News Banner

FAQs

FAQs

FAQs

Here you will find answers to some frequently asked questions on sugars and health.  The answers are based on a summary of the best available scientific evidence and reflect findings of scientific studies, not opinion.

This information is primarily for health professionals and may include some practical advice which can be used in everyday practice.

How do we define sugar?

Sugar is commonly thought of as table sugar. It is also known as sucrose. This is just one of many different types of sugars which include glucose, galactose, fructose and lactose1.

Sucrose is made up of one molecule of glucose and one molecule of fructose joined together. Most of our sucrose comes from sugar cane. In Europe sucrose comes mainly from sugar beet.

All sugars are carbohydrates. The body uses carbohydrates as its main source of energy.

Sugars are present in nature and are found in a variety of fruits, vegetables, milk and dairy products. Plants make sugars through a process known as photosynthesis.

Further reading:
1Cummings JH and Stephen AM. Carbohydrates terminology and classification. FAO/WHO scientific update on carbohydrates in human nutrition. Eur J Clin Nutr. Dec 2007;61 Suppl 1:S5-18  http://www.nature.com/ejcn/journal/v61/n1s/pdf/1602936a.pdf

What is a recommended amount of sugar to eat?

Dietary guidelines in Australia and in New Zealand do not recommend a specific amount of sugars that we should eat1,2. Instead they say to limit intakes, with a key focus on choosing food and drink to meet your energy needs and being physically active, in order to maintain a healthy weight1,2.

How much energy you consume depends on how many kilojoules of energy you burn off during the day. The more physically active a person is, the more kilojoules they are recommended to eat.  In general, just over half of the daily diet should come from a variety of carbohydrate sources, including a proportion of sugars and starches3

Further reading:
1Ministry of Health (2003) Food and Nutrition Guidelines for Healthy Adults - A Background paper. Wellington. Ministry of Health.
2National Health and Medical Research Council (2013) Australian Dietary Guidelines. Canberra: National Health and Medical Research Council.
3Institute of Medicine. (2005) Dietary reference Intakes for Energy, Carbohydrate, Fibre, Fat, Fatty Acids, Cholesterol, protein, and Amino Acids. The National Academies Press. Washington D.C. 

 

How much sugar do we eat?

On average, in both New Zealand and Australia, the population consumes a moderate* amount of refined sugar.

The most recent sugar intakes (in grams and as a percentage of total energy) for both countries are reported in the tables below. These provide information on both total sugars and where possible, added sugars – measured as sucrose in New Zealand.

In New Zealand and Australia total sugar intake has declined in both males and females since the mid-nineties. For New Zealand, this trend was also seen in median sucrose intake. The contribution to total energy from sucrose remained about the same (9-10%).ab In Australia, contribution to total energy intake from total sugars (natural and added) has decreased from 22% in 1995 to 20% in 2011-12,cd. The top three contributors to total sugars were: ‘Fruit products and dishes’, ‘soft drinks and flavoured mineral waters’ and ‘dairy milk’. d

No trends in children’s intake could be determined within New Zealand as currently only one data point exists. The relative contribution to energy intake  from  sucrose decreased as the children got older.e In Australia mean total sugar intake (natural and added)  for children remained at around 21-26% of total energy between 2007 and 2011.fg

These downward trends in actual intake are supported by apparent consumption data collected by Green Pool Commodities Specialist on behalf of the sugar industry that show apparent sugar consumption per capita has fallen by 26% between 1951 and 2011.h

More detailed information about how we are consuming sugar can be found in the sugar – what, where, when factsheet

TABLE 1: Sugar intake in New Zealand adults

   

New Zealand (median)

 

   

Total

Trend

Sucrose

Trend

   

1997

2008/09

1997

2008/09

Women

(g)

 99ga

96gb

 45ga

42gb

%E

 22%

22%

10% 

9.50%

 

 

 

 

 

 

 

 

Men

(g)

 131ga

120gb

  62ga

55gb

%E

 19%

20%

 9%

9%

TABLE 2: Sugar intake in Australian adults

   

Australia (mean)

   

Total

Trend

Added

   

1995

2011

2003

Women

(g)

 97gc

91gd

45gc

%E

 21%

20%

9%

 

 

 

 

 

 

Men

(g)

134c 

115gd

74gc

%E

 19%

19%

10%

NOTE: Where previous data is available, arrows indicate any change in sugar intakes. No arrow indicates there is no earlier data. Total sugar intake includes sugar from all sources including intrinsic sugars such as lactose in milk and free sugars added by the consumer or manufacturer.

TABLE 3: Sugar intake of New Zealand and Australian children

   

New Zealand (median)

 

Australia (mean)

   

Total

Sucrose

 

Total

Total

Trend

   

2002

 

2007

2011

Children

(g)

105-144ge

56-71ge

 

99-145g

92-122gg

>

%E

23-26%

12.6-14%

 

22.9-25.9%

21.4-24.5%

?

*Moderate intake of refined sugar defined as about 10 per cent of the total energy intake per day.i

References

a. National Nutrition Survey (Adults) 1997 (Russell et al, 1999)
b. National Nutrition Survey (Adults) 2008 (University of Otago and Ministry of Health, 2011)
c. Cobiac L et al (2003) Sugars in the Australian diet: results from the 1995 National Nutrition Survey. Nutr Diet 60:3
d. Australian Health Survey: Nutrition First Results - Food and Nutrients, 2011-12
e. Children’s Nutrition Survey 2002 (Ministry of Health, 2003)
f. 2007 Australian National Children’s Nutrition and Physical Activity Survey- Main Findings (Commonwealth of Australia, 2008)
g. Parnell W, Wilson N, Alexander D, et al.  Exploring the relationship between sugars and obesity.  Public Health Nutr. 2008; 11(8): 860-6.
h. Sugar Consumption in Australia. A Statistical Update. Brisbane. Green Pool Commodities Specialists. 2012
i. Sugar. Better Health Channel. October 2011. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Sugar

How many kilojoules of energy are there in sugar?

Sugars contain 17 kilojoules (kJ) of energy per gram. 1 rounded teaspoon of table sugar or sucrose is 4g (68 kJ).

Sugars have less than half the energy content of fat which contains 37 kilojoules per gram and almost half that of alcohol, which contains 29 kilojoules per gram.

Nutrient

Kilojoule content (kJ)

1g Carbohydrate 17
1g Protein 17
1g Alcohol 29
1g Fat 37

Why are sugars used in foods and drinks?

Sugars are mainly used for their sweetening properties but they also have many practical uses beyond this.

The functions of sugars in foods1

  • Used as a natural preservative and prevents bacteria from growing in products such as jam
  • Adds texture to give a smooth soft consistency to ice cream and frozen deserts
  • Enhances the flavour of fruit products such as chutney and tomato dishes
  • Gives flavour, texture and contributes to a golden colour to bread and baked products 
  • Balances the acidity of non-sweet foods such as sauces and salad dressing

Because of the many functions of sugars, they can be difficult to replace in foods. For example substituting fruit juice or other sweeteners for sugar in baking at home.

Further reading:
1Schorin et al (2012) The science of sugars part 1. Nutrition Today 47 (3) 96-101

What’s the difference between naturally occurring and added sugars? Are naturally occurring sugars better for you?

The human body cannot tell the difference between sugars which are found naturally in foods, like those in milk, fruit and vegetables, and those sugars which are added to foods during processing. All sugars, regardless of their source, are carbohydrates and provide the same amount of energy, 17 kilojoules per gram. The Food and Agriculture Organisation/World Health Organisation (see further reading below) recommended the term ‘Total sugars’ should be used to describe sugars in the diet and to avoid confusion1.

You will usually just see a figure for ’total sugars’ content in the Nutrient Information Panel (NIP) on a packaged food label. That is because there is no accurate or practical method of measuring sugars which are added, separate from the total sugars content of foods1.

Further reading:
1Cummings JH and Stephen AM. Carbohydrates terminology and classification. FAO/WHO scientific update on carbohydrates in human nutrition. Eur J Clin Nutr. Dec 2007;61 Suppl 1:S5-18  http://www.nature.com/ejcn/journal/v61/n1s/pdf/1602936a.pdf

Is there any difference between sugars in sweet foods and sugars in sweet drinks?

In terms of body weight, there is no clear adverse effects of sugars in sweet drinks versus sweet foods.1  Regardless of whether it is a liquid or solid, overall kilojoule content is what matters to total energy intake.2

It is often thought that sugar containing drinks are more rapidly absorbed in the body, and cause a rise and then crash in blood glucose levels.  In fact, soft drinks have a moderate GI, as does sucrose itself, and so does not cause large blood glucose fluctuations.3

Also, it is presumed sugar containing drinks do not make you feel as full (satiated) as sugar containing foods, however there is no clear agreement on this in scientific studies.4

When thinking about diabetes, it is interesting to note the most recent evidence based recommendations for prevention of Type 2 Diabetes do not mention sugar containing drinks.5,6  Associations with diabetes seen in the some research studies have not been proven in terms of causation in human intervention trials.4

Sugars provide kilojoules in the diet, and weight gain and obesity are related to consumption of too much energy from any source, solid or liquid, which is not burned off during physical activity.  For some people, drinking less sugar containing drinks or any other caloric beverage can help lower total kilojoule intake.

Further reading:
1Van Baak & Astrup (2009) Consumption of sugars and body weight. Obesity Reviews 10 (Suppl 1) 9-23
2 USDA. What is the impact of liquid versus solid foods on energy intake and body weight? Evidence Analysis Library 2010. http://www.nutritionevidencelibrary.com
3 Foster-Powell, K., Holt, S.H. & Brand-Miller, J.C. (2002) International table of glycemic index and glycemic load values: 2000. Am J Clin Nutr, vol. 76, no. 1, pp. 5-56.
Schorin et al. (2013) The science of sugars, Part 3. Sugars and chronic disease risks. Nutrition Today: 47 (5) 252-260.
5 Bantle JP, Wylie-Rosett J, Albright AL, et al. Nutrition recommendations and interventions for diabetes: A position statement of the american diabetes association. Diabetes Care. (2008) 31 Suppl 1:S61-78.
6 Dyson PA, Kelly T, Deakin T, et al. Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes. Diabet Med (2011) 28:1282-1288.

Is sugar responsible for the obesity crisis?

Sugars can be included as part of a healthy balanced diet.

Many people believe sugars are fattening however international scientific evidence has not shown a driect link between sugar intake and obesity1-5.   Sugars provide kilojoules in the diet however weight gain and obesity are related to consumption of too much energy from any source, which is not burned off during physical activity. 

As with all carbohydrates, sugars contain 17 kilojoules per gram. This is less than half the energy content of fat which contains 37 kilojoules per gram and almost half that of alcohol, which contains 29 kilojoules per gram.

In order to achieve and maintain a healthy weight it is recommended to choose nutritious foods within your energy needs and be physically active6,7.

Further reading:
1EFSA. Scientific Opinion on Dietary Reference Values for Carbohydrates and Dietary Fibre. EFSA Journal 2012; 8(3):1462 http://www.efsa.europa.eu/en/efsajournal/doc/1462.pdf
2FAO/WHO. (1997) Carbohydrates in human nutrition (FAO Food and nutrition Paper 66). FAO Rome  http://www.fao.org/docrep/w8079e/w8079e00.htm
3Institute of Medicine. (2005) Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, proteins, and amino acids. The national Academies Press. Washington, D.C.   http://www.nal.usda.gov/fnic/DRI/DRI_Energy/energy_full_report.pdf
4WHO/FAO (2003) Diet, nutrition and the prevention of chronic diseases. Joint WHO/FAO technical report Series No. 916. WHO Geneva http://whqlibdoc.who.int/trs/who_trs_916.pdf
5Parnell W, et al. (2007) Exploring the relationship between sugars and obesity. Public Health Nutrition. 11 (8) 860-6.
6National Health and Medical Research Council (2013) Australian Dietary Guidelines. Canberra: National Health and Medical Research Council. http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55_australian_dietary_guidelines_1.pdf
7Ministry of Health 2003 Food and Nutrition Guidelines for Healthy Adults - A Background paper. Wellington. Ministry of Health.  http://www.health.govt.nz/publication/food-and-nutrition-guidelines-healthy-adults-background-paper

Does sugar cause diabetes?

Sugar is not proven to cause diabetes. Diabetes is caused by inadequate production or a lack of the hormone insulin. The most common form of diabetes, Type 2, is strongly associated with overweight and obesity, low physical activity and family history.

For management, Diabetes Associations recommend a healthy balanced diet and physical activity, similar to the recommendations for any healthy population1,2.

There is no longer a need for people with diabetes to focus on a sugar free diet as this advice was not found to be based on scientific evidence1. Therefore, sugars can be included in moderation as part of a healthy meal plan for people with diabetes1,2

Further reading:
1Diabetes New Zealand. The facts about sugar and diabetes http://www.diabetes.org.nz/food_and_nutrition/healthy_food_choices__and__tips/food/sugar
2Diabetes Australia. Diabetes and food- what should I eat?  http://www.diabetesaustralia.com.au/en/NDSS-Content/Living-with-Diabetes/Eating-Well/What-Should-I-Eat/#Sugar

Does sugar increase risk of dental disease?

Sugars and cooked starches (bread, pasta) are fermentable carbohydrates that can increase the risk of tooth decay1.

Bacteria on the teeth can breakdown fermentable carbohydrates to produce acid, which can eventually lead to tooth decay or caries, without proper oral hygiene, especially fluoride toothpaste1.

The frequency or how often sugars and starches are consumed may be more important than the actual amount that is consumed, when considering risk of tooth decay2.

There are many factors linked to risk of tooth decay, other than just what we eat and drink3. These include the flow of saliva in the mouth, how long food stays in the mouth, whether teeth are regularly cleaned and if they are exposed to fluoride4.

Practical advice as guided by the New Zealand and Australian Dental Associations, in order to minimise the risk of dental decay:

If you have a sensible diet, a good flow of saliva, a cleaning routine and your teeth are regularly exposed to fluoride, decay is unlikely.

  • Be careful with how often you eat sugary foods or have sugary drinks5,6.
  • Brush and floss your teeth carefully to reduce the amount of bacteria on their surfaces5,6.
  • Use fluoride toothpaste5,6. This will make the surfaces of teeth more resistant to acid.
  • Eat a wide variety of nutritious foods6.
  • Visit the dentist for regular check-ups6.
Further reading:
1EFSA. Scientific Opinion on Dietary Reference Values for Carbohydrates and Dietary Fibre. EFSA Journal 2012; 8(3):1462
2Anderson CA, Curzon ME, Van Loveren C, Tatsi C, Duggal MS. Sucrose and dental caries: a review of the evidence. Obes Rev. Mar 2009;10 Suppl 1:41-54.
3FAO/WHO. (1997) Carbohydrates in human nutrition (FAO Food and nutrition Paper 66). FAO Rome
4Ruxton, C. H., Gardner, E. J. & McNulty, H. M. (2010) Is sugar consumption detrimental to health? A review of the evidence 1995-2006. Crit Rev Food Sci Nutr, 50, 1-19
5Australian Dental Association Inc. Your oral health. FAQ dental caries. Accessed 13 May 2013. http://www.ada.org.au/faqs/faq,documentid,26787,category,Dental_Caries.aspx
6New Zealand Dental Association. Healthy Smiles. Your oral health. Accessed 13 May 2013.  http://www.healthysmiles.org.nz/default,45,adults.sm

Are added sugars shown on food labels?

Almost all packaged foods and drinks in Australia and New Zealand are required to carry a Nutrition Information Panel, which must include the total amount of Carbohydrates, including total sugars in the product. This provides useful information for consumers to determine how much of the total carbohydrate is made up of sugars.

Some labels will also show how much each nutrient contributes to an average adult’s daily intake. The reference value for daily sugar intake is 90g1, so if a food contained 9g of sugar in one serve, this would be about 10% of your recommended daily intake.

Current nutrition labeling does not show what proportion of total sugars comes from naturally occurring sugars (for example those found in fruits, vegetables and milk products), and how much comes from ‘added sugars’. There is no readily available test to separate the added sugars content of a food or drink from the naturally occurring sugars - as they are chemically identical.

This is a complex issue. Within one food, the amount of added sugar may vary depending on natural sugar levels. Ingredients such fruits, vegetables and milk will have differing natural sugar levels depending on seasonality, variety, ripeness etc. In a food containing fruit ingredients less added sugar would be required when the fruits are very ripe, compared to when made with less ripe fruit.  However, overall the total amount of sugar in the final product remains the same every time it is made – and is shown on the label.

Where you will find information on added sugars is in the ingredients list.  These list all ingredients in the product with the largest amount being listed first, and the lowest ingredient listed last.  Looking at where sugars feature in the ingredients list will give an idea of how much and how many added sugars are in the food. For more information on labelling please click here.

Our bodies process sugars the same whether they come from within other ingredients (e.g. fruits), or are added. However, as part of the wider review of food labelling, the Food Standards Australia New Zealand (FSANZ) are looking into labeling approaches that might provide more information on sugar.

Reference1: www.foodstandards.gov.au

Is fructose bad for you?

Fructose is a sugar naturally found in honey and many fruits and vegetables. Table sugar or sucrose is made up of fructose and glucose in equal portions and is the most common sugar added in food production, therefore highly processed foods can also be a major dietary source of fructose.

Fructose has received a great deal of negative attention, largely due to differences in how the body breaks down sugars. While fructose is mostly metabolised by the liver, glucose can be metabolised in many different cells throughout the body. You can read more about this here.  

It has been suggested that high levels of fructose may have a harmful effect on the liver, cause high cholesterol, obesity and insulin sensitivity resulting in diabetes. However, a large proportion of the research underlying this argument is based on animal studies where unrealistically high intakes of pure fructose have been used.

Research from human studies show that when fructose is eaten at normal (physiological) levels, it does not cause any more or any less weight gain compared to other carbohydrates or any harm above that of other sources of excess calories in the diet1 . It also has no detrimental effect on metabolic health2,3.  At very high intakes (i.e. ≥ 100g/day, equivalent to 16 bananas or 18 apples/day) fructose may have adverse effects on health in people with metabolic disorders or in those who are overweight/obese. However, there is no evidence that fructose is the main factor in the development of these diseases, nor that it is harmful to everybody 2.

While the study of fructose at high intakes has certainly driven debate, the reality is that it is very uncommon for people to eat pure fructose, particularly in the levels required to see health problems. It is recommended that all added sugars, including fructose, be eaten in moderation.

References:

  1. Sievenpiper JL. Sickeningly Sweet: Does Sugar Cause Chronic Disease? No. Can J Diabetes 2016, 40: 287–295.
  2. Madero M, Arriaga JC, Jalal D, Rivard C, McFann K, Perez-Mendez O, et al. The effect of two energy-restricted diets, a low-fructose diet versus a moderate natural fructose diet, on weight loss and metabolic syndrome parameters: a randomized controlled trial. Metabolism, 2011 Nov; 60(11):1551-9.
  3. Tappy L, Mittendorfer B. Fructose toxicity: is the science ready for public health actions? Curr Opin Clin Nutr Metab Care, 2012 May.

Further reading:

Sign up to our newsletter

Receive the latest newsletter with research on sugar. Plus insights from scientific experts.


View previous issues