Very little is settled in nutrition science. Sugar, along with trans fats (the next blog post) is one of them. Added sugar – even naturally occurring sugar – should be limited in most people’s diets, because it raises risk of diabetes and possibly heart disease.
Unfortunately, your current health risk assessment (HRA) almost certainly provides inadequate, even incorrect, information to guide employees on this topic.
For instance, while it is great that HRAs almost invariably advise employees to “eat a healthy breakfast” or “avoid added sugar,” that information by itself is of very limited value absent health literacy to help employees learn how to accomplish that goal.
Here are six things employees need to know about sugar that are not adequately addressed by the most widely used HRAs. It is important that employees learn how to put HRA advice into action -- and when to ignore the advice altogether. And when you yourselves, as employers, may inadvertently be contributing sugar to their diet.
1. A “healthy breakfast” should not include many cereals marketed as healthy
An HRA advises (and often gives you “points” for) claiming that you “eat a healthy breakfast.” But what does that mean? It turns out that even some of the most popular healthy cereals are full of added sugars. Kellogg’s Smart Start with Antioxidants, sounds very healthy and is clearly targeting the “eat a healthy breakfast” segment of the market.
Unfortunately, it is also on Eat This Not That!’s list of 20 Worst 'Good-for-You' Cereals.
2. Nonfat or low-fat items are often high in sugar
This HRA recommends “low-fat or nonfat yogurt.” Such yogurts are often high in sugar. Further, to continue with this HRA’s “make healthier choices” recommendation, it is completely unclear whether lowfat or nonfat dairy is better than whole fat dairy in general. Much recent research says the opposite of what HRAs say.
3. “Avoid added sugar” is by itself unhelpful advice
Virtually every HRA advises employees to “avoid added sugar.” Would that it were that easy! This HRA makes it even harder by limiting their avoid-added-sugar advice to “drinks,” when in fact solid processed foods are huge contributors to overconsumption of sugar. And whereas in beverages it is easy to spot the sugars, processed food companies use several tricks to complicate the process of spotting added sugars.
To begin with, there are at least 56 types of sugar. Some sound like health foods – agave syrup, turbinado, malted barley extract. Others just try to avoid using the word “sugar,” like “dehydrated cane juice.” Others are used because they sound like fruit – grape juice concentrate, apple juice concentrate. Our favorite is “organic brown rice syrup,” the #1 ingredient in Clif Bars, which they advertise as one of their “nutritious, organic ingredients.”
And that brings us to the next item...
4. Granola bars are candy...and they may be lurking in your break rooms
The worst type of candy is candy disguised as health food. Most people know to limit their consumption of candy…but they likely don’t know to limit their consumption of granola bars. You may even have granola bars in your break rooms, a tacit endorsement of their health value.*
Further, as you can see, food companies have figured out how to split up the sugar so that the first ingredient is not sugar. Quizzify often advises employees to beware of long ingredients labels. Nothing good ever came out of a long ingredients label.
5. “Fruits and vegetables” are not created equal
Every single HRA recommends increasing consumption of fruits and vegetables, two words invariably joined at the hip in all employee nutritional advice.
However, there can be a huge difference between the two. While no one doubts the health benefits of broccoli, employees often think they can count a glass of fruit juice toward their five-servings-a-day goal.
Three problems with that. First, health-wise, fruit juice has nowhere near the nutritional value of fruit, let alone broccoli. An eight-ounce glass of orange juice has roughly the same calories and sugar as eight ounces of sweetened soda.
Once again, as with considering granola bars to be health food, most employees uneducated in health literacy would assume that fruit juice is healthy.
Second, fruit juice is more readily digested than fruit itself, causing a spike in blood sugar that may be unhealthy for some employees (although diabetics whom you are incentivizing to reduce Hba1c may occasionally need fruit juice to prevent a trip to the ER for hypoglycemia).
Second, at least according to the American Heart Association, two ounces of fruit juice is considered one serving. Our suspicion is that this is a rookie mistake on their part, but in case you don’t believe us…
6. Virtually every packaged beverage claiming “100% of your Vitamin C” is full of sugar
This is pure marketing. Virtually no insured American has scurvy, while about 30-million people have diabetes.
There are dozens more items we could add to this list – the difference between juice and a “juice cocktail” or a “juice drink,” sugar in smoothies, the very positive value of sugarless gum – but one reason Quizzify is effective is that the education is spread out over months or years (and presented in an engaging format, of course). We don’t want to overwhelm you any more than we want to overwhelm them.
So what is the take-away? The single most important nutrition education goal is to help employees avoid sugars that can and do lead to diabetes. Yet without health literacy education, HRAs are not going to accomplish that goal – any more than a left shoe is helpful without a right shoe.
Fortunately, for about the price of a once-a-year HRA (when purchased or priced separately), companies can provide their employees with a full year of education on sugar as well as many other topics in health and healthcare.
Contact us to see how health literacy can turbo charge your HRA.
*They are actually quite hard to get rid of without an employee revolt. The best advice is to obscure them from view.