In view of the ongoing (and increasing) obesity epidemic, the question of how healthy or harmful dietary carbohydrates can be has been a topic of much discussion among scientists. Many recommendations for the composition of our daily diets regarding the big food groups (carbohydrates, proteins, fats) have been published and discussed. Low carb/high protein diets are en vogue among those who want to lose weight. At the same time, carbohydrates are the best and most bioavailable energy source, especially for the brain and for athletes who require a short-term energy supply.

In 2008, the U.K. Food Standards Agency, together with the U.K. Department of Health, commissioned the Scientific Advisory Committee on Nutrition (SACN) with determining the connections between dietary carbohydrates and health and formulating recommendations for public health in the U.K. A draft of the resulting report was recently published.

In this very substantial draft report, SACN evaluated the role of carbohydrates in cardiovascular and metabolic health, including insulin resistance, obesity and glycemic response. Colorectal health of adults and children as well as oral health were evaluated. Specifically, total carbohydrates, sugars, sugar alcohols, sweetened foods and drinks, starch, starch-rich foods, fibers, non-digestible oligosaccharides, resistant starch and glycemic index and glycemic load were considered. Evidence from both prospective cohort studies and randomized controlled clinical trials was included in reviews specifically commissioned for this report and assessed according to the SACN Framework for the Evaluation of Evidence.

Findings Confirmed
The results were not surprising, at least not for those in the nutrition business. According to SACN, evidence for a diet based on whole grain products, leguminous plants, potatoes, vegetables and fruit was confirmed. At the same time, consumption of sweet spreads, fruit juices and sweets as well as refined sugar itself should be reduced—again, not surprising.

Daily consumption of carbohydrates, currently recommended to be 50% of the total daily energy, should remain where it is. However, the composition of those carbohydrates should be changed, according to SACN. Dietary fiber intake should be increased (to 30 grams per day for adults), and free sugar consumption should be reduced to 5% of total daily energy intake.

Free sugars, according to the WHO definition, are monosaccharides and disaccharides that are added to foods, plus sugars naturally present in honey, syrups and unsweetened fruit juices. These are the sugars that should be reduced. In other words, complex carbohydrates such as starches or branched polysaccharides that are naturally included in foods should make up the large majority of total carbohydrate intake.

Free sugars increase the diet’s glycemic load, which is associated with a greater risk of type 2 diabetes mellitus. The studies and trials referenced by SACN for the draft report supported this finding, also resulting in the recommendation for less free sugars in the diet.

While all this sounds, again, not very surprising, it nevertheless emphasizes a message that health officials of various capacities, among them WHO, have repeatedly stated during recent years. Free sugars increase energy intake, which often results in an increase in body mass index. This, of course, includes sugar-sweetened beverages, which make up a main part of free sugar intake.

As for fibers, the report found that increased intake of dietary fibers, cereal fibers and whole grain is associated with a lower risk of cardio-metabolic disease and colorectal cancer, which led to SACN’s recommendation of increasing the recommended intake of dietary fibers.

So, this well-researched and very long report (more than 350 pages in its draft version) confirmed what nutritionists and health professionals have been saying for a while—obesity as a health issue can only be tackled through a change in diet habits, and free sugars are the main culprit.

Fighting the Obesity Battle
The question remains how this information can be used to help consumers battle obesity. Many options have already been discussed and/or are in place, starting from putting taxes on certain snacks (rejected repeatedly) to marketing all sorts of weight management supplements or foods for special medicinal purposes that help manage weight. There is even movement toward a “tobacco-style response” against unhealthy and obesity-promoting foods, arguing the impact of unhealthy foods on consumer health is comparable to that of cigarettes.

What everyone agrees on, though, is that obesity is indeed a serious and increasing problem, and that consumer education must be the first step toward alleviating it. While the new report from SACN doesn’t really offer new insights, it at least supports the messages that have been sent out for a while; as such, it can be used to further consumer education and thus achieve this first step.

In any case, obesity and its many concomitant health problems remains a promising field for manufacturers. Analyze & realize has extensive experience with regulatory-strategic decisions as well as clinical trials and health claim applications in this indication and stands ready to assist.   

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Dr. Joerg Gruenwald is president of analyze & realize ag, a specialized business consulting company and CRO in the fields of nutraceuticals, dietary supplements, herbals and functional food, and author of the PDR for Herbal Medicines. He can be reached at analyze & realize ag, Waldseeweg 6, 13467 Berlin, Germany, Tel: 49-30-40008100; Fax: 49-30-40008500; E-mail: jgruenwald@analyze-realize.com; Website: www.analyze-realize.com.