Fructose is a type of sugar that occurs naturally across a variety of foods, including fruits, honey, and some vegetables. It may also be used as a sweetener in some processed foods and drinks we consume. While fructose is a natural component of many healthy foods (fruits and vegetables, for example), excessive consumption of fructose (such as high-fructose corn syrup) has been linked to health problems including obesity, diabetes, and fatty liver disease. It should be noted that high-fructose corn syrup is not widely used in Australia, but some imported foods may contain it. In addition, some people with Irritable Bowel Syndrome (IBS) can be sensitive to fructose, as well as other sugars in foods collectively known as FODMAPS (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols). Fructose is a monosaccharide.

31 March 2023

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10 March 2023

The New Zealand Ministry of Health has released key findings from the 2021-22 Health Survey . The snapshot below shows vegetable and fruit intake is significantly below recommendations, hazardous alcohol intake remains high, physical activity levels are insufficient, and only two-thirds of people brush their teeth as recommended.

• Only 10.4% of adults met the vegetable intake recommendation (5 to 5.5 servings).
• Half of adults (49.8%) met the fruit intake recommendation (2+ servings per day).
• 6.4% of children (2–14 years) met the vegetable intake recommendation (2.5 to 5.5 servings).      
• 73.9% of children (2–14 years) met the fruit intake recommendation (1 to 2 servings). 
• 18.8% of adults had a hazardous drinking pattern - Maori (33.2%) and Pacific (21.7%) peoples had higher rates - and this has remained stable since 2015/16. 
• Just over half of adults (51.9%) met physical activity guidelines; 12.8% did little or no physical activity.
• 63.7% of children (1-14yrs) and 68.7% adults brush their teeth with fluoride toothpaste at least twice each day, and rates were lower (57.5% adults) in deprived neighbourhoods.     

10 March 2023

Dr Alan Barclay, Accredited Practising Dietitian, completed a PhD on carbohydrate and the risk of developing lifestyle-related diseases like type 2 diabetes. He was previously Research and Development Manager / Head of Research at Diabetes Australia NSW, and Chief Executive / Scientific Officer the Glycemic Index Foundation. He is currently a consultant and private practitioner, a Honorary Research Associate at the University of Sydney and editor of the University’s GI News. He has co-authored 40 peer-reviewed articles and has presented his research at scientific conferences around the globe. He is the co/author of 5 books including Reversing Diabetes, Low GI Diet: Managing Type 2 Diabetes, The Good Carbs Cookbook, and The Ultimate Guide to Sugars and Sweeteners. 

How food labels shape our reality

Studying Psychology and Communications in the mid 1980’s, I learnt that language shapes our perception and understanding of reality. And this has been the case for language around fats and carbohydrates on food labels over the years.

Fats on labels

While science is not a popularity contest, it does progress in waves that might be described as fashion. Thanks in part to the popularity of very low-fat diets such as the Pritiken Diet (10-15% fats; 80% carbohydrates), the “West” went through a period of fat-phobia in the 1980’s and 90’s. Fats became the focus of nutrition research over this period, and this in turn influenced food labelling. “Low fat” became the most common claim on food labels.

While the initial focus was reducing total fat in foods, dietary advice became more nuanced as our scientific understanding increased, singling out saturated fats and then trans fats. Programs like Australia’s Heart Foundation’s “Tick” program commenced in the late 1980’s, further encouraging the provision of Nutrition Information on foods.

This encouraged the development of much more detailed nutrition information on food labels. From 2002, In Australia and New Zealand the mandatory Nutrition Information Panel (NIP) required saturated fat as well as total fat (1). And when a claim was made about the fat or cholesterol content, detail about the types of fats was also required on the NIP (trans, polyunsaturated, monounsaturated). 

Carbohydrates on labels

Now in the 2020’s, low carbohydrate, very low carbohydrate and the “keto diet” are in fashion, with the latter advocating 5-10% of energy from carbohydrate, and 80% from fats - essentially the opposite of what was recommended 50 years ago! Now “low carb”, “low sugar” and “sugar-free” have become popular claims on labels.

While the dietary demons have changed, surprisingly, food labels haven’t. Only Carbohydrate and Sugars are required on food labels in Australia and New Zealand. 

What’s missing from food labels is maltodextrins and starches – the other ‘available carbohydrates’ apart from sugars. 

And despite being important for a healthy microbiome, unavailable carbohydrates- dietary fibre- is only an optional component of the NIP, required only if a nutrition claim is made about carbohydrate.

Dietary fibre should be mandatory on Nutrition Information Panels to help consumers make healthier choices and encourage food manufacturers to incorporate more fibre in products.

Do the missing carbohydrates on labels matter? 

Compared to sugar, maltodextrins and starches provide more kilojoules per gram (16 kJ/g vs 17.5 kJ/g) (2), typically have a higher glycemic index (GI) (3), contribute to tooth decay (4) and offer no advantage for body weight (5). Put simply, maltodextrins and starches are not necessarily any better for health than sugars.

When companies reformulate foods and beverages to reduce sugars, they often add maltodextrins or starches to provide bulk and texture – other functions of sugars besides sweetness. Lower-sugar products may not be a healthier choice at all, but because of current food labelling laws this is not obvious. 

How could the NIP be improved?

Because starches (10+ glucose molecules) and maltodextrins (3–9 glucose molecules) are chains of glucose that are broken down using the same digestive enzymes (6), they should be grouped together in the NIP for simplicity. An ideal NIP would include all important information about carbohydrate- in a similar way to fats- to ensure we can make truly informed purchasing decisions, i.e.

Language shapes reality. More information about dietary fibre, maltodextrins and starches is needed on food labels. Education is also needed as most people do not know that maltodextrins or starches even exist, or that they are not likely to be any better for our health than sugars.

10 March 2023