Sian Porter Registered Dietitian BSc (Hons) Nutrition MSc Health Economics FML Tackling Obesity: Determining the role of the food and drink industry in communicating facts about sugar: orange juice as a case study 23rd November 2017

Present findings from the UK Fruit Juice and Diet Quality Study

Clarification about free sugars – portion control & nutrient density

Aim to help consumers make informed choices – choices based on fact rather than what they

read/hear/watch in the media

The truth about fruit juice: communicating the facts in a confusing environment

Confusion muddling the facts • Media reporting and perpetuating inaccuracies about sugar, fruit

juice sugar content, juice serving size and consumption trends • ‘Gotcha!’ journalism where articles “reveal” how a healthy food

really isn’t that good for you/need for extreme content • Low level of consumer (journalist/social media /health

professional) understanding: • ‘Naturally occurring sugar vs. ‘free’ sugar • Labelling of sugar • Unsure about which nutrients different foods contain

• Pure fruit juice included with sugar sweetened beverages

Fruit juice targeted in sensationalist media

Consumer confusion

Reality of fruit juice (FJ) consumption • 83% of consumers in a recent poll had no idea what the

recommend portion size was [1] • 38% people questioned in a recent survey* believed that

fruit juice contains added sugar • People are not over consuming fruit juice: mean FJ

consumption is 84mls/day (11-18 year olds) and 49mls/day (adults 19+) [2]

[1] 2016 focus group by Porter Novelli in-house research team followed by consumer polling (100 consumers) to assess basic understanding of fruit juice (FJ), London. [2] Gibson S et al. (2015) Ann Nutr Metab 67 (supp1): abstract 149/1262.

The UK Fruit Juice Health and Diet Quality Study

• Largest-ever study into fruit juice consumption (review funded by BFJA)

• Analysis of the last six years of UK National Diet and Nutrition Survey data

• Analysis of fruit juice consumption by region and age group • Contribution of 1 portion of fruit juice (150ml) to five-a-day

and other nutrients (including sugars) • Relationship between fruit juice consumption, BMI and waist

circumference

Evidence-based communications to balance the topic

• Utilised NDNS data to provide facts about: • Actual Fruit juice consumption • Nutrient intake (contribution from fruit juice and lack

of nutrients that are/could be provided by fruit juice)

• 5-a-day actual v target • Any association between Fruit juice and risk of

overweight/obesity • Shared with the media, health professionals

and consumers

Fruit juice and the five-a-day target • Consuming fruit juice is associated with a

higher not lower, consumption of fruit and vegetables across all age categories

• Adults and children aged 11+ years who drink

fruit juice are about twice as likely to reach their recommended minimum of five-a-day, compared with non-drinkers

Five-a-day falling short

• One of the best known health education messages [1]

• A target few manage to achieve • In the UK, only 8% of children aged 11-18 years, 27% of

those aged 19 to 64 years and 35% of those aged 65 years and over meet the five-a-day target [2]

• The current UK national average is : • under 3 portions (2.8) for children aged 11years + • 4 portions for adults aged 19 to 64 years and • 4.2 those aged 65 years and over meet the five-a-day

target

[1]http://webarchive.nationalarchives.gov.uk/20111205225359/http://www.food.gov.uk/science/socsci/surveys/foodsafety-nutrition-diet/eighthcas2007.

[2] NatCen Social Research, MRC Elsie Widdowson Laboratory, University College London. Medical School. (2017). National Diet and Nutrition Survey Years 1-6, 2008/09-2013/14. [data collection]. 8th Edition. UK Data Service. SN: 6533, http://doi.org/10.5255/UKDA-SN-6533-7.

Does pure fruit juice cause obesity?

• SACN report on carbohydrates and health (2015) no evidence that unsweetened fruit juices contributed to BMI, adiposity or weight gain

• The UK Fruit Juice and Diet Quality study showed adult fruit juice drinkers had significantly lower BMI (by 1.1 units)

• Adult waist circumference was significantly lower by 3.2cm (women) and 2.7cm (men) in fruit juice consumers

• 150ml of fruit juice contains around 60-80 calories, which is 4% of total calories in a 2000 calorie diet

Sugar and fruit juice

• The sugar in fruit juice is naturally occurring and comes solely from the fruit from which the juice is made

• A 150ml glass provides approximately 15g of free sugars solely from the fruit = 17% of an adult’s daily Reference Intake (RI)

• Fruit juice naturally-occurring sugars come packaged with vitamins, minerals and phytochemicals

Fruit juice as part of healthy, balanced diet

• Fruit juice is not a major contributor of sugar to the diet (represents 6-8% of adults daily sugar intake*)

• One 150ml serving provides an affordable and palatable way to get one of five-a-day and helps meet five-a-day target

• Provides important nutrients and phytochemicals • On average in the UK, people who drink fruit juice have

a lower BMI and waist circumference compared to those that don’t drink fruit juice (correlation, not cause and effect)

*https://www.nutrition.org.uk/attachments/article/990/BNF%20looks%20at%20the%20years%205%20and%206%20of%20the%20National%20Diet%20and%20Nutrition%20Survey.pdf

% contribution of fruit juice to sugar in UK diet (age 11-18 and age 19-64 years)*

*Pie charts from Why 5%? An explanation of SACN’s recommendations about sugars and health. Source PHE 2015. Contains public sector information licensed under the Open Government Licence v2.0.

Not all sugars are equal

• Pure fruit juice – by law can only be the juice that is derived from fruit, containing only naturally occurring sugars and no added sugars

One 150ml serving fruit juice (orange specifically) provides:

• Vitamin C – 149% of DRV (excellent source) • Potassium – 11% of DRV • Folate (vitamin B9) – 19% of DRV (source) • Phytochemicals – flavonoids

Nutrients provided by fruit juice to the diet

Has media started to listen to the truth about fruit juice?

Message evaluation

• Poll consumer attitudes and perceptions to see message pull through about fruit juice and sugar

• Monitor news coverage for accuracy, balance of tone

• Monitor fruit juice consumption

• Appraise 5-a-day targets

• Unintended consequences – displacement

Any questions?