Are food labels an effective tool for raising sugar awareness? A global overview

by Alexandra Jones and Roberta Nelson

The world is eating too much sugar - intake figures from Australia through to Mexico suggest most of us are exceeding the World Health Organization’s (WHO) sugar guidelines.

That guideline recommends that adults and children restrict their free sugar intake to less than 10% of total energy intake per day - equivalent to around 12 teaspoons. Ideally, WHO suggests a further reduction to below 5% of total energy for added health benefits and better dental health outcomes. This guideline is echoed by national dietary recommendations around the world calling for people to reduce free or added sugars consumption to this level.

Free sugars refer to sugars and syrups added to foods either by the consumer or the manufacturer such as honey, sucrose, table sugar, fruit juices or fruit concentrates. Free sugars do not include sugars that are naturally occurring, such as lactose found in milk products, or sugars built into the structure of the foods such as fruit and vegetables.

There is substantial and consistent evidence that diets containing large proportions of free or added sugars contribute to weight gain, overweight and obesity by promoting excess energy intake and may reduce the intake of foods containing more nutritionally adequate calories. In 2016, more than 1.9 billion adults were overweight while 462 million were underweight highlighting the major impact the modern diet is having on the global population’s waistline.

Beyond waistlines, sugar consumption is particularly linked to poor dental health - 40% of Australian children under 12 years old already have decay in their adult teeth.

While there’s been plenty of talk about taxes on sweet drinks to tackle the issue of excess sugar consumption, around the world countries are also taking steps to improve sugar labelling. Because, whilst people are being instructed to consume less sugar, devising what has added sugar in it and in what quantity has become quite convoluted.

The food label is contested real estate - for companies, it’s marketing space, for governments it’s a potential public health tool.

You only have to look at labels of other products – everything from tobacco, medicines, tools and appliances – to know labels are an important way to inform us of hazards, and guide us towards informed choices.

Labels not only provide information and nudge consumer behaviour – labelling requirements can provide an incentive for food companies to improve the recipes of their products. These changes have potential to benefit everyone, even those people who don’t care about labels. For example, mandatory labelling of trans fats in the USA is reported to have incentivised the food industry to reduce the level of trans fats in foods through reformulation.

Labels can be even more powerful when linked to other health policies – e.g. a food whose label reveals it to be high in sugars not being allowed to be marketed to children, or sold in school canteens.

With consumer interest in sugar growing, it is important to know where to find sugar information on the label. This information can be found in ingredients lists, nutrient panels and nutrient claims on both front and back of food packaging.

The Ingredient List

Most people are familiar with the ingredients list on foods, and in places such as Australia and the United States - ingredients of a food have to be listed in order of predominance meaning the ingredient used in greatest amount is showed first followed, in descending order, by those used in smaller amounts.

The problem is, there are more than 40 names used for different types of sugars in ingredients lists - from agave nectar through to white sugar - all of which can be used in varying amounts in a food and appear in different positions on an ingredient list. Whilst spread out individually, it is the sum of all these parts which accounts for the biggest ingredient - sugar. This issue has been tackled in Canada, with recent reforms requiring all the sugars to be grouped in a bracket in the list – allowing shoppers to get a better idea of their total contribution.

The Nutrient Panel

Most countries now have some form of mandatory nutrient information panel on packaged foods. Often appearing on the back of pack, it provides information about the quantity of different nutrients in the product, typically on a per/100g standardised basis, and sometimes also in a serve of the food.

Total sugars are usually required in that panel as a component of the carbohydrate content of food. However, total sugars captures ingredients like lactose in milk or yoghurt which makes it virtually impossible to follow dietary guidance that focuses on added sugars specifically.

Some countries are now moving towards mandating that added sugars be required in the nutrient panel both as a percentage of daily intake figure and in grams. USA is currently leading this change with roll out of the reform currently taking place however, it is also in the suite of options Australia and New Zealand could potentially uptake.

This labelling requirement would positively nudge consumers towards options lower in added sugars, such as yoghurt, which can have varying amounts of added sugar depending on the manufacturer. Consumers will be able to easily compare two yoghurt products and choose the option lower in or free of added sugar by simply looking at the added sugar component of a nutrient information panel.

Nutrient Claims

Sometimes companies include nutrient claims on added sugars – typically where the food has no added sugars, or is low in added sugar. This is beneficial for the consumer however, it doesn’t give a clear picture of the food the consumer needs to steer away from. The claims can also be misleading and used inconsistently due to the loose definition of added sugars.   

Currently in Australia and New Zealand - Food Standards have just closed a public consultation on six options for improving labelling of sugars in Australia and New Zealand. Food Ministers are due to make a decision on which option/s they wish to proceed with by December 2018. The suggestions include improvements to the ingredient list and nutrient panel as touched on above, but also more progressive labels including graphic warnings of pictorials. One suggestion that is highly supported by consumers is using units of teaspoons - a universally understood measurement - to clearly visualise the amount of added sugar in a food product.

Food labelling, like the sugar tax, is a public health tool to assist consumers in reducing their consumption of sugar and improve health. Currently, food labelling does not convey amounts of added sugar in foods making it difficult for consumers to respond to dietary guidelines that instruct a reduction of added sugars alone. With consumers interested in understanding sugar information, food labels pose a powerful opportunity to provide a solution and empower consumers to make a more informed decision on how much added sugar they consume as well as motivate manufacturers to reduce the amount of added sugar they use in their foods.

Join the Sandro Demaio Foundation on Thursday 4th October for our bi-monthly in-conversation. This month’s talk, ‘Let’s Talk About Sugar’ will be a deep discussion on what sugar does to our health, what is being done about it on a policy and advocacy level and how to take personal steps to live a low-sugar life. Secure your spot here.