Thursday, April 11, 2013

Sugar vs fat? Know Your Poison - April 11th, 2013

Despite living in the 'low-fat' era, many of us have been implicating sugar (and refined and processed starchy foods generally), not fat, as the dietary driving force behind many of our twenty first century health woes. Of course, the 'low-fat' paradigm remains a virtually impregnable stronghold, propped up by official government agencies and their perpetuation of (so-called) healthy eating advice and an omnipotent food industry flogging us 'low-fat' products at every turn (all in the name of good health, you understand). But is the veneer finally beginning to fade on the low-fat hypothesis? Is the pendulum finally swinging away from fat as the harbinger of all things evil, to a new culprit, sugar?

A new meta-analysis published last week in the BMJ, examining prospective cohort studies and randomised controlled trials, found that both types of studies showed an adverse effect of sugar on body weight in adults [1]. This only really marks the tip of the iceberg of the deleterious effects of sugar on health. As spelled out in an accompanying editorial, consumption of sugar, and carbs in general, raises postprandial blood sugar levels and adversely affects aspects of the metabolic syndrome, increasing insulin and triglycerides, whilst reducing levels of protective HDL cholesterol [2].

This will come as nothing new to readers of our award-winning book The Health Delusion in which we not only reveal that strong evidence implicating saturated fat in heart disease just doesn't exist, but worse still, replacing it with high GI carbs dramatically increases the risk. For example, in a cohort study of 53,644 men and women over 12 years, replacing 5% of calories from saturated fat with high GI carbs was associated with a dramatic 33% increase in heart attack occurrence [3]. Stop and think about that and you see just how dumb 'low fat' foods, typically laced with terrifying amounts of added sugars to make them palatable, really are.

The eminent Willett and Ludwig, in their editorial, sum up the scale of the problem by drawing parallels between the harm caused by sugar to that of tobacco and alcohol when they conclude "Healthcare providers could play an important role by routinely asking about consumption of sugar sweetened drinks as well as tobacco and alcohol use, by setting a good example, and by assuming leadership in public efforts to limit sugar as a source of harm" [2]. It's hard not to be seduced by parallels with the tobacco industry. Intake of added sugars accounts for 15% of our total energy (that's the equivalent to eating nothing but sugar one day each week), and powerful economic interests are vested in keeping the sugar flowing via the production and sale of sugar-laced foods and beverages. That the sugar lobby continues to be vociferous in their denials that sugar is bad for health, has more than faint echoes of a tobacco industry that once tried every trick in the book to perpetuate the lie that smoking didn't kill.

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