Cross-Sectional Survey of the Amount of Sugar and Energy in Chocolate Confectionery Sold in the UK in 1992 and 2017

The study aimed to compare the sugar (1992, 2017) and energy (2017) content of chocolate confectionery available in the UK between 1992 and 2017 using cross-sectional surveys. All major UK retailers operating at the time were included. Sugar content in 1992 was obtained from a booklet and sugar and energy content from 2017 were collected from product packaging in-store. In 1992, the average sugar content of chocolate confectionery was 46.6 ± 10.3 g/100 g and in 2017 it was 47.3 ± 12.1 g/100 g. Sugar content ranged from 0.5 to 75.2 g/100g, with large variations between different categories of chocolate and within the same category of chocolate. There were 23 products found in both 1992 and 2017. The average sugar content per 100 g for these products was 44.6 ± 9.4 g in 1992 and 54.7 ± 6.3 g in 2017, representing a 23% increase in sugar content (p < 0.001). The results show that the sugar content of chocolate confectionery has increased since 1992, which is concerning. However, they also suggest sugar levels can be reduced because (a) lower sugar versions of the same products existed in 1992 and (b) there is a large variation in sugar and energy content between different categories of chocolate and within the same category in 2017

Sugar content of carbonated soft drinks before and after the implementation of a tax on sugar-sweetened soft drinks in United Kingdom of Great Britain

Objective: To evaluate the changes in sugar and energy labelling of carbonated sugar-sweetened soft drinks after the implementation of a tax on sugar-sweetened drinks in the United Kingdom of Great Britain and Northern Ireland. Methods: We visited nine main supermarkets before (May 2014) and after (April 2018) the tax came into effect and obtained data from product packaging and nutrition information panels of carbonated sugar-sweetened soft drinks. We used the paired t-test to assess differences in sugar and energy content of the same products between 2014 and 2018. Findings: We obtained data from 166 products in 2014 and 464 products in 2018, of which 83 products were the same in both years. Large variations in stated sugar content were found between the different carbonated sugar-sweetened soft drinks in both 2014 and 2018 for all products and for the 83 products. The mean sugar content of the 83 products decreased by 42% between 2014 and 2018, from 9.1 g/100 mL (standard deviation, SD: 3.3) to 5.3 g/100 mL (SD: 3.5; P < 0.001). The mean energy content decreased by 40%, from 38 kcal/100 mL (SD: 13) in 2014 to 23 kcal/100 mL (SD: 15) in 2018 (P < 0.001). Conclusion: The significant decreases in the labelling of sugar and energy content of carbonated sugar-sweetened soft drinks after the levy came into effect suggest this tax has been effective. The sugar content of drinks still varied considerably in 2018, suggesting further reductions in sugar content of these drinks is possible. The levy thresholds should be reduced and the tax increased to drive further reformulation of soft drinks to reduce their sugar content

Effects of product reformulation on sugar intake and health-a systematic review and meta-analysis.

Context: Obesity, type 2 diabetes, and dental caries are all major public health problems in the United Kingdom and contribute substantially to healthcare costs. Objective: A systematic review and meta-analysis was conducted to determine the effect of product reformulation measures on sugar intake and health outcomes. Data sources: Using a combination of terms, the following databases were searched-The Cochrane Library, EMBASE, MEDLINE (Ovid), and Scopus. Additionally, multiple gray literature searches were undertaken. Data extraction: A total of 16 studies met the inclusion criteria. There were 4 randomized controlled trials, 6 studies that modeled reformulation in a country, 5 studies that modeled a different approach of reformulation, and 1 study was both a modelling study of a different approach to reformulation and a retrospective observational study. The studies were assessed for risk of bias and overall quality of evidence was rated using the Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE) framework. Results: Results from randomized controlled trials suggest that consumption of reformulated products can reduce sugar intake and body weight. The pooled estimates were -11.18% (95% confidence interval [CI], -19.95 to -2.41; P < 0.00001) for changes in percentage of sugar intake, -91.00 g/day (95%CI, -148.72 to -33.28; P< 0.00001) for changes in sugar intake in grams per day, and -1.04 kg (95%CI, -2.16 to -0.08; P= 0.0002) for changes in body weight. However, the quality of the evidence was very low. Results from the other studies suggested that reformulation can reduce sugar intake and improve health. Much of the evidence draws on modeling studies. Conclusions: This systematic review and meta-analysis suggests that product reformulation to reduce sugar content could reduce sugar intake in individuals and thus improve population health. These findings provide an important starting point for ongoing work on sugar reformulation