Food Matters: Identifying the key consumer trends in...

1 Food Matters Live 2014

Copyright © Global Stevia Institute 2014. All Rights Reserved.

Food Matters: Identifying the key consumer trends in weight management

Identifying key consumer trends- shape and natural

Dr. Margaret Ashwell OBE, Independent Scientific Consultant, Advisory Board Member,

Global Stevia Institute (GSI) 19th November, 2014

Trend #1 Focussing on Shape (waist-to-height ratio ) and not weight

Trend #2: Focussing on sweeteners of natural origin such as stevia



Trend #1 Focussing on Shape (waist-to-height) and not weight

2

One simple strategy to help the global obesity epidemic:

Focus prevention and treatment on those with central obesity- screened using WHtR

WHtR=0.5

“You should keep your waist circumference to less than half your height!”

BMI= BURY ME

IMMEDIATELY!



München, 11.3.2009

Danny de Vito

Ht=154 cm

85 kg

BMI 35

Waist =110

WHtR=0.71

Arnold Schwarzenegger

Ht=188 cm

120kg

BMI 34

Waist = 90cm

WHtR=0.47

Why Shape? Arnie and Danny have same BMI, but only Danny has WHtR well

The submarine (any

proxy for central body

fat) can see below the

surface

Increased insulin

Increased

pro-coagulant

activity

Increased

oxidised

LDL

Increased

triglycerides

Low HDL

Small, Dense LDL

Increased

platelet

aggregation

Increased

homocysteine

Glucose

Intolerance

BMI (Total obesity)

The Titanic can only see the tip of

the iceberg

Only sees

the

established

conditions

Prevent the

major

problems by

early detection

of risk factors

Insulin

resistance

Heart

disease

Why Shape? Many more risk

factors for CVD can be

detected earlier by measuring

central body fat rather than

BMI

Diabetes

Increased

blood pressure

Despres,1999 4

Release of

free fatty

acids(FFA) and

inflammatory

factors



Why Shape? Waist-to-height ratio is a better predictor of cardiometabolic risk facts than BMI

ASHWELL, M., GUNN, P. & GIBSON, S. 2012. Waist-to-

height ratio is a better screening tool than waist

circumference and BMI for adult cardiometabolic

risk factors: systematic review and meta-analysis.

Obes Rev, 13, 275-86.

For the first time, robust statistical evidence from 31 studies involving more than 300,000 adults in several ethnic groups, shows the superiority of

WHtR over WC and BMI for detecting cardiometabolic risk factors in both sexes.



BMI deciles

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

1 2 3 4 5 6 7 8 9 10

BMI deciles

mort

alit

y r

ate

%

male

female

Waist to height ratio

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

1 2 3 4 5 6 7 8 9 10

WHtR decilesm

ort

ality

ra

te %

male

female

There is a clearer correlation between WHtR and mortality rates than BMI and mortality rates(P<0.01).

Mo

rtal

ity

rate

(%

)

Ashwell M, Mayhew L, Richardson R, Rickayzen B (2014) Waist-to-height ratio is more predictive of years of life lost than body mass index. PLOS One 9, e103483

Why Shape? Stronger link between shape (WHtR) and mortality rates than between BMI and Mortality rates (using HALS 20 year follow-up data, 1985 to 2005)



7

Early edition Sunday Times 7/9/14 Later edition Sunday Times

Spot the Difference



0

4

8

12

16

20

24

< 0

.36

0.3

6

0.3

8

0.4

0.4

2

0.4

4

0.4

6

0.4

8

0.5

0.5

2

0.5

4

0.5

6

0.5

8

0.6

0.6

2

0.6

4

0.6

6

0.6

8

0.7

0.7

2

0.7

4

0.7

6

0.7

8

≥ 0

.8

Waist-to-height ratio (WHtR)

ye

ars

of lif

e lo

st (Y

LL

)

age 30

age 50

age 70

Minimum YLL at WHtR 0.4 to 0.5 ‘OK’

Take action WHtR>0.6

OK WHtR0.4-0.5

Consider action WHtR 0.5-0.6

Take care WHtR<0.4

Slightly Increased YLL at WHtR 0.5 to 0.6 ‘Consider action’

Much increased YLL at WHtR >0.6 ‘Take action’

Slight Increased YLL at WHtR <0.4 ‘Take Care’

Years of life lost (YLL) for men by waist-to-height ratio

Why Shape? Mortality data lends support to the boundary values of Ashwell ® Shape Chart



NDNS data (2008-2012) 1170 adults aged 19-64y

Ashwell and Gibson BMC Medicine (2014) 12,207

Why Shape? 28% of U.K. adults classified as “normal” by BMI have WHtR>0.5 They would be misclassified as ‘not at risk’ by BMI screening.



Trend #2 Focussing on sweeteners of natural origin such as stevia

Stevia is anew type of sweet

Sugar “Artificial”

Sweeteners

Stevia Naturally Sourced,

Low Calorie Sweetener (LCS)



Mauro Fisberg, MD PhD Pediatric Physician, Nutrition Scientist, and Professor, Federal University of

Sao Paulo, Brazil

Bernadene Magnuson, PhD Food toxicologist specializing in ingredient and sweetener safety and regulation,

Professor, University of Toronto, Canada

Margaret Ashwell OBE, PhD Independent Scientist, specializing in

nutrition & obesity, UK

Board of Scientific Advisors from around the world

Keith Ayoob, EdD, RDN Internationally-known nutritionist, author, and Professor of Pediatrics, Albert Einstein School of Medicine,

USA Ursula Wölwer-Rieck, PhD Institut Prof. Dr. Georg Kurz GmbH,

Bonn University, Cologne, Germany

Juana Morillas-Ruiz, PhD Faculty of Health Sciences, San Antonio Catholic University

of Murcia, Spain

For more information on the science of stevia, visit www.GlobalSteviaInstitute.com

Rachel Cheatham, PhD Executive Director of the GSI PhD Nutritional Biochemist, Communications Professional and Professor of Food Marketing at Tufts university in Boston Chicago, USA

http://www.globalsteviainstitute.com/



Stevia is available in foods and beverages throughout Europe



The science of stevia

What is stevia? –Origin

–Extraction

–Definitions

–Chemistry and physiology

–Benefits

–Safety

Stevia and weight/waist management

Conclusions



Stevia is a plant native to South America

Grows as a perennial small shrub

Used as a sweet herb for hundreds of years

Dr. Bertoni discovered stevia in Paraguay in 1887

First used as a commercial sweetener 40 years ago in Japan

Now grown in 5 continents as a sustainable and profitable crop

China leads the world in stevia production



Stevia extraction process: From farm to ingredient Dry Stevia Leaves

Water Extraction (steep in water)

Filtration (remove small leafy particles)

Activated Carbon Treatment (remove organic residues)

Ion Exchange Treatment (remove minerals)

Absorption/Desorption Resin (Concentrate Glycosides)

Spray Drying

Stevia Extract



Stevia: Generic term used to refer to different forms of the sweetener, including:

the whole plant Stevia (Rebaudiana Bertoni); the leaves where the sweet compounds are found;

Stevia extract: A generic name for a preparation made by steeping the leaves of the Stevia plant to extract the sweet compounds from the leaf material.

Purified Stevia Leaf Extract: High purity stevia leaf extract contains 95% or greater steviol glycosides. Only high purity stevia extracts meeting this specification are approved by major regulatory agencies, including JECFA and CODEX for use in foods and beverages.

The term "stevia" as used in this presentation refers to high purity stevia leaf extract

Stevia Definitions



Stevia’s sweet components are called steviol glycosides

Natural compounds in the stevia leaf

Have a common steviol backbone (a terpene)

Number of sugars and their arrangement on sites of

steviol backbone vary (R1, R2) in the different

glycosides

Each steviol glycoside has unique taste and sweetness

profile



Sweetening power of 11 main glycosides in the stevia plant

The sweetness of about three stevia leaves can replace the sweetness of sugar in a 330ml can of sugar-reduced (25%) carbonated soft drink.

Stevioside and Rebaudioside A together make up 14-18% of leaf content



What happens to steviol glycosides in the body? Why zero caloric impact?

O glucoseO

glucose

glucose

O

glucose

H

H

CH3CH2

O

CH3

O

Upper GI tract •steviol glycosides are not digested •pass straight into into colon

Colon glucose removed from

side chains of glycosides

fermented by bacteria (insignificant calories produced)

steviol backbone remains

and is modified by liver to

steviol glucuronides excreted in urine

H O

H

H

C H 3 C H 2

O

C H 3

O H

No accumulation of stevia (or any component or by-product of stevia) in the body



Summary of Stevia Benefits

• Sweet ingredient in foods and beverages

• Natural origin, plant-based • Zero calories • Appropriate for diabetics • Suitable for whole family, including

children and pregnant women • Tooth friendly • Suitable for cooking, ideal for a range

of food and beverages • pH, heat, and shelf stable



Stevia safety

All major global markets have approved the use of high purity stevia leaf extract in foods and beverages for use by the general population,

which includes children and pregnant women.

Over 200 studies have been reviewed to gain approval



Steviol glycoside worldwide regulatory approval

Regulatory Authorities/Organization Key Outcome/Observations

Joint (FAO & WHO) Expert Committee on Food Additives (JECFA)

Reviewed safety and established Acceptable Daily Intake (ADI) for stevia (>95% steviol glycosides)

Food Standards Authority of Australia and New Zealand (FSANZ)

Steviol glycosides approved as food additive in Australia and New Zealand; “unlikely to have adverse effects on blood pressure, blood glucose”

United States Food and Drug Administration (FDA)

No Objections to Generally Recognized as Safe (GRAS) status (Issued in 26 separate notices)

French food safety agency (AFSSA) Approved stevia ( ≥97% Reb A) in food and beverages

European Food Safety Authority (EFSA) Pan-European Approval “Steviol glycosides…..are not carcinogenic, genotoxic or associated with any reproductive/developmental toxicity.”

Health Canada (HC) “….evaluation of available data support the safety and efficacy of steviol glycosides”

http://www.who.int/entity/ipcs/en/



In Europe, EFSA gave safety report in 2010; EC gave approval for use in products in 2011



High purity stevia extract is safe for the whole family



The science of stevia

What is stevia? –Origin

–Extraction

–Definitions

–Chemistry and physiology

–Benefits

–Safety

Stevia and weight/shape management

Conclusions



Many studies on stevia have produced results confirming

its safety, and one study showed stevia had no effect on

satiety ( Anton et al, 2010). But there are no long term

trials which look at the effectiveness of stevia in weight

control.

We have no reason to believe that the effectiveness of

stevia replacing sugar in drinks and foods would lead to

different conclusions from those obtained with other low

calorie sweeteners (LCS).

More research in humans will be important to clarify the

role of stevia in long-term energy reduction.

In the meantime, let’s look at studies with other LCS

Does replacement of caloric sweeteners with stevia facilitate weight/waist loss or weight maintenance by helping reduce energy intake?



In RCTs , use of LCS is associated with loss of BMI, fat mass and waist circumference (Miller and Perez, 2014)



Summary: Identifying key consumer trends - shape and natural Trend #1 Focussing on Shape (waist-to-height ratio ) and

not weight

Waist-to-height ratio is a better predictor of morbidity and mortality than BMI

“Keep your waist to less than half your height” is a simple Shape message for all

Trend #2: Focussing on sweeteners of natural origin such as stevia

Stevia is a new zero calorie sweetener of natural origin with any benefits

Stevia has safety approved worldwide for all target groups

Effectiveness results similar to other LCS likely to be obtained with foods/drinks sweetened with stevia

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