A lot of progress has been made to reduce sugar, salt and fat consumption to improve European diets and cut rates of obesity, diabetes and heart disease. But not all targets have been met, and there are disagreements among health professional about future strategy.
Despite positive steps in reducing levels of salt, fat and sugar in Europe - and especially in the UK - many health and government organisations are pushing for further reductions. However, some dieticians and policy makers are sceptical whether further reductions will improve public health - and believe that, in some cases, it could do more harm than good.
“People with no industry experience are asking why manufacturers are not reducing salt levels more, however I’m not convinced this would save lives or improve public health," explained UK-based dietician Dr Carrie Ruxton. "Salt also has a functional role in many processed foods – to help dough rise in bread, for example, and preserve meat – and it could be hazardous to public health to reduce levels any further.
Where are we now?
Sugar and total fat consumption in the UK – which has one of the highest obesity rates in Europe - are in line with World Health Organisation and European Food Standards Association (EFSA) guidelines – at 11% and 35% of daily calorific intake (DCI) respectively.
The story is slightly different, however, for salt and saturated fat with the average UK consumer eating 50% more salt than WHO recommendations of 5g per day and up to 4% more than the daily 11% DCI of saturated fats.
However, Ruxton suggested that when it comes to salt reduction in particular, industry has already worked hard to meet target - and there may be little else they can do.
“When you take these issues into account there really isn’t a lot more food manufacturers can do, especially when you consider that most sectors of the food industry have already met the last set of Food Standards Agency targets for salt in the UK," she said.
The same can be said for sugar consumption. While levels are now at relatively acceptable levels the WHO wants to lower the bar yet again and set a new 5% DCI target, she noted - adding that EFSA disagrees however, as it believes there is insufficient evidence to warrant more reductions.
“This is an impossible target – even drinking a glass of fruit juice would take you over the limit. Our role as health professionals is to improve public health and not comment on eating habits if they are not doing any harm,” said Dr Ruxton.
The wrong focus? Manufacturers should wake up to fibre
Ruxton added that the main problem with carbohydrates (including both sugar and starch) is the effect they have on the glycaemic index (the speed at which blood sugar levels increase).
The fast absorption of carbohydrates results in a rapid increase in blood sugar levels, she noted. However, this effect can be counteracted by introducing more fibre into diets, rather than cutting out sugars.
“Fibre slows glucose absorption in the digestive tract when we eat carbohydrates. This means that blood sugar levels don't rise as much after meals which helps to reduce the risk of type 2 diabetes."
"Fibre also lowers the glycaemic index of a food. We don’t need to constantly drive down sugar but increase fibre intake instead – manufacturers should wake up to fibre.”
The fat debate?
Total fat reduction is another bugbear for Ruxton - arguing that reducing total fat intake does not necessarily improve human health by lowering heart disease, for example.
However, switching to healthier polyunsaturated fats, like rapeseed and olive oil, would be advantageous to improve health overall and raise the nutritional profile of some processed foods.
“There is confusion about fat intake and its effects on heart disease, but evidence linking the two is very poor,” she explained. “One absolutely clear fact is the benefits of eating healthier fats, and there is rock solid evidence supporting the health benefits of nut, seed and plant oils.”
According to Ruxton, consumers also need to take responsibility for their own health and well-being - noting that food manufacturers and government educational programmes have given them the tools to make informed decisions about their diets and health eating.
If consumers still chose to eat foods that are high in sugar, salt and fat there is not a lot anyone can do about it, she suggested.
“Sugar, fat and salt content in processed food has fallen but type 2 diabetes continues to rise and this is related to obesity and lifestyle choices more than diet," she said.
“Consumers do not want to or do not have time to cook from scratch and they often turn to luxury ready meals and confectionery products, which are a lot more affordable now. It is unfair to always focus on one or two food products when it is often the consumers who are making poor choices in general.”