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کاهش مصرف قنددکتر آزاده نجارزاده

مشكل مضاعف جامعه ما گذر شتابزده تغذيه اي

از يك طرف سوء تغذيه پروتئين انرژي و كمبود ريز مغذي ها در سهم بزرگي از جمعيت كشور

مشاهده مي شود از طرف ديگر نشانه هاي هشدار دهنده اي از

گسترش بيماري هاي متابوليك از جمله بيماري هاي ديده عروقي، ديابت، چاقي و انواع سرطان ها قلبي

مي شود

گسترش دو پديده مذكور در كنار هم چه اثري دارد

بازده سرمايه گذاري در بخش آموزش تهديد

كيفيت نيروي انساني كاهش

درمان در سال هاي آيندههاي هزينه ن باال برد

آن بار بيماري و هزينه هاي اقتصادي ناشي از افزايش

داليل ايجاد گذر شتابزده تغذيه اي

افزايش متوسط هزينه خوراكي خانوار كاهش كالري دريافتي به ويژه در دهك هاي پايين درآمدي در طول دهه گذشته ،

افزايش شديد كالري دريافتي در دهك هاي باالي درآمدي ناترازي دريافت كالري در خانوارهاي كشور

. عوارض بيش خواري و كمبود دريافت مواد مغذي را در پي دارد

داليل ايجاد گذر شتابزده تغذيه اي افزايش اضافه وزن و چاقي افراد جامعه •

افزايش بيماري هاي غيرواگير •

افزايش سكته هاي قلبي و مغزي •

و سرطان ، افزايش فشارخون ، ديابت•

پوكي استخوان

زيادي ميزان مصرف قند، نمك و چربي •

زيادي مصرف هله هوله ، نوشابه، كنسرو ، •

غذاي حاضري و فست فود

كمي ميزان مصرف ماهي و سبزي و ميوه •

تازه و شير و لبنيات

خطر عامل 10 از عامل 8: سال جهان، در مهم خطر عوامل به منتسب هاي مرگاست بدني فعاليت و تغذيه با مرتبط اصلي•CVD است منطقه در ها مرگ %31 علت.

•26% hyper tension است كرده گرفتار را منطقه مردم. زناندر %48ودرمردان %61.9 بهكشورهادربرخيدخانيات مصرف•

.رسد مي.است توجه قابل لبنان و ايران كشور در ليپيدمي هايپر شيوع•.است متفاوت %7-25 از منطقه كشورهاي در ديابت شيوع•.ندارند كافي تحرك منطقه مردم 80-70%• زنان در %75 و مردان در %52 به ايران كشور در چاقي و وزن اضافه شيوع•

.رسد مي

Did you know?

• A 12-ounce can of sugar-sweetened soda contains about 150 calories and 9 tsp. of sugar. Diet (low calorie) soda contains no sugar.

Evidence of harm of high intake of foods and drinks with added sugar

Reasonable evidence linking high sugar consumption (especially beverages) with:

• Weight gain and obesity

• Nutrient dilution and insufficiency

• Dental caries and erosion

• Possibly bone health

Terminology Related to Carbohydrates

Sugars• The term "sugars" is conventionally used to describe the mono and

disaccharides."Sugar",• by contrast, is used to describe purified sucrose as are the terms "refined

sugar" and "added sugar"Intrinsic and extrinsic sugars• Intrinsic sugars occur within the cell walls of plants.• Extrinsic sugars were those which were usually added to foods.

Can foods and drinks with added sugar be good for you ?

Suggestions that increasing sugar may:

• encourage intake of nutritious unpalatable foods and beverages

• Reduce the intake of fat and thus achieve better weight control

Per capita consumption ofsugar

Nutrient sufficiency

• Does consuming more foods high in added sugars lead to better or worse nutrient intake?

Calcium intake in US children 4‐8 Y as a function of added sugar intake

US NHANES data

Relationship between added sugar intake and Zinc intake Children Children 2-16 2007 Australian National Children’s Nutrition

and Physical Activity Survey

Unpublished – Boden Institute

R2 = 0.6582

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

1 2 3 4 5 6 7 8 9 10

Age and sex specific, energy adjusted deciles of added sugar intake

Zinc

(mg)

Relationship between added sugar intake and fibre intake Children

R2 = 0.8336

0

5

10

15

20

25

30

1 2 3 4 5 6 7 8 9 10

Age and sex specific, energy adjusted deciles of added sugar intake

Fibr

e (g

)

Children 2-16 2007 Australian National Children’s Nutrition and Physical Activity Survey


Relationship between added sugar and risk of nutrient insufficiency in Children

≥ 5 nutrients at risk

0.00

2.00

4.00

6.00

8.00

Q1 Q2 Q3 Q4

Age and sex specific energy adjusted quartile of added sugar intake

Adju

sted

odd

s ra

tioChildren 2-16 2007 Australian National Children’s Nutrition

and Physical Activity Survey


≥ 7 nutrients at risk

0.001.002.003.004.005.006.00

Q1 Q2 Q3 Q4

Age and sex specific energy adjusted quartile of added sugar intake

Adju

sted

odd

s ra

tio

Serve size Males |31-50 years

Females31-50 years

Starchy vegetables 75g 7 5Green & brassica vegetables 75g 7 7Orange vegetables 75g 7 2Legumes 75g 7 2Nuts/seeds 30g 7 7Other vegetables 75g 14 14Fruit 150g 14 14Wholegrain cereals/grains Equiv 40g bread 28 28Refined cereals/grains* Equiv 40g bread 14 14Meat and alts minus red Equiv 65g red meats 7 7

Red meats (beef, lamb, veal, pork) 65g 7 7Dairy foods ** Equiv 250g milk 17 17Additional category:‘Other foods

(600kJ equivalents)

7-14 3.5-7

Unsaturated fats and oils*** 10g 28 14

Consultation draft – Foundation and Total Diets 2010

Weekly food required to meet NRVsMen and women average height, moderate activity PAL 1.7

مي دهد که سرانه مصرف قند و شکر در کشور ما نسبت به وضعيت جهاني، بسيار باالست، به طوري که برآورد مي شود هر آمارنشان

کيلوگرم است، ٢٠تا ١٩کيلوگرم قند و شکر مصرف مي کند که از ميانگين جهاني که حدود ٣٠تا ٢٩ايراني به طور متوسط ساالنه مقدار به مراتب بيشتر مي باشد

گرم در روز در ۴٢(کيلوگرم در سال ١۵ميزان مطلوب مصرف قند و شکر طبق مطالعات سازمان جهاني بهداشت، حداقل بايد به کمتر از درصد از کل انرژي دريافتي فرد را تامين نمايد و به عالوه، خطر بيماري هاي ١٠برسد تا قند و شکر، حداکثر ) کل مواد غذايي مصرفي

دندان را به پايين ترين حدبرساند

Most countries have a dietary guideline restricting sugar intake

2007 Canadian Food Guide• – Limit foods and beverages high in calories, fat, sugar and salt.

2000 Malaysian Dietary Guidelines• - Reduce sugar intake and choose foods low in sugar.

2007 New Zealand Dietary Guidelines• Prepare foods or choose pre-prepared foods and snacks: with little added sugar; limit your intake of high-sugar

foods.

2011 Singapore Dietary Guidelines• Choose beverages and food with less sugar

2008 UK National Dietary Goals FSA• Sugars (added) - No more than 11% of food energy (currently at 12.7%)

2010 Dietary Guidelines for Americans• Consume fewer foods with sodium (salt), saturated fats, trans fats, cholesterol, added sugars, and refined grains

Prepared Meal Solutions 18-19 October 2005

Problems encountered in Replacing Sugar

• Texture

• Flavour

• Colour

• Cost


The only way to keep your health is to eat what you don't want, drink what you don't like, and do what you'd rather not.

Mark Twain


Sugarfree Success


Technologists Options

• Reduce

• Remove

• Replace


1 hour 2 hour 1 hour 2 hour

Glucose (reference) 50g Fructose 50g

100%19%

GI Factor 100 GI Factor 19

Glycemic Index


Glycemic index ( or GI factor) is a ranking of foods from 0 – 100

This tells us whether a food will raise blood sugar levels just a little, moderately or dramatically

Low GI <55Intermediate GI foods 55 - 70High GI foods > 70

Glycemic Index

Glycemic Index


Alternative Sweeteners Basic Properties

• Relative Sweetness

1.0

1.8

1.00.9

0.8

0.5 0.5 0.5

0.02

0.4

0.00.20.40.60.81.01.21.41.61.82.0

Fructose

SucroseXylito

l

Maltitol

Maltitol Syrup

Sorbitol

MannitolIsomalt

Lactitol

P/dextrose


Other SweetenersSweetener Relative sweetness in comparison

to sucroseApplications

Aspartame ~200 times Soft drinks, juices, desserts, cereals, jams etc.

Saccharin 300-500 times Table-top, soft drinks, jams, confectionary etc.

Sucralose 600 times Processed fruit, soft drinks, baked goods etc.

Acesulfame K 130-200 times As aboveCyclamate 30-50 times As above in combination

with other sweeteners

Thaumatin ~2000-3000 times Coffee drinks, chewing gum, yogurts & desserts etc

Alitame (not yet approved in EU)

2000-3000 times Baked goods, confectionary etc.


Alternative Sweeteners Basic Properties• Solubility

0100200300400500600700800

0 10 20 25 30 40 50Temperature °C

g / 1

00 g

Wat

erSorbitol Mannitol Xylitol Lactose Lactitol Sucrose Fructose


Within the EU and Switzerland (and some other countries outside of the EU), foods containing more than 10 % sugar alcohols (irrespective of polyol type) must carry the following warning on the package:

“Excessive consumption can cause laxative effects”

Polyols – Labelling Requirements

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