Sugar added to foods consumed in New Zealand and Tokelau.

Cane sugar, sucrose, is a molecule composed of one unit of glucose and one of fructose. In the body, both the glucose and fructose are eventually burnt to produce carbon dioxide and water and provide energy that allows the body to maintain homeostasis. Other dietary macronutrients including other carbohydrates e.g. as in taro, fats, protein and alcohol are also be burnt to provide energy. There is consistent evidence for adults1 and children 2 that the intake of free sugars, including sugar sweetened drinks, is a determinant of body weight and fatness. A randomised controlled trial with normal weight children provides evidence that replacement of sugar containing drinks with non-caloric drinks for 18 months reduced weight gain and fat accumulation.3 In the last 10 years (2003 to 2012) imports of “centrifugal cane sugar” (sugar) into New Zealand have averaged more the 220,000 metric tonnes each year.4 For the New Zealand population of 4.2 million this is equivalent, each year, to 52 kg of sugar for every person, or one kg a week. An unknown quantity of this sugar is not directly consumed. Within New Zealand sugar is used to feed yeast as part of the fermentation process to produce alcoholic beverages and bread. In addition, sugar is exported both as refi ned sugar (white and brown), and as an ingredient in manufactured food products. Some sugar may be used for the production of biofuels. What is known is that in the 2008/9 adult nutrition survey5, for the average adult, 9% of total energy came from non-alcoholic beverages, sugar and sweets (including confectionary, jams but not sugars added to biscuits, cakes and muffi ns, breakfast cereals and snack bars). The World Health Organisation6 recommends that no more than 10% of energy in the diet be obtained from free sugars – defi ned as mono and disaccharides added to foods by the consumer, cook or manufacturer plus sugars naturally present in honey, syrups and fruit juices. More recently the World Health Organisation has produced a draft consultation which states that a reduction of free sugars to below 5% of total energy intake per day would have additional health benefi ts 7. There are, of course, other natural sources of sugar, in whole, not refi ned foods. The main contributors to natural, intrinsic sugars are fruit, vegetables (Table 1) and Food item Average number of times a week Portion size g intrinsic sugars*/ serve