Sorry to break it to you, but low-sugar booze is still bad for you

New research presented at this year's International Congress on Obesity (Melbourne, 18–22 October) and to be published in the journal Alcohol & Alcoholism shows that women can be misled by the "health halo" effect of alcoholic drinks labeled as low sugar, believing them to lower in alcohol content, overall energy, and healthier compared with "regular" alcoholic drinks. They are also less likely to state they would make adjustments to their diets and physical activity if they had consumed these low sugar alcoholic drinks. The study is by Dr. Ashleigh Haynes, Cancer Council Victoria, and University of Melbourne, Melbourne, VIC, Australia, and colleagues.

Alcohol is energy dense and alcoholic products are the largest discretionary source of energy in the diets of Australian drinkers (around 16% of daily energy intake, around double the 8% provided by discretionary cakes and muffins). Excess alcohol consumption can increase the risk of weight gain and chronic diseases such as cancer and heart disease. Up to one in five alcohol products in selected categories on the Australian market feature a "low sugar" or other sugar-related claim. The authors say, "Such claims have the potential to create a 'health halo,' misleading consumers to perceive products displaying them as healthier than other options, which may increase consumption."

The authors explain there are currently no published data on calorie differences between low sugar and products with no related claims in Australia, and this would be hard to estimate reliably because there is no mandatory energy labeling for alcohol products and information is voluntarily provided for very few alcohol products. While any sugar content would add to the overall energy content, alcohol as a macronutrient contributes to the energy content of the drink by definition and this is extra "discretionary" energy in the diet that is often not compensated for. The authors say that any claims that alcohol drinks that are lower in sugar and overall calories are healthier/less harmful to health is problematic, since alcohol in any amount is harmful to health in addition to the calories it contributes.

In this study, 501 Australian women aged 18–35 years were recruited from an opt-in online survey panel. Half of the participants viewed images of products with a low sugar or related claim, and half viewed identical products with no claims. Participants did this using six images of ready to drink (RTD) spirit drinks with mixer if they had consumed these in the past 12 months, or cider drinks if they had consumed those in the past 12 months. Where participants had consumed both, they were randomly allocated to one or the other.

Using a numeric rating scale from 1–7 for each outcome, the ratings given by the participant to their six drinks were averaged. The authors found that products with low sugar claims were rated as significantly lower in sugar (by 1.8 points on the 7-point scale) and kilojoules/energy (by 0.9 points), healthier (by 0.3 points), less harmful to health (by 0.3 points) and more suitable for weight management (by 0.5 points) and a healthy diet (by 0.3 points) than identical products with no claim, with all findings statistically significant. Despite participants being informed that all products (with or without the low sugar claim) were of an equivalent alcohol and standard drink content, those with low sugar claims were rated as significantly lower in alcohol (by 0.3 points on the 7-point scale) than products with no claim.

There were no significant differences between conditions in anticipated social approval associated with consuming the products (that is the level to which drinking such a drink would help the participant feel socially accepted), or in hypothetical intentions to consume the products (participants were asked how likely they would be to consume the product and how many servings they would consume in the next two weeks if it was available to them).

Participants who viewed low sugar claims were significantly less likely to intend to compensate for calories in these low sugar products by modifying their food intake or physical activity. The authors established this by asking, "If you drank this product next time you were drinking alcohol, how likely are you to…. (a) ...Eat less than usual in one or more meals to make up for the kilojoules/calories in this drink? (b) ...Exercise more than usual to make up for the calories in this drink (c)...Eat low calorie, low fat, or low sugar foods in one or more meals to make up for the calories in this drink?" Looked at another way, those participants who viewed the no claim drinks were more likely to state that they would adjust their diet and activity habits to account for calories consumed in "regular" alcoholic drinks.

The authors say, "Low sugar and related claims on alcohol products generate a 'health halo,' whereby consumers generalize from a specific favorable attribute (low sugar) to other attributes (lower in calories, alcohol) and global appraisals of the product (healthier, less harmful, better for weight management). These claims also have the potential to impact diet and activity behaviors following consumption."

They conclude, "Our findings demonstrate that low sugar claims on alcohol products can be misleading and support policy options to prohibit such claims on alcohol products and/or counter their effects, for example via health warning labels and/or mandatory energy labeling."

Alcohol product labeling in Australia is currently under review by the regulator, Food Standards Australia New Zealand (FSANZ). Other jurisdictions such as the U.K. are considering such labeling as part of their national obesity strategy.

Jane Martin, President of the Australian & New Zealand Obesity Society and Executive Manager of the Obesity Policy Coalition commented, "These low or no sugar alcohol products are the latest fad pushed by the industry to hook young people. Alcohol companies shouldn't be allowed to use promotional claims that imply these harmful products are better for consumers.

"With FSANZ currently reviewing alcohol labeling, this is a critical opportunity to enact positive changes that benefit everyone. Higher standards must be implemented to stop promotional sugar claims on alcohol products and introduce mandatory energy labeling. Consumers need clear, honest labeling to allow them to evaluate alcohol products and make informed purchases without being influenced by marketing claims."