We need more than good intentions to stop Diabetes.

By November 11, 2010Uncategorized

The science is now very clear. Sugar consumption causes type 2 diabetes. But our governments persist with programs that try everything except removing sugar from the diet. Is it any wonder we are being overwhelmed by a diabetes epidemic?

The Treasurer’s Intergenerational Report (released in February) soberly warned that treating diabetes must be a financial priority. Treasury estimates that by 2032-33, “Costs from diabetes alone are projected to increase 436 per cent, from $1.6 billion to $8.6 billion.”

Diabetes Australia thinks that (scary as they are) those numbers are likely to be a vast underestimate. They reckon almost 15 percent of the population already suffer from Type 2 diabetes (or pre-diabetes). Worse still, those numbers are going in only one direction – up, big time.

Governments haven’t been sitting on their hands waiting for the diabetes tsunami to wipe out the health system. In 2007, the Council of Australian Governments decided to spend $204 million to reverse the significant growth in type 2 diabetes. The Commonwealth Government announced that it would focus the funding on people at high risk of type 2 diabetes using something called “Subsidised Lifestyle Modification Programs” (SLMP).

Despite the disturbing name, the idea was that when GPs identified an ‘at risk’ individual they’d be told to go and get a SLMP. The SLMP involved accredited allied health professionals providing nutrition and exercise information designed to steer the punter away from becoming a diabetic.

Well the results are now starting to come in, so how did the SLMPs go?

The Health Department’s review of the program for the 2009-10 tax year concludes that uptake of SLMPs is “below the level anticipated.” Ya think? – just 680 people (out of an expected 45,500) bothered. I think we can safely conclude the government’s big gun in the war on diabetes has turned out to be somewhere between wishing and hoping on the scale of effective disease prevention measures.

But that may just be a good thing (or at least not a bad thing), because the evidence is that nutrition advice delivered in accordance with the current national guidelines is completely ineffective. A paper released by the Australian Productivity Commission this month concluded government funded childhood obesity (a strongly associated risk factor for diabetes) interventions to date “have not been effective in stabilising or reducing obesity prevalence to any significant degree.”

So it’s timely that last week the Harvard School of Public Health published the results of its meta-analysis of the research on the relationship between sugar sweetened drinks and diabetes. They reviewed eight high quality studies which involved 310,819 participants and 15,043 cases of Type 2 diabetes. Each of the underlying studies was significant in its own right and all had been concluded between 2004 and 2010.

All but one of the studies revealed a strong (and significant) association between sugar and diabetes. Taken together they showed that consuming one or more soft drinks (or fruit drinks or vitamin waters) per day would increase your chance of contracting type 2 diabetes by 26 per cent.

As convincing as this meta-analysis is, it just confirms what a very strong series of studies (on the link between soft drinks and diabetes) have been saying for over six years now. But the research has recently gone much further than mere population level correlations.

Last year researchers at the University of California fed volunteers diets supplemented with fructose drinks (the dangerous half of sugar). The result was a 20 percent decrease in the effectiveness of clearing the glucose out of the bloodstream – step one on the Type II Diabetes treadmill. And other recent studies have shown that when carbohydrates (including sugar) are pulled out of the diet, Type II Diabetes symptoms are actually reversed.

But if that wasn’t enough, there is even more powerful evidence of a link. Nestle Australia and CSR Sugar both go out of their way to say exactly the opposite. CSR says “There is no evidence that eating sugar causes diabetes” and Nestle chimes in with “eating sugar doesn’t directly cause diabetes.”

The Californian study lasted just 10 weeks (and clearly longer term studies are needed) but taken together with last week’s meta-analysis, red flags are waving all over the place. Sugar consumption creates type 2 diabetics. It shouldn’t come as much of a surprise then that as our per person sugar consumption soars past 1 kg per week, type 2 diabetics are being minted at the rate of 275 per day (and counting).

In the face of a deadly epidemic (accelerating at epic proportions) why do our healthy eating guidelines persist in advising that there’s nothing wrong with a diet that’s 20 percent sugar? Why won’t you find any warnings about not eating fructose on the Diabetes Australia website? And why is the Australian Diabetes Council saying it wants to “end the myth that sugar causes diabetes.” (!)

Besides being our 6th biggest killer, type 2 diabetes is the most common cause of blindness (for people under the age of 60) and responsible for more than 9 limb amputations a day in Australia.

Luckily, the science says this dreadful disease can be stopped easily – just eliminate sugar from the food supply. So how about we pay attention to what the science is (repeatedly) telling us and give that a go before we waste more time and money on interventions that patently don’t work?

Join the discussion 8 Comments

  • John Cox says:

    Follow the money…

    .. sad but true.

  • CJ says:

    If we stop eating sugar, the sugar companies will go bankrupt. If we are no longer sick from sugar, pharmaceutical companies will go bankrupt and then scientists will have nobody to pay off when it comes to touting the wonderful effects of cholesterol-lowering drugs.

    Like John Cox said… follow the money.

  • Hi!

    I’m missing a facebook “like” button.

  • Jeremy says:

    David, I don’t know how much of the Australian Productivity Commission paper you read (I admit I didn’t read it all) but the first paragraph I noticed was:

    Of the two long-term dietary related interventions, one focused on fruit and vegetable intake, and the other on reducing carbonated drink consumption . Neither intervention resulted in statistically significantly anthropometry (body measurement) differences between the intervention and control groups, although there was a reduction in self-reported soft drink consumption in the intervention
    group in one study.

    The nutrition advice you label as being completely ineffective includes cutting out soft drink.

    Reducing soft drink consumption didn’t appear to help, why? Not because the advice is wrong, but because it is harder to change peoples behaviours than you might think.

  • Jeremy,

    The interesting thing is that when go and read the actual study they cite as the source for that statement (see http://www.bmj.com/content/328/7450/1237.full) it reports:

    “At 12 months the percentage of overweight and obese children increased in the control group (the ones not told to drink soft drink) by 7.5%, compared with a decrease in the intervention group (the ones told not to drink soft drink) of 0.2% (mean difference 7.7%, 2.2% to 13.1%).”

    … and here’s a graph of the results http://www.bmj.com/content/328/7450/1237/F2.large.jpg

    I’m not at all sure how the authors of the Productivity Commission report arrived at the conclusion they did regarding this study …


  • Jeremy says:

    David, I looked at the actual study (thanks for the link)and the graph is very impressive, however the people who did the study themselves stated there was not a difference in the average BMI of the children (from 17.6 to 18.3 for the control group, and from 17.4 to 17.9 for the intervention group).

    I could only see the abstract for the other study I mentioned but I suspect that a similar thing occurred, ie there were improvements but the actual change in BMI was too small to be noteworthy.

    People continue to drink soft drinks and people continue to eat junk food, even the studies.

    Like the first 2 people said, “follow the money”, but they stopped too soon… the money comes from the consumers, the companies only make the products that people buy.

  • Andria says:

    Wow. At age 36, overweight and mother to a three year old. I decided to try and find out why there is a high incidence of type 2 diabetes and kidney failure in my matriarchal family.

    It has never been explained to me. My gp once put me on diabex. An endocrinologist put me on an androgen suppressant for my polycystic ovary syndrome, but no one told me what I read in your book yesterday.

    Thank you David. You are about to be responsible for extending my life past 60 and probably preventing my son from suffering the same diabetic fate as the rest of my aunties and uncles.

    Amazing. Amazing. Amazing.


  • Janelle says:

    In today’s Canberra Times (top of page 2 Monday 2 May 2011) is the headline “Cardiovascular funding aims to achieve better outcomes” and goes on to say how ACT Govt will tackle Australia’s biggest killer with a preventative program to be announced in tomorrows budget – A 3 year pilot project to improve detection and ensure Canberrans get help to decrease their risk by REFERRAL TO A COMMUNITY BASED LIFESTYLE COACH.

    Surely the $218,000 quoted could be used to disprove David’s work…unless of course it’s TRUE.

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