly petitioned the FDA to set gradual, voluntary targets to reduce added sugars in food and drinks over the next 10 years. This gradual reduction model is based on targets developed by the Health Department’s National Salt and Sugar Reduction Initiative, which, since 2018, has created voluntary targets for the 15 categories of packaged food and drink that provide the most added sugars to our diet.

Besides setting targets, the petition also asks the FDA to track industry progress in meeting added sugars reduction targets; release public reports about industry-wide progress; create a public online database of best-selling items by category where consumers could view and compare added sugar levels; and set added sugars reduction targets for restaurant foods. Foods and beverages consumed from restaurants account for 20% of the average daily added sugars intake for individuals 2 years and older.

What kind of impact could an FDA added sugars guidance have on the health of Americans? A modeling study evaluated what would happen if the New York sugar targets were met. It estimated that the initiative could prevent 2.48 million cardiovascular disease events like heart attacks or strokes, 490,000 deaths due to cardiovascular disease, 750,000 diabetes cases over a lifetime, and save $161 billion in costs.

There is no sugarcoating the truth. With added sugars in so many products, Americans cannot reduce their intake of added sugars alone. The FDA must take steps to lower the amount of added sugars in our food supply by pushing the food industry to reformulate their products. Only then will consumers be able to enjoy healthier choices that will protect them from devastating chronic diseases related to eating too much added sugar.

Vasan is the New York City health commissioner and Lurie is the president of the Center for Science in the Public Interest.

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