Can food labels mislead? Experts decode the use of sugar in products

Off late, ‘sugar’ has drawn a lot of attention in India. 

Nearly two months ago, Bournvita found itself in a soup when a health influencer called them out for its “unhealthy high sugar content.” The influencer, Revant Himatsingka, took down his video following a legal notice from Mondelez India, the company that produces Cadbury Bournvita in India, but it led to questions about the actual health benefits of the drink.

Following this, the National Commission for Protection of Child Rights (NCPCR) ordered the company to pull down all its misleading advertisements, packaging, and labels. 

Given this conversation around sugar and ‘misleading labeling’ of products, we spoke to health experts and doctors to decipher how to read these food labels. 

But first – why is there even fuss about sugar? 

The Food Safety and Standards Authority of India (FSSAI) says, “Sugar provides only calories and no other nutrients to our bodies. High sugar intake is a risk factor for obesity and predisposes individuals to diabetes and other diseases.” It is, therefore, essential to keep a check on daily sugar consumption. The British Heart Foundation, too, suggests cutting down on "free sugar," which is essentially added sugar. Fruit or dairy products have natural sugars but are nutritious. 

For adults, the recommended amount is 30g of free sugars (or 7 cubes a day), according to National Health Services UK. This isn’t necessarily bad for a healthy adult, but high intake is harmful. To put this into context, a can of an aerated drink may have up to nine cubes of sugar.

The Harvard Medical School, in a blog post, quotes Vera Novak, associate professor of medicine at Beth Israel Deaconess Medical Center, as saying, “The brain is dependent on sugar as its main fuel.” Simply put, the brain needs glucose, but too much of this energy can be harmful.

So, one needs to be mindful of the added sugar in food products. Many foods, like cereals and savories, which we do not consider sweet, may contain a large amount of sugar. Products are often labeled using the words "sugar-free," "no sugar added," and "zero sugar." This may sound similar, but are they synonymous? 

Not really, each label means something different, and thus food labels can be tricky to read.

Reading the labels correctly

Ingredient labels on food products often have an added sugar column. “The label ‘added sugar’ means that in addition to [a product’s] natural sugar content, more sugar has been added to enhance its sweetness,” explains Dr. Shafi Kuchey, Senior Consultant, Division Of Endocrinology and Diabetes, Medanta.  

However, the label ‘sugar-free’ means the food item has less than 0.5 grams of sugar per serving.

Krish Ashok, author of the bestseller ‘Masala Lab: The Science of Indian Cooking,’ who often debunks myths around food on social media, says,  “In India, it is only recently that we have become sensitive to the amount of sugar we are consuming.” He added, “now that the public sees added sugar as [a] one dimensional villain, companies started using ingredients that are naturally sweet like dates or mango pulp. Since it’s the main ingredient, it’s not added sugar but it is sugar.” 

In this scenario, the product can be marketed as ‘no added sugar’ as it has not been added separately. 

According to the American Heart Association, “it’s tempting to look to alternative sugars as a magical solution,” but “too much sugar is too much, no matter the source.” It adds that products made with natural sugar alternatives such as honey and maple syrup are perceived to be healthier, but it is sugar. 

“Jaggery and white sugar have almost the same effect,” according to Ashok.

Dr. Kuchey thus emphasized that it is important to read the label correctly. Often the label mentions quantities per serving, which looks small, and the actual food item consists of several servings. For example, a food item with five servings (two grams per serving) and a label of ‘added sugar’ will have 10 grams of added sugar. 

We also looked at a popular biscuit brand available in the market. The label says sugar – 0.0 gm. However, a sidebar under the ingredients section says “sweetener (E965, Maltilol, FOS L95).” A simple search for E965 reveals that it’s a synthetic carbohydrate alcohol produced from malt sugar, maltitol, which is again a sugar alcohol. And FOS Liquid L-95 is a soluble prebiotic fiber derived from sugar cane. However, the amount of these sweeteners was not mentioned on the product box.

The ‘health halo’ effect?

The health halo effect is a strategy to create a perception that a particular food is good when there is little or no evidence. 

FSSAI advised to avoid using misleading ‘fancy adjectives’ to describe the contents of food packs and brand names. The above advisory states that from July 2022, food brands using words that mean fresh, natural, pure will have to give a clear disclaimer. 

Krish Ashok explains, “People need to understand that carbohydrates also become sugar on digestion, especially when the product has refined carbohydrates (such as a potato starch or ulta refined grains) have the same effect as sugar.”  

Using the example of ‘multigrain,’ Dr. Kuchey says it may sound healthy, but what does it mean? “The product has more than one type of grain, and these may be refined grains, which are not healthy.” 

We looked at one of the most popular multigrain cookies available in the market. The label says, “Wheat flour (maida, which is refined flour; derived from wheat grain) 45 percent.” It also mentions the quantity of other grain flour as 14 percent. It is indeed multigrain and not whole grain, with 45 percent refined flour added to it.

Another widely available food label is ‘organic,’ this sure sounds healthy and says very little about whether a product is actually healthy. 
Dr. Kuchey said, “Organic sugar is still sugar.” However, organic fruits and vegetables have been found to contain more nutrients and contain fewer pesticides than regular fruits and veggies. But no strong evidence is available to confirm that organic foods benefit human health more than conventional foods. 

A 2020 study highlights that “the current evidence base does not allow a definitive statement on the health benefits of organic dietary intake,” and further clinical research focussing on long-term whole-diet substitution with certified organic interventions is required.

Quick hacks to read labels

Another quick hack could be to look out for ‘natural’ labels on products. 

These may be natural products that are naturally sweet or natural products with ‘added sugar.’ Processed juices are also natural and may or may not have added sugar. Similarly, natural flavors are simply flavors and may not have any health benefits. There is hidden sugar in salty snacks too. This is added to improve the taste and shelf life of products. So it's important to look out for it. 

“It’s important to note that we love sugar and we want to be fooled. So, companies take advantage of it. As consumers, we have the power to choose between products and should have the power to say no,” added Ashok. 

Harvard Health suggests that reading food labels is one of the best ways to monitor your intake of added sugar. Labels also help you understand ingredients that may or may not be healthy.