HOME juices and smoothies represent a new risk to our health because of the
amount of sugar the apparently healthy drinks contain, warn the US
scientists who blew the whistle on corn syrup in soft drinks a decade
ago.
Barry Popkin and George Bray pointed the finger at high fructose corn
syrup in soft drinks in 2004, causing a huge headache for the big
manufacturers, including Coca-Cola and Pepsi.
"Smoothies and fruit juice are the new danger," said Popkin, a
distinguished professor at the department of nutrition at the University
of North Carolina, in an interview with the Guardian.
He added: "It's kind of the next step in the evolution of the battle.
And it's a really big part of it because in every country they've been
replacing soft drinks with fruit juice and smoothies as the new healthy
beverage. So you will find that Coke and Pepsi have bought dozens [of
fruit juice companies] around the globe."
In the UK, Coca-Cola owns Innocent smoothies while PepsiCo has
Tropicana. Launching Tropicana smoothies in 2008, Pepsi's sales pitch
was that the drink would help the nation to reach its five a day fruit
and vegetable target. "Smoothies are one of the easiest ways to boost
daily fruit intake as each 250ml portion contains the equivalent of 2
fruit portions," it said at the time.
However, Popkin says the five a day advice needs to change. Drink
vegetable juice, he says, but not fruit juice. "Think of eating one
orange or two and getting filled," he said. "Now think of drinking a
smoothie with six oranges and two hours later it does not affect how
much you eat. The entire literature shows that we feel full from
drinking beverages like smoothies but it does not affect our overall
food intake, whereas eating an orange does. So pulped-up smoothies do
nothing good for us but do give us the same amount of sugar as four to
six oranges or a large coke. It is deceiving."
Nine years ago the two scientists had identified sugar-sweetened soft
drinks, full of calories and consumed between meals, as a major cause
of soaring obesity in developed countries. But they argue that as people
change their drinking habits to avoid carbonated soft drinks, the
potential damage from naturally occurring fructose in fruit juices and
smoothies is being overlooked.
All
sugars are equal in their bad effects, says Popkin – even those
described on cereal snack bars sold in health food shops as containing
"completely natural" sweeteners. "The most important issue about added
sugar is that everybody thinks it's cane sugar or maybe beet sugar or
HFC syrup or all the other syrups but globally the cheapest thing on the
market almost is fruit juice concentrate coming out of China.
It has created an overwhelming supply of apple juice concentrate. It is
being used everywhere and it also gets around the sugar quotas that
lots of countries have."
In a survey of sweeteners in US food products between 2005 and 2009
for a paper published in 2012, Popkin and colleagues found that fruit
juice concentrate was the fifth most common sugar overall and the second
most common, after corn syrup, in soft drinks and in babies' formula
milk.
More studies need to be done before governments and health bodies
around the world will take notice. There are only two really good
long-term trials – one in Singapore and one by Harvard, he says. "But
all the long term studies on fruit juice in anything show the same kind
of effect whether it's a smoothie or natural [juice] and whether it's a
diabetes or weight gain effect," Popkin added.
Further evidence supporting the theory came last week from a study
published by the British Medical Association. Researchers from the UK,
USA and Singapore found that, in large-scale studies involving nurses,
people who ate whole fruit, especially blueberries, grapes and apples,
were less likely to get type 2 diabetes, which is obesity-related, but
those who drank fruit juice were at increased risk. People who swapped
their fruit juice for whole fruits three times a week cut their risk by
7%.
Most of the attention from those concerned about growing obesity
levels among children is still on soft drinks with added sugar, such as
colas and lemonade, which are consumed in enormous quantities. In 2012
we drank nearly 227 litres of liquid each in the UK, according to the
industry, which says 61% of those had no added sugar. Excluding water
brings the "no added sugar" total to 54%. Fruit juices and smoothies are
also included in the total. We each drank 17.6 litres of those.
British health campaigners are calling for a soft drinks tax in the
UK. In January Sustain published its Children's Future Fund report,
saying that £1bn a year could be raised from a tax of 20p a litre and
invested in children's health programmes. It has been backed by more
than 60 organisations and the first children's commissioner, Al
Aynsley-Green, gave his support. In February the Academy of Medical
Royal Colleges also called for the tax in its obesity report.
The British Soft Drinks Association says that consumption of soft
drinks containing added sugar has fallen by 9% over the last 10 years,
while the incidence of obesity has risen by 15%. "Obesity is a serious
and complex problem requiring concerted action by a wide range of
organisations as well as by people themselves. Soft drinks
companies recognise the role they have to play," it said. Companies
were reducing the calorie content of their drinks. PepsiCo, it said, had
only advertised the no added sugar variants of its soft drinks since
2005.
Innocent Smoothies claims that people who drink juice have better
diets and lower rates of obesity than others, although the studies it
cited had funding from the juice industry.
"Smoothies are made entirely from fruit and therefore contain the
same amount of sugars that you would find in an equivalent amount of
whole fruit," it said in a statement.
Meanwhile, efforts by the soft drinks companies to grow the market
continue. Coca-Cola in the UK this year declared its ambition to
increase the market by £2.1bn by 2017, identifying six "moments" in the
day when we could be persuaded to buy more soft drinks, including fruit
juice and smoothies for breakfast and soft drinks for children when they
come home from school. Sales of sweetened Coca-Cola, containing nine
teaspoons of sugar in a standard can, still outstrip those of Diet Coke
and Zero Coke combined.
"Unless Coca-Cola drastically reduces its marketing for sugary
drinks, its strategy to reach more people more often will mean that it
pumps record levels of sugar into our diets," said Charlie Powell,
campaigns director of Sustain.
"This is a business model that is unhealthy and unsustainable,
perfectly highlighting the 'profit versus public health' conflict of
interest endemic in the sugary drinks industry."
Coca-Cola argues that taxes do not change behaviour and that sugar
should not be vilified. In a statement, it said: "We believe that rather
than single out any ingredient, it is more helpful for people to look
at their total energy balance. This is because obesity and weight gain
are caused by an imbalance in calories consumed and burnt off. Our
products should be enjoyed as part of a sensible, balanced diet and
healthy lifestyle that includes regular physical activity.
"For those that are watching their calorie intake, we offer a wide
range of low or no calorie options, which represent more than one third
of our sales."
In an article this year in the journal Pediatric Obesity,
Bray and Popkin review the issue 10 years on from their famous paper.
"The concern with HFCS in our diet has led to a reduced proportion of
HFCS in beverages compared to other sugars," they say, but add "this is a
misplaced shift … fructose remains a major component of our global
diet. To date, to the best of our knowledge every added amount of
fructose – be it from fruit juice, sugar-sweetened beverages or any
other beverage or even from foods with high sugar content – adds equally
to our health concerns linked with this food component."
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