What do you do when a strategy you’ve been executing for almost 30 years is plainly not working? If you’re the nutrition hierarchy in Australia, apparently the answer is you just keep doing what you’ve always done.
In 1981, the National Health and Medical Research Council (NHMRC) published the very first set of guidelines aimed at making Australians healthier. Fat was blamed for the increasing rates of obesity and heart disease, so the guidelines were focused on fat consumption. In short, fat makes you fat and sick and you should eat a lot less of it. Sugar was also mentioned but only because it rots our teeth but it was ok to consume ‘in moderation’ (whatever that means).
I very much doubt that anyone actually pores over the guidelines while they fill their shopping trolley, but many of us use them without realising it. They are the basis for the nutrition (daily intake) recommendations on every packaged food we buy. They form the foundation for every piece of advice any government agency or nutritionist gives us (from school canteens to hospitals). And every meal for our military forces is created using a policy based on the guidelines.
Because of this, the eat-less-fat message got through to us loud and clear. Between 1980 and 1995, the average Australian successfully decreased the amount of fat they were eating by 5% and the amount of cholesterol by a whopping 18%. We replaced the fat with carbohydrates (bread, cereals and sugar), increasing our consumption by 16.5%.
Unfortunately the obesity statistics went in exactly the opposite direction to our fat consumption. In 1980, two in five (39%) Australian Adults were either overweight or obese. By 2011, only two in five weren’t (63.4% were overweight or obese). In just 28 years, all that low-fat eating (or was it the high-carbohydrate eating?) had managed to increase the number people with a weight problem by 64 per cent!
Heart disease sufferers didn’t fare much better. The percentage of the population afflicted doubledbetween 1989 and 2011 (despite significant advances in health care for heart patients in that period).
Evidence that fat makes you fat and sick was suspiciously lacking by the time the revised guidelines came out in 1992. And the evidence that the theory was nonsense was there in spades by the time the third release hit the streets in 2003. Increasingly sugar was being fingered as the culprit but that evidence was suspiciously absent from the reviews undertaken at that time.
The guidelines are currently being reviewedahead of publication of new version (hopefully next year). So can we expect a sudden change of heart from the nutrition elite? History suggests pigs may be approaching the runway before that happens.
The draft update to the new NHMRC dietary guideline on sugar suggests they plan to change from this
“Consume only moderate amounts of sugars and foods containing added sugars.”
To this:
“Limit intake of foods and drinks containing added sugars. In particular, limit sugar-sweetened drinks.”
Again, no actual limits or recommendations will be included.
The reason for this momentous change (go on, I bet you can spot a difference if you look hard enough) is that the NHMRC has unearthed very high quality evidence which tells it that consuming soft drinks makes us fat. Apparently sugar is dangerous when combined with bubbles and water but is otherwise ok.
Last week I was invitedto Canberra to explain why that was just plain daft. I submitted that a refusal to consider any evidence produced beyond 2009 made for a very weak review. I pointed out that the American Heart Association had reviewed the evidence on sugar in 2009 and come out with a position statement which recommended dramatic reductions in consumption. I presented the mountain of evidence that has accumulated since 2009 including high quality human trials. And I highlighted some of the startling conclusions from the current NHMRC evidence report such as “three of the four cohort studies reviewed showed positive associations with fructose[half of sugar] and pancreatic and colo-rectal cancer”
I concluded that given that even their own review (limited and defective as it was) was throwing up high quality evidence of very real harm from sugar consumption, the anaemic recommendation to ‘limit intake’ just isn’t good enough.
It’s a long time between drinks with these guidelines (it will be a decade between reviews by the time this lot are published) and we already have powerful evidence of very real harm from sugar. But millions of real people are making daily decisions about what to shove in their mouth based on this advice (whether they know it or not) with the direct result that they are significantly fatter and sicker than they were the day before.
Let’s not wait until 2023 to get tough on sugar. Let’s not let millions more perfectly healthy children suffer the lifelong destruction of amenity which is type II diabetes. Let’s not stand by and watch the heart disease, kidney disease and pancreatic cancer rates double again. Let’s do something about it now.
My husband was watching a doco the other day about how Coca cola went into a 3rd world country with unclean water and put coke in every possible place and it is now the only drink available in many places including schools, now all the kids and the parents have weight problems that they didn’t have before and the only thing to change their diet was the addition of Coke!
Evidence that sugar does make you fat!
The mentioned documentary is almost surely ‘Globesity – Fat’s New Frontier’ and it can be seet at http://www.abc.net.au/foreign/content/2012/s3547707.htm
It touches on several aspects brilliantly covered previously by David Gillespie in his book ‘Sweet Poison’ and also in these pages.
Once again David it is alarming to see the numbers of simple errors you have made in putting together your latest blog entry in an effort to ‘convince’ people on the credibility of your position on fructose!
> Because of this, the eat-less-fat message got through to us loud and clear. Between 1980 and 1995, the average Australian successfully decreased the amount of fat they were eating by 5% and the amount of cholesterol by a whopping 18%. We replaced the fat with carbohydrates (bread, cereals and sugar), increasing our consumption by 16.5%.< Loud and clear is a 5% reduction? I’m sure you are aware that most people also say calories/energy matter, so is it not possible any benefit was removed by the increase in energy intake (and decrease in energy expenditure)? Why would you just account this to one factor (that you just happen to have created a mini empire out of eliminating)? > Evidence that fat makes you fat and sick was suspiciously lacking by the time the revised guidelines came out in 1992. And the evidence that the theory was nonsense was there in spades by the time the third release hit the streets in 2003. < The (only) link is to article Dietary fat intake and prevention of cardiovascular disease: systematic review http://www.ncbi.nlm.nih.gov/pmc/articles/PMC30550/pdf/757.pdf – and the summary states “There is a small but potentially important reduction in cardiovascular risk with reduction or modification of dietary fat intake, seen particularly in trials of longer duration.”
How do you turn this into ‘nonsense’?
Are you purposely misrepresenting studies still knowing that most people don’t read them or just unable to understand them?
The final paragraph of the paper YOU CITED states “The findings on cardiovascular events are broadly in keeping with benefits that might be expected from modest lowering of cholesterol concentration and certainly provide support, at an individual level, for the central role of dietary fat intake in the causation of cardiovascular disease.”
Why is the above reduction in dietary fat in take for Australians (especially considering errors in collection methods) of 5% so significant and yet in this study you ignore the findings that demonstrate “Pooled results of dietary fat trials indicate that reduction or modification of intake of dietary fat reduces the incidence of combined cardiovascular events by 16% (rate ratio 0.84; 95% confidence interval 0.72 to 0.99) and cardiovascular deaths by 9% (0.91; 0.77 to 1.07)”?
The paper also says that ‘Observational studies(2) and systematic reviews of clinical trials with risk factors as end points(3–7) support this relation.’ So for you to represent this as being baseless or a bad guess as you so regularly do, is once again misrepresenting the science that you CLAIM guides your findings. While intervention studies are the highest quality evidence, it isn’t correct to suggest everything else is a guess!
> Increasingly sugar was being fingered as the culprit< Conspicuously absent is any link to evidence supporting this claim! > I presented the mountain of evidence that has accumulated since 2009 including high quality human trials.< And yet only linked to one trial which used 25% of energy from fructose. I also note that your normal mechanism of debunking research i.e. conflicts of interest, wasn’t employed here – is it because they came up with the ‘right’ conclusion? Your link to the draft guidelines page: which when viewed states “The evidence base has strengthened for:
The association between the consumption of sugar sweetened drinks and the risk of excessive weight gain in both children and adults”
Is this not what the evidence suggests? Do you think it suggests the levels of fructose that you recommend and that they have gotten it wrong?
> Apparently sugar is dangerous when combined with bubbles and water but is otherwise ok.< Hoping this conclusion is tongue in cheek, since most other people seem to understand than the dose makes the poison – and since soft drinks are one of the major sources of sugar in the Australian diet, you would realise this? Why are not embracing this as a step forward? > I submitted that a refusal to consider any evidence produced beyond 2009 made for a very weak review.< Can I submit that you haven’t looked at the evidence – the following link shows a number of studies dated after 2009, so on what basis is this conclusion being reached? http://www.eatforhealth.gov.au/sites/default/files/files/public_consultation/full_reference_list.pdf
It also mentions “The association between the consumption of fruit and decreased risk of heart disease” – which is interesting because you seem to keep flip-flopping on fruit!
While you aren’t alone in suggesting more strict (and definitive) guidelines re sugar intake (as much as you like to appear the lone ranger!) again your fallback to the American Heart Association guidelines is a misnomer. They clearly state that their limits are as a result of a percentage of discretionary calories (and nutrient dilution) and not that it is a poison as you so regularly claim!
If you read the document the young male who is very active is ‘allowed’ more than the 9tsp of sugar so misrepresent so often as an upper ceiling!
Also wondering which NHMRC paper in 1981 you are referring to re healthy eating guidelines at the start of your article?
I am still at a loss to understand why you must misrepresent the research to suggest that your experiences and claims are unequivocal – although your extreme versions of ‘reality’ to seem to get you a lot of press and book sales. Maybe I have answered my own question?
David, I gave up sugar for my 2013 New Year’s resolution. Less than two weeks in I find myself identifying with all of the feelings you mention in the quit plan book. My appetite has reduced and I am eating less. Food tastes better and I am losing weight already.
I have also been reading about the paleo diet which cuts out grains and legumes and would be interested in your thoughts on the “grains are poisonous and full of anti-nutrients” ideas.