Nutritional Pearls: Are "Natural" Ingredients Always Healthier?

Joe is an overweight 36-year-old man who has struggled with weight for most of his life.

When asked about his eating habits, he says that while he does eat a lot of sugary foods, he always chooses the options with “natural” and “healthy” ingredients like honey over those with refined, processed sugars.

How would you advise your patient?
(Answer and discussion on next page)

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Answer: Calling something "natural" does not mean it's good for you.

Sugar is a hot topic right now: it's the ingredient people love to hate. Concern about added sugars in foods is so great that the federal government is considering putting "added sugars" on its redesigned nutrition label, and that concern is so pervasive that I've received questions about the source of sugars in some of my recipes that contain no sugar-type ingredients such as honey, brown sugar, white sugar, or maple syrup. It's been so demonized recently that Coca-Cola has purchased its own set of scientists to claim that lack of exercise is a greater contributor to obesity than consuming too many calories.
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Yet there's still a perception that some sugars are "healthier" than others. Honey and brown sugar are often believed to be better for you than white sugar, even though all three break down in the body into the same chemical components and are ultimately utilized by the body in the same way. Why? Because of the generalized belief that things that are more "natural" are better for you.

The Research

A team of researchers in Switzerland recently explored this perception as it relates to sugar in a series of 4 experiments carried out as online questionnaires. They theorized that simply labeling the sugar content of a food "fruit sugar" (because what could be better for you or more natural than fruit?) instead of "sugar" would lead people to think a food was more healthful.

In their first experiment, 164 men and women were randomly assign to evaluate 1 of 2 nutrition labels for what they were told was a breakfast cereal. Both labels gave identical calorie, protein, carbohydrate, fat, and sugar content information, but in one label the sugar content was simply labeled "sugar" while the other label read "fruit sugar." The participant was asked to rate how healthy they felt the cereal was on a scale of 1 to 100, with 100 being "very healthy."

In the second experiment, another 202 men and women compared the same 2 labels presented in a random order. Again they were asked to rate the healthfulness of each label on a scale of 1 to 100.

The Results

In both the first and second experiment the subjects consistently rated the cereals containing "fruit sugar" to be healthier than the cereals containing "sugar"—even though the labels were identical in every other respect.

The researchers realized that the label "fruit sugar" might have implied to the participants that the cereal contained actual fruit, so they devised a third experiment, adding a picture of the cereal's packaging. The package is labeled "Corn Flakes" and includes a picture of a bowl of generic corn flakes with no fruit depicted (not even a few blueberries scattered on top for color). This third experiment was otherwise nearly identical to the second experiment: the other change was to increase the amount of "sugar" and "fruit sugar" to a higher, but still identical amount. This experiment confirmed the findings of the first 2: foods containing "fruit sugar" were still considered to be healthier than those containing "sugar"—even though the product contained no fruit per se.

A fourth experiment repeated the third experiment (nutrition label and picture of box) and added a third factor: the same "fruit sugar" nutrition label along with the same cereal box, but this time with a big "Made with 100% fruit sugar!" on the front of the box. Interestingly, the "fruit sugar" health claim on the front of the box did not make the cereal seem healthier than the cereal with the same nutrition information label but without the health claim.

What’s The “Take Home”?

It's important to be aware of how a consumer can be manipulated into thinking something is healthier when it is not. Sugar is not the only ingredient affected by manipulation: as you probably know, calling something "natural" does not mean it's good for you, either. Be a smart consumer and don't let yourself be fooled.

Reference:

Sutterlin B, Siegrist M. Simply adding the word "fruit" makes sugar healthier: The misleading effect of symbolic information on the perceived healthiness of food. Appetite. 2015;14(95):252-261.