FA CT S H E ET
Sugar - what, where, when?
This fact sheet looks at the intake of sugars in Australia and New Zealand.
It summarises the scientific evidence on sugars intake and obesity and current
advice on how much we should be consuming.
Sugars are types of carbohydrates which are found in a wide
variety of foods. Carbohydrates contain carbon, hydrogen and
oxygen and are the main energy source for the body. As such,
sugars are an integral part of our diet. Sugars are present in many
different forms, and perform numerous roles in foods and beverages.
There is often misunderstanding about where sugars occur in the diet
and exactly how much we are consuming. The following information
is an overview of the scientific evidence on these topics.
Where is sugar in our diet?
As shown in Table 1, the sugars in our diet come from
different sources, and there are varying ways in which
TYPES OF SUGARS
ingredients list. At the same time, the body does not
› BARLEY MALT
› CAROB SYRUP
› CORN SYRUP
› DEXTRAN
› DEXTROSE
› DIATASE
› DIASTATIC MALT
› ETHYL MALTOL
› FRUCTOSE
› FRUIT JUICE
› FRUIT JUICE
distinguish between sugars which occur naturally and
CONCENTRATE
those which are added, and they both contribute the
› GLUCOSE
› GRAPE SUGAR
these are described. Some sugars are naturally
present in foods, and some are added to foods.
‘Sugar’ or ‘table sugar’ typically refers to sucrose
from sugarcane or sugar beets. Food composition
data on sugars, often do not record added and
naturally occurring sugars. This is because there is no
practical method to measure these separately and
accurately.1 Total sugars is usually reported, and the
presence of added sugars can be determined by the
same amount of kilojoules to the diet. Australian and
› HIGH - FRUCTOSE
CORN SYRUP
(HFCS )
› HONEY
› INVERT SUGAR
› LACTOSE
› MALT SYRUP
› MALTODEXTRIN
› MALTOSE
› MANNITOL
› MOLASSES
› SORBITOL
› SORGHUM SYRUP
› SUCROSE
How much sugar
do adults eat?
KEY FINDINGS OF THE 2008/09
NEW ZEALAND ADULT NUTRITION
SURVEY (2011) 2
Carbohydrate provided 46% of daily energy
intake for males and 47% for females. The
main source of carbohydrate in New Zealanders’ diets was bread (17%). Males had a
greater total sugar intake than females
although overall the proportions of sugar from
sucrose, fructose, and lactose were relatively
similar, see Table 2.
TABLE 2
Sugars intake in New Zealand adults
(median, g/d) 2
ALL
MALES
FEMALES
New Zealand national nutrition surveys provide us
Total sugars
107
120
96
with the best information on sugars in our diets.
Sucrose
48
55
42
Fructose
20
22
18
Lactose
13
14
12
TABLE 1 - TERMS USED TO DESCRIBE SUGARS 1
TERM
DEFINITION
Free sugars
All monosaccharides and disaccharides added to foods by the
manufacturer, cook or consumer, plus sugars naturally present in
honey, syrups and fruit juices. Difficult to measure accurately.
Added sugars
Sugars added during cooking, preparation and manufacturing of
food. Difficult to measure accurately.
Sucrose
A disaccharide of fructose and glucose that occurs both naturally
in foods and as added sugar. Table sugar is sucrose extracted
from sugar cane or sugar beet. Because sucrose intake is easier to
measure, it is sometimes used as a proxy for intake of added sugars,
although is a slight overestimation.
Total sugars
All naturally occurring and added sugars that contribute to overall
sugar intake.
Fruit (18%), non-alcoholic beverages (17%),
sugar and sweets (15%), and milk (10%) were
the major sources of total sugars.
The majority of people consumed soft drinks
or energy drinks never or less than once a
week (57%). A small proportion consumed
soft drinks daily (7%).
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FA CT S H E ET
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How much sugar do we eat?
Differences between the 1997 and 2008/2009 New Zealand nutrition surveys for adults
• The reported energy intake of
New Zealanders aged 15 years and over
has dropped since 1997, although the
decrease for females was not significant
• Total sugars intake has decreased in both
males and females compared with 1997
• Median daily sucrose intake was 48g
in 2008/09 (down from 53g in 1997),
contributing approximately 9% of
total energy.
KEY FINDINGS OF THE 1995 AUSTRALIAN NATIONAL NUTRITION SURVEY (1997)
3, 4
Carbohydrate provided approx. 45% of daily energy intake for Australian adults. The percent contribution of sugar decreased with age, and that
of starch increased slightly with age. Sugars intake was greater for males than for females, although there was little difference in percent energy
contribution between the sexes (Table 3). The largest contributor to total sugars intake in all adults was non alcoholic beverages, followed by
milk products and dishes. These categories made up about half of all sugars consumed. Sugar based drinks contributed to 16% of the total
sugars intake in men and 19% in women.
MEAN SUGARS INTAKES IN AUSTRALIAN ADULTS 4
TABLE 3
Differences between the 1983 and 1995 Australian adult
national nutrition surveys.5
• Mean intake of total carbohydrate increased among men and
women.
Males
Females
Total sugars (g/d)
% total energy
134
19
97
21
• Total sugars intake increased significantly between 1983 and 1995
by 14 g in men and 5 g in women.
Added sugars (g/d)
% total energy
74
10
45
9
Natural sugars (g/d)
% total energy
60
9
52
11
• Regarding the percent energy contribution, the proportion of
energy from total sugars increased between 1983 and 1995 from
~18 to 20% in men, and stayed relatively constant at 21% in
women.
How much sugar do children eat?
ANALYSIS OF NZ CHILDREN’S NUTRITION SURVEY (2002) 6
• Mean total sugar intake contributed 23-26% of total energy intake
across all age groups (5 – 14 years); sucrose accounted for approximately half of this.
• The main contributors to total sugars intake were beverages (all hot
and cold beverages excluding plain milk) (24%), fruit (17%) and sugar
and sweets.
• Sucrose was the most predominant form of sugar in children’s diets.
• The main contributors of sucrose were beverages (26%), sugar and
sweets (21%), fruit (11%) and biscuits (11%).
• Principle sources of overall energy were: Bread and bread-based
dishes (17%), potatoes, taro and kumara (8%), milk (6%), biscuits
(6%) and beverages.
• Sugar, sweets, cakes and muffins contributed less than 10% of total
energy.
• Powdered drinks contributed the most sucrose from beverages
(45%), followed by soft drinks (33%).
ANALYSIS OF THE 2007 AUSTRALIAN NATIONAL
CHILDREN’S NUTRITION AND PHYSICAL ACTIVITY
SURVEY (ANCNPAS) 7, 8
• Mean total sugar intake contributed 23-26% of total energy
intake across all age groups (2-16 years).
• Milk products and dishes, non-alcoholic beverages and fruit
products and dishes made the largest contributions to total
sugar intakes.
• Cereal and cereal products,milk products and dishes, and
cereal-based products and dishes contributed 17%, 18% and
16% respectively, to total energy intake.
• Confectionery and cereal/nut/fruit/seed bars contributed less
than 10% of total energy.
• Soft drinks and flavoured mineral waters contributed less than
3% of total energy intake.
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FA CT S H E ET
Relationship between sugar intake and obesity
Sugars provide energy. It is often assumed that there is a direct and
causative relationship between sugar and obesity, however the
causes of obesity are now well known to be multi-factorial.
• For both adults and children there was no significant difference
between overweight/obese and normal individuals regarding energy
intake from the four different diet types.
Studies have found an inverse relationship between sucrose intake
and body weight or Body Mass Index (BMI) 9, 10, 11 and the Institute of
Medicine concluded there was “no clear and consistent association
between increased intake of added sugars and BMI”.12 Reducing
sugar consumption may lead to weight loss (or a reduction in weight
gain), if there is an energy deficit. Although the same could be said for
other energy containing nutrients.
• There was no significant relationship between sucrose from
sugar-containing beverages and BMI amongst children or adults.
This included alcohol for adults.
The association between the consumption of sugar sweetened
beverages (SSB) and weight gain or obesity has gained much
attention, both scientifically and politically, but research has been
conflicting. Evidence from randomised controlled trials suggests a
possible link between SSBs and bodyweight, largely due to their
additive effect on total energy intake,13, 14 though reviews show not all
studies have consistent findings.15, 16
In New Zealand, analysis was carried out on the 2002 children’s and
1997 adult national nutrition surveys looked at the relationship
between the intake of sucrose (from 24 hour diet recall data) and
BMI.17 The researchers concluded that there was no evidence of a
positive association between sugar (total sugars) or sucrose intake
and body weight.
• Obese men, women and children had significantly lower intakes of
sucrose from sugar-containing beverages than normal weight
individuals.
In Australia, further analysis of the 1995 National Nutrition Survey
revealed no significant associations between sugars intakes and
health variables4.
The authors examined total, added sugars and sugars from naturally
occurring sources. Survey dietary data was collected using the 24
hour recall method.
• For both men and women, intake of sugars did not significantly
contribute to variance in BMI. Data was adjusted for age, exercise,
use of weight reduction diets, under- or over-reporting, and total
energy intake.
• There was no significant association with systolic or diastolic blood
pressure, or blood pressure risk categories.
Other interesting conclusions included the following:
• No significant relationship observed between sugar intake and
self-reported health status.
• Total sugars intake but not sucrose was significantly lower amongst
obese, compared to normal weight children.
• The authors concluded intakes of sugars are poor predictors of
health variables.
• The predominant diet type for children was low fat/high sugar
(35%) and for adults high fat/low sugar (40%).
Recommended intake of sugar
In relation to sugars, the New Zealand Food and Nutrition Guidelines
series state: 'Prepare foods or choose pre-prepared foods, drinks
and snacks.... with little added sugar; limit your intake of high-sugar
foods.'18 The Australian Dietary Guidelines state: 'Limit intake of foods
and drinks containing added sugars such as confectionary, sugarsweetened soft drinks and cordials, fruit drinks, vitamin waters,
energy and sports drinks'.19
The European Food Safety Authority reviewed the evidence and
found insufficient data in order to set an upper limit for intake of
(added) sugars.20 This was based on risk of dental caries, weight gain,
micronutrient denisty of the diet, serum triglyceride and blood
cholesterol. The World Health Organisation recommend that no more
than 10% of our total energy comes from free sugars.21 However, it
should be noted that this recommendation is based on risk of dental
caries, rather than obesity, and also the interpretation of a range of
epidemiologic, social, economic and political impacts rather than
being solely based on scientific evidence.22
ENERGY VALUES
The energy provided by carbohydrate is similar to protein while
fat provides over twice the energy content. Whatever form sugars
are consumed in, it contributes to our energy intake, with every
gram providing 4kcal of energy. Appropriate intake of sugar is
dependent on an individual’s total energy intake and output, and
what foods or drinks have provided that sugar. In general it is
recommended that carbohydrate (which includes sugars) should
contribute 45-65% of total energy.12
TABLE 3
Carbohydrate (including sugars)
4kcal or 17kJ per gram
Protein
4kcal or 17kJ per gram
Fat
9kcal or 37kJ per gram
Alcohol
7kcal or 29kJ per gram
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FA CT S H E ET
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Recommended intake of sugar
The New Zealand Food and Nutrition Guidelines provide the following
practical advice on carbohydrates in the diet18:
• Eat a variety of carbohydrate foods including bread, cereal and
legumes
• Include wholegrain/wholemeal breads and cereals in the diet.
• Eat plenty of fruit and vegetables
• Remember that plant foods such as cereals, bread, vegetables ,
fruit and legumes are good sources of dietary fibre.
• Choose foods and drinks that are low in sugar to avoid excess
energy intake. Remember that non-alcoholic beverages such as
soft drinks and fruit juices are a significant dietary source of sugar.
• Sweets, honey, sweet spreads and dried fruits are concentrated
sources of sugar.
• Keep high sugar foods such as cakes and sweets for treats.
• To reduce dental decay, restrict the frequency of eating foods and
drinking beverages with high sugar content. If eating sugary foods,
do so at mealtimes instead of between meals.
Discussions around sugar intake should also consider a number of
other factors which include the following:
• Overall energy density of the food (total energy per gram). This will
be determined by total fat and water content
• Total amount of the food consumed and therefore total kilojoules
from all dietary sources
WHAT IS HIGH-FRUCTOSE CORN SYRUP?
High-fructose corn syrup (HFCS) is a sweetener derived from corn.
It is used by the food industry in the USA and some other
countries. Although not typically used in Australia23 or NZ, it may be
an ingredient in some imported food products. Like sucrose, it is a
mixture of glucose and fructose, though the ratio of glucose to
fructose varies. The most common form is HFCS-55, which is 55%
fructose and 45% glucose.
OUR PREFERENCE FOR SWEET TASTE
We all have a preference for sweet taste, which is with us from
birth. The body's sensory system has evolved to detect the basic
tastes. Sweetness can indicate energy rich food that is safe to eat.
This natural preference for sweet taste is often linked to the idea of
food addiction, as a cause of obesity. However studies have not
found sucrose is addictive in humans24 and urge caution when
considering the scientific evidence for this concept25.
CONCLUSION
Sugars in the diet come from a great many food sources. The
body cannot differentiate between sugar that is naturally
present in a food or drink from that which is added. It is also
difficult to separate and measure the two, analytically.
A simple way of looking at a healthy balance is to first ensure
that total energy intake does not exceed energy output.
Secondly; it is advisable to ensure that the overall nutrient
composition of the diet is sufficient, by eating a wide range of
foods from the main food groups.
A moderate amount of sugar can be included and enjoyed as
part of a varied and balanced diet and an active lifestyle.
REFERENCES
1. Cummings JH & Stephen AM (2007) Carbohydrate terminology and classification. Eur J Clin
Nutr. 16, Suppl 1, S5-S18
2. University of Otago and Ministry of Health (2011). A Focus on Nutrition: Key findings of the
2008/09 New Zealand Adult Nutrition Survey. Wellington: Ministry of Health.
3. Australian Bureau of Statistics. Nutrition Survey: selected highlights. Australia (1995) (cat.
No. 4802.0)
4. Cobiac L et al (2003) Sugars in the Australian diet: results from the 1995 National Nutrition
Survey. Nutr Diet 60:3
5. Cook T et al (2001) Comparable data on food and nutrient intake and physical measurements from the 1983, 1985, and 1995 national nutrition surveys. Australian Food and
Nutrition Monitoring Unit.
6. Ministry Of Health (2003) NZ Food: NZ Children key results of the 2002 National Children’s
Nutrition Survey , Wellington
7. Department of Health and Ageing 2007 Australian National Children’s Nutrition and Physical
Activity Survey: Volume 1: Foods Eaten. Commonwealth of Australia, (2012)
8. Department of Health and Ageing 2007 Australian National Children’s Nutrition and Physical
Activity Survey: Volume 2: Nutrient Intakes. Commonwealth of Australia, (2012)
9. Saris WH. (2003) Sugars, energy metabolism, and body weight control. Am J Clin Nutr;
78(4):850S-857S.
10. Hill JO, Prentice AM. (1995) Sugar and body weight regulation. Am J Clin Nutr.;62(1
Suppl):264S-273S; discussion 273S-274S.
11. Gibson SA. (1996) Are high-fat, high-sugar foods and diets conducive to obesity? Int J Food
Sci Nutr.;47(5):405�15.
12. Institute of Medicine, (2002). Dietary carbohydrates: sugars and starches. Dietary Reference
Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino
Acids. National Academies Press, Washington
13. de Ruyter JC, et al. (2012) A trial of sugar-free or sugar-sweetened beverages and body
weight in children. N Engl J Med.; 367(15): 1397-406.
14. Ebbeling CB, et al. (2012) A randomized trial of sugar-sweetened baeverages and
adolescent body weight. N Engl J Med.; 367(15): 1407-16.
15. Van Baak BA, Astrup A. (2009) Consumption of sugars and body weight. Obes
Rev.;10(suppl):9Y23.
16. Vartanian LR et al. (2007) Effects of soft drink consumption on nutrition and health: a
systematic review and meta-analysis. Am J Public Health.; 97: 667-75.
17. Parnell W et al. (2008) Exploring the relationship between sugars and obesity. Public Health
Nutr. 11(8): 860-6. Epub 2007 Sept 21
18. Ministry of Health (2003) Food and Nutrition Guidelines for Healthy Adults: a background
paper, Wellington.
19. National Health and Medical Research Council (2013) Australian Dietary Guidelines.
Canberra: National Health and Medical Research Council.
20. EFSA (2010) Scientific Opinion on Dietary Reference Values for Carbohydrates and Dietary
Fibre. EFSA Journal; 8(3):1462
21. World Health Organization, Diet Nutrition and the Prevention of Chronic Diseases, Report of
a Joint WHO/FAQ Expert Consultation. WHO Technical Report Series 916. Geneva, 2003.
22. Ruxton, C. H et al (2010) Is sugar consumption detrimental to health? A review of the
evidence 1995-2006. Crit Rev Food Sci Nutr, 50, 1-19
23. Green pool commodity specialists. (2012) Sugar consumption in Australia. A statistical
update.
24. Benton D. (2010) The plausibility of sugar addiction and its role in obesity and eating
disorders. Clin Nutr.;29(3):288Y303.
25. Ziauddeen H & Fletcher PC. (2013) Is food addiction a valid and useful concept? Obesity
Reviews. Jan;14(1):19-28
The Sugar Research Advisory
Service (SRAS) is a scientific
information service funded by
the New Zealand Sugar Company
Limited and Sugar Australia.
The SRAS is advised by
a panel of independent health
and nutrition experts.
To contact SRAS and for further
information please go to
www.SRASANZ.org
Last updated August 2013
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