Report No. 33

NUTRIENT CONTENTS OF
COMMON NON-PREPACKAGED BEVERAGES
IN HONG KONG

April 2009
Centre for Food Safety
Food and Environmental Hygiene Department
The Government of the Hong Kong Special Administrative Region

Correspondence:
Risk Assessment Section
Centre for Food Safety
Food and Environmental Hygiene Department
43/F, Queensway Government Offices,
66 Queensway, Hong Kong
Email: enquiries@fehd.gov.hk

Table of contents

Risk Assessment Studies

Report No. 33

NUTRIENT CONTENTS OF
COMMON NON-PREPACKAGED BEVERAGES
IN HONG KONG

Nutrient Contents of Common Non-prepackaged Beverages
in Hong Kong

OBJECTIVES

This study aims to reveal the nutrient contents of common non-prepackaged beverage items in Hong Kong, and to compare the energy and sugar contents of hot beverages with and without added sugars, as well as cold beverages with regular and "less-sweet" (少甜) versions.

BACKGROUND

2.   Food is essential to human life because it is the source of energy and nutrients. Eating the right amount of different kinds of food is the key to a balanced diet and optimal nutrition. Many chronic diseases such as coronary heart disease, diabetes and certain types of cancer are related to imbalanced diet. These nutrition-related diseases are important public health problems in many parts of the world including Hong Kong.

3.   Knowing the nutrient contents of food is crucial for making healthy food choices. To establish a database of nutrient composition of local food items, the Food Research Laboratory (FRL) has started conducting nutrient analysis of local foods since 2002. The latest study on the nutrient values of fruit and vegetables was completed and released in June 2007.

4.   Recently, there has been discussion on the consumption of energy-dense food regarding their effect on unhealthy weight gain. Most local common non-prepackaged beverages are sugar-sweetened, and are examples of energy-dense food.

5.   According to the Population Health Survey 2003-04, food choices of Hong Kong people were affected by concerns over the nutrition contents. It was found that sugars content was one of the major concerns. 47.7% respondents would choose or avoid certain foods by consideration of the sugars content.^{1, 2}

6.   Nevertheless, there has been no systematic analysis on the nutrient contents of non-prepackaged beverages that are popular and commonly found in Hong Kong. To fill this gap, the Centre for Food Safety (CFS) initiated a study on the nutrient composition of common non-prepackaged beverages that are locally available.

Non-prepackaged beverages

7.   In Hong Kong, an international metropolitan, foods are being introduced from all over the world. With increasing globalisation, foods and beverages popular in other countries or areas may soon be introduced into the Hong Kong market. An earlier example that gained popularity locally was pearl tapioca drinks from Taiwan that was introduced more than ten years ago. More recently, specialty coffees from the western world also gained their foothold locally. Together with our local choices, Hong Kong-style milk tea, "yuan-yang", salted lemon soda, red bean icy drink, sour plum drink, just to name a few, tea restaurants, coffee shops and fast food restaurants around the corner have a long list of beverages to offer.

8.   The nutrient values of the non-prepackaged beverages vary greatly, depending on the types and amounts of food ingredients.

Nutrition and noncommunicable diseases

9.   Unhealthy diet is one of the major lifestyle risk factors related to development of noncommunicable diseases (NCDs). Together with physical inactivity, they are among the leading causes of NCDs, including cardiovascular disease and certain types of cancer. As part of the recommendation for prevention of chronic diseases, the World Health Organization (WHO) and Food and Agriculture Organization of the United Nations (FAO) proposed a set of population nutrient intakes to enhance health (Annex I).³

10.   WHO/FAO considered that restriction of free sugars (i.e., all monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and fruit juices) was likely to contribute to reducing risk of unhealthy weight gain. Concerning the consumption of sugars-sweetened beverages, WHO and FAO considered that high intake of free sugars in beverages probably promotes weight gain. Overweight and obesity increase the risk of cardiovascular diseases, certain cancers, and type 2 diabetes. ³

11.   It was also considered that frequency and amount of sugars intake increase the risk of dental caries. ³

SCOPE OF STUDY

12.   The study covered the common non-prepackaged beverages sold on the local market. A total of 73 non-prepackaged beverage items were sampled for nutrient analysis. Differences in nutrient contents in items of different amount of added sugar were studied for 23 hot beverages and 50 cold beverages. A list of samples taken was shown in Annex II.

METHOD

Sampling

13.   The food samples were purchased and analysed from August 2006 to September 2007. For each non-prepackaged item, one sample was randomly collected from a food premise in each of the 10 different districts, which was randomly selected from the 18 districts of Hong Kong.

14.   During sample collection, hot beverages were collected as "no sugar added" whenever possible. On the other hand, for cold beverages, regular version and less sugar "less sweet" version were collected at the same time as far as possible.

Laboratory analysis

15.   Laboratory tests were performed by the Food Research Laboratory (FRL) of the CFS. For each food item, the 10 samples were paired and formed 5 composite samples for nutrient analyses. All tests were conducted using single-laboratory validated methods. A brief description of the test methods is shown in Annex III.

Data analysis

16.   The nutrient contents of non-prepackaged beverages were mainly presented in per 100 ml basis. Mean values for energy and content of each nutrient were reported, and the values were corrected to two significant figures. If the level of a nutrient is too low for reliable reporting, the term "trace" is indicated (refer to Annex IV for details).

17. The average result of these 5 composite samples will be presented as the mean energy and nutrient contents of that particular non-prepackaged beverage in the report.

RESULTS AND DISCUSSION

18. In this study, nutrient contents of 73 non-prepackaged beverages were examined. The value of energy, carbohydrate, protein, total fat, saturated fat, cholesterol, sugars, dietary fibre, calcium, and sodium per 100 ml of the samples are presented in Annex V.

Content of nutrients

19. The energy content of the non-prepackaged beverage samples ranged from 12 kcal to 87 kcal per 100ml. The energy in the samples mainly came from sugars. Among all non-prepackaged beverage samples, an average of 60% and a maximum of 92% energy came from sugars. In more than 60% of the beverage samples, sugars contributed to more than a half of the total energy. Sugars content in the samples ranged from 0g to 12g per 100ml. The sample with the highest energy and sugars contents per 100 ml was Red bean icy drink (regular) (紅豆冰 (普通)).

20. On the other hand, the fat content of many samples are low, more than one third of them (26 samples) contained 0g or only trace amount of fat. The fat content of the remaining samples ranged from 0.3g to 3.9g per 100ml. Cholesterol was absent in more than half of the samples, while its content is low in other samples, ranged from trace amount to 8.3mg per 100ml. The sample with the highest fat content per 100 ml was "Cendol" icy drink (regular) (珍多冰 (普通)). Most samples (89%) contained no or only trace amount of dietary fibre.

Hot beverages

21. In this study, 23 hot beverage samples have been collected. The energy content of 100ml hot beverage samples ranged from 12 kcal to 75 kcal, with a mean of 41 kcal. The three hot beverage samples with the highest and lowest energy content were listed in Table 1 and Table 2 respectively.

Table 1. Hot beverages with the highest energy content per 100 ml

Table 2. Hot beverages with the lowest energy content per 100 ml

22.   The sugars content of 100ml hot beverage samples ranged from 0g to 11g , with a mean of 5.3g. As 1 gram sugar contributes to 4 kcal energy , from calculation, it was found that the sugar in these hot beverages contributed to 0 kcal to 44 kcal per 100 ml, with a mean of 21 kcal per 100 ml. The three hot beverage samples with the highest and lowest sugars content were listed in Table 3 and Table 4 respectively.

Table 3. Hot beverages with the highest sugars content per 100 ml

Table 4. Hot beverages with the lowest sugars content per 100 ml

23.   The content of energy and energy from sugars per 100 ml of hot beverages sampled were shown in Figure 1.

24.   Sugar is usually added to some hot beverages such as coffee and tea before consumption for a better taste. The energy and sugars content of hot beverages can be affected by the amount of sugar added. 13 samples of individually packed sugars provided by restaurants and cafes were obtained and weighed. Their weights varied from about 4.1g to 11.5g per pack, with an average of about 7.1g (or about 1.5 teaspoons) per pack. One teaspoon granulated sugar contains 4.2g sugars and provides 16 kcal energy.⁴ The sugars content of hot beverages (1 cup, 240 ml) with no added sugar, one teaspoon added sugar and two teaspoons added sugar were compared in Figure 2.

25.   It was found that adding one teaspoon sugar to hot beverages increased their sugars content by 23% to 236%, with a mean increase of 77%. Adding two teaspoon sugar, on the other hand, contributed to 47% to 473% increase of sugars content, with a mean increase of 154%.

26.   Concerning the energy content, it was found that adding a teaspoon sugar to a cup (240 ml) of hot beverages increased the energy content by 6% to 56%, with a mean increase of 21%. Adding two teaspoon sugar to a cup of hot beverages increased the energy content by 18% to 111%, with a mean increase of 43%. The energy contents of hot beverages with different amount of added sugar were compared in Figure 3.

Cold beverages

27.   50 cold beverage samples have been collected. The energy content of 100ml cold beverage samples ranged from 23 kcal to 87 kcal, with a mean of 48 kcal. The three cold beverage samples with the highest and lowest energy content were listed in Table 5 and Table 6 respectively.

Table 5. Cold beverages with the highest energy content per 100 ml

Table 6. Cold beverages with the lowest energy content per 100 ml

28.   The sugars content of 100ml cold beverage samples ranged from 3.9g to 12g, with a mean of 7.2g. From calculation, these sugars contributed to 16 kcal to 48 kcal of energy per 100 ml beverages, with an average contribution of 29 kcal energy per 100 ml. The three cold beverages with the highest and lowest sugars content were listed in Table 7 and Table 8 respectively.

Table 7. Cold beverages with the highest sugars content per 100 ml

Table 8. Cold beverages with the lowest sugars content per 100 ml

29.   The content of energy and energy from sugars per 100 ml of cold beverages sampled were compared in Figure 4.

30.   In many cases, sugar was added to cold beverages before serving. However, as some consumers prefer to have less sugar in their cold beverages, some food premises provide cold beverages in less sugar "less sweet" version upon request. Less sugar "less sweet" cold beverages were compared with their regular counterparts in terms of their energy and sugars contents. It was found that less sugar "less sweet" version provided 6% to 36% less energy than regular cold beverages. The mean difference was 17% (Figure 5). Concerning the sugars contents, less sugar "less sweet" beverages contained 3% to 36% less sugars than their regular counterparts, with a mean difference of 22% (Figure 6).

31.   The difference in energy and sugars contents can be small between regular and less sugar "less sweet" versions of some cold beverages, such as Mixed fruit punch (什果賓治) and Mixed fruit icy drink (什果冰), and Tri-colour icy drink (三色冰). For other cold beverages such as Iced lemon tea (凍檸檬茶), Iced milk tea (凍奶茶) and Iced green tea with pearl tapioca (凍珍珠綠茶), the difference in energy and sugars contents between the two versions can be greater.

Tea and coffee

32.   Tea and coffee type beverages are commonly consumed in Hong Kong. They are available in different varieties. Tea and coffee are often flavoured with milk, sugar, and/or other ingredients upon consumption. The nutrient contents of different varieties of tea and coffee type beverages were compared in Figure 7.

33.   It was found that tea and coffee beverages without added milk and sugar, such as Espresso and Lemon tea were lower in energy and sugars, and they only contained trace amount of total fat. On the other hand, tea and coffee with milk or cream as one of the ingredients, such as Milk tea and Cappuccino, contained total fat of 5.3g to 6.7g per cup (240ml), and generally provided more energy than tea and coffee varieties without added milk. Adding sugar to tea and coffee increased the energy and sugars content of the beverages. The more sugar added, the higher the sugars and energy contents.

WHO/FAO recommendation

34.   WHO and FAO recommended intake of free sugars should be limited to less than 10% of total energy intake. For example, an individual with daily intake of 2000 kcal energy should limit the free sugars intake to less than 50g per day.

35.   In this study, sugars being analysed included free sugars (such as granulated sugar and syrups added to foods, sugars naturally present in fruit juices and honey) and non-free sugars (such as sugar naturally present in fruits and milk). Assuming all sugars in the non-prepackaged beverages sampled were free sugars, consuming two cups of the beverages listed in Table 9 would contribute to an intake of close to or over 50g of free sugars. This contributes to about 200 kcal energy intake. In other words, such energy intake from consuming 2 extra cups of such beverages every day could lead to an increase of about 9.5 kg body weight in a year.

36.   Some other beverages also have sugars content similar to the beverages listed in Table 9. All beverages and their different versions studied were ranked by their sugars content per cup (240 ml for hot beverages, 300 ml for cold beverages), and those beverages belong to the top 25% of the list were shown in Table 10. The beverage with the highest sugars content per cup was Red bean icy drink (Regular). A single cup of the beverage (300 ml) provided almost 9 teaspoons sugar. This is similar to the sugars content in a can of regular cola. Among the list of beverages with relative high sugars content, some belonged to less sugar "less sweet" version, such as Red bean icy drink (Less sweet) (紅豆冰(少甜)), Mixed fruit icy drink (Less sweet) (什果冰(少甜)) and Tri-colour icy drink (Less sweet) (三色冰(少甜)). The beverages belong to the bottom 25% of the list were also shown in Table 11 for comparison.

Table 9. Examples of beverages with high sugars content (per cup)

 Table 10. Beverages with higher sugars content in one cup (above 75th percentile)

* For cold beverages, 1 cup = 300 ml; For hot beverages, 1 cup = 240 ml

Table 11. Beverages with lower sugars content in one cup (below 25th percentile)

* For cold beverages, 1 cup = 300 ml; For hot beverages, 1 cup = 240 ml

Limitations of the study

37. A large variety of non-prepackaged beverages is available in Hong Kong. This study included some of the non-prepackaged beverages commonly found on the market. There were still a number of non-prepackaged beverages not being covered.

38. There was variability in the nutrient composition of foods. The nutrient content of non-prepackaged beverages varies as they may have different ingredients and recipe formulations. Their nutrient contents are also influenced by the variation in nutrient composition of the ingredients.

39. The nutrient composition of non-prepackaged beverages was evaluated in this study. Owing to the lack of comprehensive food consumption data in Hong Kong, the nutrient intake of the whole population and population subgroups from non-prepackaged beverages could not be quantified.

CONCLUSION AND RECOMMENDATIONS

40. This study provided data on the nutrient content of non-prepackaged beverages. The result of the study suggested that energy and sugars contents of non-prepackaged beverages vary, whilst their cholesterol and dietary fibre contents were generally low.

41. For most non-prepackaged beverages, energy mainly came from sugars. Addition of sugar increased the energy and sugars contents of the beverages, whilst less sugar "less sweet" version cold beverages were generally lower in energy and sugars than regular version.

42. Tea and coffee beverages without added sugar and milk were generally lower in energy and sugars, while some non-prepackaged beverages were high in sugars and energy, such as "Icy drinks" (冰類飲品), Caffe Mocha (朱古力咖啡), and Milk tea with pearl tapioca (珍珠奶茶).

Advice to consumers

43. In order to prevent excess intake of energy and sugars from non-prepackaged beverages, patrons could -

1. Choose non-prepackaged beverages with lower energy and sugars contents
2. Add less sugar to hot beverages; Use teaspoon to measure the amount of sugar to be added to beverages to avoid adding too much sugar without conscious
3. Order less sugar "less sweet" cold beverages instead of regular version
4. Maintain a balanced diet and limit the consumption of sugary beverages

Advice for the trade

44. Members of the trade are advised to provide non-prepackaged beverages with lower energy and sugars contents to consumers. This could be achieved by -

1. Providing sugar or syrup to consumers separately instead of mixing them with the beverage before serve
2. Adding less sugar to beverages if they must be pre-sweetened before serving to consumers
3. Providing less sugar "less sweet" version beverages to consumers
4. If sugar in individual packs is provided to consumers, provide smaller packs. Give consumers a minimal number of sugar packs.

Prepared by Risk Assessment Section
Centre for Food Safety
Food and Environmental Hygiene Department
April 2009

REFERENCES

1. Population Health Survey 2003/2004. Hong Kong SAR: Department of Health and Department of Community Medicine, University of Hong Kong.
2. Department of Health. Health facts--Major health behavioural factors. Available at: URL: http://www.healthyhk.gov.hk/phisweb/en/healthy_facts/
3. FAO/WHO. Joint WHO/FAO Expert consultation on diet, nutrition and the prevention of chronic diseases. Geneva : WHO, 2003.
4. U.S. Department of Agriculture, Agricultural Research Service 2004. USDA Nutrient Database for Standard References, Release 19. Nutrient Data Laboratory Home Page. Available at: URL: http://www.nal.usda.gov/fnic/foodcomp/search/

Annex I

Recommendations of WHO and FAO on Nutrient Intakes

In 2003, WHO and FAO updated the technical report entitled "Diet, nutrition and the prevention of chronic diseases"¹. In this report, a series of population nutrient intake goals for preventing diet-related chronic disease was established, and they are presented in Table 1.

Table 1. Ranges of population nutrient intake goals established by FAO/WHO

# This is calculated as: total fat – (saturated fatty acids + polyunsaturated fatty acids + trans fatty acids)

The population nutrient intake goals were set up for consideration by national and regional bodies establishing dietary recommendations for the prevention of diet-related chronic diseases. It represents the population average intake that is judged to be consistent with the maintenance of a low prevalence of diet-related diseases in a population.1 If existing population averages fall outside this range, or trends in intake suggest that the population average will move outside the range, health concerns are likely to arise.

However, no population nutrient intake goal for calcium was established by FAO/WHO in this report. In another report of a joint FAO/WHO expert consultation entitled "Vitamin and mineral requirements in human nutrition"2, the data of balanced studies and factors affecting the calcium requirement of human was reviewed. Based on the available data, the experts of FAO/WHO agreed to set the recommended calcium allowance of 1000 mg/day for adults. The recommended calcium allowances of individuals in developed countries at different stages of life cycle were shown in Table 2.

Table 2 Recommended calcium allowance (daily) of individuals in developed countries established by FAO/WHO

¹ Particularly during growth spurt

(Source: FAO, 2004 ²)

Reference for Annex I

1. FAO/WHO. Joint WHO/FAO Expert consultation on diet, nutrition and the prevention of chronic diseases. Geneva : WHO, 2003.
2. FAO/WHO. Vitamin and mineral requirements in human nutrition. 2^nd ed . Report of a joint FAO/WHO expert consultation. Rome : FAO, 2004

Annex II

Non-prepackaged beverages samples collected in this study

Non-prepackaged beverages samples collected in this study (continue)

Annex III

Testing Methods for Determining Nutrient Contents in Foods

Single-laboratory validated test methods based on the following references:

Note:

All AOAC Official Methods quoted are referred to AOAC Official Method, 17^th edition, 2000 AOAC INTERNATIONAL.

* ICP-OES refers to inductively coupled plasma – optical emission spectrometry

Nutrient parameters by calculation

1. Energy is calculated as the sum of contents of total fat, protein and carbohydrate multiplying their corresponding conversion factors (i.e. carbohydrate: 4kcal/g, protein: 4kcal/g, fat: 9kcal/g).
2. Total carbohydrate is calculated by subtracting the sum of moisture, ash, total fat and protein from the total weight of the food sample.
3. Protein is calculated by multiplying the content of total nitrogen in the food sample with the conversion factor of 6.25.
4. Saturated fat is the sum of 13 saturated fatty acids including C_4:0, C_6:0, C_8:0, C_10:0, C_12:0, C_14:0, C_15:0, C_16:0, C_17:0, C_18:0, C_20:0, C_22:0 and C_24:0.
5. Sugar is the sum of individual sugars including fructose, glucose, sucrose, maltose and lactose

Annex IV

The definition of "trace"

Annex V

Nutrient content of non-prepackaged beverages sampled (per 100ml)

Annex VI

Nutrient content of non-prepackaged beverages sampled (per unit)