Debbie MitchellDirector of Global Communications and Marketing

California Prune BoardMay 21, 2018

Sugars and TraditionalDried Fruits

Few issues in nutrition todaygenerate more scientific controversyand consumer confusion than theassociation between sugar andhealth. Dried fruits, whether thosewith only natural sugars or addedsugars, have increasingly been atthe center of the debate.

S U G A R S A N D T R A D I T I O N A L D R I E D F R U I T S

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• Sugars in dried fruit are considered intrinsic – those sugarsincorporated in the structure of intact cells. Per fruit, they have no moresugar than their fresh counterpart.

• Traditional dried fruits include prunes, raisins, dried apricots, peaches,figs, and dates.

• Minimally processed traditional dried fruits retain most of thenutritional properties of their fresh counterparts and so are includedwithin the World Health Organization definition of “fruit.”

• A study comparing the glycemic response of 100 calorie serving ofdried and fresh fruit show no difference in peak sugar levels.¹

INTRINSIC SUGARS RECOMMENDEDOVER FREE OR ADDED SUGARS

5¹Alasalvar C. and Shahidi, F. Composition, Phytochemicals, and beneficial health effects of dried fruits: An Overview. In:Dried fruits: Phytochemicals and Heath Effects. Wiley-Blackwell, 2013, Oxford, U.K. pp 1-18.

DRIED FRUITS, SUGAR & DENTAL HEALTH

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Current position: Common misperceptions among HCPs are barriers to communicating beneficialhealth messaging of dried fruits:

‘Dried Fruit sticks to teeth & increases caries, so should not be consumed between meals’

What has the California Prune Board been doing to address this?• Commissioned independent literature review SADLER, 2016• Raising awareness of conclusions which demonstrate current perception is unjustified:

HCP & industry publications Letters to UK Government agency Raise awareness of distinction between traditional dried fruit (no added sugar) and others Exhibit at EU Dietitians & Nutrition conferences CPB HCP seminar on current topics (sugar/dental health & bone health) 2016 Associated media activity, including educational messaging via social media UK Dietitians Network to roll out messages to dietitians/nutritionists Joint UK dried fruit industry–sponsored health care professional workshop scheduled June 2018

DR. MICHELE SADLER “DRIED FRUITAND DENTAL HEALTH”

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Dr. Michele Sadler "Dried Fruit and Dental Health" published in InternationalJournal of Food Sciences and Nutrition (Int J Fd Sci Nut. 2016, 67; 944-59)

Link to abstract:http://www.tandfonline.com/doi/full/10.1080/09637486.2016.1207061.

Conclusions:• Unconvincing evidence to draw conclusions regarding oral health• Available information, as basis for evidence-based advice on the suitability of prunes/dried fruits

for snacking is very limited• On balance, likely positive & negative attributes of prunes

Need to chew & organoleptic qualities- encourage salivary flow Contain polyphenols – potentially anti-microbial Contain dietary fiber – potential cleansing action Sorbitol content & low sucrose- fermentability

• More research is needed to ensure evidence-based practice

SUN MAID FUNDED ARTICLE

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Sun Maid funded Dr. Sadler towrite a further paper for BritishNutrition Foundation’s JournalNutrition Bulletin that reachesresearch nutritionists and FoodIndustry, November 2017

CURRENT STUDY: DRIED FRUITS ANDCARDIOMETABOLIC DISEASE

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Bioactives in Dried Plums, Figs, Dates, and RaisinsCompared with a High Carbohydrate Snack on

Risk Factors for Cardiometabolic DiseasePenny Kris-Etherton, Pennsylvania State University

• 50 adults ages 25-60 with 1 risk factor– High cholesterol, blood pressure, blood glucose,

blood fats, large waist• ¾ cup mixture of dried fruits compared to animal crackers

or fruit gummies• 4-week cross over study• 23 completed as of February 2018• 2 year: 197,450 Euros

CPB: EU ACTIVITY UPDATE

‘Train the trainer’: Dietitians Network team recruitedto deliver sugar/dental health messaging

Sarah Bowyer - based in Scotland & Stoke- currently completing PhD, (Sustainability Studies) hasbroad background in social nutrition and public health; Local Officer- Scottish Health CouncilInverness

Dr Frankie Phillips - previous roles include nutrition scientist at BNF; Snr dietetics lecturer atPlymouth University; National Public Relations Manager for BDA, is a media spokesperson for the BDAand now freelance and based in Exeter

Kathy Cowbrough - Scottish-based Canadian dietitian with long standing reputation within UK BDA;experience in NHS, public & private sector includes needs assessment, programme planning,community development nutrition education; training health professionals. Also co-wrote the newchapter on dental health for the Manual of Dietetic Practice (not yet published).

Dawn Shotton - MSc in weight management; PG cert in psychological counselling; teaching cert;bariatric dietetics; now Senior Specialist bariatric Team Lead Dietitian, Teesside.

CHALLENGE THE SUGAR/DENTALHEALTH ISSUE

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Goal: To start to changethe current recommendedadvice that dried fruitconsumption should berestricted compared tofresh fruit – i.e., that driedfruit can only count oncewithin the 5-a-day scheme

How?: letters to UKGovernment Agencyresponsible for consumernutritional advice andrecommendations (PublicHealth England)

A RT I CLES FOR I NC MEMB ERS, B YCA LI FORNI A P RUNE B OA RD A ND SUN MA I D

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"Dried Fruit: Dispelling the Sugar Myths" Jennette HiggsThe Cracker Magazine in July 2016 and resulted in online coverage inNew Food Magazine

Sugars and Traditional Dried Fruits: NoReason for ConcernDr. Arianna Carughi & Jennette Higgs21 November, 2017https://www.nutfruit.org/what-we-do/publications/inc-magazine/articles/detail/sugars-and-traditional-dried-fruits-no-reason-for-concern

COMMUNICATING WITH HEALTH CAREPROFESSIONALS

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HCP COMMUNICATING WITH HCPs-e-Newsletters to dietitians

Distribution to all UK dietitians within BritishDietetic Association (BDA)

Infographic addresses all key facts around prunes &sugar/dental health issue in one place

D R I E D F R U I T WO R K S H O P P R O G R A M

HCP

THANK YOU!For more information:

www.CaliforniaDriedPlums.org