The ACL epidemic is caused by sugar-water

By | Sugar | No Comments

Last week Gold Coast Suns co-captain Jarrod Witts collapsed with a season ending ACL injury. This week Carlton defender Caleb Marchbank suffered the same fate.  They are just the latest high-profile examples of the rapidly growing list of ligament injuries in the AFL and AFLW. Ironically, the science tells us the damage is being done by one of their sponsors’ products.

ACL injuries are not a problem exclusive to the AFL but they do keep very good stats on them. The average male professional AFL player will suffer an ACL injury after playing 1,428 hours of footy.  The average AFLW player will do her knee after just 133 hours. In general, women are up to 10 times more likely to injure an ACL than men because the wider female pelvis makes a knee collapse, or movement towards the other knee, more likely. ACLs in sports are not generally caused by contact with another player but by landing.

The dreaded ACL injury is a tear in the anterior cruciate ligament, one of the four ligaments that hold our knee together.  The ACL is inside the knee joint connecting the bottom of the thigh bone (the femur) to the top of the lower leg bone (the tibia).  It is attached to the tibia by a little spit of bone called the tibial spine.

ACL rates have been accelerating massively over the last few decades.  Between 2000 and 2015, the annual incidence of ACL’s requiring surgery increased by 43 per cent. In people under 25 they increased by 74 per cent.  The fastest growing group are children aged 5-14 where the rate of injury is growing at around 8 per cent a year.

Twenty five years ago kids didn’t tear their ACL, they broke the tibial spine.  Orthopaedics textbooks from the nineties warned doctors to look for tibial spine fractures because children don’t tear their ACLs.  In essence, they thought they were immune to ACL tears by virtue of being children. This was because in growing children the bones are not at full strength, but the ligaments are.  In a stressed situation, where the ACL is yanking on the tibial spine, the bone gave way before the ligament, hence the fracture.

Fortunately, there is good science that tells us why our ACLs are suddenly failing.  Sugar.

The massive increase in our consumption of sugar is responsible for us producing substandard ligaments and cartilage.  If we make knees out of rubbish material its little wonder that they are suddenly not up to the job.

A byproduct of human metabolism is that sugars can become randomly attached to proteins in a process called glycation. Glycation results in the formation of all sorts of unpredictable (and haphazard) molecules called AGE’s (Advanced Glycation End-products).

All sugars can form AGE’s but the fructose half of table sugar (sucrose) is ten times as likely to do so as glucose (the other half). AGE’s are dangerous because they bond easily (and randomly) to each other and to other proteins in a process called cross-linking. Cross-linking significantly degrades the quality of the protein.

Our bodies are used to garden variety (glucose-produced) AGE’s. And we are pretty good at breaking them down and disposing of them. But even so, over time they accumulate in our organs and tissues and we, well, age (the acronym AGE is very much on purpose).

Unfortunately the AGE’s made with fructose molecules are resistant to our disposal system. So not only they made at 10 times the rate, they hang around.

Long-lived proteins such as collagen, elastin (both used in ligaments), lens crystallins (used in the eyes) and cartilage are much more susceptible to the effects of AGEs because once we make a bad batch, they’re part of us for an awfully long time.

Collagen degraded by AGEs makes less elastic ligaments.  And substandard ligaments, rather like rubber bands left in the sun, tear much more easily. So it would seem that it is less than intelligent to be telling people who play sport to drink sugar that will significantly increase their chances of never playing sport again. That is, of course, unless you are the one selling the sugar-water.

Coca-cola sponsors the AFL and many other sports under the Powerade brand and Pepsi does the same for an array of sports under its Gatorade brand.  They are not doing this because they want to give money to professional sports. They are doing it so young players will see their heroes knocking back blue, green, yellow and pink sludge during and after games and come to the conclusion they need to do the same.  And it’s working, sport drinks are the one part of the sugar water industry doing well.  The global sports drink market is worth $30 billion and it is growing rapidly.

ACLs and other ligament and cartilage damage are now a standard part of sporting life because fructose is being consumed at unprecedented rates (ironically, particularly by those playing sport) and the group suffering the most explosive growth in injuries are those kids emulating their sporting icons.

ACL’s can be repaired (by transplanting other ligaments) but even a well repaired ACL is likely to have debilitating long term consequences.  A Swedish study for example found that half of all adult soccer players who tore their ACL had developed severe arthritis of the injured knee within 14 years. Apply that timeline to an 8 year old and it means they will spend most of their lives battling severe debilitation.  And that’s from an injury that 8 year olds are supposed to be ‘immune’ to.

Let’s stop paying professional sportspeople to suck down sugar. Let’s stop advertising sugar nonstop during broadcast sport. Most of all, let’s stop teaching our kids that sugar and sport go together. And then hopefully we can stop putting severely injured teenagers and their sporting idols in the back of ambulances every weekend.

 

Picture: Adelaide’s Taylor Walker was one of 15 AFL players to tear their ACL in 2013. (Joe Castro: AAP Image)

Don’t give kids sugar flavoured seed oil masquerading as Health Food

By | Big Fat Lies, Sugar, Vegetable Oils | No Comments

Do you have a fussy eater? Are your kids refusing to eat their greens?  Worry no more, you should just give them a chocolate milkshake instead. Well, that’s what the makers of PediaSure would have you believe.  But is filling a kid with flour, sugar and seed oil really a better alternative to telling a kid to eat their greens for dinner or risk getting them for breakfast?

The latest Television Commercial for PediaSure shows a ‘busy kid’ playing basketball, riding his bike and sucking down a ‘delicious PediaSure health shake’ to ‘help support immunity, growth and a healthy appetite.’  The ad was in high rotation on Sunday night prime-time telly. The packaging looks a little like an infant formula tin but was clearly being sold as something active kids should be inhaling by the bucket-load. So what is it?

Here’s the ingredient list for vanilla PediaSure:

Hydrolysed corn starch, sucrose, PROTEIN (milk protein concentrate, soy protein isolate), VEGETABLE OIL (canola oil, high oleic sunflower oil, sunflower oil, medium chain triglycerides (MCT) oil), maltodextrin, MINERALS (potassium citrate, sodium citrate, calcium phosphate tribasic, potassium chloride, magnesium chloride, potassium phosphate monobasic, calcium carbonate, potassium phosphate dibasic, sodium chloride, magnesium phosphate dibasic, ferrous sulfate, zinc sulfate, manganese sulfate, cupric sulfate, potassium iodide, chromium chloride, sodium selenite, sodium molybdate), oligofructose (FOS), EMULSIFIER (soy lecithin), flavoring, DHA from C. cohnii oil , choline chloride, VITAMINS (ascorbic acid, Vitamin E, niacinamide, calcium pantothenate, thiamin hydrochloride, pyridoxine hydrochloride, riboflavin, Vitamin A palmitate, folic acid, phylloquinone, biotin, Vitamin D3, cyanocobalamin), ascorbyl palmitate, taurine, myo-inositol, carnitine tartrate, Lactobacillus acidophilus, mixed tocopherols

As delicious as that explosion in a chemical factory sounds, it boils down to garbage. Here’s my translation of the ingredient list (in descending order by calories supplied)

  1. Seed oil (35% of the calories)
  2. Pre-digested corn flour (for volume and ‘creaminess’ – also used in cosmetics) (30%)
  3. Table sugar (20%)
  4. Protein extracted from milk and soy (12%)
  5. Multi-vitamin
  6. Man-made soluble fibre
  7. Emulsifier (so the oil doesn’t layer out)

Yes, that’s right, this swill can summarised as Seed oil, Corn Flour and protein extracts with a serious dose of sugar to make sure the ‘busy kid’ will actually swallow it. It has a very similar make-up to so-called Toddler formula, the completely unnecessary marketing extension to actual infant formula. It also looks pretty similar to the shakes being sold to the elderly.

The omega-6 fats which dominate the seed oils are implicated in (at least) osteoporosismale infertilityrheumatoid arthritisParkinson’s diseaseallergies, asthmamacular degenerationimpaired intelligence and cancer. And the sugar will put the kid on track to an even more spectacular array of chronic diseases including Type II Diabetes, Kidney Disease, Fatty Liver Disease, Heart Disease, Erectile Dysfunction and Alzheimer’s.

This is all part of powder-creep. Baby formula is a, sometimes, vital food for infants who cannot be breast fed. But manufacturers are legally prohibited from filling infant formula with sugar and the margins are thin. If the manufacturers want to grow their revenue, they need new tummies to fill. So, we can expect more and more ‘nutritional supplements’ that look and taste like a milkshake but spouting dubious medical sounding benefits.

The reality is that a child in Australia today has about as much risk of being clinically undernourished as I do of being elected Pope. Yes, there are an exceedingly small number of Australian kids who could be considered at risk and they probably already have the support of a medical diagnosis and supervision.  So, let’s stop pretending that flogging this sugar flavoured seed oil on prime time TV is anything other than a cynical attempt to sell cornflour at a massive markup.  If you really want a kid to be well nourished give them a glass of milk or an egg.  Both are almost perfect foods from a human nutritional perspective.

Corn flour, sugar and seed oil will not boost the average kid’s immune system or help them grow (well at least not vertically).  PediaSure is no more a health food than the similarly composed seed oil and sugar effluent sold as Up&Go.  It should be avoided with just as much diligence. And under no circumstances should it be given to children.

Don’t hand Sugar Tax money to the people who got us in this mess

By | Conflicts of Interest, Sugar | 3 Comments

It’s already been quite a year for the Australian Sugar Industry.  Just 6 sleeps into the New Year they were taking sustained incoming fire from the AMA (Australian Medical Association). Suddenly the doctors were demanding a soft drink tax.  It was something the AMA had sort-of mentioned before but now they were going postal on the issue.

Wiping the holiday sleep from their eyes, the pro-sugar lobby struggled to respond.  But eventually they managed to inspire a National Party Minister to regurgitate the soft drink industry response. Then they then lined up a climate change denial think tank to try and jazz it up with ‘science.’

And last but certainly least, yesterday they wheeled out an ever-reliable University of Sugar (sorry, Sydney) dietitian who sagely warned us that if soft drinks were taxed we’d all hit the booze instead.  Yes, lock up the vodka at Macca’s, Coke now cost 2c more.

It’s a familiar merry-go-round but in every other civilized place in the world it eventually ends with the introduction of a soft drink tax.  Since 2014, 28 countries and 7 US cities have implemented sugar taxes.  And there are very good reasons for that.  The science on the health destroying effects of sugar is unequivocal.  The costs of managing that harm are crippling. And unlike most tax increases, sugar taxes are popular.  A January 2018 poll tells us that 53 per cent of Australians want it.

The real question then is not whether we will have a soft drink tax but when.  Most importantly, when the inevitable happens, what will we do with the money it raises.

The AMA has clearly put its stake in the ground to be the first in the queue for handouts.  But their record on sugar has hardly been stellar.  No, they haven’t actively promoted sugar consumption like dietitians or the Heart Foundation, but they have sat on their hands for at least a decade and happily refused to use their considerable influence to advocate against sugar.

Even now, playing catchup, their support of the Health Star System (which labels sugar loaded Milo a health food and unflavoured Greek Yoghurt a health hazard), suggests they remain a little confused on potential solutions. The AMAs new found conscience should therefore be regarded with suspicion and their plans for the dough scrutinized carefully.

A soft drink tax is unlikely to have any measurable health effect on its own. Taxing one source of sugar will certainly reduce consumption from that source but people simply find a cheaper, or just different, supply (iced coffee anyone?).

But the siren call of cold hard cash will apparently do what I and many like me have failed to do for a decade.  It will remove the single greatest obstacle to real progress, the nutrition rent-seekers.

These organisations have been perfectly happy to ignore the science for decades.  They have been happy to dictate health policy that lets ever increasing numbers of us suffer.  And they have been happy to do it because of ego or profit or consensus or stubbornness or all of the above.

If, however the tax funds consistent government public health campaigns aimed at making sugar consumption slightly less desirable than persistent public flatulence, then it will have a measurable and significant effect.  The outcome can’t be to hand money to the organisations that got us in this mess in the first place and hope for the best.  Because if there is one thing we should know about sugar, our health comes a very long way second to the self-interest of the people with their hand in the cookie jar.

How the Healthy Eating Guidelines have destroyed our health

By | Big Fat Lies, Conflicts of Interest, Sugar, Vegetable Oils | 5 Comments

The first Australian healthy eating guidelines were published in 1982.  Its now been 35 years since our government became worried enough about our health to start telling us what to eat.  There is now little doubt that it has been an unmitigated disaster.

The guidelines told us to eat more fruit and vegetables and less animal fat and salt, moderate our intake of sugar and alcohol and exercise more.

And we pretty much did as we were told.

We eat less fat and the fat we do eat is vegetable oil. Between 1982 and 2012 we dropped our total fat consumption by 25% but our animal fat consumption plummeted by an incredible 85%.

We now add salt to our food a third less frequently than we did in 1982. And Between 1992 and 2011, we increased our consumption of vegetables by 15.4%, and our fruit consumption by 7.5%.

We also exercise more.  In 1995, 30.2% of us performed moderate or high levels of exercise every week and in 2012 that had increased to 32.4% with the proportion doing high levels of exercise almost doubling.

Between 1980 and 2012 we also cut back on the booze, dropping our consumption by 21%.

The only guideline we appeared to ignore was the one about ‘moderating’ our sugar consumption.  Data on that is spongy due to the Australian Bureau of Statistics discontinuing its monitoring in 1995 but based on comparable data in the US, we are likely to have increased the amount of sugar we consume by about 20%

So how have the Guidelines gone?  Have they reduced chronic disease?  Have they improved health outcomes?  Are we all pictures of glowing good health after a third of a century of politician inspired, food industry sponsored, dietitian enforced eating advice?

Not so much.

Chronic disease is now killing us at rates which were unimaginable in the 1980s.  Here are some of the most egregious examples, but they are just the tip of the ice-berg.

Weight

In the early 1980s, Forty percent of us were overweight including 10% who were obese.

Thirty-five years later, we would kill to only have that kind of weight problem.  Now almost 70% of us are overweight and obesity has tripled.

The science tells us weight gain is caused by sugar’s unique ability to dysregulate our appetite control.

Type II Diabetes

In 1989, less than 1% of the Australian population had Type II Diabetes.  By 2015, that number had more than quadrupled (to 4.4%).  As a result, every day in Australia around 12 people will undergo a diabetes-related amputation.

Type II Diabetes is caused by consumption of sugar.

Kidney Disease

Chronic kidney disease is now responsible for more than 1 in every 6 hospitalisations. And that rate has gotten very bad, very quickly. Between 2001 and 2015, hospital admissions for kidney dialysis alone more than doubled.

Chronic kidney disease is caused by consumption of sugar

Cancer

The incidence of all cancers has increased by 23% but some cancers have exploded.  Australians are now three times as likely to have Thyroid or liver cancer and between 2 and 3 times as likely to have Kidney, Anal or prostate cancer or melanoma.

Cancer is caused by consumption of vegetable oils and its growth is accelerated by sugar.

Allergies

Reported rates of Hay Fever, Asthma and Eczema have doubled in the last 15 years according to survey data. Hosptilisation rates for the most extreme form of allergic reaction, Anaphylaxis (life threatening acute inflammation usually in response to food) also doubled between 1994 and 2005. And the biggest overall change has been a five-fold increase in anaphylaxis admissions for children aged 0 to 4 years (as compared to just double for the rest of the population). Five times as many admissions in just ten years.

Impaired inflammation responses like these are caused by consumption of vegetable oil.

Fertility

Around one in six Australian couples now meet the World Health Organisation definition of infertility and this is due in no small part to the alarming drop in male fertility.  Since the 1980s, male sperm counts have dropped by at least 30% and if the trend continues, fertile men will be as rare as hen’s teeth within two decades.

Male fertility is destroyed by consumption of vegetable oils.

Those we trusted with health advice told us to eat vegetable oils, focus on the fat and calorie content of foods and exercise more.  They also had scant concern for sugar.  The food industry paid attention and pushed the ‘healthy eating’ barrow as hard and fast as it could.

Our food was filled with vegetable oil and sugar and that was ok as long as it was ‘low in saturated fat’.  The dietetics industry merrily accepted the sponsorship of the food producers and sung uncritically from the same hymn sheet.

But now we see the grisly consequences of that gormless obsession with saturated fat unfolding before our eyes (provided they haven’t been destroyed by vegetable oil induced macular degeneration).

The evidence that sugar and vegetable oil is crippling us is now abundant, but those in charge of health advice refuse to act.  These same experts who have presided over three decades of culpably negligent public health advice, now refuse to either acknowledge their error or change their foolhardy ways.

That advice must change immediately.  We cannot afford to throw millions more of us under the bus driven by the egos of academics and fueled by the blood money of the processed food industry.

Why buy Viagra when you can roll your own?

By | Sugar, Vegetable Oils | 6 Comments

Viagra is a drug which helps us get more out of the nitric oxide we naturally produce.  Besides its highly successful commercial use, a recent trial has shown it could make a significant difference to heart disease patients.  But it won’t because – money.

Nitric Oxide is a highly reactive gas created naturally by lightning strikes and less naturally by car exhausts.  It’s also somewhat of a superstar in the biological world.  It was declared molecule of the year in 1992, has its own scientific journal and its own fan club, the Nitric Oxide Society.  And every year about 3,000 new studies about its properties are published.

Biochemists are obsessed by the stuff because it is critical to the way some of our fairly important bits work (brain heart, lungs, immune system, genitalia etc.).  Nitric Oxide is used as a signaling molecule.  It tells one part of our body that another part wants it to do something.  Because it is a gas and it decays within seconds of release it is perfect for the job.  It easily and quickly gets through cell membranes passes on the message and then disappears.  This means we don’t have to go to the bother of having all sorts of mechanisms to clean it up afterwards.

We produce it in loads of places in our body, but critically in the linings of our blood vessels.  The Nitric Oxide produced there seeps into the muscles surrounding them and tells them to relax.  When they relax the blood vessels become wider and blood pressure decreases.

We’ve known since shortly after it was discovered in 1846 that nitroglycerin (yes, the stuff that goes bang) helped a lot with heart disease.  But we didn’t know why until we discovered that when ingested it increases Nitric Oxide levels.  The chaps who made those connections picked up the Nobel prize for medicine in 1998.  Ironically that prize is funded by the estate of Alfred Nobel, the inventor of dynamite, the safe form of nitroglycerin.  He had heart disease and was prescribed nitroglycerine for it in the late 1800s.

During the 1990s researchers from Pfizer were beavering away on a new drug which helped Nitric Oxide work better.  They wanted to come up with a better way of lowering blood pressure than asking people to suck on explosives.  But when they got to human trial stage of their drug, Sildenafil, they discovered a very lucrative side effect.

The heart wasn’t the only place that Nitric Oxide increased blood flow.  It turned out that it was extraordinarily effective at temporarily fixing erectile dysfunction.   Needless to say, the market for what became Viagra was significantly more tempting than just another blood pressure med.  Financially it was a very good call.  Viagra quickly became a license to print about $2 billion a year for Pfizer.

Rather unsurprisingly a long term study released last year showed just what a good thing they were on.  The study followed 5,956 men with type II diabetes who were taking Viagra.  After almost 8 years, the study found that when compared to matched men not taking the pills, they were 5% less likely to die from anything, 38% less likely to have a heart attack and 15% less likely to die if they did have one.

The heart attack risk reduction makes every other anti-blood pressure or cholesterol lowering medication look like a placebo.  And the reduction in death after heart attack was roughly 8 times as effective as the next best option (a surgically inserted stent).  The Viagra was unbelievably effective and they weren’t even taking it for their health.

That is just one of the, now thousands of, studies on the power of Nitric Oxide.  We now know that if our ability to produce it is in anyway impaired then besides heart disease, we much more likely to also suffer from hypertension, preeclampsia, Type II Diabetes, kidney disease, obesity, and of course erectile dysfunction.  It also plays a part in our learning and long term memory and supercharges our immune system. Obviously then, being able to increase our ability to produce Nitric Oxide should be something we strive for.  Likewise it’s a really good idea to avoid things which impair it.

Besides explosives and Viagra, eating garlic or green leafy vegetables like spinach (yes, Pop-eye was right)or lettuce for example increases Nitric Oxide production.  Exercise and living at high altitudes also does the trick.  But none of that will matter in the least if you also consume fructose or omega-6 fat.

Cane sugar (sucrose) is one half glucose and one half fructose.  The fructose half is unique among sugars we eat in that our liver processes it to fat without any feedback or control.  It was so rare in our evolved environment (there were so few coke machines in Paleolithic times) that we never bothered to develop the capacity to regulate that process.

A waste product from converting fructose to fat is uric acid, a substance that we are very poorly evolved to deal with in the quantities produced when we eat sugar.  Unfortunately for us uric acid reacts with the nitric oxide we produce and disables it.

The omega-6 fats that dominate seed oils (canola, soybean, sunflower, grapeseed, rice-bran and cottonseed) produce highly reactive compounds.  Those compounds directly impair our ability to produce nitric oxide.

Our food supply is now stuffed with sugar and seed oils.  There is barely a product on the supermarket shelf that does not contain one or, more usually, both.  If your aim was to impair our production of nitric oxide you’d struggle to do better than create a food supply which looked like the average supermarket.

Given that, it is little wonder that we are now drowning in the flood of chronic diseases that flow automatically from impaired nitric oxide – heart disease, hypertension, preeclampsia, Type II Diabetes, kidney disease, obesity, dementia, communicable infections and of course erectile dysfunction.

Sadly Viagra is not an option.  It is not approved for use as a heart medication and never will be.  Pfizer will not spend the $100s of millions required to do the required trials now that it is off-patent.  That leaves us with just one solution and it is the same one as always.  Self-medicate with real food that contains neither sugar nor seed oils.

Drug Companies are throwing billions at a disease that can be cured with 3 words

By | Conflicts of Interest, Sugar | 5 Comments

Liver Disease is the next big gold mine for the pharmaceutical industry.  Billions are being spent on an elusive drug cure.  But not one cent is being spent on the one thing we know will cure it – quitting sugar.

Liver diseases fall into two main groups, those caused by viruses (Hepatitis – currently afflicting about 518,000 Australians), and, accounting for the other 90 odd per cent of cases, those caused by ‘lifestyle’ (5.5 million people).

The lifestyle group is usually further divided into drinkers (who have the same symptoms but have a history of consuming  more than 2 standard drinks per day for women or 3 for men) and everybody else.  Alcoholic Fatty Liver Disease now affects 6,203 people but Non-Alcoholic Fatty Liver Disease (NAFLD) afflicts a massive 5,538,677 Australians.  That’s a pretty big number for a disease was first identified just over 3 decades ago.

As the name suggests, NAFLD starts out as an accumulation of fat in the liver.  It can then progress through various disease stages and ultimately end in cirrhosis requiring a liver transplant (if you’re lucky enough to find a donor).   There is no other cure.

There are very few symptoms until the later disease stages, so most people are unaware that they have it all. There is also no way to diagnose it other than using a liver biopsy, an invasive procedure done under anaesthetic.

NAFLD is frequently described as the liver component of the metabolic syndrome (elevated blood fats, insulin resistance and obesity), because it’s rapid growth has paralleled the same runaway growth in each of the diseases which are a consequence of the syndrome.  More than 90% of obese people and up to 70% of people with Type II Diabetes have NAFLD.

The number of people with NAFLD is accelerating at a tremendous rate.  If you make it to the ripe old age of 50 you have a 2 in 5 chance of having the disease today in Australia.

Even worse, the age of onset is declining rapidly.  A study published in 2013 revealed that the number of US teenagers with the disease more than doubled in the last 20 years and then affected almost 11% of US children aged 12-19.  An ongoing Australian study estimates the rate is even higher in our kids (12.9%).  This means the average high school classroom now contains four children suffering from chronic liver disease.  Every classroom.  Four kids.

It might have no symptoms, but NAFLD is not a harmless disease.  It significantly increases the risk of developing cirrhosis (liver scarring and inflammation) and liver cancer.  Liver cancer has more than tripled in Australia in the last three decades.  It is almost always fatal within months of diagnosis.

Of course, none of this has escaped the notice of the drug companies.  Explosive growth in a chronic disease means there is money to be made.  Analysts are predicting that the global market for liver disease medication could be worth US$35 billion a year.

Drug companies have already spent billions on 25 experimental compounds.  As yet, none have been proven to work, but the potential goldmine is so deep and so wide that they won’t be giving up anytime soon.  Drugs that must be taken by healthy people for their whole lives are a gift the drug industry hasn’t seen since they convinced us to take statins.

Even though one of the liver’s functions is to make fat from any excess carbohydrates we consume, the fat is normally exported for storage in all the places that make our jeans too tight.  NAFLD starts when the liver’s ability to export fat is overwhelmed.  The excess fat remains in the liver and eventually progresses to significant liver scarring.

All but one carbohydrate triggers an insulin response which shuts down appetite and stops us eating too much (and therefore producing fat). The one carbohydrate which subverts this handy appetite control feature is fructose.  Fructose also bypasses an important control step which directly stops too much fat being stored in the liver.

So of course, recent nutrition research has focused on whether fructose (and its primary modern delivery vehicle, sugar or sucrose) might be the source of the sudden explosion in NAFLD. As a result, over the last decade research that proves that sugar is the culprit has been pouring in.

Scientists have shown that you can give ducks and rats NAFLD using fructose.  Those were followed by a series of human studies have also shown that the consumption of soft drinks is strongly associated with the onset of NAFLD).  And in 2012 a pair of randomized human trials from Scandinavia advanced the case even further.

The first trial involved feeding four groups of people four different drinks (Coke, milk, Diet Coke and water).  After 6 months of this, the Coke group had massively (140%) increased liver fat (as well as significantly increased blood pressure, cholesterol and blood triglycerides).  The folks knocking back Diet Coke and water were pretty much the way they were at the start and the milk drinkers had even slightly improved their liver fat status.

A similar story unfolded in the second trial.  Some very unfortunate volunteer humans were put on the path to NAFLD (27% increase in liver fat) in just three weeks by overfeeding them chocolates, pineapple juice, soft drinks and sports drinks. And to top it all off, in a study published this month, researchers found that fructose consumption in teens was independently associated with a 61% increase in the risk of developing serious liver damage.

The trials are done, the evidence is clear.  Fructose consumption causes NAFLD in exactly the same way that alcohol causes Alcoholic Fatty Liver Disease.  NAFLD’s alcoholic cousin can be usually be reversed by ensuring the patient avoids alcohol.  And the science tells us avoidance of sugar would work just as well to turn around NAFLD and prevent its deadly cascades.

When the harm is significant, the cause is clear and the solution even clearer, we do not need to spend billions a year looking for new drugs. NAFLD currently has at least a quarter of the population, and 1 in 8 kids, on an expressway to a liver transplant (if the rest of the metabolic syndrome doesn’t get us first).  Yet it can be easily and effectively reversed with a pathetically simple piece of advice – don’t eat sugar.

We are overflowing with national health agencies, specialist doctors and charities charged with keeping our liver well.  But not one of them is telling us about the only proven cure.  Those groups need to immediately start giving that advice unequivocally and fighting hard on the side of sugar abstinence.  Given the incontrovertible state of the evidence, the current gormless hand-waving is nothing short of negligence.

How Big Food is using our health system as a marketing tool.

By | Big Fat Lies, Conflicts of Interest, Sugar, Vegetable Oils | 6 Comments

Nestle, Danone and others like them, use our health system as a tool for flogging cheap and addictive powdered milk products.  Regulators have clamped down on them doing it with baby formula, now it is time to stop them doing it to our elderly.

In the early 1970s Nestle decided to exploit mothers in developing countries.  The plan was to convince breastfeeding mothers that using Nestle formulas was healthier for their children than breastfeeding them.

Nestle had realized that many mothers in Africa, Asia and South America had a strong desire to imitate Western culture.  So they leveraged this by implying that formula was the modern way to feed babies.  Anything else was old fashioned and primitive.

The aggressive marketing was extraordinarily effective. Formula sales took off like a rocket (the market is now worth $25 billion a year) but so did the incidence of childhood diseases in the developing world.  Drinking water was often unsafe and mixing it with milk powder and sugar didn’t do anything to fix that.

Breastfeeding protected children from the vagaries of the local water supply.  It is also free and doesn’t drain critically important money away from families who can least afford to buy formula.  The cost often results in mothers using less powder than required to make the tin stretch further.  So even if the water is clean the child is undernourished.

Nestle’s aggressive marketing led, in 1977, to a worldwide boycott of Nestle’s products.  And as a result, in 1981, the World Health Organization (WHO) created guidelines on the marketing of formula, but to this day there are continual breaches in the developing world and many of the groups who started the boycott continue to fight against Nestle and others.

The message was equally effective with Australian mothers.  Manufacturers provided formula ‘donations’ to Hospital nurseries and in hospital promotions often delivered by healthcare workers. And it worked.  Breastfeeding in Australia fell to record low levels in the 1970s.  In 1972 just one in 20 children was breastfed for 12 months.

In 1992 the Australian government finally implemented a voluntary code (based on the WHO rules developed more than a decade earlier) which severely restricted the way infant formula could be marketed and include a requirement that mother’s be told breast is best in all marketing material.  Promotion cannot occur at all on healthcare facilities and healthcare workers cannot receive any form of inducement to promote the products.  If formula is donated to an institution, it can only be used for children who a doctor has determined requires formula.

The code is voluntary but all the major manufacturers has signed on and breastfeeding rates are now 6-fold what they were in 1972 (although they are still just a third of the WHO recommended level).  Even so, Nestle and others continue to circumvent the ban on marketing by advertising unregulated toddler milks with exactly the same packaging and branding as the infant formulas.

But that is just fiddling at the edges compared to the latest gold mine for medical formula reps – the elderly.

Doctors are rightly concerned that older people not suffer from under-nutrition. They take weight loss among the elderly very seriously and therein lies the opportunity for Nestle and others (such as Danone, the maker of the Fortisip range).  These companies actively markets the use of food supplements for elderly patients, whether they are losing weight or not.  Hospitals and dietitians are encouraged to use things like the Nestle Nutritional Assessment tool to assess the need for supplements. Using that tool it would be almost impossible not to be assessed as requiring supplementation.

These powdered milk concoctions are offered as drinks with (or even instead of) hospital meals and patients are provided with order forms (often by dietitians employed by the hospital) for discounted purchase after they are discharged.  The products themselves are usually just hideously overprice powdered milk, sugar and a multi-vitamin and sometimes a dab of seed oil just for good measure.

The ingredients are very similar to Up&Go except they can have loads more sugar and sometimes a pile of seed oil as well.

Fortisip Vanilla Ready to Drink Sustagen Hospital Powder UP&GO Vanilla Ice Ready to Drink
water, maltodextrin, milk protein, sucrose, vegetable oil (canola oil, sunflower oil), tri potassium citrate, emulsifier (soy lecithin), flavour, magnesium chloride, acidity regulator, tri calcium phosphate, carotenoids, choline chloride, calcium hydroxide, potassium hydroxide, sodium L-ascorbate, ferrous lactate, zinc sulphate, colour, magnesium hydroxide, nicotinamide, retinyl acetate, copper gluconate, DL-α tocopheryl acetate, sodium selenite, manganese sulphate, calcium D-pantothenate, chromium chloride, D-biotin, cholecalciferol, thiamin hydrochloride, pterolylmonoglutamic acid, pyridoxine hydrochloride, cyanoccobalamin, sodium molybdate, riboflavin, sodium flouride, potassium iodide, phytomenadione Non Fat Milk Solids (63%), Corn Syrup Solids, Whole Milk Powder, Sugar, Minerals (Magnesium Hydrogen Phosphate, Ferric Pyrophosphate, Zinc Gluconate, Copper Gluconate, Manganese Sulphate, Sodium Molybdate, Chromium Trichloride, Sodium Selenite), Vitamins (C, E, Niacinamide, A, D3, B6, B1, B2, Folic Acid, K1, B12), Stabiliser (414), Flavour. water, skim milk powder, cane sugar, wheat maltodextrin, soy protein, vegetable oils (sunflower, canola), vegetable fibre, hi-maize™ starch, corn syrup solids, flavours, fructose, oat flour, mineral (calcium), acidity regulator (332), vegetable gums (460, 466, 407), stabiliser (452), salt, vitamins (C, niacin, A, B12, B6, B2, B1, folate).
Sugar: 13.3% Sugar: 45% Sugar: 7.6%
Polyunsaturated Fat: 2.8% Polyunsaturated fat: 0.8% Polyunsaturated Fat: 0.7%

The sugar in Sustagen had until May 2016, been glucose.  But then Nestle decided to ‘improve the nutritional profile’ by replacing the much of the glucose with cane sugar.  Effectively this means they replaced half the nutritionally harmless glucose with toxic fructose.  Yep, the same fructose that has been nailed as causing Type II diabetes, Obesity, Fatty Liver Disease and probably Alzheimer’s disease (just to name a few of its greatest hits).

I can’t see how introducing a confirmed source of chronic disease improves the nutritional profile (and they have refused to respond to my written requests for an explanation), but I can see how it improves the financial profile of Nestle.  Sustagen’s competition all use it.  Fructose is highly addictive, so products that contain it always sell better than products without it.  And since the aim of this game seems to be follow on sales after the patient leaves hospital, an addictive product would be a better choice. Commercially its a no-brainer.

The seed oils in many of these products cause cancer, heart disease, Parkinson’s Disease osteoarthritis and rheumatoid arthritis (just to name a few of the greatest hits). Seed oils are cheap as chips, so using them instead of milk fat increases the profit margin.  Another commercial no-brainer.

These products are being directly promoted and marketed to patients within our healthcare system, something which would be prohibited if they were infant formula.   Nobody, but especially not a sick elderly person, needs sugar and (often) seed oil, loaded milk powder.  Nestle and their mates were barred from using hospitals as a sales tool for infant formula and its time the same thing happened for this garbage as well.

Chocolate Nesquik Earns 4 Health Star rating

By | Big Fat Lies, Sugar | 2 Comments

Sydney, Australia (24 January 2016): Nestlé Australia announced today that its popular Nesquik Chocolate drink has earned a four star health rating.

This will be one of the first times that a product which consists almost entirely of sugar has earned such a high rating. “We don’t know why we didn’t think of this before,” said Mr Bill Wonka, Regional Director, Nestle Australia. “But once we took a close look at the Health Star criteria, we knew that Nesquik could become a key part of our promise to deliver superior nutrition to Australian families.”

“All we had to do was calculate the rating after adding Nesquik to skim milk, just like we did with Milo. Nesquik has almost twice as much sugar as Milo so we were a bit worried, but the rating doesn’t seem to be affected too much by the product being nothing but cane sugar and cocoa. From today, consumers have a healthier chocolate milk option that means they don’t sacrifice on taste. It’s a win for everyone.” he said.

“We are now looking closely at the rest of our confectionery lines and a number of beloved brands are currently undergoing renovations to meet the Health Star’s strict nutrient criteria. Keep an eye out for a five star chocolate with added fibre and vegetable oil later in the year.”

“We are proud that Nestle now has another a four star health rating in a confectionery line. Nestle Australia should be congratulated on their commitment to an extensive reformulation programme that provides Australian families with more healthier choices at snack time,” said a spokesperson for the Australian Federal Department of Health.

“The new Health Star system has been successfully challenging food companies to produce healthier foods. Now, we are challenging more confectionery makers to match the commitment of Nestle Australia.”

Reaction from the public has been mixed. Joyce Barnaby from Canberra was pleased that Nesquik was now healthy “I was sick of feeling guilty every time I knocked back a choccy milk,” she said, “Now it has exactly the same number of stars as a glass of milk without any sugar, I know it must be doing me good.”

Health professionals also welcomed the news. “A 10 year old can now run off a 4 Star glass of Nesquik in around 60 minutes,” said dietitian Ms Pixie Golightly, “With the old junk food Nequik, it would have taken almost an hour,”

But on social media the mood has been less positive. “Not fun for the kids at all any more,” wailed Dimity Smythe-Jones on Nestle’s Facebook page. “my kids won’t touch health food – as soon as they see that healthy food rating they’ll avoid it – what chance do I have of getting them to drink the new healthy Nesquik?” she wrote.

Note: This is satire – nothing about this piece is true except that if Nestle were to apply for a health star rating for Nesquik it would get 4 stars when served with reduced fat milk (as suggested on the label)

Are dietitians selling us out?

By | Big Fat Lies, Conflicts of Interest, Sugar | 10 Comments

Dietitians are rolling out their ritualistic warnings about ‘fad diets’ so it must be January. Prepare to be warned about the dangers of avoiding gluten, quitting sugar or going Paleo. Instead you will be told to give the new (heavy on whole grains) microbiome diet a go or perhaps become a Vegan.

According to dietitians, crazy ‘fads’ like quitting sugar are dangerous because they ask us to ‘cut out whole food groups.’ Only a dietitian high on sugar would describe sugar as a ‘food group’, but I guess the argument could apply to the stricter forms of paleo which ask devotees to ditch dairy, legumes and grains.

If food group deletion is the reason for official opposition to paleo, gluten free and quitting sugar why are they quite happy to give a free pass to vegetarianism and its more extreme cousin, veganism? Both of these diets do actually cut out food groups and both require careful management in order to avoid significant nutrient deficiencies. But they are never attacked by Dietitians.

Vegetarian diets do not contain meat, poultry or fish. Vegan diets go a little further and also exclude dairy products and eggs. Both diets have been part of British and US culture since the mid-19th century so we’ve had a bit of time to study them in the wild.

Those studies tell us that (compared to omnivores) vegetarian diets provide higher amounts of carbohydrates, omega-6 polyunsaturated fats, fibre, vitamin C, vitamin E and magnesium but lower amounts of protein, saturated fat, omega-3 fats, vitamins A, D and B12 and Zinc. Vegans are usually particularly low in B12 and also Calcium, a deficiency they are likely to share with hard-core paleo enthusiasts because both avoid dairy.

We use vitamin B12 to create our DNA, red blood cells and the myelin insulation around our nerves. Not having enough of it can result in fatigue, weakness, psychiatric problems and anaemia. B12 deficiency in children and the elderly is even more worrying. Studies have consistently shown that children and older people lacking B12 suffer significant cognitive defects such as memory and reasoning.

The lack of long chain omega-3 fats, the abundance of omega-6 fats and deficiencies in the fat soluble vitamins A and D are also serious cause for concern particularly in pregnancy.

This does not mean that vegetarian or vegan diets should not be followed, just that they need to be carefully managed, particularly in pregnant women, children or the elderly. But that is what you might expect from a diet that actually does delete ‘whole food groups.’

So where then are the January warnings to avoid those ‘fad diets’? Why are the dietitians’ scare tactics focused only on diets which might stop people eating grains and legumes? It’s a real conundrum.

Coincidentally, the body that regulates dietitians in Australia is sponsored by Arnott’s, Nestle and the Australian Breakfast Cereal Manufacturers Forum. And while that last one sounds like an almost official body, it’s really just a long-winded way of saying the Breakfast Club. No not that one, this one is responsible for supplying all those sugary boxes of grain we are supposed to consume as part of a ‘balanced breakfast.’ The gang’s all there. Kellogg’s (coincidentally founded because of a vegetarian religion), Freedom, Nestle (again) and Sanitarium (coincidentally founded, and run by, the same vegetarian religion).

But surely that can’t be the answer? Surely dietitians wouldn’t sacrifice their professional integrity just to grasp a few stray dollars from the Breakfast Cereal manufacturers? No, there must be some other reason which is not fathomable to us uninformed masses. Because if that were the case, it would mean dietitians are really just the undercover arm of Nestle (etc)’s marketing departments. And that would spell big legal (not to mention moral) trouble.

If dietitians have really been selling us out to flog processed food, then collectively they would owe this country the hundreds of billions a year spent treating the chronic disease disaster those foods have inflicted. But even more importantly they owe us something that can’t be repaid, our health.

This is not a game. Australians are no longer prepared to accept dietetic advice which is curiously aligned with the interests of the processed food industry rather than what the science tells us. Now would be a good time for the dietitians of Australia to lead, follow or get out of the way. A good start would be to stop telling us that quitting sugar is a ‘fad’ that should be abandoned. And they can hope like crazy that when the lawsuits start, everyone has forgotten their role in the catastrophe which is Australia’s health in the 21st century. I, for one, won’t.

 

Also published in the Huffington Post

How a Soft Drink Tax (and not science) will change nutritionists’ views on sugar.

By | Conflicts of Interest, Sugar | 2 Comments

For a decade, the guardians of public health have fought tooth and nail against the science on sugar and the harm it causes.  But now that the government might pay more for their allegiance than the food industry, they are all ears.

This week, the Grattan Institute produced yet another proposal for a soft drink tax.  It’s an idea that just won’t go away, no matter how much the politicians want it to.

Convincing people not to smoke results in a measurable health outcome. Smoking is a primary cause of lung cancer and heart disease.  And rates of both diseases have plummeted since the introduction of tobacco taxes.  But this is in the context of tax being part of a package of measures aimed at making smoking slightly less socially desirable than persistent public flatulence.

Unfortunately, the same cannot be said for sugar.  Taxing one source of sugar will certainly reduce consumption from that source but detailed studies have been so far unable to detect a significant health benefit from reducing the consumption of those drinks alone.  This is likely to be because people simply find a cheaper, or just different, source.  The bloke avoiding the slightly more expensive Coke is probably still chowing down on sugar loaded cereal for breakfast, chugging an iced coffee for lunch and having sugar loaded BBQ sauce all over his sausage in bread.

Until you need to sneak into a dank corner of the car-park to snarf your cream-bun for fear of being hounded by the Heart Foundation, we are not comparing apples with apples.  But tax dollars might just achieve what science has failed to do for at least a decade.

This week’s Grattan report suggested $520 million a year could be raised from an Australian soft drink tax.  The authors didn’t put much thought into what that might be spent on, other than to vaguely waft in the direction of ‘health initiatives’ or some such.  But that was enough to get the attention of some of those who have been the most resistant to the idea that sugar is bad.

The food industry sponsored, Dietitians Association of Australia (DAA) for example has steadfastly opposed the notion that sugar is a problem.  After Sweet Poison was released it published a press release entitled “Sweet truths: Eating sugar may not make you fat.”  And it has not wavered from that position over the 8 years since.  Similarly Nutrition Australia, to this day maintains “there is no consensus that [sugar] is the sole, or even major cause” of obesity, type 2 diabetes and heart disease.

The Heart Foundation has so comprehensively opposed the notion that sugar is harmful, that it sent out a cardiologist to consume significant radio time arguing against me on that point.  And it has been willing to raise the better part of $3 million a year from certifying that sugar loaded food is a heart healthy choice. It says this is because “there is no scientific consensus that sugar … causes heart disease.”

Diabetes organisations have also been happy to tell sufferers of Type II diabetes that sugar does not cause their disease.  Meanwhile the Australian Medical Association (AMA) has done its best to not have a position on sugar at all.  And it has certainly never openly condemned it.

But, my goodness what a difference a bit of green makes to one’s outlook.   The first to fall was the Heart Foundation, calling for a sugar tax like the one announced in the UK in May.  Then last week (after it became clear exactly how much money was in the pot), they all rushed in.  Within days of Grattan’s report being released the AMA, the DAA and Nutrition Australia all put out press releases demanding a sugar tax.  Some of them even while continuing to host pro-sugar content on their websites.  Their greed reflex outpaced even the fastest website editor.

Suddenly each of these peak health bodies are singing from a different song sheet. The prospect of loads of tax dosh trying to find a home for ‘health initiatives’ has converted them to sugar haters in a heartbeat.

A soft drink tax won’t directly reduce the amount of sugar we consume.  But the siren call of cold hard cash will apparently do what I and many like me have failed to do for a decade.  It will remove the single greatest obstacle to real progress, the nutrition rent-seekers.

No doubt much to the despair of the processed food industry, the loyalty which had been so painstakingly built over decades with speaking fees, sponsorships, endorsements and carefully crafted non-science will all likely be blown away by government tax money looking for a home.

These tax-payer funded organisations have been perfectly happy to ignore the science for a decade.  They have been happy to dictate health policy that lets ever increasing numbers of us suffer.  And they have been happy to do it because of ego or profit or consensus or stubbornness or all of the above.

I suspect nothing has changed about nutrition industry views on sugar but their collective campaigning (no matter how much it is motivated by greed), will undoubtedly have the effect of telling us all something we desperately need to hear – there is a very real problem with sugar.  And if that’s the way we get there, then so be it.