The David Gillespie Blog

ABC’s Steve Austin was kind enough to invite me for a chat on his show this morning. As is usually the case with Steve, he was bristling with the latest news in the world of sugar research. He asked me about a story doing the rounds on the wire last night.

David Paterson has a big problem.  There are too many fat people where he lives and they are sending him broke.  But he has a solution and his solution marks him out as a pioneer.

David is the Governor of New York State and the problem is that the cost of providing even the limited free health care that he provides (called Medicaid) is blowing out as fast as the waistlines of his constituents.  Medicaid provides free health care to the very poorest of America’s citizens.  To qualify they essentially have to have less than $2,000 in assets, no income AND be a child, pregnant, elderly or disabled.

New York currently spends US$2,283 per person per year on Medicaid.  It’s not much by Australian standards, but it’s more than twice the US national average of US$1,026.  This coming year David expects to spend US$45.4 billion (with a B) on Medicaid.  This is a 51% increase in what was spent in 2000. 

A rapidly increasing part of the Medicaid bill is going towards the treatment of Type II Diabetes, heart disease and the other complications associated with obesity. Nearly a quarter of New Yorkers under the age of 18 is obese and almost half the Medicaid budget is spent on those children.  David’s solution is tax the cause of those diseases.  Here’s what his says:  

“To combat obesity, the budget proposes an additional 18 percent tax on non-diet soft drinks to discourage consumption of beverages that contribute to obesity, diabetes and heart disease, with all of the revenues to be dedicated to health care programs.”

Welcome to the future.  David’s solution to a runaway train is to attach lead weights to the caboose rather than turn off the engine.  It’s a solution first proposed by Dr Kelly Brownell,  director of The Rudd Center for Food Policy and Obesity at Yale in the early 1980s, but now a cash strapped government has finally gotten desperate enough to do it.

David is not alone in his need to do something about the cost of obesity, he is just the first to hit the panic button.  As more and more governments do the maths, you can expect the covers to come of those panic buttons quickly. 

If you doubt that we will ‘solve’ the problem this way here, you need look no further than the Queensland government’s ‘solution’ to the blowout in public dental costs caused by the consumption of sugar.  Did they ban sugar?  No, they mass medicated us with fluoride. 

Likewise, since David is obviously convinced that sugar is the problem, it might have been logical to consider banning it.  But in a move reminiscent of the ‘cure’ for smoking, he decided to tax it instead.

The interesting thing about David’s new tax is that he didn’t target fats.  I guess the sugar industry’s ‘research’ smokescreen about fat being bad and sugar being good ‘in moderation’ isn’t fooling those who have to pick up the tab for obesity.

As the last of the Christmas pudding subsides from view, many thoughts turn to the inevitable New Years resolution to lose weight.  

Over at the facebook group, Liz has suggested that it would be a good idea to have a holiday photo challenge for Sweet Poison.  She says people should get snaps of Sweet Poison in the wild.  Liz got the ball rolling with a photo she took at the “Toowoomba Bookcrossers Christmas Meetup”.

Know someone famous? How about a snap of them holding the book?

Going somewhere on hols? How about a snap of the book enjoying a new location?

Take as many as you can and post your photos over at the facebook group. Just to make it interesting, I’ll send a ‘Nothin Sweet About Me’ T-Shirt to the taker of the photo that I like the most.

I rather suspect that you are sitting there saying ‘boy, Gillespie is scrapping the bottom of the barrel with this post – of course it is!’.  But believe it or not until now this has not actually been proven by anybody who counts in the scientific community.

These rats were being fed a 10 percent sugar solution, which exactly the same as what you’d find in a soft drink or fruit juice. And they were becoming dangerously addicted to the point of encouraging other more dangerous addictions.

The research showed that when hungry rats binge on sugar a surge of dopamine is provoked in their brains. After a month, the structure of the brains of these rats adapts to increased dopamine levels, with fewer of a certain type of dopamine receptor than they used to have and more opioid receptors. These dopamine and opioid systems are involved in motivation and reward, systems that control wanting and liking something. Similar changes also are seen in the brains of rats on cocaine and heroin.

Avid readers will know that I was called to give evidence to the Federal Government’s Inquiry into Obesity on Monday.  Since a few people have asked what I said to them, I thought I’d post a copy of my notes (see below).

In 1910 there weren’t many overweight people – in fact 4 out of every 5 people you’d meet were downright skinny by today’s standards. There was no such thing as heart disease. The medical speciality of cardiology wasn’t even going to be necessary for another 15 years.

Obviously no-one was getting rich selling diets or gym-memberships. There wasn’t even enough interest in diets to start a Woman’s magazine – The first copy of Woman’s weekly wouldn’t be rolling off the presses for another quarter of a century and it would be more than half a century before the first Weight Watcher’s meeting would happen.

By the 1960s the number of overweight people in the population had doubled!

Heart disease was endemic – with two out of every three premature deaths being caused by it. A previously unknown disease – Type II Diabetes had just been identified.

Cardiologists were trained at a rate never seen before for any profession. Medical schools were endowed with fortunes.

Drug companies launched massive research programs with government money helping to grease the wheels.

A new profession was invented. Human Nutrition. And along with it, the mass market diet was invented.

At the urging of the newly minted experts in Human Nutrition we all went on low-fat diets and took up the brand new sport of jogging (never before in human history had it been necessary to run for a purpose other than catching food or getting away from danger).

Huge new industries were created – Having shoes designed for running had never been necessary before. Going somewhere to ‘work-out’ had only previously been necessary if you spent your days at her majesties pleasure in a 3×3 cell.

Food manufacturers made low-fat everything because it sold well. The consumers were doing what the experts said to do. Eating low-fat and exercising lots. We ate even more breakfast cereals and drank more juice and coke because none of these things had the devil fat.

We did what the experts told us – we started having Skinny Latte’s. We stopped our children drinking milk at school because it was high fat. We stopped having bacon and eggs for breakfast – we drank orange juice and we made sure our kids had plenty of juice to drink at school – we switched our kids and us from high fat sausage rolls and pies to low fat dried fruit and muesli bars – we worked out at the gym – we got personal trainers and bought sport shoes – we made our kids exercise more at school (with the assistance of Nestle Milo) – we pilloried McDonald’s and made them introduce low-fat options and we created a whole new kind of fast food outlet – the low-fat sandwich bar (Subway) – which still sold Coke in 1 litre buckets.

And all of that had the effect of doubling the number of obese people again and accelerating the rate of associated health problems.

Obesity – once a disease of old age and high living – is now affecting younger and younger slices of the population. Now the skinny guy is the odd-man out in most rooms.

Type II diabetes is taking over as the new killer.  And our health systems are collapsing under the weight of treating the complications of weight-related diseases that simply did not exist just 40 years ago.

Is there an elephant in the room?

In the 90s the Drug Companies that had gotten rich from cholesterol lowering drugs started looking for a ‘cure’ to obesity and Type II diabetes – our continuing fatness had made those very worthwhile targets for investment dollars.

For decades there had been grumbling by researchers that couldn’t prove that feeding rats fat made them fat but could prove that feeding them sugar not only made them fat but gave them heart disease, type II diabetes, fatty liver disease and testicular atrophy. Recent human studies have backed up these findings in spades.

Important new appetite related hormones were discovered and what emerged from two decades of work was a scientific consensus as to how we digest food and how our appetite control system works.

They found:

We are designed for equilibrium. Like all other animals, we won’t get fat unless something is broken about our appetite control system.

When we eat fat and protein a hormone is released by our gut that tells us to stop eating when we’ve had enough.

When we eat carbohydrates a different hormone is released by our pancreas that does the same thing.

That is true MOST carbohydrates – but there is one that doesn’t trip either appetite control switch – FRUCTOSE.

Now that on its own wouldn’t be such a big deal if we didn’t eat much fructose. Worst case we eat a few more calories than our brains thought we did.

Unfortunately our bodies don’t just ignore the fructose – our livers are blindingly efficient at converting it to fat! Before you even finish the glass of apple juice, the fructose in the first mouthful will be circulating in your bloodstream as fat.

Ok – so that’s a little worrying but still not a big deal if we don’t eat much fructose.

In 1860, our primary source of fructose was from the occasional bit of ripe fruit (and if they were very lucky – some honey). At most that amounted to 1kg of fructose per person per year.

Today almost 15% of the average Australian’s daily calorie intake comes from fructose! – a substance that our body does not detect as food and which is converted immediately to fat.

But it gets worse – the drug company researchers found that if you put that much fat in your arteries you mess up the appetite control system for the foods that do trigger it.

The hormones which tell us when to stop eating no longer work. If we’re not told to stop, we keep eating and overproduction of hormones destroys our pancreas and gives us Type II Diabetes.

So not only is fructose undetected and turned to fat it actually increases the amount of other food we can eat. This is why our average daily calorie intake has increased by 30% in the last three decades.

Fructose is a perfect storm if the desired outcome is obesity, heart disease and Type II diabetes.
The miracle is not that we all became overweight and sick. The miracle is that we are not all dead in the face of the incessant fructose doping.

So what should be done? What can be done?

The quickest and easiest solution would be a regulation that requires the clear and unambiguous labelling of the fructose content of all foods or even better, a complete fructose ban.

Do this and the obesity epidemic would be cured with the stroke of a single legislator’s pen.

If you subscribe to this blog for hard hitting research then you’ll be sadly disappointed by this post.  This is an update on goings on in general.  Hard hitting research will follow in a day or two (on Xylitol and its brothers).

Lyn and Ron spotted something a little strange a few weeks ago.  They were leafing through the November/December issue of Diabetic Living magazine when they came across a full-page advertorial for fruisana Fruit Sugar.

Just because you’re watching your weight or managing diabetes, you don’t have to miss out on the sweeter things in life.

…

If you or or your child has diabetes, up to 30-40g of Fruisana Fruit Sugar can be eaten (in place of sucrose) daily.

Julia,

On page 103 of your Nov/Dec issue there is a full page advertorial for fruisana fruit sugar. The advertorial positions this added fructose product as a suitable addition to the diet of a person suffering from diabetes.

In 2002 the American Diabetes Association (ADA) reversed its previous advice to diabetics that they should consume fructose.

The ADA’s new position is that added fructose should be completely avoided. They explain their change of heart by saying that notwithstanding its proven lack of insulin response, “fructose may adversely effect plasma lipids”. That’s doctor-speak for eating fructose may increase the amount of fat you have circulating in your bloodstream. And there is no shortage of research which shows that fat in the blood from fructose leads to obesity, heart disease and diabetes.

I ask that you stop publishing advertising from fructose manufacturers. I would also like you to publish editorial information concerning the ADA statement of position and the research on which it was based.

Cheers

David Gillespie

Dear Mr Gillespie,

Thank you for your feedback dated 13th November 2008. We have investigated the information you provided and discussed your concerns with our health professional team. We have confirmed that Fruisana is in fact safe for people with diabetes and we have provided information to support the decision, as sourced from the American Journal of Clinical Nutrition 2008. These findings are detailed below.

All sugar substitutes, including Fruisana, are deemed safe for human consumption by the Food Standards Australia New Zealand (FSANZ). Most of the fructose scare is around large doses of fructose. Large doses are found primarily in consuming large amounts of diet style products, and particularly consuming large amounts of sucrose (sucrose is glucose and fructose together). Our body then breaks it down into glucose and fructose. The biggest concern of fructose is when manufacturers add high fructose corn syrup to products to lower its Glycemic index but keep the sweetness. Fruisana is not corn derived (corn syrup). The American Diabetes Association is recommending companies to not use high fructose corn syrup to sweeten food.

As you can see from the paper below shown below, a safe level of fructose per day is considered between 25g and 40g per day. We only included one recipe using Fruisana, which recommended 2 mini muffins per serve, which gave 16.5g of total carbohydrates, 6.7g sugar and 4.5g fructose, well below the safety amount. All fruit and vegetables contain fructose naturally, for example, one apple contains around 12-15g of fructose per medium apple.

Fruisana is considered safe in Australia for general consumption for people with and without diabetes. It is part of the GI symbol program which is run by Sydney University, Diabetes Australia NSW and JDRF, and has to fit into a strict criteria as well as being low GI. There is a lot of research showing the benefits of low GI foods, and Fruisana has a lower kj content making it beneficial for weight management.

In large doses, all sugar substitutes would be considered unsafe, including fructose. We recommend everything in moderation. The amount we used in our recipe was well within the limits.

[She then pastes in an abstract of this journal article]

We appreciate you taking the time to express your concerns. It is our commitment to readers to ensure that everything appearing in Diabetic Living is accurate and the products we promote are safe for people with diabetes. All advertising, particularly food products, must go through a thorough screening before being allowed to book. Your email was taken very seriously and we can assure you that Fruisana, when consumed in moderation, is safe for people with or without diabetes. Thank you again for your feedback.

The journal article that she relies upon was published in the November issue of the American Journal of Clinical nutrition.  It does indeed say that it is safe to consume fructose in the amounts the advertorial suggests.  There are however a few itty bitty problems with it, most of which were pointed out in a highly critical editorial analysis of the article which appeared in the same issue of the journal.  They are:

I know I’ve been a bit quiet on the blog this week but I’ve been busy getting my mug in other media.  Greg Cary (4BC) kindly had me on again yesterday to discuss flouride.  Well really it was to discuss the fact that, but for sugar, we wouldn’t need to be discussing flouride.