understanding and managing sweetness conference

UNDERSTANDING AND MANAGING SWEETNESS CONFERENCE

September 17, 2009, Taj Mahal Hotel, New Delhi, India

All Calories Count — Why Manage Calorie Balance

John P. Foreyt, Ph.D.Baylor College of Medicine

Houston, TX

John P. Foreyt, Ph.D.Baylor College of Medicine

Houston, TX

Sweetness, Obesity & Health

• Public health officials worldwide are frustrated that consumers do not follow dietary guidelines to promote good health

• Private health practitioners and providers have similar frustrations

• Governments predict steep increases in the rates of chronic diseases, putting serious strains on the world’s healthcare systems and on national budgets

PREVALENCE (%) OF OVERWEIGHT (BMI > 25)

AMONG ADULTS MALE FEMALE

UNITED STATES 71 62AUSTRALIA 68 52NEW ZEALAND 62 50ENGLAND 65 56GERMANY 75 59

IOTF Website 2005; Ogden et al, JAMA 2006


AMONG ADULTS

MALE FEMALE

FINLAND 68 52

ICELAND 64 54

SWEDEN 51 42

IOTF Website, Updated March 16, 2005


AMONG ADULTS

MALE FEMALE

CROATIA 79 50

CZECH REPUBLIC 73 58

HUNGARY 63 49



AMONG ADULTS

MALE FEMALEMEXICO 67 72ARGENTINA 67 55CHILE 60 60BRAZIL 38 39

PREVALENCE OF OVERWEIGHT & OBESITY IN BEIJING CHINESE MEN (1998)

Overweight (%) Obese (%)

(BMI > 24-27.9) (BMI > 28)

Beijing• Workers 51 7 • Farmers 50 8• Urban Residents 52 7

Wu et al, 2002

PACIFIC ISLANDERS ARE THE MOST OBESE (BMI > 30)

IN THE WORLD

• 70% Tongan Women Obese

• 63% Samoan Women Obese

• 79% Nauru Women Obese


PREVALENCE (%) OF OVERWEIGHT (BMI>25) AMONG U.S. ADULTS

%

19801 46.0

19901 56.0

20001 64.5

20102 73.5

20202 82.5

20302 91.5

20402 100.0

1Flegal et al., JAMA, 2002; 2Foreyt Projected 2006

PREVALENCE (%) OF OBESITY (BMI>30) AMONG U.S. ADULTS

%

1980 14.4

20001 30.5

20202 46.5

20402 62.5

20602 78.5

20802 94.5

21002 100.0

1Flegal et al., JAMA, 2002; 2Foreyt Projected 2006

HEALTH RISKS OF OBESITY

For every increase of 2 BMI units

the relative risk of:

• CHD ↑ 14%

• Stroke ↑ 4%

• Ischemic Stroke ↑ 16%

PREVALENCE OF OVERWEIGHT & OBESITY IN

U.S. CHILDREN (AGES 6-11)• 30.3% Overweight

• 15.3% Obese

• Obesity has quadrupled over 25 years

• African American, Hispanic American & Native American children have highest obesity prevalence

American Obesity Association, 2005

ESTIMATES OF PREVALENCE OF DIABETES IN 2000 & 2010 (IN MILLIONS OF CASES)

2000 2010 Increase (%)Asia 84 132 57North America 14 17 23Europe 26 32 24South America 16 22 44Africa 9 14 50World Average 151 221 46

Eckel et al, Circulation 2004

FINNISH DIABETES PREVENTION STUDY

• Design:

• 522 middle-aged overweight (BMI 31)

• 172 men and 350 women

• Mean duration 3.2 years

• Intervention Group: Individualized counseling

• Reducing weight, total intake of fat and saturated fat

• Increasing uptake of fiber, physical activityTuomilehto J. et al., NEJM, 2001; 344: 1343-

1350

Finnish Diabetes Prevention Trial Modest, sustained reduction reduced morbidity

Cumulative Probability of


Remaining Free of

Remaining Free of

Diabetes

Diabetes



Remaining Free of

Remaining Free of

Diabetes

Diabetes

Study YearStudy YearStudy YearStudy Year

1.01.01.01.0

0.90.90.90.9

0.80.80.80.8

0.70.70.70.7

0.60.60.60.6

0.50.50.50.5

0.40.40.40.4

0000 1111 2222 3333 4444 5555 6666

Wt changeWt change – – 0.9 0.9 ++ 4.2%4.2%

Wt changeWt change – – 0.9 0.9 ++ 4.2%4.2%

Intervention groupIntervention groupIntervention groupIntervention group

Control groupControl groupControl groupControl group

Adapted from Tuomilehto J, et al. NEJM 2001; 344: 1343-50Adapted from Tuomilehto J, et al. NEJM 2001; 344: 1343-50Adapted from Tuomilehto J, et al. NEJM 2001; 344: 1343-50Adapted from Tuomilehto J, et al. NEJM 2001; 344: 1343-50

Wt changeWt change-4.7-4.7++5.4%5.4%

DIABETES PREVENTION PROGRAM INCIDENCE OF DIABETES

Lifestyle = 7% weight loss, 150 min physical activity/week

Diabetes Prevention Program. NEJM, 2002; 346: 393-403

0

2

4

6

8

10

12

14

cases/100 person-yr

Placebo Metformin Lifestyle

Men

Women

Big Texan Steak RanchAmarillo, Texas

72-oz Steak FREE if eaten within 1 hour


• Global concern regarding increase in obesity & obesity-related diseases

• Critics have singled out sugar & sweetness as primary suspects for obesity & obesity-related diseases

• Scientific evidence does not support “single culprit” theory


• The “culprit” is an excess of calories

• There is a need to understand the “calorie equation”

• If calories in exceed calories burned off, excess becomes body fat, & weight goes up


• In studying diets of obese people, scientists have not determined that any specific food or beverage is the root cause of obesity

• A well-balanced diet is the key

• According to the American Dietetic Association, all food and beverages can be a part of a well-balanced diet


• In 2004, scientists and researchers met to develop a scientific consensus statement about sweetness & health

• They introduced the concept of managing sweetness to teach the calorie equation

• They encourage consumers to incorporate it into their daily lives so they can enjoy the pleasures of the table, but do so wisely


• The conference was entitled “Scientific Straight Talk on Sweetness & Health: Managing Sweetness Conference”

• Organized by Oldways Preservation Trust, Boston, USA

• Held in Mexico City, Mexico


• In 2006, scientists and researchers met in Brussels, Belgium at the EU to update the scientific research on managing sweetness since 2004


• In 2007, Oldways and scientists presented Managing Sweetness to health professionals, scientists and media in four Latin American countries (Brazil, Chile, Argentina and Mexico)


• In 2008, scientists and researchers met in Beijing, China and Istanbul, Turkey to update the scientific research on managing sweetness since 2006.

• In 2009, scientists met in Bangkok to review the scientific research on managing sweetness.

• And now in New Delhi, India -- scientists are meeting to update the consensus statement on sweetness.

Sweetness, Obesity & Health Conference Summary

• Research results indicate that individuals can incorporate sugars and sweeteners into a healthy eating plan and meet guidelines for healthful diets

• There is no credible evidence that total sugar intake is associated with the development of type 2 diabetes

Sweetness, Obesity & HealthConference Summary

• Children are born with a liking for sweet taste

• It is important for parents to learn to manage, not banish, sweet foods


• Research suggests banishing favorite foods, like sweets, can lessen a child's ability to control intake of these foods when not under supervision

• Research has shown sugar in food and beverages does not cause hyperactivity in children

• All foods and beverages can be part of a healthy diet


• Carbohydrates in food and beverage, including sparkling beverages, provide energy for daily activities

• There is no need to give up favorite foods

• Consumption in moderation with an active lifestyle is the key to weight management

• A balanced diet is the key


• The achievement and maintenance of good health depends on the wise management of the energy from all food and beverage sources, along with a habit of regular physical activity

• Sweet foods and beverages can compliment a balanced diet, regular physical activity, and other healthy lifestyle choices

Sweetness, Obesity & HealthConclusions

• Managing sweetness involves reconciling our innate taste preferences with the realities of our modern life and food supply

• All foods and beverages can be part of a healthy lifestyle

“The Current Epidemics of Chronic Diseases are a Result of Discordance

Between Our Ancient Genes and Modern Lifestyle.”

Eaton et al., The Paleolithic Prescription. 1988.

NATURE VS. NURTURE

understanding and managing sweetness conference

Documents

middleaged overweight

obese bmi

overweight bmi25

estimates of prevalence

obesity bmi30

health risks of obesity

adults male femalemexico67

adults male femalefinland