1. Policies that Promote Sugar Reduction

2. Natural Sugars VS Added Sugars Natural sugars – Fruits Bananas Mango Papaya Added sugars – soft drinks – candy – fruit drinks – pastries

3. Added Sugars Links to Obesity & Diabetes  Grocery stores are filled with products containing added sugar Consumption of added sugars is on the rise

4. How much sugar do you need? Women: 6 teaspoons of sugar or 24 grams Men: 9 teaspoons of sugar or 36 gram

5. Examples of Sugar Content in Products Serving size (Examples of common foods) Estimated Sugar Content (grams) 1 teaspoon of sugar4g 1 can Coca Cola (12 oz)39g 1 can RedBull Energy Drink (8.3 oz)27g 8 oz orange juice24g 8 oz Nesquik chocolate milk29g 1 cup of coffee with sugar6-8g ½ cup fruit cocktail (in a can)23g 1 small papaya12g 1 medium sized banana14g 1 cup of breadfruit24g 1 Hershey’s milk chocolate bar24g

6. Added Sugars Links to Obesity & Diabetes Studies have linked sugar intake to diabetes, cancer and heart disease Lowering intake of sugar is recommended to reduce health problems

7. Health Impacts in the Pacific Obesity rates in the Pacific are among the highest in the world:

8. Added Sugars Links to Obesity & Diabetes Dietary Guidelines for Americans 2005: the healthiest way to reduce calorie intake is to decrease consumption of added sugars, fats, and alcohol choose and prepare foods and beverages with little added sugars some foods that have lots of sugar supply calories, but few or no nutrients

9. Health Impacts in the Pacific There are 25-47% of young children who are overweight or obese in American Samoa, CNMI, Guam and Hawaii. The number of adults with diabetes in the Pacific region is among the highest in the world. – 47 of 100 in American Samoa compared with 13 of 100 in mainland USA Women who are diagnosed with diabetes while pregnant have gestational diabetes (high blood sugar during pregnancy). – They have a 35% to 60% chance of developing diabetes in the next 10-20 years.

10. Why Policies in Reducing Sugar Intake? Impact of obesity includes the value of income lost from decreased performance and absence from work. The U.S. spends an estimated $190b on obesity- related conditions annually. About 80 of 100 heart diseases, stroke and type-2 diabetes and 40 of 100 cancers can be prevented through Inexpensive and cost-effective interventions.

11. What can churches do? Encourage the congregation to eat and drink healthier Educate your community about the health risks of too much sugar in their diets and health benefits of lowering sugar intake Ensure ready access to potable drinking water Initiate a policy for healthier foods and drinks at church events

12. What can schools do? Educate your youth about the health risks of too much sugar in their diets and the problems it can have on their future Educate students on understanding food labels, including information on sugar content Promote school activities or a week of health awareness to discuss the health risks of too much sugar Ban high sugary foods from school events and other school activities and promote access to and consumption of more healthy alternatives, such as water and fresh fruit or canned fruit in water Initiate a policy to reduce sugar and provide healthier food options to be served at school

13. What can communities do? Talk to restaurants in your community about reducing sugar in their food Promote access to and consumption of more healthy alternatives, such as water and fresh fruits Initiate a policy to reduce sugar and provide healthier food options to be served at community events and activities Work together and contact local government to ask them to help enforce policies to that will reduce sugar in your jurisdiction, such as no sweetened beverages in vending machines

14. What can I do? Talk to people that you know are interested in taking action in your community Educate others on the health risks of high dietary sugar and how to reduce sugar intake Educate others on understanding food labels, including information on sugar content Reach out to people in the public health sector or local government to address this concern Put together a project with a team/working group who can help you speak at community meetings and local government to help reduce sugar in food at restaurants, schools, community events, etc. Talk to restaurants and markets in your community about providing foods with low sugar food

15. Implement policies that reduce sugar consumption An American Samoa Example Target Population: All Department of Health employees Summary: American Samoa Department of Health (DOH) Employee Wellness Policy #13-01  October 2013: DOH implemented a policy for all DOH employees relating to proper nutrition, physical activity and tobacco smoking  Employee Wellness Activities: restricts DOH employees from having incentives, fundraisings and activity vendors advertising and selling unhealthy foods, alcohol, tobacco and gift cards to fast food chains  Increased Access to Healthier Foods: prohibits DOH and its contracted food services from serving unhealthy foods  All DOH internal meetings, conferences, community meetings sponsored and funded by DOH must serve healthy and local options of food and drinks; no red meat, soda products and artificially flavored drinks are to be served

16. Implement policies that reduce salt consumption A Guamanian Example Target Population: All government of Guam employees Summary: PL31-141: Healthy Vending Machine Policy Guam was awarded with the Communities Putting Prevention to Work Grant to have healthy foods more accessible to the community. PL31-141: mandates all vending machines in government of Guam facilities to be serving at least 50% healthier food options The Guam Department of Public Health and Social Services (DPHSS) worked with all government agencies, and vending machine operators before the Healthy Vending Machine Policy could be passed DPHSS took the law a step further by enforcing 100% of all vending machines in all DPHSS facilities to be selling healthy foods and water content only Guam’s Non-Communicable Diseases (NCD) Consortium is looking towards having the Worksite Wellness Health Coaches in each of the participating government agencies to be the enforcing agency, to ensure vending machine vendors are in compliance to the standards set forth by Healthy Vending Machine Policy

17. Implement policies that reduce sugar consumption A Palauan Example Target Population: Elementary and high school students Summary: 2009 Executive Order 263 2009 Executive Order 263  2009: President Johnson Toribiong signed Executive Order (EO) No. 263, establishing a Committee to create a Healthy Lifestyle Curricula in elementary and high school students  Curricula focused on teaching students healthy eating habits and daily physical exercise  Domino Effect: Peleliu Elementary School implemented a “water-only” drinking policy  By 2014, 11 out of 14 (75%+) of the elementary schools in Palau had imposed their own “water-only” policy for their students and staff

18. Who Can You Contact? Adrian Bauman Boden Institute of Obesity, Nutrition and Exercise and Prevention Research Collaboration University of Sydney Sydney, Australia Email:  adrian.bauman@sydney.edu.auadrian.bauman@sydney.edu.au