Comments on: Sugar-sweetened drinks and obesity: threat, opportunity, or both?

By: Bill Shrapnel

Bill Shrapnel — Mon, 22 Apr 2013 02:23:23 +0000

Hi Liz
I agree with you – context is everything. That’s why I argue that sugar content is a very poor measure of a food’s nutritional quality. How can anyone argue that sugar in fruit is OK but sugar in chocolate milk is bad? Sugar is sugar. If sugar content is a good measure of nutritional quality we should be able to apply it universally, but we can’t, or we don’t.
We really need to embrace measures of carbohydrate quality that can be applied universally. For me, glycaemic index is important and can be applied to all carbohydrate-rich foods, sugary or starchy. And nutrient density is important. If any carbohydrate-rich food has a high GI (due to sugar or starch) and it’s not nutrient-dense, there is a good case for restricting it in a healthy diet. Regards, Bill

By: Liz

Liz — Mon, 15 Apr 2013 02:10:07 +0000

Discussions about added sugar need to be in context to the situation. If added sugar in a milk beverage, high in other nutrients, enhances its food of choice, rather than a non nutrient high energy dense product, then it’s a valuable one. Eg, tradesmen who work long hours in physically demanding jobs , often driving between jobs, tend in my experience, to have a liking for chocolate or coffee flavoured milks which provide them with protein, calcium and B vitamins that would be otherwise reduced in their diet if they chose a soft drink of negligible nutritional value except energy. It is only when there is excessive use of any given food that is not expended by physical activity that it becomes problematic as part of the overall diet-style.

By: Bill Shrapnel

Bill Shrapnel — Tue, 18 Dec 2012 23:59:16 +0000

Hi Will
From what I have read the satiating potential of fat and carbohydrate are similar and both less than protein. Not sure if this has been tested using beverages. Regards, Bill

By: Will

Will — Tue, 18 Dec 2012 06:12:39 +0000

Hi Bill,

Is there evidence demonstrating that a liquid fat beverage would be similar to a sugar-sweetened beverage in its inability to induce satiety? If sugar’s effect here were unique, then we might expect it to have a poor showing against fat-rich liquids with equal protein and calorie content.

By: Kate

Kate — Thu, 08 Nov 2012 01:36:39 +0000

Thank you so much for your input, these have been my thoughts exactly. Plus I feel less guilty about my breakfast. I agree too many dietitians try and impose the ‘idealistic breakfast’, even the next generation (or at least thats what I found amongst the majority of students in my course). I wish I had been reading this blog during my studies, rather than at the end.

By: Bill Shrapnel

Bill Shrapnel — Thu, 08 Nov 2012 01:01:54 +0000

Hi Kate
I’d rather not comment on individual products so let me comment generally on the two concepts you mention.
The first is a breakfast replacement beverage designed for people pressed for time in the morning. So the likely scenario is no breakfast or a breakfast drink. The breakfast drink has to be better than nothing. It’s certainly nutrient-rich, which is a good thing. And it’s portion-controlled which is also a plus in this day and age. I believe it has added sugar but why should I be concerned about that? How would the sugar content affect any parameter associated with an adverse health outcome? I suspect the glycaemic load of the beverage would actually be less than that of a more traditional breakfast (bread, cereal, juice, etc). And the energy content is controlled.
Sometimes I think dietitians have an idealised view of the way a breakfast should look – a family sitting around the table eating bread, cereal, juice, etc. But that’s not the modern world with both parents tearing off to work. Whether we like it or not I suspect the breakfast beverage may be where many people are heading. Aesthetically, it’s the pits. But, looked at it scientifically, I think it’s fine.
In relation to adding sweet chocolate flavouring to milk, I think we should think about the nutritional issues facing children and the beverage alternatives. Some children, especially adolescent girls, have borderline calcium intakes. Ideally they should drink more milk and less soft drink. But let’s face it children like sweet drinks and soft drinks are popular in this age group. If the cost of achieving higher milk intakes is a little added sugar and chocolate flavouring, is that such a bad thing? In this scenario I see sugar as facilitating the intake of important nutrients, a total contrast to the role of sugar in a soft drink.
That’s why I think a focus on sugar per se is counterproductive. Why not just focus on nutrient density? On this basis I would give both concepts the green light. Regards, Bill

By: Kate

Kate — Wed, 07 Nov 2012 23:55:02 +0000

Hi Bill
So based on this discussion, (which was really interesting and informative), you would say commercial products such as an up or go, or milo in a low fat milk are not necessarily adverse to an individuals health?

Kate

By: Bill Shrapnel

Bill Shrapnel — Wed, 07 Nov 2012 02:42:39 +0000

Hello Cam.
Compared with full-cream milk, chocolate milk has more sugar but less fat so calories are similar and the nutrient density is almost identical. Yet we tend to judge the beverage with ‘added sugar’ adversely. If chocolate milk is nutrient-rich, who cares if it has some sugar in it?
Neither the sugar content nor the fat content of the diet affects the risk for conditions of public health significance, but they both have the potential for nutrient dilution. However, whether this potential is realised depends on which sugar-rich or fat-rich foods are included or excluded from diets. Rather than tying ourselves in knots over which sugar-containing foods should be included in healthy diets, why not forget about sugar (and fat) altogether? Just focus on nutrient density. As a general rule, if a food is nutrient-dense, it’s in. If it’s nutrient-poor, it’s out. Nice and simple. Regards, Bill

By: Camerob

Camerob — Wed, 07 Nov 2012 01:54:10 +0000

Great discussions. I agree that there should be a focus on what we need as well as what we should have less of, rather than just the latter. In addition, chocolate milk is a great tool for recovery from exercise, but as you stated, it has significantly more sugar with similar amounts of the other nutrients to normal milk. Doesn’t the added sugar and therefore extra energy mean that a chocolate milk has less nutrient density per kJ.
I think the lowering of added sugar is pertinent as advice and should be in conjunction with appropriate replacements.

By: Bill Shrapnel

Bill Shrapnel — Tue, 06 Nov 2012 23:06:25 +0000

Hi Fiona
Totally agree with you on the need to see less nutrient poor, energy dense beverages available to children. I just don’t see ‘no added sugar’ and ‘nutrient poor, energy dense’ as meaning the same thing.
Chocolate milk has the same (high) nutrient density as full cream milk, even though one has added sugar and one doesn’t. Why do dietitians and nutritionists argue against chocolate milk?
I think we should focus more on nutrient density and less on sugar. Our advice would be more logical and more consistent. Regards, Bill