Research focus

Research focus: sugar consumption

Childhood obesity and dental caries are major public health issues in the UK associated with excess free sugars. In 2015 the World Health Organization recommended the consumption of sugar be limited to 10% of total dietary energy and 5% for health benefits.

Childhood obesity and dental caries are major public health issues in the UK associated with excess free sugars. In 2015 the World Health Organization recommended the consumption of sugar be limited to 10% of total dietary energy and 5% for health benefits.

Understanding the effects and health issues from excessive sugar consumption
has been varied – three recent studies have analysed the results. Picture: Getty Images

More recently, Public Health England set out guidelines for the food industry to reduce sugar by 20% across the top nine food categories that contribute most to children’s intake. Three recent sugar-related papers have been reviewed.

An Online Survey on Consumer Knowledge and Understanding of Added Sugars

This survey investigated participants’ ability to identify added sugars (AS) and their awareness of the World Health Organization (WHO) guidelines on sugar intake.

Participants (n=445) were a convenience sample of university staff and students, over 18-years-old and resident in the UK.

Data collection included demographics, food label use and awareness of WHO guidelines, respondent’s ability to identify AS and strategies to manage sugar intake.

Most participants (89%) were ‘interested’ or ‘very interested’ in nutrition. Reported food label use was high; 84% claimed they looked at labels at least sometimes. Calories, total sugar, total fat, salt and saturated fat were looked at most frequently.

Many participants (65%) were not familiar with the WHO guidelines and only 3% reported it would be ‘very easy’ to implement them based on current labelling. Correct identification of AS was poor; on average only four of the 13 items were classified correctly. Participants managed their sugar consumption through food labels, avoiding processed foods and those obviously high in sugar.

The study highlighted that understanding the AS content using current food labels was problematic even for educated participants. It was limited by the convenient sample, over-representation of female respondents and high proportion of degree educated consumers.

Tierney M, Gallagher AM, Giotis ES et al (2017) Nutrients. 9, 1, 37. doi: 10.3390/nu9010037


Cross-sectional survey of the amount of free sugars and calories in carbonated sugar-sweetened beverages on sale in the UK

Carbonated sugar-sweetened beverages (CSSB) available in major UK supermarkets were evaluated in this cross-sectional survey for their free sugars (FS) and calorie content using manufacturers’ packaging and labels. 

In total, 169 CSSBs were included in the analysis; both branded and supermarket own brands. Sugar levels of supermarket own brand and branded products were compared using independent sample t-tests. 

FS content in the CSSBs was high; 91% would be categorised as ‘red’ for sugars per serving (greater than 13.5g/serving) using the traffic light system. However, there was a wide variation in the sugar content between and in the different flavours, from 3.3 to 52.8g/330mL serving. On average ginger beer contained the highest level of sugars and ginger ale the lowest; supermarket own brands contained lower levels than branded CSSBs.

Average calorie content of the CSSBs was 126.1± 43.5kcal/330mL, with a wide variation in calorie content between and in different flavours. Of the products surveyed over half (55%) contained greater than the maximum daily recommendation for FS consumption of 30g per 330mL serving. In the UK, FS in CSSBs have a significant impact on overall FS consumption. Their wide variation in sugars content demonstrated the scope for manufacturers to reduce FS in CSSBs in the future.

Hashem KM, He FJ, Jenner KH et al (2016) BMJ Open. 6, 11 e010874.


Efficacy of school-based interventions aimed at decreasing sugar-sweetened beverage consumption among adolescents: a systematic review

The effectiveness of school-based interventions to reduce consumption of sugar sweetened beverages (SSBs) by adolescents aged between 12 and 17 years were assessed in this systematic review. Randomised controlled trials, quasi-experimental studies and one group pre-post studies were included if the interventions were based in schools or referred to as school-based and reported information on individual SSB consumption as an outcome.  

Thirty-six papers reporting on 36 interventions were included: 20 were classified as educational/behavioural; ten as legislative/environmental and six included both components. Most (21) aimed to reduce SSB intake as part of a general health intervention; and only four aimed to reduce SSB intake specifically. SSB intake was most commonly measured through a survey or questionnaire; only ten studies used a validated tool.

The majority of interventions (26) were effective in reducing SSB intake regardless of whether they targeted individuals, their environment or both.

Legislative/environmental only approaches were the most successful (90%); and educational/behavioural only and combined approaches had similar success rates, 65% and 66.7% respectively. Most frequently used behaviour change techniques included information on the health consequences of performing a behaviour; restructuring the physical environment; behaviour goal setting; self-monitoring behaviours; health threats and provision of social support.

School-based interventions have the potential to reduce adolescents’ consumption of SSB. Legislative/environmental approaches that reduce availability and or eliminate SSBs in schools should be followed.

Vezina-Im, LA, Beaulieu D, Bélanger-Gravel A et al (2017) Public Health Nutrition. doi:10.1017/S1368980017000076


Further information

Compiled by Susan Davies, research fellow at the Centre for Research in Primary and Community Care, University of Hertfordshire

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