In the absence of intervention, low- and middle-income countries will see pervasiveness of added sugars in both beverages and packaged foods, according to the study titled Sweetening of the Global Diet, Particularly Beverages: Patterns, Trends, and Policy Responses.
Meanwhile, high-income countries such as the US have seen a decrease in sugar-sweetened beverages and will continue to see a decrease.
The rise of sugar across the world
Will the rest of the world have as much trouble with sugar as the US has had in recent decades? Dr. Barry Popkin, professor of nutrition at the University of North Carolina’s School of Public Health and one of the authors of this study, believes this will be the case.
Sugary beverages are increasing in both calories and volume sold per person per day, he told BeverageDaily.
Popkin noted that many products in Latin America are simply US products without any changes, even down to the label. In China, companies are copying practices of the US, including the heavy use of sugar.
As an example, he said 33% of calories in China came from packaged foods and beverages in 2011, while he estimated this would rise to more than 50%. This is because retail growth in China is at around 50% annually.
“And that’s just one country that started late,” he said. “All of Asia is moving this way, and there’s not a single village in Africa where you can’t find a convenience store. This is a pretty universal change going on."
There will be countries that attack sugar’s prevalence via laws and regulations, he said, as the World Health Organization and many countries have noted the association between caloric sweetener and cardiometabolic risks. The study said there is already evidence from Mexico which shows taxation can be effective at reducing sugar intake.
“There’s a consensus that we have to cut our sugar intake globally,” Popkin said. “There are going to be a few countries that attack sugar. That will have an effect … Once that happens, that might have an effect in those countries, slowly.”
Water’s dominance in the US
Popkin said that the prevalence of water products in the US beverage industry has meant fewer purchases of sugar-laden drinks. In particular, bottled water sales are way up and both diet and regular soda sales are way down.
Popkin said middle- and high-income, highly educated and white people in the US are the main drivers of this reduction in sugary drinks. However, he said sugar reduction is still largely being ignored in packaged foods, with most taxes and formulation changes mainly taking place in the beverage category.
In the US, the number of calories consumed per day on average via caloric soft drinks was at nearly 110 calories per day in 2009, according to the study. By 2014, that number had dropped to approximately 95 calories.
Disguised added sugar
Popkin said one thing that stands out on the beverage side is the number of fruit juices that use sweeteners in the ingredients.
“We go into not only ingredients: we go into the ingredients of the ingredients,” he said. “Added sugar can be in an ingredient, but [the label] doesn’t tell you.”
Popkin said companies will buy such ingredients, so they do not have to use sugar as an ingredient on the label. However, he said this practice will have to change quickly if the US Food and Drug Administration makes “added sugar” labeling mandatory.
“Then they’re going to have a lot of figuring out to do,” he said. “Once we looked at the natural ingredients, then looked at how much sugar they list, we found a lot of added sugar."
The study found that 74% of US foods and beverages include both caloric and low-calorie sweeteners, with just 5% made with low-calorie sweeteners only. This is a practice that will likely change if the “added sugar” labeling practice is put into place stateside.
Source: The Lancet Diabetes & Endocrinology
http://dx.doi.org/10.1016/S2213-8587(15)00419-2
"Sweetening of the Global Diet, Particularly Beverages: Patterns, Trends, and Policy Responses"
B. Popkin, C. Hawkes