New 'added sugars' labeling could save money and improve health

(Reuters Health) - The Food and Drug Administration’s new mandatory rules requiring labels on all packaged foods and drinks to indicate the presence of so-called added sugars could have substantial health and cost saving benefits in the United States over the next two decades, a new study suggests.

Granulated white sugar and sugar cubes are seen in this picture illustration taken December 16, 2018. REUTERS/Emmanuel Foudrot/Illustration

Using a computer model, researchers determined that the labeling policy, which is set to go into effect between 2020 and 2021, might prevent nearly 1 million cases of heart disease and diabetes, according to the report published in Circulation.

“Our study is the first to estimate the potential health and cost-saving benefits of the FDA’s added sugar labeling,” said study coauthor Renata Micha, a research associate professor at the Friedman School of Nutrition Science and Policy at Tufts University. “We found that, over the next 20 years, the impact of the FDA’s added sugar labeling to nudge consumer choices could save nearly 1 million cases of cardiovascular disease and type 2 diabetes, $31 billion in net healthcare costs, and $62 billion in societal costs.”

If the labeling spurred the food industry to reduce the amount of sugar used in its products, that could result in even bigger benefits, Micha said.

For their computer models, the researchers used data from the National Health and Nutritional Examination Survey (NHANES), which each year involves a nationally representative sample of about 5,000 people. In particular, the researchers looked at 24-hour dietary intake forms completed on two separate occasions by adults ages 30 to 84.

Among the assumptions made in the modeling was the impact labeling would have on sugar consumption. Micha and her colleagues estimated that people would decrease added sugar intake by 6.8 percent because of the labeling. In an analysis of what would happen if companies reformulated their products as a result of the labeling, the researchers assumed an additional 8.25 percent decrease in added sugar intake.

Those sugar reduction estimates came from “real world studies where the presence of a label on a product led to positive consumer responses,” Micha said in an email. “As with any medical or public health intervention, our estimates represent average population effects; for any given individual there may be larger or smaller changes.”

A model with just consumer behavior changes and no industry reformulations in response to the label changes predicted 354,400 fewer cases of cardiovascular disease, 599,300 fewer diabetes cases, $31 billion saved in healthcare costs and $61.9 billion saved in societal costs. When the researchers ran the model with both the label change and the reformulation of products, the result was 708,800 fewer cases of cardiovascular disease, 1.2 million fewer cases of diabetes, $57.6 billion saved in healthcare costs and $113.2 billion saved in societal costs.

Micha suspects that the second scenario is a real possibility with the new labeling.

“Our work and that of others, including recent experience with trans-fat labeling in the U.S., suggests that mandating labeling of added sugar content would stimulate the food industry to reduce sugar in their products,” Micha said. “Some companies are already reformulating their products to reduce added sugar content, partly driven by the consumer’s demand for healthier products.”

Experts welcomed the new study for providing a window on how new labeling might impact health and healthcare costs.

“Overall, I think it’s an important study,” said Dr. Rekha Kumar, an endocrinologist at NewYork-Presbyterian and Weill Cornell Medicine and medical director or the American Board of Obesity Medicine. “What I think is the biggest assumption is that people will know how to read the food labels and will actually read them.”

The other big assumption is that people “will understand the correlation of added sugars with long term cardio metabolic health,” Kumar said. “For many, the connection is not immediate.”

Consumers may need more education to make that connection, said Shelley Kendra, clinical manager of food and nutrition services at Magee-Women’s Hospital at the University of Pittsburgh Medical Center.

“My hope is that the findings will turn out to be correct,” Kendra said. “With cardiovascular disease and diabetes continuing to rise it would be great if a simple thing like changing food labels could help. But I think there definitely has to be an education piece involved.”

SOURCE: Circulation, online April 15, 2019.