Ministry of Health Press Release-Scientific Board Report on “Health Impact of Starch based Sugars (SBS)”



Here below are the opinion and recommendations of the Scientific Board of the Ministry of Health related to Starch based Sugars (SBS) and sugar consumption as a result of evaluation taking into consideration the scientific researches and relevant reports:

Saccharide, widely known as table or tea sugar, consists of 50% glucose and 50% fructose.

Saccharide, or table sugar, is the leading sweetener in food and beverage products around the world whereas the second most consumed type is the Starch-based Sugars (SBS). SBSs are also called as high fructose corn syrup and produced mainly from corn with lower costs as well as potato, wheat and tapioca. SBSs contain variant percentages of fructose and glucose (58% glucose-42%fructose or 45% glucose-55% fructose). Glucose and fructose in saccharide are bound at molecular level whereas fructose and glucose in SBSs are in free liquid form.

Over the recent years, scientific researches investigating causes of increasing obesity and chronic diseases are observed to be putting more focus on sugar metabolism, particularly on table sugar and fructose metabolism in SBS structure.

Insulin released with glucose stimulation in the metabolism stimulates leptin (satiety hormone) and repress ghrelin (hunger hormone). As a result, satiety center is stimulated and ends eating behavior. On the other hand, fructose does not stimulate insulin in very less level. This pattern is claimed to trigger obesity as it leads to more sugar consumption, does not release insulin, does not enable satiety and therefore, eating is continued.

Metabolism of fructose in liver is different than glucose. Fructose dissolves more quickly than glucose and turns into lipid acids rapidly. Some studies suggest that this can lead to hepatic steatosis (fatty liver), fibrosis and cirrhosis.

When compared to glucose, fructose is sweeter than fructose and some researches show that it stimulates appetite increasing hedonic pathways. Consumption of fructose based products, especially among babies and children, can cause developing more sugar-oriented taste.

There are also some researches suggesting that fructose can lead to change in flora and microbiata of intestine. Different from glucose, fructose leads to uric acidity in blood, can trigger gout disease or exacerbates the existing conditions.

Some other studies put forward that as a result of over consumption of sugary (saccharide and SBS) food (high fructose -55% and above- corn syrups can be more consumed as they taste sweeter) can lead to increased eating habits, insulin resistance, obesity, diabetes, cardiovascular diseases and accompanying diseases.

Furthermore, over consumption of saccharide and SBS containing food is an enabler of metabolic diseases as well as obesity related cancer types (such as colon, pancreas, liver and breast cancers).

European Food Security Authority (EFSA) emphasized that high sugar intake and consumption of high sugar food can have an impact on increase in body weight.

European Union recommends to promote healthy eating habits and to develop a reformulation by the industry to reduce sugar.

Obesity and associated diseases are a public health problem not only for Turkey but also for many parts of the world. In Turkey obesity prevalence among adults over the age of 15 is recorded as 32%, overweight prevalence as 34.8% and diabetes prevalence as 12.1% (according to STEPS 2017, preliminary results).

The obesity rate among children at 7-8 age group is recorded as 9.9%, overweight as 14.6%. The obesity prevalence among secondary school children increased to 12.4% and overweight to 21%.

“Turkey Dietary Guideline”, WHO and other international recommendations advise that energy derived from all free sugars should not be more than 10% of daily energy (calorie) amount and even be less for certain countries.

In light of evaluations, below recommendations of the Scientific Board are shared for the attention of public opinion:

- All measures to be taken to reduce all types of sugar consumption (including subsidies, taxation, information and awareness initiatives and so on).
- The SBS quota (production), which is currently 10%, should not be increased and its usage in food should be limited with solid and severe inspection.
- The sugar content on food and beverage stickers should clearly indicate “sugar”, “glucose syrup”, “high fructose corn syrup”, “invert sugar” and so on in accordance with Turkey Food Codex by showing sugar content, origin and fructose percentage.
- In the scope of healthy diet promotion activities, the industry should provide support to these efforts through a reformulation and lowering high fructose corn syrup usage to minimum level. 
- Awareness among consumers should be increased in order to reduce sugar consumption, and healthy diet policies should be developed for all individuals of our society to embrace healthy eating habits starting from childhood.
- Under the coordination of the Ministry of Health, cooperation among all relevant sectors and public institutions should be ensured. 

Updated: 13/03/2018