Despite the warnings and boom in low-sugar options we're still eating a kilo each a week - more than double the recommended amount. Niki Bezzant explores the confusion in a world where food manufacturers play fast and loose with sugar-free claims.

I was sitting in the audience at the recent symposium "The Cost of Sugar" held at Auckland Hospital, when a fellow attendee shared a story with me.

For a long time, she said, she hosted jam-making workshops at a community garden in Auckland. They were well-attended until recently, but now she struggled to fill the course.

"People are scared of the sugar," she said. "When I run the workshops now, people always ask, how can we make jam without the sugar?"

As a hot nutrition topic it shows no sign of cooling. We're more conscious of the sugar in our food than ever before. There's good reason for this: emerging research and worldwide health recommendations have highlighted its harmful effects - it is implicated in the rise of obesity, dental decay and diabetes - and the fact our food supply is full of it.


How much sugar Kiwis are eating is tricky to determine. There's a lack of data on consumption.

Professor Elaine Rush of AUT co-authored a paper in 2014 that looked at what has been recorded. It stated: "In the last 10 years ...imports of 'centrifugal cane sugar' (sugar) into New Zealand have averaged more the 220,000 metric tonnes each year.

"For the New Zealand population of 4.2 million this is equivalent, each year, to 52kg of sugar for every person, or one kilo a week."

Not all this is sugar we're eating or drinking. An unknown amount is used in producing beer and bread as part of the fermentation process. We export some sugar in refined form, and as an ingredient in processed food. And some may be used in the biofuels industry.

Beer, bread and exports aside, these numbers still suggest many probably consume a lot more than is good for us. How much sugar we should consume is far more clear.

The World Health Organisation recommends we get no more than 10 per cent of our energy (calories or kilojoules) from free sugars. In practical terms, that means around 11tsp (a tsp is 4.9g) a day for an average adult. For added health benefit, the WHO recommends we aim for half that - or no more than 5 per cent of energy - 5½ tsp a day.

It's important to note that reference to free sugars. These are added to foods in processing, by the cook or by the consumer, and also syrups, fruit juices and honey.

Professor Jim Mann of Otago University, who helped formulate the WHO guidelines, says it's important to note the difference between free and added sugars - and to focus on the former.

"It's really important to use the term free sugar, because there's quite a lot of free sugar that doesn't necessarily qualify as added sugar.

"Fruit juice in New Zealand is a very obvious example".

The other type of sugars occur naturally - known as intrinsic sugars - in foods such as fruit, vegetables and dairy.

Intrinsic sugars are encapsulated by a plant cell wall. This means they tend to be digested more slowly because the cell wall must be broken down first. They take longer to enter the blood stream than free sugars, and tend to come in foods that have other health-giving elements such as fibre, vitamins and minerals. The WHO hasn't placed any limits on intrinsic sugars.

It's easy to see why many of us are still unsure about what counts as sugar and where it hides. And marketers are seizing on our growing interest in sugar and coming up with products and packaging claims that are not helping.

A quick scan of the supermarket aisles reveals new front-of-pack claims ranging from a straightforward "no added sugar'" to the emphatic "absolutely no refined sugar". But products bearing these claims are not always what we might expect.

Nutrition Foundation nutritionist Sarah Hanrahan says such claims could mask sugar by other names. "The sugar could be replaced by another ingredient that behaves in essentially the same way".

Read the packet, she suggests, and often you'll find honey, syrup, coconut sugar or fruit juice.

"That's incredibly misleading. Saying 'no refined sugar' is nonsense," says Mann.

Hanrahan says there's another problem: by focusing on sugar in isolation we risk similar mistakes to those made in the past, when manufacturers gave us a wide array of fat-free processed foods in response to demand for less fat.

Products were laden with sugar and other refined carbohydrates. They were highly processed and often sugary foods no healthier than the ones they replaced.

Mann agrees, and says the new Health Star ratings system isn't helping. "It needs radical revision, particularly with regard to sugar, because you can have four stars [on a product] loaded with sugar, provided it hasn't got much saturated fat and it's got a whole load of fibre, which could be extracted or synthetic, which nobody knows the benefit of."

There's also the issue of some types of sugars being promoted as healthier than white sugar.

Coconut sugar has acquired a health halo thanks to marketing claims it contains nutrients and is unrefined. Rice malt syrup is promoted by some as being a healthy alternative to sugar because it contains no fructose.

But these are red herrings, according to the experts.

They all count as free sugars.

To further muddy the waters, some bloggers and recipe writers have their own take on what constitutes acceptable sugar.

The "I Quit Sugar" website carries recipes using rice malt syrup.

The "NZ Sugar Free" site has its own lists of "good" and "bad" sugars and features recipes using glucose and dextrose as sweeteners.

All these sugars are classified as free sugars by the WHO.

And then there's confusion around fruit. I Quit Sugar recently published a "fruit pyramid", in which followers are encouraged to eat certain fruits sparingly, including bananas and pineapple.

Mann says fruit is not an issue. "I've never recommended restriction of fruit.

"I'd have quite a high intake of total sugar, I'd imagine, because I eat an awful lot of fruit. But there's no evidence that sugar in fruit is harmful."

We're unlikely to overload on sugar from fruit, anyway, he says.

"How many people would eat more than one or two apples, say. Whereas in a glass of fruit juice, there might be five or six apples."

Hanrahan says we shouldn't limit fruit because of its sugar content, but we should prioritise veges. "I don't think we need to worry too much as fruit comes with lots of other nutrients.

"But vegetables and fruit are not interchangeable. The emphasis needs to be on a diet rich in vegetables with fruit added."


hat are practical ways we can lighten our sugar load? Label reading is a good start, but picking the free sugars isn't possible at a glance. Only total sugar is listed on food labels. This could include intrinsic sugars, of course, as is the case with foods like yoghurt.

Mann suggests three ways to reduce the sugar in our diets. The obvious place to start, he says, is to eliminate sugar-sweetened drinks. "And if you're going to have juice, dilute it, or better still, have fruit."

Confectionery products are number two on the list to watch. And number three is to read labels carefully on items like cereal.

"This is an interesting one because the label has total sugars.

"But this is the crunch: the total sugar in cereal is largely free sugar. If you think about it you haven't got the whole fruit; it hasn't got vegetables. Something like Nutri Grain - even if the label says total sugar, you can be pretty sure that's all free sugar."

He also sounds a note of caution about dried fruit. "There's a lot of sugar in dried fruit, and if you're trying to cut down on sugar, yes, you've got to add that to the list."

Hanrahan suggests we look at the bigger picture rather than getting obsessed with labels. "It's good to be aware but we don't need to obsess. I think as long as you're eating lots of vegetables, eating modest portions and cooking at home you're on the right track.

"Label reading is important," she says. "But the reality is most people don't have the time or inclination, so we need to make it as simple as possible a la [US writer] Michael Pollan.

"My new mantra is: eat lots of vegetables; eat with someone else; cook at home as much as possible."