Under South Africa’s latest proposed food labelling regulations, 100% fruit juices won’t have to show a high sugar warning because their sugars are “naturally occurring”, but researchers who helped provide input on the rules say that’s a mistake, writes Zano Kunene for Bhekisisa.
Juices can pack as much – or more – sugar than some sodas or energy drinks, say nutritional experts, warning that more than one in 10 children in South Africa under five are already overweight. They add that drinking just one sugar-sweetened beverage (e.g, cold drinks or fruit juice with artificially added sugar) a day more than doubles the chances of a child being overweight.
“Coke, for instance, has too much sugar, but fruit juices also have too much natural sugar,” said Edzani Mphaphuli, executive director of Grow Great, a non-profit organisation which works to shape childhood nutrition policies.
Under the current draft – which the National Department of Health (NDoH) is still reviewing, according to spokesperson Foster Mohale – fruit juices will fall through a definition loophole. But that’s not what researchers who gave input on the rules recommended, or what many public health experts advise.
“Our evaluation used the criteria of ‘free sugars’, where all 100% fruit juices would have carried a warning label,” said Tamryn Frank, a researcher at the University of the Western Cape and who was part of the technical team. “That highlights the importance of reconsidering the best term to include when the final regulation is published.”
The World Health Organisation (WHO) says “free sugars” are sugars added to products like sodas and energy drinks, as well as those naturally found in fruits. But our current draft proposal says only products with “added sugar” will be required to carry a label.
The draft regulations say any drink with more than 5g of sugar (just more than one teaspoon) per 100ml, or any amount of artificial sweetener (like the calorie-free chemicals aspartame or sucralose) must show a black and white triangle with the word “warning” in bold capital letters.
If passed in their current form, the researchers say almost six in 10 of all sodas, energy drinks and juices sold in South Africa would carry a warning label. But while 94% of soft drinks and 97% of energy drinks would need warning labels for high sugar or artificial sweeteners, just 30% of juices would be labelled.
Bhekisisa did the sums to work out which drinks have the most sugar and which will – or won’t – need a warning label, according to the current version of the regulations.
Fruit juices
While they didn’t have any artificial sweeteners, all of the juices we compared – Fruugo sparkling apple juice, Ceres orange and Rhodes grape juice – had more sugar than all of the other drinks we compared except for Coke.
“Because they come straight from nature, people think they must be healthy. But it’s not exactly the same thing as eating a single fruit,” says Mphaphuli. “Juice is highly concentrated and you need to dilute it with water if you’re going to give it to a child (to reduce the sugar content).”
Whole fruits are filled with fibre, which slows digestion and helps control blood sugar. But that fibre is shed when fruit is turned into juice. Without it, sugar reaches the bloodstream faster, which can cause spikes and drops in energy. Research has shown that swopping a fruit juice for some types of whole fruit three times a week can lower a person’s chances of getting type 2 diabetes.
A study published in the South African Journal of Clinical Nutrition earlier this year found that almost three-quarters of fruit juices have more sugar than the proposed limit. But as regulations stand now, only 17% would require a warning label because most of the sugar is natural, not added (because the regulations only look at the total amount of sugar in products with added sugar and not those with natural sugars).
Cold drinks
Among the three sodas, Coke has the most sugar – and is the only one that contains caffeine, a stimulant, which means it speeds up the messages travelling between the brain and the body, and can therefore make you sleep less well. Too much caffeine can lead to anxiety, restlessness and affect the heartbeat.
The WHO says an adult should not consume more than six to 12 teaspoons of sugar daily. A can of original taste 440ml of Coke contains 2.65 teaspoons of sugar per 100ml, which means an entire can contains about 11.5 teaspoons of sugar — more than the maximum WHO daily limit.
Sodas are some of the sweetest drinks you can buy and, research shows, South Africans drink an average of 254 Coca-Cola products per person per year, almost triple the global average of 89.
Before South Africa’s tax on sugar beverages was introduced in 2018, which requires manufacturers to pay 2.1 cents tax for every gram of sugar that exceeds 4g of sugar per 100ml, the average 330ml can of soda had about 10 teaspoons of sugar. But to avoid the tax some producers changed ingredients in their drinks.
For example, said Frank, Sprite and Fanta drinks lowered the sugar content but added non-nutritive sweeteners to keep the sweetness.
While chemical sweeteners, which are often used in “diet” drinks, can help people with short-term weight loss, the WHO says they should “not be used as a means of achieving weight control or reducing the risk of non-communicable diseases” like obesity in the long-run.
Meanwhile, the International Agency for Research on Cancer has listed aspartame, a sweetener found in diet drinks such as Fanta Zero, as a possible cause of cancer, though more research is needed.
The new regulations will require sugary drinks containing artificial sweeteners to carry the following warning on the front of the container: “This product contains artificial sweeteners. Excessive consumption may be detrimental to your health.” Manufacturers will also not be allowed to market such products to children.
“None of these products is recommended as part of a healthy diet because they don’t contain any nutrients other than sugar and energy,” said Makoma Bopape, a nutrition researcher and lecturer at the University of Limpopo. Bopape was part of the technical group who worked on the labels. “What makes it worse is that some contain sweeteners.”
Energy drinks
Monster has nearly four times more sugar than both Dragon and Power Play and all contain artificial sweeteners. A 500ml can of Monster has around 13 teaspoons of sugar – more than the maximum sugar intake the WHO recommends for adults per day.
Energy drinks aren’t just packed with sugar, like many sodas, they also contain caffeine. Experts say teens who weigh between 40kg and 70kg shouldn’t consume more than 100mg-175mg of caffeine a day. At an average of about 150mg, all three energy drinks contain almost the maximum amount of caffeine per can per day that experts recommend.
Under the proposed regulations, these three drinks would all need a warning label, either for high sugar or containing artificial sweeteners.
Flavoured water
Of the three flavoured waters we looked at, Bonaqua Pump Lemon has the least sugar and doesn’t contain any artificial sweeteners.
Even though they’re often marketed as “healthier” options, the flavoured waters we looked at had similar amounts of sugar and sweeteners as sodas. One option had both sugar and three sweeteners, making it more soda than water.
aQuelle naartjie and Thirsti berry use artificial sweeteners to keep the sugar low, but they respectively also contain nearly two and four full teaspoons of sugar in a 500ml bottle.
See more from MedicalBrief archives:
Surge in children's sugary drink intake – global study
Sugared beverages: ‘An enemy with a mask of a friend’ – an endocrinologist's plea to Parliament
Sweetened drinks pose greater diabetes risk than other sugary foods
Activists flag serious health risks as sugar tax increase is delayed again