Healthy Food & Healthy Living by Dr. Ayala

Sugars added to 68% of packaged foods – here's what can be done about it

This is the season for sweet surprises, special treats and indulgent bliss.

But the amounts of added sugar year-round, on ordinary days is staggering. Most of this added sugar is in processed foods, as food makers have learned long ago that to increase sales, just add sugar. Or high fructose corn syrup, or fruit juice concentrate, or any of the other sneaky forms of caloric sweeteners that practically act in the same way in our body.

We’ve come to understand, over the last few decades, that caloric sweeteners not only add to overall caloric intake – leading to overweight and obesity – but also have direct effects on the risk of diabetes, heart disease and other metabolic adverse outcomes.

In a new paper in the Lancet Diabetes & Endocrinology Barry Popkins and Corinna Hawkes review the current global trends in sugar intake –- especially sugary drink intake.

Here are some interesting findings:

• 68 percent of packaged foods and beverages contain added sugars

This finding comes from analyzing a representative sample of American households, looking at what they buy, and then examining the nutritional profile of these products.

• Governments around the world are looking to reduce sugar in the diet

The authors look at tactics and policies undertaken by countries, which include:

Taxation:

5 countries in Latin America and Europe are trying this: Chile, Mexico, Finland, Hungary and France. There are a few small islands (such as Samoa and Mauritius), and a city (Berkeley CA) that also passed a tax. Those taxes are rather small, well below the 20 percent recommended by scholars.

Outcomes have been positive in Hungary, France and Mexico.

A recent article in the Economist assesses that “taxes on fizzy drinks seem to work as intended” – namely, they increase the price of sugary products to consumers, and curb the sugary slurp.

Awareness campaigns, restricted availability and marketing: 

Governments have been setting standards for what should be served and sold in schools, trying to reduce exposure to soda ads and enacting public campaigns such as NYC’s Pouring on the Pounds. Getting the message out relies on sustained and continuous efforts, on multiple channels.

Labeling: 

A food label that clearly states how much sugar is in a product might affect both consumers, who want to eat less added sugar, and food makers, who’d like to declare a healthier product. Ecuador started a traffic light label, which displays sugar, fat and salt levels with red, orange and green lights. It seems to work. The UK had a similar, voluntary, traffic light label, which was revised in 2013 by the government. Chile requires a warning label on foods high in added sugar, salt and saturated fat. The authors say that the effects of these labels on what people buy and eat are not fully evaluated, but can change both habits and formulation. 

Here in the US, it’s still hard to know how much sugar is added to a product.

Naturally occurring sugar, such as what’s in fruits and vegetables, and added sugar, such as HFCS, are lumped together as “total sugar”, despite the big difference between how those behave in our body. The FDA wants to make it easier, and has proposed a label makeover that will require listing the amount of added sugar on the nutrition panel, and also, to put it in perspective, by calculating how much of the daily value this added sugar represents. Up until now, upper limits for sugar were not listed on labels at all. Since added sugar should not exceed 10 percent of total calories, a 20-ounce of soda will have to admit it supplies well over the entire daily sugar allowance.

The proposed label changes were up for public comment until the end of October, and the final decision will be out soon. If it passes, already motivated people will have a chance at making better-informed sugar choices.

Dr. Ayala

Anti-aging with cocoa?

The good news keeps on coming. After a large study found that coffee can save your life (well, not really, but coffee drinkers had lower mortality rates), a new study suggests cocoa can make your skin supple and radiant during that long, happy life, brought to you by 3-5 coffee cups a-day.

Cocoa is very rich in antioxidants -- flavonoids and flavonols in particular. Our skin suffers ultraviolet damage from exposure to the elements, leading to photo aging, and antioxidants can potentially mitigate those effects.

This is what researchers were testing in a neat new study, reported in the American Journal of Clinical Nutrition, in which 64 women consumed chocolate drinks for 24 weeks. Half of them had drinks with 4 grams of real cocoa powder, a powder produced so that it preserves the naturally occurring flavonols (each drink had 320 mg cocoa flavonols). The other half drank a nutrient and taste-matched cocoa-flavored beverage with no flavonols. The participants and the researches were unaware of which group they were in (a double blind, randomized placebo controlled study, which is the gold standard of studies).

After 24 weeks, the women treated with cocoa showed improvement of wrinkles in the crow-feet area, and their skin was more elastic – these results were objectively and elaborately measured and are not personal impressions. These improvements didn’t appear immediately, but rather 12 weeks into the experiment.

A good-for-you pleasure?

Over the years, cocoa, used in traditional folk medicine, has demonstrated quite a few health benefits, and has been shown to lower blood pressure and cholesterol, and aid in insulin resistance.

And a series of recent studies have hinted that not only will you look young, cocoa can also help keep your mind supple. A study published in Nature Neuroscience, showed that healthy 50 to 69 year-olds who drank a mixture rich in cocoa’s flavonols for three months improved their cognitive function. In another new study researchers gave 90 elderly people who were cognitively intact one of 3 cocoa drinks: high, medium or low in flavonol. The groups that drank the intermediate and high flavonol drinks showed improved cognitive performance and improvement in some mental tasks. A similar study with older people that already suffered mild cognitive impairment showed that high cocoa flavonol drinks improved verbal fluency and speed of mental processing.

Before you start a chocolate binge

As a chocolate lover I really enjoy these studies, but before we see this as permission to eat chocolate in all its delicious incarnations let’s be honest: Most of the chocolate in the market is mostly sugar. Cocoa flavonol content isn’t listed in the nutrition label, and many chocolate foods have very little of it. So if you love chocolate, here's your excuse to enjoy it; if you’re not into it, there isn’t compelling evidence to start a cocoa habit at this point, even if your laugh lines are digging into permanency.

Looking for flavonoid rich cocoa foods? Here are a few tips:

Cocoa powder: This is pure cocoa solids: fermented, dried cacao beans, with the cocoa butter separated out, and the remaining solids ground into a fine powder. Processed right, it is one of the most antioxidant rich foods in the world. Natural cocoa powder has more antioxidants than the Dutch-processed or alkalized version.

Cacao nibs: These are pieces crumpled from whole cacao beans, with pure chocolaty flavor, but no sweetness at all. They can be added to both sweet and savory dishes and are super rich in antioxidants.

Dark chocolate: Cocoa solids in dark chocolate vary, and are often listed on the pack, the higher the percentage the more flavonols it packs.

Milk chocolate: By definition the milk varieties will have less cocoa solids than the dark versions, but some fine milks have as much as 35-45 percent cocoa solids, while others have as little as 10 percent, making them a good source of – let’s admit it – sugar.

Dr. Ayala