1 Risky Liquid Candy Lesley James Wednesday, November 26

2 Why sugar? ► Excess sugar consumption is associated with heart disease, stroke, obesity, diabetes, high blood cholesterol, cancer and dental caries. ► Sugar, Heart Disease and Stroke Position Statement – released September

3 Media highlights ► Globe and Mail ► National Post story also appeared in Vancouver Sun, Ottawa Citizen, Windsor Star, The StarPhoenix (Saskatoon), The Leader-Post (Regina), Montreal Gazette, Edmonton Journal, and Calgary Herald. ► Front page of the Vancouver Sun ► CBC syndication – all major CBC drive-home shows across the country ► Canadian Health and Lifestlye, Canadian Living ► Global, CTV ► Social highlights: Blogs: Marion Nestle (Foodpolitics.com), Yoni Freedhoff (weightymatters.com). Tweets from major media that covered the story and Andre Picard (Globe and Mail) and Mark Bittman (New York Times food writer and food policy critic)

4 Free vs. bound sugars ► Free sugars: all monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and fruit juices.

5 Health effects of sugar ► Those with 10% - 25% of total energy from added sugar have a 30% higher risk of death from heart disease or stroke. 1 ► With 25% or more of calories from added sugar the risk is nearly tripled. 1 ► Systematic review - reduced intake of dietary free sugars results in weight loss and increased sugar intake is associated with weight increase. 2 1 Yang et al. JAMA Te Morenga et al. BMJ 2012.

6 Sugar consumption in Canada ► Estimated Canadians consume as much as 13% of their total calorie intake from added sugars. 1,2 ► The Heart and Stroke Foundation recommends that an individual’s total intake of free sugars not exceed 10% of total daily calorie (energy) intake, and ideally less than 5%. 1 Brisbois et al. Nutrients Srinivasan CS. Food Policy 2006.

7 Sugar consumption in Canada ► 10% of total energy (calories) from free sugars in a 2,000-calorie-a-day diet = 48 grams (roughly 12 teaspoons) of sugar. ► 5% of total energy = 24 grams (roughly 6 teaspoons) of sugar.

8 Liquid candy ► Sugar sweetened beverage (SSB), sugary drinks, or sugar loaded drinks. ► These include soda/soft drinks, fruit drinks (punch, cocktail), juices (including 100% fruit juice) sport drinks, sweetened coffees and teas, vitamin waters and energy drinks.

9 Health effects of sugary drinks ► Just 1 serving/day increases diabetes risk by 22%, 2 – 3 sugary drinks/day associated with 31% greater risk diabetes compared to consumption at less than 1/month. 1 ► Each additional serving/day increases risk of CHD by 19% and childhood obesity by 60%. 2 ► 180,000 deaths worldwide each year. 3 1 Schultz MB. JAMA Chiuve et al. J of Nut Singh et al. EPINAM 2013.

10 Sugary drink consumption ► Largest contributor of sugar in diet. 1 ► 1/3 of Canadians aged 5 – 19 report daily consumption. 2 ► Top calorie source among NA ages 12 – ► As children get older, they consume more sugar from soft drinks. 4 1 Yang et al. JAMA Int Med Langlois et al. Health Reports Brownell et al. NEJM Garriguet. Health Reports 2008.

11 What’s the issue? ► Canadians are often unaware of the amount of sugar in beverages. ► Drinkers don’t feel as full as they do if they ate the same number of calories from solid food. ► Liquid sugar facilitates caloric uptake/over consumption.

12 Sugar backlash ► Adverse health effects of sugar shown in media ► The consumer is more health conscious ► Sugary drink policy successes exist

13 Sugary drink campaigns

14 Public opinion ► The time is right; 88 % agree that large serving sizes of sugary drinks can lead to bad health. 94 % consider over consumption of sugary drinks to be an important contributor to obesity among Canadians. 79 % agree that large sized sugary drinks in restaurants and convenience stores are usually offered at little additional cost in order to encourage people to spend and consume more. 63 % would support a plan to eliminate large sugary drink sizes in restaurants and large sugary fountain drinks in convenience stores as a way to improve health.

15 Healthy public policy progress ► Sugary drink taxes in various jurisdictions (Mexico, Norway, France, Denmark, & Berkeley) ► Warning labels in California (did not pass) and NY state (proposed) ► Marketing to kids restrictions (Quebec, Denmark, Finland, Belgium, Sweden, Mexico, UK) ► Portion size standardization in NYC (did not pass, but being revived by new administration) ► Procurement policies in various municipalities and institutions

16 What is HSF doing? ► Recommendations for all levels of government, researchers, food and beverage industry, health professionals and educational institutions, workplaces and individuals to reduce sugary consumption ► Specific HSF policy asks and campaigns to reduce sugary drink consumption

17 Bigger portions means more sugar 7 ounces 12 ounces 16 ounces 32 ounces 64 ounces 140 calories 82 calories 180 calories 374 calories 780 calories 22g sugar 38 g sugar 49 g sugar 102 g sugar 217 g sugar

18 ► Standardize the portion size of sugary drink containers in foodservice sector outlets. Portion size standardization

19 ► HSF recommends a manufacturer’s levy on sugary drinks (provincial and federal). ► Levy sugary drinks would be placed on manufacturers with revenues dedicated to government led healthy living initiatives (school healthy lunch programs, and subsidization of vegetables and fruit). Sugary drink tax

20 Restrict marketing to kids ► Asking provincial and federal governments to: Restrict the commercial marketing of foods and beverages to children.

21 Restrict marketing to kids

22 ► We can’t do this alone! Please join our efforts. ► Lesley James Senior Health Policy Analyst Collaboration is key to success