Determining the amount of added sugars and free sugars in foods listed in the AUSNUT 2011-13 dataset

• Access the AUSNUT 2011-13 food nutrient database

The Australian Government Department of Health provided funding for a project to determine the amount of added sugars consumed by Australians.

In order to do this, two datasets were developed to allocate an amount of added sugars and free sugars present in each food in the AUSNUT 2011-13¹ dataset, the nutrient database for the 2011-12 National Nutrition and Physical Activity Survey (NNPAS) component of the 2011-13 Australian Health Survey (AHS).

The dataset development was undertaken by Food Standards Australia New Zealand (FSANZ) with input from the Australian Bureau of Statistics (ABS). An Expert Reference Group (ERG) was established consisting of key persons/organisations with expertise in food, nutrition, dietary analysis and the Australian Dietary Guidelines, to inform and provide comment on the development of the dataset. The groups represented included the Dietitians Association of Australia, State Health Department nutritionists and researchers and academics.

Limitations of developing a food composition dataset for added sugars and free sugars

There are a number of limitations of developing food composition datasets for added sugars and free sugars.

There are no analytical methods that distinguish between sugar added to foods by manufacturers and sugars inherent in foods.All determinations of added sugars are therefore an estimate and may change depending on how the researcher defines added sugars and/or the methodology used for estimating the level of added sugars in the food.

FSANZ does not have a definition of added sugars, but for the purposes of this project has used two definitions, one based on the Food Standards Code and one on the WHO free sugars definition.

Another limitation of developing a food composition dataset for added sugars and free sugars is that this project is based on the AUSNUT 2011-13 dataset developed for estimating food, dietary supplement and nutrient intakes from the AHS. Therefore the nutrient levels in a particular food are indicative only of the products available during this period and only of the nutrients reported as part of the AHS.

The nutrient composition of foods and ingredients can also vary substantially because of a number of factors, including changes in season, production and processing practices, formulation changes, variations between brands and changes in the source of an ingredient.

Developing the added sugars and free sugars datasets

The process of developing the datasets for added sugars and free sugars utilised parts of a 10-step methodology for estimating added sugars described by Louie et al (2014)² to estimate the added and free sugar values of each food in the AUSNUT 2011-13 dataset on the basis of analytical data for total sugars and known ingredients in food products. Further details relating to the development of the added sugar dataset are available in the links below.

Definition of added sugars and free sugars

Two definitions of sugar were used for the purposes of this project: added sugars, based on the definition of 'sugars' in the Australia New Zealand Food Standards Code (the Code) and free sugars, as defined by the World Health Organisation (WHO). This meant that two datasets needed to be developed.

The first dataset for added sugars, applied the definition of 'sugars' in clause 1 of Standard 1.1.2 of the Code to all AUSNUT foods ³

“Sugars means -

a) hexose monosaccharides and disaccharides, including dextrose, fructose, sucrose and lactose; or

b) starch hydrolysate; or

c) glucose syrups, maltodextrin and similar products; or

d) products derived at a sugar refinery, including brown sugar and molasses; or

e) icing sugar; or

f) invert sugar; or

g) fruit sugar syrup; derived from any source,

but does not include -

h) malt or malt extracts; or

i) sorbitol, mannitol, glycerol, xylitol, polydextrose, isomalt, maltitol, maltitol syrup or lactitol.”

Although the definition in Standard 1.1.2 indicates that 'sugars' includes maltodextrin and similar products, these ingredients have not been captured in the components included in the added sugars amount in the dataset. This decision was made to maintain consistency with the definition of sugars used in nutrition labelling and health claims standards in the Code and with international food composition database practice where total sugars has been defined as being only mono- and di-saccharides. It is also consistent with the definition of sugars used in the reporting of total sugars intake in the AHS. Honey, fruit juices and fruit juice concentrates were not included in this Standard and as such were not considered 'added sugars' under this definition.

The second dataset for free sugars, applied the definition provided by the WHO as part of their work on diet, nutrition and the prevention of chronic diseases to all AUSNUT foods:

“Free sugars include monosaccharides and disaccharides added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates”⁴.

Unlike the added sugars definition, this free sugars definition does include honey, fruit juices and fruit juice concentrates and is thus the point of difference between the two definitions. The only forms of sugar not included in the WHO definition of free sugars are intrinsic sugars and milk sugars. Intrinsic sugars is defined by the WHO as the sugars incorporated in the structure of intact fruit and vegetables. Milk sugars are the natural sugars present in milk (see WHO Guideline). The definitions and how they fit together for this analysis is depicted in Figure 1.

Figure 1. Total sugars, free sugars and added sugars⁵

 

Given these definitions, for each AUSNUT food the free sugars value will always be equal to or higher than the added sugars value, as the free sugars definition includes a wider range of foods compared to the definition of added sugars.

Classification of foods

The classification process utilised parts of the 10-step methodology described by Louie et al (2014)2 to estimate added or free sugars values on the basis of analytical data for total sugars and ingredients in food products. The first three steps described by Louie et al dealt with foods which could be categorised as having no sugars, no added or free sugars, or only added or free sugars. The remaining foods, which contained a portion of both added or free sugars and intrinsic sugars, milk sugars, honey and/or fruit juice, could not be directly classified in one of those three steps. An in-house specifically tailored recipe dataset was used for these remaining foods to derive the proportion of added or free sugars and determine the added sugars and free sugars values expressed in g/100 g. The use of recipes meant the remaining steps outlined in the Louie et al process were not required. This recipe database is based on a standard dataset that is also used by FSANZ for other food chemical risk assessments.

This process is summarised in Figure 2 and outlined further below.

Added sugars dataset

To develop the added sugars dataset based on the Standard 1.1.2 definition for sugars, foods were assigned to one of four groups:

1. Foods containing no sugar

Foods that had 0 g/100 g total sugars as reported in AUSNUT 2011-2013 were classified as containing no added sugar. Foods in this group were primarily meat, poultry, fish and fats and oils.

These foods were assigned 0 g/100 g added sugar in the added sugars dataset as per step 1 of Louie et al (2014).

2. Foods containing only intrinsic sugars, milk sugars, honey and/or fruit juice

Included in this group were foods that had >0 g/100 g of total sugars which was likely to be naturally occurring in the food rather than added during processing or preparation, such as fruit, vegetables, unflavoured dairy products, honey and fruit juice.

These foods were assigned 0 g/100 g added sugar in the added sugars dataset as per step 2 of Louie et al (2014).

3. Foods containing only added sugars

Included in this group were foods used as sweeteners and those which would not contain any portion of intrinsic sugars, milk sugar, honey and/or fruit juice, such as:

• Table sugar, including white, brown, raw, icing, low GI.

• Sugar syrups, glucose syrup, maple syrup, corn syrup, agave syrup, molasses, and grape syrup.

• Sugar confectionary with no additions (i.e. no chocolate, cream or milk).

• Soft drinks, cordials, flavoured mineral waters and energy drinks that do not contain any fruit juice.

• Beverage bases that do not contain malted grains, malt extract or milk powder (determined by ingredient information).

These foods were assigned an added sugar value equivalent to their total sugar value from AUSNUT 2011-13 as per step 3 of Louie et al (2014).

4. Foods containing both added sugars and intrinsic sugars, milk sugars, honey and/or fruit juice

For foods which contained a mix of added and intrinsic sugars, milk sugars, honey and/or fruit juice, recipes were developed to determine the proportion of added sugars in that food.

Details of the recipe development methodology are available in Section 3.

These foods were assigned an added sugar value as calculated by recipe as per step 4 of Louie et al (2014).

Figure 2. Method for estimating added/free sugars content of AUSNUT 2011-13 foods. Modified from Louie et al (2014).

Free sugars dataset

To develop the free sugars dataset based on the WHO definition for free sugars, foods were assigned to one of four groups, as for the added sugars dataset:

1. Foods containing no sugar:

Foods that had 0 g/100 g total sugars as reported in AUSNUT 2011-2013 were classified as containing no free sugar. Foods in this group were primarily meat, poultry, fish and fats and oils.

These foods were assigned 0 g/100 g free sugar in the free sugar dataset as per step 1 of Louie et al (2014).

2. Foods containing only intrinsic sugars and/or milk sugars

Included in this group were foods that had >0 g/100 g of total sugars which was likely to be naturally occurring in the food rather than added during processing or preparation, such as fruit, vegetables and unflavoured dairy products.

These foods were assigned 0 g/100 g free sugar in the free sugars dataset as per step 2 of Louie et al (2014).

3. Foods containing only free sugars:

Included in this group were foods used as sweeteners and those which would not contain any portion of intrinsic sugars and/or milk sugars such as:

• Table sugar, including white, brown, raw, icing, low GI.
• Sugar syrups, glucose syrup, maple syrup, corn syrup, agave syrup, molasses, grape syrup, malt syrup and extract.
• Honey
• All fruit juices, fruit drinks and cordials, commercial or homemade. While the WHO guidelines did not specify vegetable juices or drinks, it was assumed they were analogous to fruit juice.
• Wine (table and fortified) and cider. While these drinks were not specified in the WHO guidelines, it was assumed they were analogous to fruit juice.
• Sugar confectionary with no additions (i.e. additions such as dried fruit, chocolate, cream or milk which may contain naturally occurring sugar).
• -Soft drinks, flavoured mineral waters and energy drinks with or without fruit juice.
• Beverage bases that do not contain milk powder.

These foods were given a free sugar value equivalent to their total sugar value from AUSNUT 2011-13 as per step 3 of Louie et al (2014).

4. Foods containing both free sugars and intrinsic sugars and/or milk sugars

For foods which contained a mix of free and intrinsic sugars and/or milk sugars, recipes were developed to determine the proportion of free sugars in that food.

Details of the recipe development methodology are available in Section 3.

These foods were assigned a free sugar value as calculated by recipe as per step 4 of Louie et al (2014).

Recipe development

Where an AUSNUT 2011-13 food was identified within the classification process as containing added sugars plus intrinsic sugars and/or milk sugars, recipes were used to break these mixed foods or dishes down into their component ingredients in order to derive the added sugar values for those foods. In a similar way, where the food contained free sugars plus intrinsic sugars, milk sugars, sugars from honey and/or sugars from fruit juice, recipes were used to derive the free sugar values for those foods.

It was determined that there would be a zero threshold for ingredients in a mixed food to trigger the need for a recipe. For example, if a yogurt had a small amount of vanilla or honey or fruit, it required a recipe.

The dataset was based on recipes developed to provide nutrient profiles for AUSNUT 2011-13. For AUSNUT 2011-13 foods which were not developed using a recipe approach e.g. their nutrient profiles were developed through laboratory analysis of the food, additional recipes were developed using standard food composition principles⁶. Existing recipes used for other FSANZ food chemical risk assessment work were used as a basis for the recipe database development.

Recipes were developed according to the following guidelines, and adjusted as required to match as closely as possible to the values for total sugar published in AUSNUT 2011-13:

• duplication and modification of an existing recipe for a similar food
• researching popular recipe sources to determine a typical recipe for that food
• reviewing label data to estimate ingredients and proportions of commercial products
• researching technological processes of commercial food production to inform the identification of types of sugars used in the manufacture of particular foods

Once the recipe dataset was finalised, the recipes were run through a set of calculations previously established for similar dietary intake assessments. The calculations include summation of multiple uses of added or free sugar ingredients in the same food, take into account any weight changes due to processing or cooking of ingredients and estimate the proportion of added or free sugars in the final food. The result of this process was a value (expressed in g/100 g) for added sugars and free sugars for each AUSNUT 2011-13 food.

Note: fermented foods

It is difficult to accurately assess added or free sugars in fermented foods with residual sugars (yoghurts, sweet cider, sweet wines and yeasted breads) using recipes traditionally used for determining nutrient content from the ingoing ingredients. Where recipes were required for these foods, they were based on an unsweetened variety of the food rather than raw ingredients (e.g. a recipe for a bread roll with icing and sultanas was based on an unsweetened bread roll with sugar, sultanas and icing, instead of flour, water, sugar, yeast, sultanas and icing).

Validation and references

There were a number of validation checks undertaken to ensure the added and free sugars datasets gave an accurate and logical estimation of the added/free sugars content of AUSNUT 2011-13 foods. These checks included:

• The added sugar and free sugar values were equal to or lower than the AUSNUT 2011-13 total sugar values. This was particularly important where the values were derived from a recipe.
• The free sugar values were equal to or higher than the added sugar values, as highlighted in section 1.
• The total sugars from recipe matched total sugars from AUSNUT 2011-13 to ensure the recipe was accurate.

Recipes may have then been refined to ensure reliable estimates of added and free sugars for foods when derived using recipes. In some cases, the amount of total sugars calculated by recipe did not equal the total sugars reported in AUSNUT 2011-13 due to inherent variation in the nutrient composition of foods and/or different derivations for foods or ingredients (e.g. analysis versus recipe derived). For these foods, as no amount of recipe refinement would align the two values, the total sugars value for the database which was derived from the recipe was adjusted up or down to match the AUSNUT 2011-13 total sugars value. The amount of added/free sugars estimated by recipe was then adjusted in proportion to the change in total sugars.

References

1. Food Standards Australia New Zealand (2014). AUSNUT 2011-13 - Australian Food Composition Database. , FSANZ Canberra, Australia
2. Louie et al (2014). A systematic methodology to estimate added sugar content of foods. European Journal of Clinical Nutrition. Vol. 69, No. 2, pp. 154-61.
3. Food Standards Australia New Zealand (2016). Australia New Zealand Food Standards Code, Version 161 - Standard 1.1.2 - Sugar. FSANZ Canberra, Australia (the revised code took effect on 1 March 2016; Standard 1.1.2 was previously covered in Standard 2.8.1 in the old code).
4. WHO/FAO (2003). Diet, nutrition and the prevention of chronic diseases: report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series, No. 916. Geneva, Switzerland http://www.who.int/nutrition/publications/obesity/WHO_TRS_916/en/
5. Australian Bureau of Statistics (2016). Australian Health Survey: Consumption of Added Sugars, ABS 4364.0.55.011, Canberra, Australia.
6. Food Standards Australia New Zealand (2014). Development of additional nutrient profiles for foods and beverages consumed in the NNPAS, FSANZ Canberra, Australia.