Projects / Programmes
Sugars in human nutrition: availability in foods, dietary intakes and health effects
| Code |
Science |
Field |
Subfield |
| 3.08.00 |
Medical sciences |
Public health (occupational safety) |
|
| Code |
Science |
Field |
| B420 |
Biomedical sciences |
Nutrition |
| Code |
Science |
Field |
| 3.03 |
Medical and Health Sciences |
Health sciences |
sugar, free sugar, dietary intake, health effects, food composition, food advertising
Researchers (34)
Organisations (3)
Abstract
Sugars are simple carbohydrates that the body uses for energy. While many foods contain sugars naturally, they are also commonly added to foods during processing. According to the WHO definition, free sugars are all sugars added to foods or drinks by the manufacturer, cook or consumer, as well as sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates. Sugar-sweetened beverages (SSBs) and desserts are among the top sources of free sugars, but many other foods contain free sugars.
High intake of free sugars increases the risk of overweight, obesity and dental caries, and other health problems. Avoiding excess free sugars intake is, therefore, an accepted dietary guideline throughout the world. This is highly applicable also for Slovenia, where high prevalence of obesity is reported in both, children and adults. Free sugars intake can be reduced by limiting the consumption of foods and drinks containing high amounts of free sugars, and eating whole fruits and vegetables instead of free sugar in liquid form and sugary snacks.
There are several initiatives trying to lower intake of free sugar, both internationally and nationally. However, a precise knowledge of the current situation regarding sugar intake in the population is required for successful policy decisions. This is also noted in the Slovenian Resolution on Nutrition and Physical Activity for Health 2015–2025. Voluntarily measures to reduce sugars in SSBs were accepted in 2015 by the Slovenian food industry association, but the efficacy of these has not yet been evaluated. We are also lacking the data on the sugar intakes in different populations. Studies from other European countries are showing that consumption of free sugars is exceeding current recommendations, but the data for Slovenia is scarce. While excess free sugars intake is clearly recognized as a health concern, a number of controversies exists regarding the real reasons for the observed negative health effects. These can be either free sugars intake related to high energy intake, intake of specific foods (i.e. SSBs), intake of total sugars, or intake of specific sugars.
The proposed project’s overall hypothesis is that due to the high content of added sugar in foods and drinks their intake in the population exceeds the recommendations and presents a public health risk. For this reason sugar content in processed foods should be lowered, while consumption of foods high in sugar should be reduced. Applying a highly multidisciplinary approach, we will: (O1) collect data on the composition of foods on the market, use sales-weighting approach to identify major sources of (added) sugars, and make a comparison with situation prior to self-regulation of the food industry; (O2) collect data on broadcasted marketing of foods to children and assess effectiveness of implementation of nutrition profiles to regulation in 2017; (O3) determine total and free sugars intakes in the population, using the nationally representative sample; (O4) identify population groups with the highest free sugars intakes and assess their overall dietary and lifestyle habits, associated with risks for non-communicable diseases, particularly obesity; (O5) determine the effectiveness of nutritional counseling in regard to a decreased intake of foods with high free sugars content using a prospective trial in obese adolescents; (O6) investigate consumer’s behaviors and preferences for free sugars-containing food groups, also focusing on free sugars alternatives; and (O7) inform policymakers with the evidence needed for future decisions related to free sugars in foods and diets.
Significance for science
The project results will significantly improve progress in research in the areas of public health and nutrition. For the first time, innovative sales-weighting approach will be used for assessment of changes in the content of (free) sugars in processed foods, as well as in the relative contribution of different food categories to the total and free sugars intake. To improve feasibility of this innovative approach, we already successfully conducted a feasibility study with the dataset of processed foods available in year 2015 (Zupanič et al., 2018), when National Programme on Nutrition and Physical Activity for Health 2015-2025 was accepted (RS, 2015). This gives us an excellent opportunity not only for further development and testing of this new approach, but also to carefully investigate changes in the food supply and impacts of food policies. It should be noted that nowadays food retailers operate with data that would enable unprecedented insights into consumers’ exposure to all kinds of food constituents (not only nutrients, but also bioactive food ingredients and contaminants) and support risk assessments, but currently these data are mostly underexplored. Our research has a unique opportunity and infrastructure to use such data for public health research (contracts with major retailers in Slovenia, which provide use with yearly sales data on the product level). Additionally, sophisticated assessment of the dietary intakes will be possible because of the unique opportunity to link the project with the EC funded EU MENU project.
Considering that currently different organisations are recommending very different upper levels of free and total sugars intakes (from ( 5% of free sugars by ESPGHAN and SACN, to 18% of “total” sugars by the EU food labelling regulation), insights of their actual consumption will be very useful. Given the high rates of overweight and obesity in Slovenia, particularly in the most deprived socioeconomic groups, the results will also provide new insights into the role of socioeconomic inequalities in sugar consumption. The project will exploit the efficiency of the programme for managing children obesity at the University Children's Hospital Ljubljana. Considering our careful selection of sophisticated state-of-the-art biomarkers related with the metabolic syndrome, the study will provide new insights on the usefulness of the lowering of fructose intake in such conditions. Therefore, we believe that results of this project will be original and will contribute to the scientific development in this field in global prospective.
Significance for the country
Project’s relevance for society is proven by the co-financing by the Government (Ministry of Health, 25%). The results of the project will be used by the Government as a scientifically credible basis for the adoption of appropriate health care and public health policies, guidelines, and preventive programs.
The objectives of this applied research project are consistent with the National Programme on Nutrition and Physical Activity for Health 2015-2025. This programme states the importance of research in the field of nutrition, especially the priorities of Horizon 2020 program (Health, demographic change, food safety) and strengthening interinstitutional cooperation. The resolution also highlights the need for collection of data on dietary habits in different population groups, while the "implementation of periodic cross-sectional surveys of qualitative and quantitative type, used to monitor the status and trends in the field of nutrition habits and dietary intake of the individual population groups" is mentioned as a specific objective. Education and training are also listed as priorities. The proposed project will contribute to better realisation of all these areas.
The project’s objectives are also in line with Slovenian strategic resolution on the development of Slovenian agriculture and the food industry until 2020 “Food for the future” and supporting a number of priorities of the WHO Commission on Ending Childhood Obesity (WHO, 2016b) and the WHO European Food and Nutrition Action Plan (WHO, 2014).
Results of the project will also contribute to the development of science in the field of nutrition and medicine, and food technology. The project will contribute important results about the role of nutrition interventions in management of obesity in children, not only focusing on energy and macronutrients intakes, but also on specific food constituents, such as fructose. Project results will thus timely contribute to controversial discussions on the relationship of sugar intakes and obesity. Additionally, for the first time in Slovenia, relevant data on dietary intake of sugars in different target groups will be provided.
Project will be also very important for the businesses, specifically in the food industry. Particularly, project results will support food reformulation and responsible food production decisions in the food industry. With relevant data about the current food supply and dietary status of different populations, the industry will have the data needed for more responsible food development.
The collected data will be indispensable not only for the creation of appropriate policies, but also for further research, particularly in interconnected areas of nutrition, health and non-communicable diseases. Simultaneous implementation of the project and the MENU EU food intake study (financed by the EC/EFSA) will ensure optimal use of resources/funds and enhance the effects of the two projects. The project will also improve international cooperation and reputation of Slovenian science in the world.
Most important scientific results
Interim report
Most important socioeconomically and culturally relevant results
Interim report
