My heart rate was significantly raised this morning while at the gym. Not because of my less than challenging treadmill pace, but because of a news item that came onto breakfast TV about the new food labelling system that is expected to be in place by the Summer of 2013.
I wrote about the public consultation on the subject that took place in July 2012. At that stage I was full of giddy optimism that my eloquently worded appeal would result in a Marvellous New World of clearly labelled, impeccably helpful packaging that assisted the entire UK in making better food choices, but in particular supported the millions of people living with (or at risk of developing) diabetes of one form or another - something upward of 5% of the population by 2010's numbers. The people for whom this stuff really matters.
The precise details of the new front of pack splodges are still being worked out, but from what I've read my life is about to get just a little bit more difficult and I'm going to be very grateful that my phone has a calculator on it.
I don't really have a particular problem with the traffic light system as an infographic device, my concern is based mostly on the information that the current systems display, and in particular the obsession with listing 'of which sugars'.
Let's just get this straight, 'of which sugars' is an almost entirely useless piece of information. Well, not quite. If you were comparing two products side by side that were virtually identical in all other respects, then perhaps 'of which sugars' might be worth casting an eye over.
The Really Big Problem is that most people *think* they know what 'of which sugars' means. People will believe (because they have always been told that this is the case) that all food with lots of sugar in it will zoom straight into the bloodstream, while food with no added sugar will be absorbed more slowly. Like most of the best misconceptions this opinion persists because it is almost true. Food with a large amount of added sugar is likely to hit your bloodstream fast. But there are many many foods which are broken down significantly faster than sucrose. And the REALLY Really Big Problem is that many of the foods that break down in the gut faster than sucrose (table sugar) are the very same ones that people think of as being 'healthy'. Brown or wholemeal bread, for example... Pretty much any breakfast cereal you can think of... Mashed or baked potato...
The Glycemic Index (or more helpfully the Glycemic Load which takes portion size into account) is a measure of how disruptive a food is likely to be to blood glucose levels. To measure GI a smallish number of test subjects are usually given 50g in carbohydrate of a particular food and then their blood glucose levels are measured to establish how fast the energy in the food hits the bloodstream. Simplistically, all carbohydrate is made up of units of monosaccharides (glucose) joined up in chains. The easier it is to break down the chains into glucose, the faster it will be absorbed. On the GI scale, pure glucose scores 100. Sucrose, table sugar scores a 'moderate' 60. Despite it's 'starchy' reputation the carbohydrate in wheat is very readily broken down and there is far less difference between white and brown versions than we might hope for - exact values will vary, but wholemeal bread is likely to be between 68 and 78. Yes, that's right... gram for gram of carbohydrate it's faster than sugar. When you begin to look at breakfast cereals things get even more bizarre as far as the 'of which sugars' is concerned. Cornflakes weigh in at a blistering 77-93, while Crunchy Nut drop a little at 72 and Frosties score a mere 55. These breakfast cereals will be slowed a little when eaten with milk, but completely counter-intuitively the ones with added sugar are *slower* than those without, presumably because the corn itself is so darned fast.
That's not to say that any of the foods I mentioned are necessarily 'off limits' for a person with (or without!) diabetes - but I really think we need to get over our obsession with sugar in this country and especially where food labelling is concerned. A low 'of which sugars' does not make something OK. It cannot be relied upon as a marker of how quickly the carbohydrate in a food will pass into your bloodstream at all. And for a T1 person playing at being their own pancreas, or a T2 attempting to eat in a way which helps their wonky metabolism this stuff really matters.
From a carb-counting type 1 perspective the proposed changes are also incredibly inconvenient. This fatuous obsession with the display of 'sugar content' means that prepackaged foods will, most likely, no longer display total carbohydrate content per portion, certainly not on the front of the packs. Sainsbury's made this change some time ago adopting a 'traffic light' system and it bugs me every time I need to eat something of theirs. I find myself scrabbling around on the back of the pack for the 3.5pt 'per 100g' details then have to fish out a calculator and endure some mathematic acrobatics to evaluate what my portion of a 326g pack will end up being in terms of carbohydrate. And it used to be just written there in big letters 'per serving'.
Of all the groups of people in the UK with a borderline obsessive interest in what food contains, the ones who stand with furrowed brow in supermarkets poring over pack labelling smallprint more often than perhaps any others are those living with diabetes. This initiative *could* have made our lives easier, it could have included GI indications as standard, and scored total carbohydrate as a proportion of Guideline Daily Amounts so that people went easier on carbs generally. Who knows - that could have saved 1000s of people from developing T2D in the first place if their metabolisms are already beginning to struggle. Instead we are stuck in the same old rut of sugar=bad, fat=bad, carbs=good which just isn't helping anyone.
I await next summer's pack designs with a heavy heart.
What can we do about this Mike?
ReplyDeleteI also posted my comments in response to the consultation. This government have had to do some u-turns, perhaps we need to up the anti - I think it's time to write to my MP using your posting as my outline proposal. (Currently in Singapore, but will act on my return next week!)
Really good thought Heasandford - the BBC article suggests the 'detail' for proposed new front-of-pack labels was being worked out this week, so in part I'm just guessing that they will follow along the lines of current traffic light systems and feature sugar rather than carbs (because that's what it says in the news article). May need to do a bit more fishing and see if there are any published details yet.
ReplyDeleteEnjoy Singapore! (have you had Chilli Crab yet? Mmmmmmmmmm)
Hi there,
ReplyDelete(We have to post this in two parts as there's a character limit for comments!)
Just to give you a bit more detail around our position on traffic light labelling after our initial response to your post on our Facebook page.
Firstly, you may be interested in reading both our position statement on traffic light labelling, as well as our subsequent response to the consultation that took place in July 2012 – here’s a link to both on our website:
Position statement to traffic-light-labelling: http://www.diabetes.org.uk/Documents/Position%20statements/food-labelling-briefing-0512.pdf
Consultation response: http://www.diabetes.org.uk/About_us/Our_Views/Consultations/Past_responses/Consultation-on-front-of-pack-nutrition-labelling/
This particular consultation was aimed at the UK’s population as a whole, to address rising obesity, as well as poor dietary-choices and diet-related chronic conditions which are also increasing in the UK. We do realise that the traffic light labelling does not address or include information for people who are affected by specific health conditions. Therefore this consultation doesn't address your concerns regarding information on total carbohydrates and ‘of which sugars’ to be included within the traffic light label, as regards the perspective of managing blood glucose levels, and you are quite right in that sugar in itself does not cause diabetes. However, products which contain a high content of sugar can contribute to weight-gain if eaten in quantity, and so where total sugars are listed within the traffic light, it does enable people to see if a product is healthy or balanced and are therefore able to make more informed choices.
Agreed EU-wide controls on food labelling were introduced in a number of directives and nutritional labelling information relating to ‘of which sugars’ will continue to be listed as it has been mandated under these EU directives.
You also mention the possibility of ‘GI’ or ‘GL’ labelling, which we agree, could be helpful information for consumers. However, though we understand that this system can be helpful to some people, it does have its limitations – for instance, some foods listed with a low GI index can be very unhealthy (chocolate, cake and ice cream), whereas some foods with high GI ratings are healthy foods and are widely eaten in countries with low rates of diabetes (such as potatoes and rice). Also, as you know, the GI of a food only tells you how quickly or slowly it raises the blood glucose when the food is eaten on its own. In practice, we usually eat foods in combination as meals - bread is usually eaten with butter or margarine, or as an accompaniment to a meal, or another example; potatoes are often eaten with meat and vegetables. So cutting out all high GI foods is not the answer. The good thing is you can apply the GI concept so that you can lower the overall GI of a meal by including in it more low GI foods, and we do try to encourage people to think about the overall balance of meals, which should include starchy foods and be low in fat, salt and sugar.
(Continued in next comment...)
(Part 2...)
ReplyDeleteAs regards to 'GI' or 'GL' labelling, a product can only carry a GI rating if they have been tested by a legitimate testing service and currently, only a few nutrition research groups around the world can provide this service. This may be why only a very small proportion of food products have been tested. It is an expensive process, and as yet has not been made compulsory by the Food Standards Agency - we can only guess that this is one of the reasons more manufacturers don't test.
Another aspect we wanted to tackle was consistency of labelling – a number of manufacturers and supermarkets do offer these types of labels on their products, but are all different which can be confusing for consumers.
With regards to whether people should eat low carbohydrate diets and diet information in general, Diabetes UK believes that for most people it is sensible to eat a balanced healthy diet which is low in fat (especially saturated fats), low in sugar and highly refined carbohydrates, and low in salt.
What we want is to help people to find a way of eating healthily that they can stick to and enjoy - and for most people with diabetes (and for most people without diabetes as well) that means that people are better served by a diet that incorporates a reasonable portion of starchy carbohydrate at each meal. It is also important that people watch the amount they eat as well as the foods they eat.
I do hope that this is helpful and that you can understand Diabetes UK’s position on this, but please do get back to us if you have any further questions or points you want to raise with us.
Nikki Joule
Senior Policy Officer
Diabetes UK
I did write to my MP who sent me a letter saying he had written to Dr Dan Poulter who is the newly-appointed relevant Health Minister. In saying that I almost felt that my MP wasn't very confident of a reply! I'll let you know if I hear anything. Apparently patients' experiences is one of his 'things' so I should be a high priority!
ReplyDeleteI have had a reply via my MP from the Department of Health. It is an over-complex so-called explanation from which I have finally discovered why nothing we would want is going to happen. (I am happy to pass on the letter, but no idea how to add an attachment) The choice of which nutrients are to be on the Front of Pack was determined many lifetimes ago, since they are 'regarded as having key importance for public health'. As such, that part of the consultation was never up for discussion at all, so we were always on a hiding to nothing there. The latest EU legislation allows for the voluntary REPETITION of nutritional details on the front of pack, although these MUST comprise of energy value only or energy value plus fat, saturates, sugars and salt PER PORTION.ie NOT carbohydrate.
ReplyDeleteThe last paragraph of the letter irritates me even more. The 'good' part is that from 13th December 2016 (!), almost all foods will have to provide nutritional information per 100g/ml on the back of the pack (including carbohydrate content, following previous legislation)The not-so-good bit is that the same information PER PORTION will remain voluntary, although it says '...we anticipate that in practice the majority of producers in the UK will continue to express this information...as well'. My feeling is that they will not, because they are also apparently displaying it on the front. You can tell by the capitals that I am not happy. I share your frustration. The consultation was only about the way to display the information. Interestingly, EU research seems to show that it makes no difference! http://www.eufic.org/article/en/nutrition/food-labelling-claims/expid/pan-eu-study-nutrition-labelling-eufic-forum-4/
There is other interesting stuff in the website if you haven’t got a life….
Thanks very much for the update Heasandford. Unfortunately it is much as we diabetics feared then. What a wasted opportunity :( And meanwhile everyone and their Aunt will continute to believe that there is something 'special' about the carbohydrate provided by sugar. Humph!
ReplyDelete