The Role of Fructose as a Cardiovascular Risk Factor: An Update

There is increasing presence of fructose in food and drinks, and some evidence suggests that its higher consumption increases cardiovascular risk, although the mechanisms still remain not fully elucidated. Cardiovascular diseases (CVD) are still responsible for one-third of deaths worldwide, and therefore, their prevention should be assessed and managed comprehensively and not by the evaluation of individual risk factor components. Lifestyle risk factors for CVD include low degree of physical activity, high body mass index, alcohol consumption, smoking, and nutritional factors. Indeed, nutritional risk factors for CVD include unhealthy dietary behaviors, such as high intake of refined foods, unhealthy fats, added sugars, and sodium and a low intake of fruits, vegetables, whole grains, fiber, fish, and nuts. Even though there is no definitive association between CVD incidence and high consumption of total sugar, such as sucrose and fructose, there is, however, evidence that total sugars, added sugars, and fructose are harmfully associated with CVD mortality. Since high fructose intake is associated with elevated plasma triglyceride levels, as well as insulin resistance, diabetes hyperuricemia, and non-alcoholic fatty liver disease, further longitudinal studies should be conducted to fully elucidate the potential association between certain sugars and CVD.

Highlights on the Labels of Packaged Foods Sold in Jordanian Market from A Cross-Sectional Study

Jordan has adapted a strategy to prevent chronic diseases. Accordingly, Ministry of Health is looking for controlling food labeling particularly food fat, trans-fat, and caloric content. This study aimed to screen the food label of products that are sold in Jordanian market in terms of serving size, energy, macronutrient, fiber, total and added sugars, saturated and trans fat, cholesterol, dietary fiber, and micronutrient contents. A cross-sectional study was performed to screen the food label for the food products based on the standards of The United States Food and Drug Administration (FDA) regulations of 2016 and Jordan Food and Drug Administration (JFDA). Generally, food labels were not clear. The screened products were compliant with JFDA standards and not in compliance with some FDA standards. In addition, many products were found to be sources of added sugars, Na, and saturated fats. Stakeholders and legislators are called to focus on developing new laws, regulations, and polices for developing food label. Food manufacturers are needed to work hardly on developing informative, clear, easy-to-understand, and attractive food labels. The legislators of food label policies are called to look for ways to indicate the presence of high amounts of dietary risk factors such as sugars, added sugars, Na, saturated, and trans fats in packaged foods.

A Progressive Nutrient Profiling System to Guide Improvements in Nutrient Density of Foods and Beverages

Improving the nutrient density of processed foods is one way to bring the global food supply closer to the WHO Sustainable Development Goals. Nutrient profiling (NP) has emerged as the preferred method of monitoring the progress toward product innovation and reformulation. This paper presents PepsiCo Nutrition Criteria (PNC), a new internal NP model that was designed to guide and monitor improvements in nutrient density and overall nutritional quality of foods and beverages. The new PNC NP model assigns food products into four classes of increasing nutritional value, based on the content of nutrients to limit, along with nutrients and ingredients to encourage. The nutrient standards used for category assignment followed those developed by global dietary authorities. Standards are proposed for calories, sodium, added sugars, saturated, and industrially produced trans fats. Also included are minimum values for food groups to encourage, low-fat dairy, and for country-specific gap nutrients. Internal use of the NP model has spurred product changes that are consistent with WHO goals for industry transparency. An audited review of company products showed that 48% met added sugar, 65% met sodium, and 71% met saturated fat goals. By the end of 2020, in the top 26 regions in which products are sold, 48% of the total sales volume of global beverages had 100 kcal or less from added sugars per 355 ml serving representing 80% of beverage volume and over 90% of food volume sold globally. The PNC NP model is not consumer-facing but is specifically intended for internal use to motivate stepwise and incremental product innovation and reformulation. Transparent and published NP models further WHO goals of engaging industry stakeholders in the (re)formulation of processed foods and beverages consistent with public health goals.

Losing sleep by staying up late leads adolescents to consume more carbohydrates and a higher glycemic load

This study examined how short sleep impacts dietary consumption in adolescents by testing whether experimentally shortening sleep influences the amount, macronutrient content, food types, and timing of food consumed. Ninety-three adolescents completed a within-subjects crossover paradigm comparing five nights of short sleep (6.5-hour sleep opportunity) to five nights of Healthy Sleep (9.5-hour sleep opportunity). Within each condition, adolescents completed three multiple-pass dietary recalls that recorded the types, amount, and timing of food intake. The following outcomes were averaged across days of dietary recall within condition: kilocalories, grams of carbohydrates, fat, protein, and added sugars, glycemic load of foods, and servings of specific types of foods (low-calorie drinks, sweetened drinks, fruits/vegetables, meats/proteins, processed snacks, “fast food” entrees, grains, and sweets/desserts). Timing of consumption of kilocalorie and macronutrient outcomes were also examined across four noncumulative time bins: 06:00–10:59, 11:00–15:59, 16:00–20:59, and 21:00–01:00. Adolescents slept 2 h and 20 min longer in Healthy Sleep than in Short Sleep (p < .0001). While in Short Sleep, adolescents ate more grams of carbohydrates (p = .031) and added sugars (p = .047), foods higher in glycemic load (p = .013), and servings of sweet drinks (p = .023) and ate fewer servings of fruits/vegetables (p = .006) compared to Healthy Sleep. Differences in consumption of kilocalories, fat, and carbohydrates emerged after 9:00 pm (ps = .012, .043, .006, respectively). These experimental findings suggest that adolescents who have insufficient sleep exhibit dietary patterns that may increase the risk for negative weight and cardiometabolic outcomes. Future health promotion efforts should include promoting optimal sleep to increase healthy dietary habits.

Assessment and Evaluation of the Intake of Sugars in European Countries

The intake of sugars is a trending topic in nutrition and health. For an evaluation of the sugar intake (comparison with existing guidelines), up-to-date information on the guidelines, dietary intake and trends in the intake is needed. The available information for European countries is presented in this review. The existing guidelines on the intake show that there is currently no consensus among the experts from different organizations. The differences are mainly due to the selection of the adverse health outcomes for which there is sufficient evidence. Data from national European surveys show that the mean proportion of energy coming from added sugars for most European population groups is below 10%, and that the trend in the intake seems to be downwards. There are, however, many serious uncertainties and assumptions needed for the assessment of the intake of sugars. For instance, the assessment reflects a short period of the lives of the respondents, the data collection in several surveys was conducted more than 10 years ago, and recent reformulations of the industry are not considered in the food composition tables. Due to the uncertainties regarding the assessment of the sugar intake in Europe, the information should be used prudently and with care.

HP1a-mediated heterochromatin formation inhibits high dietary sugar-induced tumor progression

High dietary sugar (HDS) is a modern dietary concern that involves excessive consumption of carbohydrates and added sugars, and increases the risk of metabolic disorders and associated cancers. However, epigenetic mechanisms by which HDS induces tumor progression remain unclear. Here, we investigate the role of heterochromatin, an important yet poorly understood part of the epigenome, in HDS-induced tumor progression of Drosophila Ras/Src and Ras/scrib tumor systems. We found that increased heterochromatin formation with overexpression of heterochromatin protein 1a (HP1a), specifically in tumor cells, not only decreases HDS-induced tumor growth/burden but also drastically improves survival of Drosophila with HDS and Ras/Src or Ras/scrib tumors. Moreover, HDS reduces heterochromatin levels in tumor cells. Mechanistically, we demonstrated that increased heterochromatin formation decreases wingless (wg) and Hippo (Hpo) signaling, thereby promoting apoptosis, via inhibition of Yorkie (Yki) nuclear accumulation and upregulation of apoptotic genes, and reduces DNA damage in tumor cells under HDS. Taken together, our work identified a novel epigenetic mechanism by which HP1a-mediated heterochromatin formation suppresses HDS-induced tumor progression likely by decreasing wingless and Hippo signaling, increasing apoptosis, and maintaining genome stability. Our model explains that the molecular, cellular, and organismal aspects of HDS-aggravated tumor progression are dependent on heterochromatin formation, and highlights heterochromatin as a therapeutic target for cancers associated with HDS-induced metabolic disorders.

A multi-level, multi-component obesity intervention (Obesity Prevention and Evaluation of InterVention Effectiveness in NaTive North Americans) decreases soda intake in Native American adults

Objective: To evaluate the impact of a multi-level, multi-component (MLMC) adult obesity intervention on beverage intake in Native American adults living in five geographically and culturally diverse tribal communities. Design: A 14-month, community-randomised, MLMC design was utilised, with three communities randomised to Intervention and two communities randomised to Comparison. FFQ were administered pre- and post-interventions, and difference-in-differences (DiD) analysis was used to assess intervention impact on beverage intake. Setting: The intervention took place within food stores, worksites, schools and selected media outlets located in the five communities. Key activities included working with store owners to stock healthy beverages, display and dispersal of educational materials, support of policies that discouraged unhealthy beverage consumption at worksites and schools and taste tests. Participants: Data were collected from 422 respondents between the ages of 18 and 75 living in the five communities pre-intervention; of those, 299 completed post-intervention surveys. Only respondents completing both pre- and post-intervention surveys were included in the current analysis. Results: The DiD for daily servings of regular, sugar-sweetened soda from pre- to post-intervention was significant, indicating a significant decrease in Intervention communities (P < 0·05). No other changes to beverage intake were observed. Conclusions: Large, MLMC obesity interventions can successfully reduce the intake of regular, sugar-sweetened soda in Native American adults. This is important within modern food environments where sugar-sweetened beverages are a primary source of added sugars in Native American diets.

Examination of dietary intake of UK preschool children by varying carers: Evidence from the 2008-2016 UK National Diet and Nutrition Survey

Early years caregivers can play a key role in young children’s eating and the prevention of childhood obesity. The UK National Diet and Nutrition Survey (NDNS) is a large representative survey collecting detailed food and nutrition consumption data. Using these data, the aim of this study was to investigate the relationship between dietary intake of preschool children in the UK aged two to four years old and accompanying adult/s. Nutrition consumption data from 1,218 preschool children from years one to eight of the NDNS (2008 to 2016) were accessed. Dietary data was captured using three or four day estimated food diaries. Regression analyses were performed to explore the association between dietary intake and accompanying adult. There were significant differences in consumption when children were not accompanied by their parents. Compared to when children were with parents, children consumed significantly more energy (15kcal, 95% CI 7-23kcal) sodium (−19mg, 95% CI 6-32mg), added sugars (0.6g, 95% CI 0.1-1.1g), vegetables (3g, 95% CI 1-4g), total grams (12g, 95% CI 3-21g) and saturated fat (0.2g, 95% CI 0.1-0.4g) per eating occasion when accompanied by wider family. When children were accompanied by a formal carer they consumed significantly less added sugars (−1.6g, 95% CI −2.4-0.8g) and more fruit (12g, 95% CI 3-21g) per eating occasion than when they were with their parents. The results demonstrate that non-parental caregivers might be an important target to promote healthy eating in young children. Further research is needed to establish which caregivers would benefit most.

Low- and No-Calorie Sweetener (LNCS) Presence and Consumption among the Portuguese Adult Population

The use of low and no-calorie sweeteners (LNCS) in food and beverages has become increasingly common in the development and reformulation of products to reduce energy derived from added sugars. Our aim was to identify the presence and consumption of LNCS through food and beverages according to consumption patterns in a representative sample (n = 256) of the Portuguese adult population. The study had a descriptive cross-sectional observational design and was based on the application of a Food Frequency Questionnaire. Overall, it was found that 4.1% of the foods and 16.7% of the beverages consumed by the Portuguese adult population contained LNCS. Food groups mostly contributing to LNCS consumption were non-alcoholic beverages such as soft drinks and juices (34.2%); milk and dairy products (16.5%); appetizers such as chips (8.6%); sugars and sweets such as chocolates, candies, or chewing gums (6.1%); meat and derivative products (2.2%); cereals and derivatives (1.2%) and canned fruits (1.2%). Main LNCS consumed were acesulfame-K, sucralose, and aspartame, single or combined, although their prevalence of use differs greatly among foods, beverages, or tabletop sweeteners. In conclusion, LNCS were found across a wide variety of products available in the Portuguese market and their prevalence of inclusion in the diet of the population evidences the need to develop more studies on the evolution of LNCS intake and its impact on the full dietary model and health. Consequently, these food additives should be included in food composition databases and, periodically, updated to reflect the recurrent reformulation strategies adopted by the food industry in its efforts to reduce the energy contribution of added sugars.