In This Issue

• Understanding Sweetness: A Letter from Coca-Cola
• Events: "Moving Mountains" and "The National Obesity Summit"
• Profile: Q&A with Sharon Zeiler of the Canadian Diabetes Association
• Trends and Developments: The Science of Sweetness
• Ask Coca-Cola
• From the Beverage Institute: 10 Tips for Managing Sweetness
• News: Coca-Cola unveils Red Ribbon Panel
• The Coca-Cola Commitment

Understanding Sweetness: A Letter from Coca-Cola

In this issue, we'll take a look at the subject of sweetness. In today's increasingly health-conscious society, people are aware that excessive consumption of sweet foods, like any other food, can have health consequences. So how do we incorporate an innate desire for sweets into our lifestyles? Understanding our desire for sugar goes a long way to properly managing our intake, and we've put together some great resources to help with that, including an article on The Science of Sweetness and 10 Tips for Managing Sweetness.

You may have noticed that we have changed our newsletter name to Live Positively. This reflects our Company's commitment to making a positive difference in the world by rethinking the way we work and live, to lead a balanced lifestyle. Our journey starts within. We can't ask others to live positively until we begin to explore what it means for us, as a community, and we'll be exploring this in future issues.

We welcome your feedback, questions, or suggestions for future topics and issues, please let us know.

Regards,

Leigha Cotton
Communications Manager
Coca-Cola

Feedback on this newsletter? We'd love to hear from you.

Events

Physical & Health Education Conference, Moving Mountains
Presented by PHE Canada and HPEC
April 30 - May 2, 2009
http://www.phecanada.ca/Banff09/e/index.cfm

Canadian Obesity Network's National Obesity Summit
May 7 - May 10, 2009
http://www.con-obesitysummit.ca

Profile: Q&A with Nutrition Expert Sharon Zeiler of the Canadian Diabetes Association

What's new with the role of health and nutrition in the fight against diabetes? How should people with diabetes handle sweet cravings? Live Positively recently put these questions to Sharon Zeiler, a Registered Dietitian and Senior Manager, Nutrition Initiatives and Strategies at the Canadian Diabetes Association.

It turns out our timing couldn't have been better! There is a wealth of new information available that is helping people make informed choices about preventing and managing this condition.

Live Positively: Sharon — thanks for joining us. The diabetes area is a constantly evolving one, and your association is always at the forefront. Is there anything new that you would like to share?

Sharon: Sure! We recently launched our new clinical practice guidelines for the prevention and management of diabetes. There is so much new data and research out there, and that is reflected in these guidelines. They contain many new topic areas and information captured from clinical and field studies undertaken over the past five years. There is about 50% more material than in the 2003 guidelines!

Live Positively: Can you expand on some of this new information and data that is available?

Sharon: We have been able to include a lot of really pertinent information regarding children with both type 1 and type 2 diabetes. There is also a good deal of new research on coping with diabetes during pregnancy. More evidence has also come to light regarding hypertension and cardiovascular diseases, which will affect some 80% of people with diabetes during the course of their lifetime. All of this new information is great, as it helps us to make more precise, effective recommendations about diabetes management and lifestyle choices.

Live Positively: People are increasingly aware that nutrition is key to maintaining good health, especially for those at risk for or affected by diabetes. How does diet affect type 1 and type 2 diabetes?

Sharon: A healthy diet is really central to both diabetes prevention and management. If your body is well nourished, it can perform well and this helps you to maintain blood glucose in the target range. Research has proven that when blood glucose is well controlled, complications such as cardiovascular disease, retinopathy, nephropathy and neuropathy can be delayed or prevented.

Live Positively: Do you find that health professionals are delivering and reinforcing the healthy diet message?

Sharon: On the whole, absolutely. And it's so important. There is strong evidence that counseling from health professionals — registered dietitians in particular — has an important effect on eating habits. Research shows that when counselled by a dietitian, people with diabetes are more successful in achieving a healthy, balanced diet. This helps to control diabetes, but it also lowers risk factors for other chronic disease including heart disease.

Live Positively: An estimated 80 to 90% of people diagnosed with type 2 diabetes are overweight or obese. What resources are there that can help them to manage their weight?

Sharon: First let's put this in perspective. Research shows that a weight loss of 5 to 10 percent — for example, 10 to 20 pounds in someone weighing 200 pounds — can significantly improve blood glucose and other metabolic parameters. So weight management is very important. We encourage people to work towards a healthy BMI, which will help lower their risk of developing a chronic disease, such as type 2 diabetes.

As for resources, we have a number of good publications. Managing weight + diabetes explains the issues surrounding overweight, explains the concept of the BMI and provides a checklist, goals and tips. It's a simple, effective tool. A great resource for professionals is our publication Beyond the Basics: Lifestyle Choices for Diabetes Prevention and Management. Several chapters concentrate on weight management and body image. And there is much more on our website.

Live Positively: What guidelines does the Association provide to healthcare professionals regarding sugar intake for people with diabetes?

Sharon: Our nutrition guidelines allow sugar to constitute up to 10% of daily calories, as there is no evidence that sugar intake up to this level has any deleterious effect on glycemic control or lipid profile in people with type 1 or type 2 diabetes. However, because sugar alone is not a good source of needed nutrients, we recommend that people eat a healthy diet, including better sources of carbohydrates such as vegetables, fruits and whole grains.

Live Positively: Has there been a move among people with diabetes towards no- and low-calorie non-nutritive sweeteners? What is the Association's position on this?

Sharon: People with diabetes, like many others in the Canadian population, want to enjoy foods that are lower in calories. It is the Association's position that choice in the marketplace is a good thing and that sweeteners approved by Health Canada should be part of that choice.

As long as people with diabetes have blood glucose within the target range and enjoy a balanced diet, they don't need to worry unduly about sweetness. I like to use the 'bucket' analogy. Imagine everything you eat over the course of a day goes into a bucket. If the contents of your bucket form a nutrient-rich, balanced and healthy diet, you should feel free to drop in the odd treat. But if blood glucose levels are spiking up and down, it makes sense to adapt what you put in the bucket to make sure those levels are back under control.

Live Positively: If you could give healthcare professionals one piece of advice regarding diabetes and diet, what would it be?

Sharon: I would encourage health professionals to emphasize a healthy diet, and also to watch portion sizes. No matter how healthy a food is, if you eat too much you're going to have a problem. Ultimately we need to think about the amount of caloric energy we take in and what we need to use. Sugar-rich foods are just part of the equation. My favourite way of managing caloric intake is to choose small servings of the special foods that are very important to me and to thoroughly enjoy them.

Live Positively: What is the best way to help people deal with diabetes in a holistic sense?

Sharon: It's really important to know that diabetes is a serious disease and requires full-time attention: every hour of every day. Of course, when you get into a routine it's much more manageable. I find that it's helpful to encourage people to think of managing diabetes as being part of a team: teamwork is much easier than going it alone. The person with diabetes is at the centre of the team, with health care professionals, family, friends and anyone else they draw upon for support surrounding them.

Sharon Zeiler, BSc, MBA, RD, is Senior Manager, Nutrition Initiatives and Strategies at the Canadian Diabetes Association. She works with and supports many of the Association's expert committees who define guidelines for the prevention and management of diabetes, develop tools and resources to assist healthcare professionals to implement them and advise the organization on nutrition-related policies.

Trends & Development: The Science of Sweetness

Sweet foods have been part of our diet since the dawn of humankind. This predilection for sweetness has become a hot topic as sweet foods have become more readily available, and the combined effect of overconsumption on health and weight management becomes clearer. Understanding the science behind this is critical to creating healthy and sustainable strategies in managing our desire for sweets.

In the beginning…

It is critical to remember that sweet taste is a key indicator of the presence of life-sustaining glucose; the primary fuel that burns in metabolic processes to generate energy. As such, it is believed that a preference for sweetness evolved to ensure adequate consumption of calorie-rich foods among herbivores and omnivores, all of which are innately drawn to sweet foods.

In fact, it is sweetness that leads newborn mammals to safe and nourishing foods. And since naturally-occurring sweet foods are rarely poisonous, we have come to identify sweet things as safe for consumption. In the context of the five taste categories, it is sweet, salty and umami that signal safety and acceptance, while sour and bitter signal avoidance.

This taste for sweets helped to expand and diversify the food supply as early humans learned to heat plants to reduce bitterness (and often toxicity) and to add sweeteners to bitter foods.

The physiology of sweetness

Our initial detection of sweetness occurs on the tongue and palate in taste receptor cells found clustered in taste buds within taste papillae. These taste receptor cells produce proteins that join in sweet taste transduction, and some of these proteins form taste receptors within the cell membrane. Inside the taste receptor cell, proteins T1R2 and T1R3 combine to create a sweet receptor. Recent studies have shown that sweetness receptors also occur in the stomach and intestines, raising the possibility that sweetness may have currently unknown functions in the digestive process.

The sweetness effect

Rapid ingestion of simple sugars will spike blood sugar levels, contributing to feelings of satiety. Consuming sweet foods also releases endogenous opiates into the blood, producing sensations of pleasure and an analgesic effect. One hypothesis holds that sweetness shares the same neurochemical pathways as those that produce opiates on ingestion of alcohol and drugs. It is this euphoria-inducing property of sweets that can bring perceived relief from depression and stress, and reduce other cravings. The flip side of this is that the onset of depression, anxiety or pain can trigger a desire for sweetness, a major consideration in strategies for managing sweetness. The good news is that research suggests that we cannot develop a physical addiction to sweets.

Managing sweetness

We are creatures of habit, and the science and physiology behind our taste for sweetness shows that human acceptance of sweetness is instinctive, innate and universal.

So what does this mean for developing strategies for managing our consumption of sweets? Well-intentioned nutritional advice in this area is often prohibitive and puts taste and palatability on the back shelf. This can be a recipe for failure, and we can't lose sight of the fact that eating and drinking are behavioral issues.

Sweetness is here to stay, so it's important to learn to be confident and comfortable with the fact that it's a part of our diet. While there is no magic formula for managing sweetness and maintaining a healthy weight, one can follow the principles of balance, moderation and variety. Above all, enjoy. If you follow these principles, sweetness can be a good thing!

Ask Coca-Cola

Reader Julie B from Hamilton, ON submitted the following question:

"I keep getting emails from lots of people that link artificial sweeteners (i.e. Aspartame) to chronic diseases like Multiple Sclerosis. Is there any correlation?"

Here's what we said:

There have been a number of studies that have consistently concluded that a link cannot be made between non-nutritive sweeteners and chronic diseases like Multiple Sclerosis.

In fact, the Multiple Sclerosis Society of Canada looked at this issue and the rumours circulating on the Internet claiming aspartame causes a toxicity that mimics the symptoms of multiple sclerosis and lupus. They found that "There has been no published peer-reviewed research on aspartame and multiple sclerosis which would support the above claims."

This is a finding supported by Dr. Bernadene Magnuson, Assistant Professor of Nutrition & Food Science at the University of Maryland, who is a specialist in food toxicology and a member of a panel review on the safety of aspartame. Dr. Magnuson noted there is "no credible link between consumption of aspartame at levels found in the human diet and conditions related to the nervous system and behaviour, nor any other symptoms or illness."

You can see Dr. Magnuson's full report here.

Got a question for Coca-Cola?

From the Beverage Institute: 10 Tips for Managing Sweetness

How do we reconcile our enjoyment of sweet foods and beverages with a balanced lifestyle?

Sugar, like all other foods, when consumed in excess may lead to caloric imbalance and can contribute to obesity, diabetes, tooth decay and uneven blood sugar levels. And a diet with too much emphasis on sweetness may be deficient in other nutrients, even if your total calorie consumption is within a healthy limit.

But research shows our taste for sweet things is innate, a biological need hardwired as part of our survival instinct.

This means a prohibitive approach simply doesn't work. So what is the answer? You have to manage sweetness, building it into your diet and lifestyle in a way that makes sense for you.

We've put together ten great tips in a free download to help people do just that, and you can get it here.

News: Coca-Cola unveils Red Ribbon Panel

Coca-Cola unveils Red Ribbon Panel to help recommend Vancouver 2010 Olympic torchbearers

In January 2009, Coca-Cola announced the creation of a Red Ribbon Panel to make recommendations on candidates hoping to be torchbearers in the Vancouver 2010 Olympic Torch Relay.

The panel is comprised of the following health, wellness and environmental organizations: the Canadian Diabetes Association, the Canadian Society for Exercise Physiology, the Heart and Stroke Foundation of Canada, ParticipACTION, WWF-Canada and the Vancouver Organizing Committee for the 2010 Olympic and Paralympic Winter Games (VANOC). Dr. K. Kellie Leitch, Chief, Paediatric Surgery, Children's Hospital, London, is also serving on the panel.

The panel members will be looking for inspirational, everyday Canadians with unique stories about their dedication, decisions and deeds in becoming more physically active and environmentally conscious, as well as in influencing others in their communities to follow their examples.

The nomination process via www.iCoke.ca will be conducted in two stages. First, lucky Canadians will be identified by a random draw in May 2009 from the millions of expected applicants. Then, moving beyond the luck-of-the-draw, these nominees will be invited to submit a short story about how they "Live Olympic."

In their "Live Olympic" stories, Canadians will share personal experiences, achievements and benefits of "Living Active" and "Living Green." The panel will recommend individuals with exceptional submissions for selection as Olympic Torchbearers.

To help evaluate the stories focused on active, healthy living, the panel will refer to Canada's Physical Activity Guide produced by the Public Health Agency of Canada and the Canadian Society for Exercise Physiology.

Coca-Cola understands the critical importance of physical fitness and environmental stewardship, as well as the impact both can have on quality of life, communities and society. So, through the 2010 Olympic Torch Relay, Coca-Cola wants to focus attention on these issues.

"Today, one in two Canadian adults is overweight, with one in seven adults being obese," said Dr. K. Kellie Leitch, Chief, Paediatric Surgery, Children's Hospital, London. "Canadians need to exercise. I'd like to commend Coca-Cola for using the power of the Olympic Flame to inspire Canadians to lead more active lifestyles."

The Coca-Cola Commitment

Coca-Cola is taking steps to provide useful information to the people who enjoy our products and to work with health and nutrition professionals to encourage a balanced approach to nutrition and active living. We promote a philosophy of enjoyment and informed choice when it comes to making food and beverage choices. Among our initiatives:

• Innovations in product and packaging offerings, including 100-calorie portion-controlled soft drinks
• Responsible marketing practices including a 50-year policy of not marketing to children under 12
• Establishment of a national policy for limiting the types and serving sizes of beverages in schools
• Promotion of and engagement in active lifestyles through a variety of programs and sponsorships, including ParticipACTION

The Coca-Cola Company is the world's largest beverage company. In Canada, the Company is represented by its subsidiary, Coca-Cola Ltd. (Coca-Cola Canada). Coca-Cola is Canada's largest beverage company. Coca-Cola markets three of Canada's top nonalcoholic sparkling beverage brands, Coca-Cola, Diet Coke and Sprite, in addition we are the largest juice and juice drinks company with Minute Maid, Five Alive and Fruitopia and the leading ready to drink tea producer with Nestea. The Company also markets DASANI, PowerAde and other hot and cold beverages.

For more information, visit www.coca-cola.ca.