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PRINT EDITION
The 100-gram solution
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Should Health Canada be recommending a limit on our daily consumption of all sugars or singling out the ones processors add? Kathryn Blaze Carlson explores the contentious issue
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By KATHRYN BLAZE CARLSON
  
  

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Saturday, August 9, 2014 – Page F4

OTTAWA -- One researcher calls it "kooky." Another says it will make Canada a "laughing stock."

After years of remaining largely silent on the controversial carbohydrate, Ottawa has announced plans to arm Canadians with a guideline on daily sugar consumption. But some experts hesitate to applaud the recent move by Health Minister Rona Ambrose and her department, saying it's based on faulty logic and doesn't go nearly far enough.

Unlike many countries and leading health organizations, Canada has never set a daily value for sugar - despite increasing evidence linking it to myriad health problems such as heart disease, diabetes and obesity, and despite studies showing the latter alone costs the economy $4.6-billion to $7.1-billion annually.

Successive governments, Liberal and Conservative alike, didn't act until last month when Ms. Ambrose proposed a daily maximum intake: 100 grams total, whether the sugar occurs naturally or has been added by a manufacturer.

By choosing not to make the distinction, the minister has raised the hackles of those who argue that added sugar is the chief culprit.

'Sugar is sugar'

The debate on sugar has been raging for decades. Some experts today see it as the new tobacco while others argue it's unfairly getting a bad rap. Even among those who agree high sugar consumption is linked to health problems, there's disagreement over whether to target the sweet stuff in all its forms or just limit added sugars, leaving naturally occurring ones alone.

Still, others in the developed world, including Australia and the European Union, years ago established daily intakes for sugar. So why has Ottawa taken so long to do the same?

Health ministers in Liberal cabinets of the past say they don't recall the issue of a daily guideline crossing their desks, while spokespeople for Ms. Ambrose's Conservative predecessors, Tony Clement and Leona Aglukkaq, didn't directly address the Globe's questions, or referred the newspaper to the incumbent's office.

Health Canada explains the timing of the announcement this way: The science around sugar has evolved, Canadians say they want a daily value, and the department is currently revamping decade-old regulations governing all food labelling so the opportunity arose.

But those who have been watching closely also know sugar was dealt several blows ahead of Ms. Ambrose's July 14 press conference.

Five months earlier, the Journal of the American Medical Association reported that people who get 25 per cent or more of their daily calories from added sugar are three times more likely to die of heart disease. A chorus of prominent health organizations soon urged Ottawa to set guidelines.

Then in March, the World Health Organization (WHO) released a draft recommendation that people limit their consumption of so-called free sugars - a category that includes added sugars as well as honey, syrup, fruit juices and fruit concentrates - to between 5 and 10 per cent of their daily calories. That amounts to roughly 25 to 50 grams based on a 2,000-calorie diet.

Ms. Ambrose told The Globe in an interview she was "very struck" by the WHO proposal and asked her department what Canada currently recommends.

Upon learning there was no daily figure, she tasked a team of about 15 scientists with developing one. After some debate, they landed on 100 grams.

"People have to reduce their consumption of sugar overall, period," she says.

"That's why we're treating sugar as sugar, whether it's from an apple or it's from a yogurt or it's from a cookie."

What Ottawa won't do, at least not as of right now, is set a specific figure for added or free sugar, as the WHO and American Heart Foundation have done and the Heart and Stroke Foundation of Canada hints it will do later this year.

"I have a lot of respect for Health Canada, and they've been leaders in many areas," says Dr. Joanne Lupton, a member of the U.S. Institute of Medicine who chaired the committee that established the institute's most recent upper limit for added sugar. "But I just find this to be an outlier position."

Ms. Ambrose says, when she asked the Health Canada team for its rationale, "they said, 'The truth is, sugar is sugar.' "Obesity researcher Yoni Freedhoff calls such a conclusion "kooky" in the context of diet.

"There's a lot more to a banana than its sugar, but there's nothing more to CocaCola than its sugar," says Prof. Freedhoff, who teaches medicine at the University of Ottawa.

Ms. Ambrose, to be clear, says she hopes Canadians will stay away from added sugars - and the labelling changes will make it easier to understand how much of it there is in a product and if sugar is the leading ingredient.

Health Canada essentially says it believes the link between sugar and health problems is indirect. Too much can lead to high caloric intake, which can lead to obesity, which can lead to chronic diseases such as diabetes, heart disease and certain forms of cancer. However, it says there isn't enough evidence to warrant a figure for added sugar specifically.

And why choose 100 grams total? The department cites several reasons: It's easy to understand, it's achievable but still encourages change (Canadians now consume 110 grams on average, with some taking in far more), and an addedsugar guideline wouldn't capture sugarpacked juice because it's considered naturally occurring. Plus, Australia, New Zealand and the European Union also chose to set total values, at 90 grams.

This logic isn't apparent to everyone.

On Feb. 19, Ms. Ambrose visited the Spruce Grove, Alta., home of one of her constituents, Ceone Fournier, a mother of three who was playing host to the minister's discussion with a group of mothers on how food labels can be improved.

Five months later, when consumer consultations had closed and the sugar guideline was announced alongside a slew of proposed label changes, Ms. Fournier was left with some questions.

She welcomes the changes but wonders why other health agencies are comfortable establishing added-sugar values and Health Canada isn't. She says it seems like a matter of common sense: "If I eat eight apples versus 10 teaspoons of sugar, they're not the same thing, so why would we call them the same thing in the recommendation?" The move also apparently caught food and beverage stakeholders by surprise, since industry hadn't been consulted and the U.S. hadn't included a sugar guideline in its own labelling announcement in February.

Health Canada says its proposed label strategy, when it comes to sugar, is basically three-pronged: give Canadians a total guideline and require companies to show the per cent daily value for sugar on labels (the latter is believed to be unique to Canada); require that companies display how much added sugar is in a product; and require companies to group together different forms of sugar in the ingredient list so consumers can see how prominently it figures in a recipe.

In addition, Health Canada is proposing serving-size guidelines to make comparing products easier, and wants labels to carry a footnote explaining that 5 per cent of a daily value is a little and 15 per cent is a lot.

The Heart and Stroke Foundation calls the daily value proposal a "step in the right direction" but says it will propose "improvements."

"We think [the value] should be lower for total, but really the more important point is to have a threshold on the added sugar or free sugar, as the WHO has done," says Manuel Arango, the foundation's director of health policy.

Marion Nestle, a New York University nutrition professor and author of Food Politics: How the Food Industry Influences Nutrition and Health, has harsher words, saying that, if Canada sticks with the 100gram total, it will be a "laughing stock" as "nobody cares about the sugar in fruit."

Will it hurt sales?

It was no secret to the food and beverage industry that Health Canada was planning to revamp nutrition labels. Regulatory changes can have short- and long-term impacts on industry, so some companies and associations were registered to lobby the government on label modernization.

The industry isn't relieved that Health Canada has opted for total rather than added sugar - for the simple reason that it wasn't expecting the labelling announcement to include a daily value at all.

However, it's easy to see why the former may be easier for some producers to swallow. Under the current proposal, the label on a soft drink would say a can contains about 40 per cent of a person's daily sugar intake. If the guideline instead specified 50 grams of added sugar, the figure would be more like 80 per cent of the daily quota because so much of a soft drink's sugar is added.

John Cranfield, a food and agriculture economist at the University of Guelph, says industry is likely concerned with two issues: the cost of revamping labels and, more important, sales.

"If you're a parent, for instance, you might rethink buying a beverage for your kid because you look at the label and realize how much sugar is in it," he says, adding that healthier products could see a correlating uptick in sales.

Health Canada is now in the midst of its second consultation phase, and will hear from industry representatives such as the Canadian Beverage Association and Food and Consumer Products of Canada. The latter says it wants to "ensure the proposed changes are based on the most reliable science and strongest evidence, and that it's helpful to Canadians in their efforts to make the nutrition choices that are right for them."

Ms. Ambrose, a stepmother who says she herself is frustrated by current labels, contends that the information is there for the shopper, not for industry. "The way we approached it - the way I approached it," she says, "is from a parent's point of view."

Health Canada, meanwhile, won't predict when the new labels will hit grocery stores. The second consultation phase ends Sept. 11, and before drafting final regulations, it has to review all the feedback it has received.

Kathryn Blaze Carlson is a member of The Globe and Mail's parliamentary bureau.

Associated Graphic

Top: Ceone Fournier and her children Owen, 11, Maisy, 6, and Claire, 9, have a snack in their home in Spruce Grove, Alta. Above: Some of their options. Ms. Fournier played host to a discussion of food labelling with Health Minister Rona Ambrose, but now has questions.

AMBER BRACKEN FOR THE GLOBE AND MAIL


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