Meeting
Event Title
Virtual Public Meeting and Listening Sessions on Strategies to Reduce Added Sugars Consumption in the United States
November 6 - 8, 2023
- Date:
- November 6 - 8, 2023
The U.S. Food and Drug Administration (FDA) and our federal partners at the Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) held a virtual public meeting and listening sessions entitled, “Strategies to Reduce Added Sugars Consumption in the United States.”
The National Strategy on Hunger, Nutrition, and Health notes that the intake of added sugars for most Americans is higher than what is recommended by the Dietary Guidelines for Americans and calls for FDA to host, in collaboration with other federal partners, a public meeting on this issue. The event covered the wide range of efforts being taken by federal agencies, communities, and private industry to reduce added sugars in the U.S. food supply and in consumer’s diets.
The FDA will review input received at the public meeting, in listening sessions, and in response to a Regulations.gov docket to determine next steps in consultation with our federal partners.
Background
In 2016, the FDA announced the most comprehensive reform to the Nutrition Facts label since its introduction in 1993. The changes to the label reflect the latest nutritional science available, emphasizing the information that consumers need to make better-informed decisions about their eating habits.
One of the reforms is that manufacturers must include the declaration of the gram amount and the percent Daily Value for “Added Sugars” on the Nutrition Facts label. This change takes into account that Americans on average are consuming added sugars in amounts that exceed recommended limits. The Dietary Guidelines for Americans recommends limiting calories from added sugars to less than 10 percent of total calories per day. Consuming too much added sugars can make it difficult to meet nutrient needs while staying within calorie limits.
Added sugars include sugars that are added during the processing of foods (such as sucrose or dextrose), foods packaged as sweeteners (such as table sugar), sugars from syrups and honey, and some sugars from concentrated fruit or vegetable juices. They do not include naturally occurring sugars that are found in milk, fruits, and vegetables. The Daily Value for added sugars is 50 grams per day based on a 2,000-calorie daily diet. For most Americans, the main sources of added sugars are sugar-sweetened beverages, baked goods, desserts, and sweets.
On September 28, 2022, the White House released a National Strategy on Hunger, Nutrition, and Health at its Conference on Hunger, Nutrition and Health. The strategy aims to end hunger in America and increase healthy eating and physical activity by 2030, so fewer Americans experience diet-related diseases like diabetes, obesity, and hypertension. The strategy includes several FDA initiatives to help accelerate efforts to empower consumers with information and create a healthier food supply, including assessing additional steps to reduce added sugars consumption.
While the U.S. has reduced added sugars consumption[1] and established a regulatory definition for added sugars, added sugars intake still exceeds recommended limits for most Americans. As a result, the National Strategy calls for the FDA, with other HHS divisions and the USDA, to begin assessing the evidence base for further strategies to reduce added sugars consumption, and the public meeting will be an initial step in understanding the scope, current landscape, and stakeholder ideas around those strategies.
Virtual Public Meeting
The public meeting explored what federal agencies, communities, and private industry are doing to encourage the reduced consumption of added sugars. During the public meeting, there were presentations to provide background on added sugars and discuss strategies for reducing added sugars used by other countries; panel sessions on federal, industry, and community approaches to reduce added sugars consumption; and multiple opportunities for participants to submit questions and share information through the listening sessions.
Listening Sessions
There were two days of facilitated listening sessions offering participants the opportunity to provide feedback on next steps to reduce added sugars consumption in the U.S: Topic 1 – Food Labeling and Food Industry Perspectives and Topic 2 – Consumer Education and Community Perspectives.
Background
On November 6-8, 2023, the U.S. Food and Drug Administration (FDA) and our federal partners at the Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) held a virtual public meeting and listening sessions entitled “Strategies to Reduce Added Sugars Consumption in the United States.” In 2016, FDA mandated that manufacturers must include the declaration of the gram amount and the percent Daily Value for “Added Sugars” on the Nutrition Facts label. The Dietary Guidelines for Americans recommends limiting calories from added sugars to less than 10 percent of total calories per day. Consuming too much added sugars can make it difficult to meet nutrient needs while staying within calorie limits.
Added sugars intake still exceeds recommended limits for most Americans. As a result, the White House National Strategy on Hunger, Nutrition and Health called for the FDA, with other HHS divisions and the USDA, to begin assessing the evidence base for further strategies to reduce added sugars consumption. The public meeting was an initial step in understanding the scope, current landscape, and stakeholder ideas around potential strategies for added sugars reduction.
During the virtual public meeting on November 6, 2023, there were presentations to provide background on added sugars and discuss strategies for reducing added sugars used by other countries as well as panel sessions on current federal, industry, and community approaches to reduce added sugars consumption.
The FDA has offered multiple opportunities for stakeholders and the public at large to submit questions and/or comments: during the registration process, at the virtual listening sessions, and to the docket FDA- 2023-N-3849.
On November 7-8, we held four virtual listening sessions on two separate topics, offering participants the opportunity to provide feedback on next steps to reduce added sugars consumption in the U.S. Over 3,300 people participated in the public meeting and listening sessions.
- Food Labeling and Food Industry Perspectives: the listening sessions on this topic focused on getting perspectives from individuals and organizations on ideas for systematic solutions to decreasing the added sugars content of foods.
- Consumer Education and Community Perspectives: the listening sessions on this topic focused on gaining perspectives on consumer education or community-centered efforts on decreasing added sugars consumption.
Key Themes Raised During Listening Sessions
The key themes, perspectives, and ideas that participants raised during the listening sessions are summarized below; these summaries do not necessarily represent FDA or our federal partners viewpoints. Themes generally cut across all listening sessions, though some applied more to one session topic than to the other. The ideas are grouped into four overarching themes with more specific feedback captured under each.
Labeling and Consumer Awareness: Participants discussed the need for simplified information on labels and research to understand consumer behavior. Key points included:
- General support for Front-of-Package (FOP) labeling, participants recommended including both Total and Added Sugars as well as calories in a FOP system. They discussed the importance of providing clear labeling with icons, particularly for non-English speakers and individuals with limited literacy.
- Avoid labeling a food as good or bad.
- More research is needed on the impact of labeling initiatives, specifically FOP and products bearing the “healthy” nutrient content claim. There was a particular interest in research on products marketed towards children and warning labels.
- General support for mandatory disclosure of added sugars on restaurant menus. Participants stressed the need to align nutrition labeling on packaged foods with requirements on menus.
- Update the National Health and Nutrition Examination Survey (NHANES) with added sugars consumption data.
Education and Marketing: Participants discussed the need to educate consumers about added sugars and sweeteners, as well as the impact of marketing tactics on added sugars consumption. Key points included:
- Concern over the use of sweeteners (e.g., high intensity sweeteners) in place of sugars in foods and stressed the need to educate consumers on the safety of sweeteners.
- Marketing tactics can lead consumers to purchase and consume foods with more added sugars, and there is concern about marketing tactics that specifically target children.
- More education is needed about ingredients in products that have unfamiliar names. Some participants expressed concern that such ingredients are being unnecessarily “demonized.”
- Collaboration is needed between government, industry, and public health agencies to effectively educate consumers on topics such as ingredients, portion control, sweeteners (e.g., low and no calorie sweeteners).
- There is a need for science-based, multi-language education campaigns about sugars in general that should utilize social media.
- Support for government sponsored education initiatives. Participants suggested interactive activities, such as using sugar cubes as a visual to show the amount of added sugars in a product.
- Participants proposed strategies, such as enlisting athletes and celebrities for public awareness campaigns, especially in major cities with food deserts. More specific examples include:
- Having athletes and performers be spokespersons for encouraging healthier food choices and avoiding unhealthy food choices with added sugars.
- Utilizing social media platforms to create short-form content around the effect of sugars on the human body.
Reformulation of Foods to Reduce Added Sugars: Participants discussed the challenges of reformulating foods to reduce the added sugars content, shared innovative strategies, and ways to improve collaboration across sectors to reduce added sugars in foods, including:
- The main challenge is that sugar can play a multifunctional role in some foods beyond sweet taste (e.g., adding texture, preventing microbial spoilage, retaining moisture, lowering the freeze point). Replacing added sugars could require adding more ingredients to foods, which may raise the cost of products, cause them to be considered “ultra-processed foods”, and not necessarily decrease the caloric content.
- Use of structural ingredients (e.g., fiber, gums) and new technologies (e.g., precise fermentation), as well as, limiting portion size were some added sugar reduction strategies discussed.
- Some suggested that reformulation could be driven by consumer demand, which is not currently strong, while others indicated that consumers are looking for more products with less sugars but cannot find them in the marketplace.
Health Equity and Added Sugars: Participants discussed that added sugars consumption is a health equity issue and offered several suggestions, including:
- There should be greater access to healthier, nutrient-dense foods through the nutrition assistance programs. For example, government could bridge the gap in food availability for certain geographical areas (e.g., food deserts) by increasing the availability of stores that can participate in nutrition assistance programs.
- Food producers need to make healthier foods more affordable and accessible.
- Many underrepresented communities do not have equitable access to grocery stores with healthy foods. Some suggestions included:
- Replacing sugar-sweetened beverages with water.
- Support target populations that exhibit higher rates of chronic conditions (coronary heart disease (CHD), Type 2 Diabetes.
Overall, the listening sessions captured diverse ideas and stressed the collaborative efforts needed between public and private entities to reduce added sugars consumption, provide educational interventions, support underrepresented populations, and encourage healthier eating choices in children through proven science-based approaches.
Submit Comments
You may submit comments to docket FDA-2023-N-3849 beginning on November 6, 2023, electronically or by mail. Electronic comments must be submitted on or before January 22, 2024. Please note that late, untimely comments submitted after January 22, 2024, will not be considered. The Regulations.gov electronic filing system will accept comments until 11:59 p.m. Eastern Time at the end of January 22, 2024. Written/paper submissions should be sent to Dockets Management Staff (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. Comments received by mail/hand delivery/courier (for written/paper submissions) will be considered timely if they are postmarked or the delivery service acceptance receipt is on or before January 22, 2024.
For Further Information
For general questions about the public meeting or listening sessions, contact CFSAN Communications and Public Engagement Staff at CFSAN-Comms@fda.hhs.gov.
[1] Lee SH, Zhao L, Park S, Moore LV, Hamner HC, Galuska DA, Blanck HM. High Added Sugars Intake among US Adults: Characteristics, Eating Occasions, and Top Sources, 2015-2018. Nutrients. 2023 Jan 4;15(2):265. doi: 10.3390/nu15020265. PMID: 36678136; PMCID: PMC9867287.