Raisin Hell

Are Mums really United in their love of Margarine?

noreply@blogger.com (David Gillespie) — Mon, 21 Nov 2011 07:26:00 +0000

The Australian Heart Foundation has found a new and even more devious way to entangle itself with the interests of the processed food industry. Its new “Mums United” campaign pretends to be a grassroots movement for healthy living. But it walks like a margarine advertisement and quacks like a margarine advertisement, so guess what it I think it is.

The Heart Foundation’s “Mums United” campaign asks mums to “change the shape of Australia.” No earth moving equipment is required so I suspect they mean they’ll change the shape of Australians. Apparently ‘Dads’ are not up to the task (or is it just that in the Heart Foundation’s world ‘mums’ do all the shopping?).

Putting aside its deeply patronising premise, mums can get going with their ‘fat-busting’ using some tips from the Heart Foundation. Tip #2 is to make sure mums use margarine instead of butter.

The campaign was only launched last month, but already it has received impressive media coverage and has a facebook group with over 4,500 followers. Selin Tas posted a link to her blog post which says “We finished our [Mum’s United] meeting pledging never to purchase butter again”.

And Selin is not the only one. The facebook page is full of mums posting stories of how they have organised groups of fellow mums and sworn off butter. The casual reader could easily come to the conclusion that the Heart Foundation has tapped into a throbbing artery of desire (among Australian mummy bloggers) to change the health of a nation (or at least to eat more margarine).

Except that (rather like the construction of sausages) it is better not to look too closely at the process. It turns out that Mums United is an advertising campaign. Roberta Donovan, marketing director of the Heart Foundation explained to an advertising industry magazine “our campaign galvanises Mums into being part of an ongoing movement – one that sees Australians work together to achieve a healthy weight for the nation.”

The social media and word of mouth campaigns are being run through “conversation marketing agency” Soup. Their website tells us that they gave mummy bloggers “a $10 voucher” and asked them to “hit the supermarket and buy margarine instead.” Soup tells us that the “results were outstanding; most [mummy bloggers] reported ... they have since made the switch to margarine ...”

And Soup’s largesse doesn’t end there. Many of the bloggers report that Soup has sent them up to $350 of shopping cards to distribute as prizes to any readers who sign up to their facebook pages or comment on their Mums United blog posts.

It all sounds like a bonanza for the mummy bloggers and their readers (and at least according to Soup, its working). I asked the Heart Foundation who was paying for all of this. They told me that there are several social media campaigns being run by Soup on their behalf but they refused to say who was picking up the tab for any of them. All they would say is that companies entitled to use the tick can optionally get involved in “co-operative marketing” programs (like Mums United).

And this is by no means the only example of “co-operative marketing.” Last year the Heart Foundation was involved (judging by the prominent use of their logo) with a series of infomercial-type advertisements put together by Goodman Fielder (the manufacturer of Meadow Lea). The commercials featured a cardiologist who told us “what saturated fats can do to your child’s health”. He then goes on to suggest that we should switch to a margarine spread made with plant seeds.

You can still see the ad on a website called Spread the Facts which is “brought to you by Goodman Fielder” and which highlights the Heart Foundation’s recommendation that we swap margarine for butter.

The cosy relationship between margarine makers and the Heart Foundation is not new. In 2001, Bill Shrapnel (then a consultant nutritionist to Unilever Australia, maker of Flora margarine) pointed out that “Modern nutrition advice is one of the most negative influences on margarine consumption.” At the time, the Australian Healthy Eating Guidelines asked people to eat a low fat diet and this negatively impacted on margarine sales (as it is a visible source of fat).

But as Bill pointed out, things were improving (for the margarine manufacturers) because the Heart Foundation had just started recommending “an increase in the polyunsaturated fat content of the Australian diet of between 80 and 100 per cent.” He then suggested this represented “a rare opportunity” and that “[p]erhaps ... margarine companies should consider assisting the Heart Foundation in its educational activities about dietary fats.” It looks like they listened to that very sage marketing advice.

The only trouble is that they Heart Foundation’s own analysis of the evidence does not support its “co-operative marketing.” It is not hard to come away from the current campaign with the impression that eating less fat is good for your weight. But the Heart Foundation’s most recent (2003) position statement on the subject says exactly the opposite - “Dietary fat is not an independent risk factor for the development and progression of overweight and obesity. [my emphasis]”

And there’s absolutely no evidence that switching polyunsaturated fat for saturated fat will have any effect on weight whatsoever. That stands to reason. They are both fats, and they both deliver 9 calories per gram. As far as our digestive system is concerned they are identical.

Margarine can be legally sold in this country. And margarine companies are entitled to use every (legal) marketing tactic to sell their product. But why is our Heart Foundation rolling around in the marketplace with them? Why are they sneaking through the back alleys of the internet whipping up mummy blogger campaigns with gift cards? And why are they happy to create an impression about health benefits which they know not to be true?

The Heart Foundation’s tick program generates money for a charity and I guess that’s a good thing. But it comes with a heavy price. Co-operative marketing means the Heart Foundation’s health halo is sullied by commercial interests. It means (whether they intend it or not) that the Foundation becomes a spokesperson for the processed food industry. And the result is that the foundation is less an independent umpire and more a player from the other team wearing the umpire’s uniform.

So do us all a favour Heart Foundation and give your tick (and the phoney campaigns that come with it) the flick.

Let those who cause the pain, pay the tax

noreply@blogger.com (David Gillespie) — Mon, 31 Oct 2011 10:25:00 +0000

Sugar causes tooth decay. No sane scientist would argue that simple statement. It is about as controversial as saying day follows night. But treating tooth decay costs Australians $7.7 billion a year. Why are we not looking to the folks who sell sugar to help pay for that?

Certainty is a hard thing to come by in science. It is very rare indeed to find a group of scientists agreeing without exception to a cause and effect relationship. But there are some examples. You will not get a fight from anyone if you say that antibiotics cure most bacterial infections. And you’ll encounter even less resistance if you say that smoking causes lung cancer.

The statement that sugar causes tooth decay is even more certain. The statistics are clear. Populations exposed to sugar for the first time go from ‘background’ levels of decay (of around 4 cavities per 100 teeth) to ‘modern’ levels of around 24 cavities per 100 teeth. The mechanism is known and the science is uncontroversial. Not even Coca-Cola dares deny that sugar and tooth decay go together like peas and carrots.

Researchers have known since the 60s that tooth decay is caused by a little chap called Streptococcus Mutans (S. Mutans). It is one of the two to three hundred species of bacteria that inhabit our mouths.

Like most bacteria, S. Mutans loves a good feed of sugar. As it chomps down on the sugar molecules it produces lactic acid as a waste product. It’s that lactic acid that does the damage to our teeth. But under normal circumstances we are up to the task of protecting ourselves and avoiding tooth decay. Our saliva quickly neutralizes the acid and we regenerate any damaged enamel.

This is fine if the only sugar in our diet is glucose or carbohydrates that are converted to glucose (which is almost all of them). But, if there is some fructose available as well as glucose (oh, such as in table sugar – half glucose and half fructose), then through a quirk of evolutionary biology, S. Mutans has the upper hand.

S. Mutans can build itself a saliva proof home if fructose is also present. We call this little anti-saliva shield, plaque. Plaque binds S. Mutans to each other and to the tooth enamel. It traps the lactic acid against the tooth surface, protects it against the waves of saliva and gives it time to eat through the enamel.

If you really want to rot teeth, the most effective way is to give S. Mutans a constant wash of sugar solution (like soft drink or fruit juice) between meals. Eating sugar at mealtimes still works but it is nowhere near as effective.

S. Mutans has really enjoyed our change in diet in the last few decades. The amount of fructose laden, soft drink, juice and flavoured milk we drink has risen from virtually nothing prior to the Second World War to almost 1 litre per person per day. Consumption of soft drink alone has more than doubled in the last 30 years. And with this our need for dental services has also risen exponentially.

Every now and then politicians bow to public anger over the rising cost of dental services and mumble indistinctly about perhaps fixing the problem. Do they suggest limiting sugar consumption? Don’t be silly. How about asking the sugar purveyors to pick up the bill? Think again.

No, the politician’s answer is to make it our problem. First they try the chemical band-aid of dosing us all with fluoride, then, when that barely dents the costs, they reach for our wallet. The most recent go-round was Kevin Rudd’s ill-fated Denticare scheme, which suggested increasing the medicare levy by 50%. Heaven forbid a processed food manufacturer be presented with the bill.

Sugar rots teeth. The evidence is abundantly clear that, but for a constant wash of sugar between meals (topped up with some nice sticky fruit snacks), we would barely need to visit a dentist at all. So why are we not asking the folks who cause the problem to pay the bill? Or better still, stop creating the problem?

We have no difficulty asking the purveyors of cigarettes to kick in for the costs of treating the disease they cause. So why is the political response to the cost of dentistry a tug of the forelock and a scurry to collect more tax from us (whether we consume sugar or not)?

To be sure, $7.7 billion is a large bill to present to anyone. It represents about two and a half times the entire annual revenue of the Australian sweetened beverage industry. But it is also about 30 times the income tax they paid. Is it really fair that an industry contribute so pathetically to the cost of the damage they cause?

This is not a sin tax in disguise. It is repugnant for food nannies to attempt to make us healthy using the blunt instrument of taxation. If sugar is bad enough to require (at least) $7.7 billion of reparation every year then we should be removing it from the food supply. The level of harm it does is out of all proportion to its utility (is there any?).

But our governments clearly don’t have the moral and intellectual steel to bite that bullet. So let us at least insist that the most obvious part of the damage being caused (the part about which there can be no argument) be paid for by those profiting from our misery.

It's time to stop drinking the Kool-Aid of Public Health Dogma

noreply@blogger.com (David Gillespie) — Thu, 15 Sep 2011 01:00:00 +0000

One of the big complaints about research on fructose (the dangerous half of ordinary table sugar) is that many of the studies are done on rats, not humans. But a pair of recent studies have shown that sugar is just as dangerous for primates (including us) as it is for rats.

People defending our right to continue eating sugar (‘in moderation’ of course) frequently waggle their fingers at the studies and say just because it kills a rat doesn’t mean it will harm a human. One defender of the white stuff, Dr Jennie Brand-Miller, recently went so far as to suggest that sugar doesn’t do us any direct harm at all.

There’s a good ethical (and legal) reason that human studies are few and far between. The ones that have been done have inevitably resulted in immediate harm to the human subjects. A study where the expected outcome is to harm the participants makes lawyers nervous. I guess that’s why you don’t tend to see studies on what happens if you don’t open the parachute.

But the science needs to be done. There really is no other way to combat the incessant ‘sugar in moderation’ chant of the processed food industry and its toadies. Thankfully a few US Universities are prepared to push the envelope.

Just last week a team from Vanderbilt University’s paediatrics department published the results of their year-long study into the effects of fructose on Rhesus Monkeys. Their stated aim was to “induce insulin resistance” (the first step on the path to Type II Diabetes) in a primate using the same methods which are so successful in rodents.

The Vanderbilt folks chose Rhesus monkeys because they are physiologically similar to us and they develop the same chronic diseases that we do (and they are far less picky than humans about being locked in cages for 12 months). Dr Bremer and his team studied a group of 29 adult male monkeys aged from 12-20 years (approximately equivalent to human ages of 36-60).

At the start of the study, all the monkeys had perfectly normal blood glucose levels and were otherwise fit and healthy. The diet for the duration of the study was standard monkey lab chow (designed to give them all the nutrients they need in a healthy mix which is 59% Carbohydrate, 30% Protein and 11% Fat). They were also given access to up to 500ml per day of Kool-Aid. The monkeys could consume as much (or as little) of the food and Kool-Aid as they wanted.

Kool-Aid is a fruit flavoured powdered sugar drink mix sold in the US. The closest Australian equivalent is Tang (which is really just Kool-Aid with a multi-vitamin chucked in). The Kool-Aid delivered up to 75g of pure fructose a day to the monkeys. I say ‘up to’ but the reality was that the monkeys drank the Kool-Aid and then topped up their calories with chow. They weren’t going to leave any of the good stuff in the tin.

Unfortunately for our furry friends, they were never healthier than when they hadn’t drunk the Kool-Aid. Four of them developed Type II diabetes between 6 and 12 months after starting. The rest of them were well on their way to the same destination (with blood glucose and insulin readings that would have had them on the latest anti-diabetes drugs if they had been humans).

They put on weight (an average of 9% of their starting weight), the percentage of their body which was fat increased by 15%, they ate more of everything, exercised less and their blood lipids were a mess.

Their fasting triglycerides (a strong risk factor for heart disease) increased by a whopping 87%, HDL (good) cholesterol decreased and LDL (bad) cholesterol increased (by 14% each). In other words these critters were also on the fast track to a heart attack.

The experiment would have been better if they’d had 29 monkeys eating nothing but chow to compare the results to. But there is no evidence to suggest that monkeys on a standard lab chow diet ordinarily develop these symptoms (and certainly not in less than a year).

The researchers set out to give diabetes to a group of primates (with an almost identical metabolism to ours). All they did was allow them access to a sugar which is plentiful in our food supply. They didn’t test chemicals on them. They didn’t inject them with drugs. They just fed them with the same stuff we give our kids. And they achieved their aim – four had diabetes and the rest were on their way – in less than a year!

Still not enough to get you to step away from the Froot Loops? Still not ready to believe, ‘till they do this to humans? Then you’re in luck, because a human study has also just been released.

This time, a team at the University of California convinced 48 healthy (human) adults to consume four cans of soft drink a day for two weeks (about the same as one in 20 Americans do every day of their lives). Some of the soft drinks were sweetened with glucose, some with fructose (the two halves of sugar) and some with High Fructose Corn Syrup (55% fructose, 45% glucose).

And guess what? That’s right, the result was exactly the same as for the monkeys. The blood fat measurements (which point to heart disease) started going in the wrong direction for the fructose and HFCS groups (and nothing happened to the glucose group). No-one was given diabetes, but it was just a 2 week study.

Try as they might, researchers have never been able to get results like these by feeding people fat or stopping them from exercising. But these latest studies could barely be more definitive on whether there is danger in that thar can of soda.

Eat fructose and the only question is when you will develop diabetes and heart disease. If you happen to be a Rhesus Monkey (well done, you, for being able to read this) you have as little as six months, if not, you might get a bit longer. But have no doubt, it will happen.

The Glycemic Index has passed its use-by date

noreply@blogger.com (David Gillespie) — Wed, 13 Jul 2011 09:30:00 +0000

The glycemic index (GI) is not just bad science, it has a dangerous loophole big enough to drive an ice-cream truck through. Its time it went to the place where old (and wrong) public health messages go to die.

Wendy’s Chocollo (with waffle cone), Bulla Light vanilla ice-cream, Nestle Milo, Uncle Toby’s Choc Chip Crunchy Muesli Bar and CSR LoGiCane Sugar all have something in common. Yes, they’d all look pretty good on the dessert menu, but they also share something else. The owners of each of these products (and almost a hundred others like them) have paid for the right to display a GI Symbol.

Much like its more famous cousin (the Heart Foundation tick), the GI Symbol is designed to guide confused consumers towards “healthier choices” in the supermarket.

The symbol alerts us to foods which have a low glycemic index. The GI is a measure of the amount that a food affects our blood sugar levels. Our body converts most of the carbohydrates in our food to blood glucose. This causes a spike and then a decline in the amount of glucose we have in circulation.

But not all foods are equal. Some (like glucose) spike our blood sugar levels more quickly than others (like potatoes). This is because the carbohydrates in some foods are more quickly converted to blood sugar than others.

The glycemic index of a food is measured by comparing the way a healthy person’s blood sugar level responds (over a 2 hour period) to 50g of glucose and how they respond to 50g of carbohydrate in the food being tested (let’s say boiled potatoes). If the tested food produces an effect which is 70% of the one measured for the glucose then it is said to have a GI of 70. A low GI food is one which has a GI of 55 or less (meaning that the blood sugar response is 55% of that of pure glucose over a two hour period).

The theory goes that if we could make sure we were eating just the foods which have a low impact on our blood sugar, then we would keep our blood sugar levels more even (and presumably somehow be more healthy as a result). I say presumably because there is a real scarcity of credible evidence that the GI of a food has any measurable (positive) health impact.

GI may be a pointless academic exercise but it is not a harmless one. It has a hidden danger in that the carbohydrate it assigns the lowest (and therefore the best) rating is fructose (it has a GI of 19). Fructose is a very sweet tasting (almost twice as sweet as sugar) carbohydrate that does not produce a significant blood sugar response.

When this little quirk of fructose was first discovered (in the early 1980’s) it was pronounced a miracle sugar for people with diabetes. They could have sweets just like everyone else and their blood sugar would never spike as long as the sweets were made with fructose. Even some sugar was ok too (because, being half fructose, it also has a low(ish) GI).

Diabetes organisations the world over happily advised diabetics they could eat sugar or, even better, pure fructose. Unfortunately for sweet tooths everywhere, by about 2001, it was becoming abundantly clear that the ‘no free lunch’ rule applied (or was it no free pudding?). Fructose was even more dangerous for diabetics than sugar.

It turned out that the reason fructose didn’t have a big glycemic index was because it is converted to fat (by our liver) and not circulating blood sugar (like just about every other carbohydrate). Telling diabetics (or anyone else, but particularly diabetics) to consume a substance that was immediately converted to fat was a very bad idea (verging on the culpably negligent).

The American Diabetes Association quietly withdrew its recommendation in 2002, but the message never got through to Australia. The Australian Diabetes Council tell us they “want to end the myth that sugar causes diabetes”, apparently because sugar-free diets aren’t “much fun.”

And the folks selling the Low-GI stickers (the GI Foundation – a collaboration of University of Sydney, Diabetes Australia and the Juvenile Diabetes Research Foundation) still tell us it is “best to ignore the sugar content of a food and instead focus on the food’s GI.” A director of the GI Foundation (Sydney University nutritionist Jennie Brand-Miller) even went so far as to say recently that “Unlike saturated fats, trans fats, salt and alcohol, sugar doesn't actually do any direct harm to the human body.”

For the last decade (at least), the research on fructose (and sugar) has shown again and again that exactly the opposite is true. Fructose consumption is a causal factor in obesity, heart disease, hypertension and Type II Diabetes. It is implicated strongly in cancer growth and it is highly likely to be behind the explosion in the number of cases of chronic kidney disease and fatty liver disease.

That all sounds pretty harmful to me. So perhaps that is why the American Heart Association recommended (after reviewing all the evidence in 2009) that Americans needed to dramatically reduce their sugar consumption. Men should consume no more than 9 teaspoons of sugar a day (about a can of soft drink’s worth). That’s less than half the current (vague) Australian recommendation (of about 23 teaspoons a day).

Just like skinny leather ties and big hair, the glycemic Index seemed like a good idea in the eighties. It held out hope (for a dessert filled future) to millions of diabetics everywhere. But science eventually found out what was really going on (as it usually does) and the world moved on.

In Australia we got stuck on the notion that GI should work (and to this day stubbornly refuse to acknowledge the fructose loophole). The food industry leapt on the marketing power of a ‘healthy label’ that meant they could still use as much sugar as they wanted. Positions became entrenched. Reputations were built. And as a result we now have folks like the GI Foundation and the Australian Diabetes Council telling us there’s nothing wrong with eating sugar.

This would all be mildly entertaining if we weren’t talking about real people with very real (and very life-threatening) problems. Every day in Australia nine people lose a limb to Type II diabetes (and 275 more people develop the disease). Every day the number of obese children grows like never before in human history. Every day the number of new cases of chronic kidney disease sets a new benchmark.

The science says all of this misery (and lots more) can be traced back to eating sugar. So how about we stop playing ducks and drakes with quaint scientific notions (that protect the processed food industry from having to face reality). How about we start caring about the people who follow the advice they see on a packet of food. How about we face the truth about sugar and demand that those we pay to care - do.

How Fructose makes us Unhappy.

noreply@blogger.com (David Gillespie) — Tue, 31 May 2011 22:48:00 +0000

We don’t know what causes depression and we certainly don’t know how to cure it. But some interesting new research suggests that there may be a very strong link between depression and what we shove in our gobs.

Depression is a catch-all diagnosis for a spectrum of illness affecting our mood. The spectrum covers everything from a mild bout of feeling down through to the most severe Major Depressive Disorder.

We can become depressed because things aren’t going well. If having your cat run over doesn’t alter your mood (one way or the other depending on how you feel about cats I guess) then you were probably built by aliens. But the science suggests how long we stay depressed has more to do with biochemistry than the state of Fluffy’s road-safety skills.

Food makes us happy (I know, you’re shocked at this revelation). Even seeing food improves our mood. This is because the anticipation of a feed, fires up the hormones responsible for how we feel.

The sight (or smell) of food gives us a squirt of the pleasure hormone, dopamine. Dopamine focuses our attention, makes us think more clearly and helps us move faster and more effectively. It’s an important signal to our body that we are in for something good and we need to pay attention. And that was probably pretty handy in times gone by (when dinner was on the hoof rather than in the burger box)

Once we actually start eating, serotonin kicks in. The serotonin makes us feel happier and less stressed. We relax, our mood improves (Fluffy will still be road kill, but we’ll feel better about it) and our minds can turn to less important things than eating (such as sex - the anticipation of which will give us another dopamine hit and the aftermath of which will give us a nice relaxing serotonin hit). While the cliché that the way to a man’s heart is through his stomach may be the G-rated version – it is largely accurate.

Researchers have known for a long time that severe depression is strongly associated with an inability to properly absorb serotonin in the brain. No (or low) serotonin absorption makes it much harder for us to come back from unhappiness. And this can translate into anxiety and depression if it’s sustained for long enough.

The primary anti-depressant drugs available in Australia (Cipramil, Luvox, Prozac, Lovan, Aropax and Zoloft) all work by targeting the serotonin system. They give the brain more time to absorb the serotonin. Some other drugs (Ecstasy, Amphetamines and LSD) work by enhancing the amount of serotonin we produce (but you might find it tricky to get a prescription for them).

If all is well with our hormone system then severe depression should be an extremely rare disease. But it’s not. Most studies suggest that one in ten of us is suffering some form of depression at any given time. So it won’t come as too much of a surprise to discover that one in every 30 GP consultations in Australia is now about depression.

Depression is a major chronic health problem and it is getting much worse at a very rapid rate. Something is messing with our serotonin system and the evidence is starting to mount that the something is fructose.

Fructose is the only carbohydrate which produces a significant spike in our cortisol levels. Cortisol is our stress hormone. It’s terribly handy for confrontations with unexpected bears (for example) because it ramps up dopamine (to focus the mind and sharpen the movements). It also rapidly increases the amount of dopamine we can absorb. But it does so at the expense of our ability to absorb serotonin.

We like dopamine. It is our reward drug. Frequent hits of fructose mean frequent hits of dopamine. This leads inevitably to fructose addiction and that is exactly the mechanism used by other man-made opiods (like nicotine and cocaine). The trouble is that it seems the upregulating of dopamine at the expense of serotonin can become hard-wired if we allow it to go on for long enough. And once we’re addicted, we cant help but let it go on for long enough.

We don’t run into that many bears on a daily basis (well, I don’t). Fructose was once about as common as a bear encounter, but is now embedded in almost every processed food we buy. And it has an addictive quality as powerful as nicotine (so it isn’t exactly going to harm sales now is it?).

We are now on a constant drip of fructose. That means we are on a constant cortisol (and therefore dopamine) high. This in turn continuously impairs our ability to absorb serotonin, the one substance that can turn our mood around.

Fluffy will still become a bumper sticker if he chooses an inopportune moment to cross the freeway and that will probably be a downer. But the science is suggesting that how quickly (or if) we bounce back from that may depend (to a large extent) on how much fructose we are eating.

In an environment of non-stop fructose infusion, the wonder is not that one in ten of us is depressed, it’s that nine in ten of us aren’t (yet).

I'll be talking more about the link between Fructose and Depression at the upcoming conference on Happiness and its Causes - June 16-17 at the Brisbane Convention Centre.

How Diabetes drugs stop us losing weight (and do nothing but delay the inevitable)

noreply@blogger.com (David Gillespie) — Sun, 08 May 2011 09:41:00 +0000

Drug companies have a solution to Type II Diabetes unfortunately their ‘solution’ will make us almost as fat as their wallets (and won’t change the outcome). The real solution is much simpler and you don’t need to buy anything from anyone to implement it.

Our body is a machine that runs on a fuel of pure glucose. When we eat carbohydrates (like fruit, vegetables, bread, pasta and rice) our liver converts the starch in those foods to glucose. Almost every cell in our body can burn (or oxidise to be more precise) the glucose to create energy.

Managing the fuel (glucose) levels in our blood is therefore pretty important to our wellbeing. The level of glucose is managed by two primary hormones. We release insulin when blood glucose goes up and glucagon when it drops.

The insulin helps cells access the glucose in the blood and either use it (if they need it) or turn it into fat for storage. Either way, a primary function of the insulin is to lower the amount of glucose in our bloodstream. If blood sugar stays high for a long time, damage starts to occur in places where we have lots of small blood vessels, such as our kidneys, our eyes and eventually our hands and feet.

Glucagon does the same thing in reverse. The combination of the two hormones working together means that normally our blood glucose levels stay in tight range regardless of what (or when) we eat.

Sometimes we can become resistant to insulin. This simply means that cells do not respond as efficiently as they should and glucose stays in our blood for too long.

Doctors can tell when we are insulin resistant because our blood glucose levels remain too high for too long after eating. But (at least at first) there are no real symptoms that we have the problem. And so a majority of people who are insulin resistant don’t know it.

If you remain insulin resistant for long enough, at certain levels, you will be declared to have Type II Diabetes.

Our body usually responds to insulin resistance by pumping up the insulin levels until the glucose is cleared. If we ask our body to run on overdrive like that for years, for most of us, our pancreas (the insulin maker) will pack it in and we will need to get daily insulin injections to live.

One carbohydrate (and only one) does not work this way. Fructose is not normally converted to glucose and does not trigger an insulin release. It is instead converted to saturated fat by our liver. So for a long time, fructose was prescribed as a perfect sugar for Type II Diabetics. Unfortunately it looks like that cure is turning out to be the cause of the disease.

Last week, the American Heart Association issued a scientific position statement which makes it clear that they are satisfied that fructose does indeed create dangerous levels of circulating fats (called triglycerides). The statement went further and warned that the creation of triglycerides is directly linked to the onset of the insulin resistance which leads to Type II Diabetes. In other words, fructose consumption is likely to be a significant cause of Type II diabetes.

The primary source of fructose in the Australian diet is sugar. So the obvious cure for Type II Diabetes would be to tell people to stop eating sugar. But there is no money in telling people to not eat something.

No, if you are diagnosed with Type II Diabetes in Australia today you will be put on drugs to sort you out (after a perfunctory nod to ‘lifestyle interventions’).

The standard treatment for high blood sugar (and therefore diabetes) is a prescription of ‘eat less fat and exercise more’. When that doesn’t work (as it almost never does) the prescription is changed to a combination of drugs.

There are a few different types of medication but the ones most commonly used in Australia work by stimulating the body to produce more insulin. The drugs squeeze that little bit more insulin out of our pancreas to help clear the blood sugar. As you might expect, putting the pancreas on overdrive eventually results in it conking out completely. Then the only option is to start injecting insulin every day.

Unfortunately a side effect of the drugs is weight gain. Insulin does clear glucose from the bloodstream, but if the cells don’t need the glucose, they just turn it into fat. Giving people more insulin (or giving them drugs to force them to produce it themselves) simply channels sugar out of the bloodstream and converts it into body fat.

Using drugs to force insulin resistant person to make more insulin just moves the immediate problem from the bloodstream to the tummy (or bot-bot). And even then it only works until the pancreas packs it in anyway. Removing the cause (fructose) would be infinitely more effective but if the drugs remain part of the prescription while that is going on, motivation will soon be a problem (because it will be very difficult to lose weight).

We need a new approach to treating insulin resistance. We need an approach based on the science rather than one based on a drug manufacturer’s bottom line. People diagnosed as being insulin resistant (or ultimately Type II Diabetic) should be told the truth about sugar and then told how to remove it from their food supply.

When this happens (and only when this happens) will we start to make a real difference in the progress of a disease that is responsible for more than 9 limb amputations a day in Australia and is our 6^th biggest killer (heading for #1 with a bullet).

Selling the ‘cure’ with the disease

noreply@blogger.com (David Gillespie) — Mon, 21 Mar 2011 04:08:00 +0000

Nestle has shown the way forward. It simultaneously sells the cause of obesity (sugar based confectionary and breakfast cereals) and some of the most popular ‘cures’ (Jenny Craig, Optifast shakes and Lean Cuisine frozen meals). But now a vitamin pill maker is taking it one step further by putting the disease and the (suggested) cure all in one delectable gummi bear shaped package.

Last month Pharmacare Laboratories released (what it undoubtedly hopes is) a game changer in the children’s vitamin supplement market. Its Nature’s Way Vita Gummies embed vitamins in delicious sugar filled gummies. And just for good measure they have former Olympian (and now Biggest Loser host) Hayley Lewis pushing them on the teev.

Shouting about the vitamin benefits of a food while blithely ignoring the other 99.99% of the product is not a new tactic in the processed food industry. Streets want every child to get their ‘afternoon calcium’ (and Vitamin B12 and Phospherus) from their Paddle Pop Moos. They proudly proclaim every single ice-block has the calcium of ‘1 Glass of Milk’ but leave the fact that it is 20% sugar to the small print.

Nestle would rather the kids get their daily calcium (and magnesium) from its (Heart Foundation approved) Milo Duobreakfast cereal (30% sugar) or a nice (Heart Foundation approved) chocolate Billabong (18% sugar). Really health conscious kids are encouraged to get “50% of their wholegrain target” by chomping on some Uncle Toby’s Oats, So Tasty for Kids (30% sugar).

For that after breakfast snack, Kellogg’s wants you to feed your young iron-men Nutrigrain Bars and perhaps give the other kids some nice (Heart Foundation Ticked) K-Time Twists (both 37% sugar). And don’t even get me started onLCM’s (also 37% sugar) and their schoolyard commercials.

I guess you could (almost – at a very big stretch) justify that kind of marketing if there was any evidence (whatsoever) that the average Australian needed any more of those Vitamins or minerals. Vitamin supplements have only been part of our food supply since just before the second world war. Prior to that our Grandparents and their grandparents managed to struggle through life without any supplementation at all.

The need for vitamins only arose because two hideous diseases reached epidemic proportions in the early part of the 20^th century. In south-east Asia beriberi was rampant because (it turned out) Europeans had started using steam driven mills to turn brown rice into white rice (and in the process stripping out Vitamin B1). And at almost the same time in the southern United States pellagra was inflicting mass agony because Europeans had decided that treating raw corn with lime (a process the Indians had used for millennia to activate the Vitamin B3) was a waste of time and money.

South East Asians derived almost all their nutrition from rice at the time and poor farmers in the southern United States derived almost all of their food from corn. Messing with those two fundamental food sources resulted in mass deficiencies which led to disease. The only other two significant deficiencies which have (in modern times) resulted in widespread disease are scurvy (if you happen to be locked in a boat without access to anything but dry biscuits and rum for six months) and rickets (if you use too much sunblock).

The reality is that the overwhelming majority of people living in Australia today have no more risk of being functionally deficient in any vitamin than I do of becoming the Queen (of England that is). Our bodies are extraordinarily efficient at extracting exactly what we need (and no more) from our food (mostly from meat) and excreting the excess. If you are inclined to the I’ll-top-em-up-just-in-case persuasion, the research suggests you are just flushing your money away.

One of the most thorough (but by no means, not the only) recent studies was the Physicians Health Trial. In that study, 14,641 US doctors were followed for 10 years while they took either Vitamin E or Vitamin C supplements, the two vitamins which are heavily promoted as having anti-oxidant (and therefore heart disease related) benefits.

Half of the doctors were actually taking placebos instead, but neither they nor the folks assessing the results knew which was which. The double blind (no-one knew who was taking what), randomized nature of the trial (together with its large size and long duration) means that it is very high quality evidence.

The point of the trial was to figure out whether the supplements had any effect at all on heart disease and stroke outcomes among the participants. And what they found would have been very disappointing for the supplement industry indeed. There was exactly no difference between the heart disease outcomes for any of the groups.

The Vitamin E folks had just as many heart attacks as the Vitamin C folks. And they had just as many as the folks taking nothing. The resounding conclusion from the study is that if any of the participants had been paying for their vitamins, they would have been well and truly wasting their money (for ten long years). While we certainly need Vitamin E and Vitamin C, it seems shoving more of it in our mouths changes absolutely nothing (except the bank balance of the folks selling the supplement).

Similar high quality trials on Vitamin D, Calcium and Vitamin B supplements have arrived at exactly the same conclusion – don’t waste your money. And as the makers of Berocca have just discovered, making claims to the contrary can get your expensive advertising campaign banned.

Despite our extraordinarily efficient efforts at mining food for nutrients, we can damage our ability to use the vitamins and minerals we do absorb. Sugar consumption interferes with copper metabolism which can result in impaired muscle growth (in children) and problems with vein and artery wall formation. It also leads to impaired iodine absorption (and therefore thyroid hormone production) and degrades our Chromium stores (which leads to insulin resistance and Type II diabetes) just to name a few of its more delightful features.

Vita-Gummies (at 23c a throw) are about 8 times the price of garden variety gummi bears (which are aren’t laced with precursors to expensive urine) but they do contain just as much life sapping sugar (something which unfortunately ends up around our waist and not down the drain).

Selling ice-creams and lollies as health food (to children and their parents) when they are in reality a package of pure sugar is unbelievably perverse. Engaging the services of Hayley Lewis’ hard earned reputation to do it is just plain deceptive.

Unfortunately nobody is breaking any laws telling us that a sugar loaded sweet (with a vitamin chaser) is good for us. And so the marketers go to town. But where do we draw the line? Chocolate coated carrot shavings, sold as Vegies the Kids Will Love (no, Nestle that is not a suggestion)? This pathetic game must stop. It’s time for truth in labelling. Surely our children are worth that much.

Heart Foundation says sugar isn't relevant.

noreply@blogger.com (David Gillespie) — Wed, 02 Feb 2011 06:52:00 +0000

The Heart Foundation has finally trashed the last of its credibility.

Last week, (an ecstatic) Nestle announced that it had secured a Heart Foundation tick on 44 of the 46 breakfast cereals it sells in Australia.

The line-up of tick-approved products will now include some of the highest sugar breakfast cereals on sale in Australia. Milo and Milo Duo (both 29.7% sugar), Uncle Toby’s Oats Temptations (up to 34% sugar) and Uncle Toby’s Healthwise for Heart Wellbeing (30% sugar) will join the Kellogg’s Just Right (31.1% sugar) on the list of cereals the Heart Foundation says you should be eating.

The only two Nestle breakfast cereals now lacking the tick of approval are Nesquick (31.7% sugar) and Uncle Toby’s Plus Protein Lift (25.3% sugar). But don’t worry they’ll both be tickety-boo in no time. They’re currently being “reformulated”.

Nestle won’t have to worry about reducing the sugar content while it is reformulating. You see, the Heart Foundation doesn’t care about the sugar content of a tick-approved product.

A fan of my blog shared some his correspondence with the Heart Foundation this week and it revealed some interesting insights into the process.

The Heart Foundation said:

“Sugar is not a criterion because added sugar and natural sugars have similar effects on the body and based on the current level of evidence, sugar is not directly linked to [heart disease], diabetes, or obesity.”

Which is a really odd stance to take because even the briefest glance at the scientific literature would reveal that the cup of evidence against sugar runneth over.

Take for example the recent review of the evidence (published in theAnnals of the New York Academy of Science), which concludes:

“…recent data suggests that fructose consumption in humans results in increased [stomach fat], [fat] dysregulation, and decreased insulin sensitivity, all of which have been associated with increased risk for [heart] disease and type 2 diabetes.”

Perhaps the Heart Foundation forgot to renew its journal subscriptions because its “evidence” proves sugar is not dangerous. If (by evidence) you’re thinking about an extensive literature review (oh say, like the one I just mentioned), you’d be unfulfilled. If you’re thinking about a series of population studies, disappointment is in your future. Even if you’re thinking of a single rat study, you’re aiming too high.

No, the Heart Foundation’s “evidence” appears to be a single graph. The (unattributed) graph shows an increasing trend of obesity plotted against a decreasing trend of sugar consumption. There’s no sign of any evidence about heart disease or diabetes, but perhaps we just have to take those on faith.

Under further questioning, the Heart Foundation revealed to my correspondent that the source of the graph was the research conducted by Alan Barclay (the chap who helps the folks slapping low-GI stickers on packets of sugar). They referred him to theDietitians Association press release about Dr Barclay’s study for confirmation.

Unfortunately, Dr Barclay’s paper has not been published, so figuring out how he arrived at the graph is a little difficult. Just about the only thing that is clear is that the graph produced by the Heart Foundation bears no relationship to the data on sugar availability (there is no current consumption data) from the Australian Bureau of Agricultural and Resource Economics (a government department).

ABARE seems to think that Australian domestic sugar availability has gone the way we might have expected it to (from about 45 kilograms per person in the mid-‘80s to about 62 kilograms per person in 2009).

But even if the Heart Foundation’s graph was entirely correct, what would it prove? Well, nothing really. No one is suggesting that sugar consumption today results in instantaneous population-wide obesity.

The science says that (one of the ways) fructose makes us fat is by interfering with our appetite control over decades of continuous consumption. The cumulative effect of this is steadily increasing weight and concurrent metabolic dysfunction (which make us prone to Type II Diabetes and Heart Disease).

The increase in obesity statistics we are seeing now is likely to be a result of the appetite disruption (caused by sugar) between the Second World War (or even earlier) and now. So comparing today’s obesity statistics with today’s consumption is a pointless academic folly (even if it were accurate).

That would be rather like looking at this graph of lung cancer death versus cigarette consumption in 1980 and concluding that there was no correlation (because the lines had gone in opposite directions since 1960). But this is exactly the scientific method that the Australian Heart Foundation has deployed in justifying its stance (that sugar is not a relevant criteria for its tick program).

That’s not just bad logic, it’s not even bad science, it’s just straight out deceptive. I guess this all raises the question, why would anyone (least of all the Heart Foundation) be attempting to prove we eat less sugar now? One glance at the local supermarket (especially the breakfast cereal aisle) will tell us that is patent nonsense, so what would motivate someone to suggest it is so?

I hope it’s not just the lousy few million smackeroos the foundation makes every year from this little jape. Because if that’s the sole motivation behind this pathetic denial, then it is a dreadfully low price to pay for the health of a nation. The cynical lawyer in me suspects somewhere, somehow, someone is making real money out of this, but the father in me just wants the deception to stop — now.

Let’s stop treating obesity like it’s a disease.

noreply@blogger.com (David Gillespie) — Wed, 12 Jan 2011 11:22:00 +0000

It’s January, the month of the diet. Prepare to have the secret of weight loss bestowed upon you every time you pick up a newspaper. But the reality is we have no more chance of losing weight on a ‘diet’ than we do of flying by flapping our arms.

No matter how special we’d like to think we are, when it comes to our body, we are just mammals. Ok we’re pretty bright mammals (well you are, if you’re reading this). But for all that braininess, the carcass we walk around in is 100 per cent pure mammal.

Just like every other mammal, we have a sophisticated mechanism for making sure we keep functioning. On auto-pilot, we keep our heart beating, our lungs pumping and our temperature stable. We also ensure that our brain (and every other cell in our body) has exactly enough fuel to perform at its best (regardless of what’s going on in the outside world). None of this requires a moment’s thought (literally).

The control system for all of these (and infinitely more) processes is our hormones. Hormones tell our bodies when (and how much) to grow. They tell (some of) us when to prepare for making babies. And they control how much fat we store (and where we store it).

We can’t control our hormones with will power (or any other conscious thought). We can no more think ourselves taller (or shorter) than we can think ourselves a lower body temperature.

A child grows because hormones tell every (relevant) part of the child’s body to grow. The hormones instruct the cells to demand more energy and other hormones accommodate the demand by up-regulating appetite control. The child eats more and has the building blocks for growth. The growth drives the appetite, not the other way round.

The science is now abundantly clear that another type of growth (this time horizontal) is also hormone driven. Our appetite control hormones are exquisitely balanced to ensure we have just the right amount of energy on hand.

But when that balance is disrupted, our fuel management system can veer wildly out of control. A disrupted appetite control system can store too little or too much fuel. Too little looks like anorexia, too much looks like, well, most of us. Obesity is a symptom of a failure of the balance of hormones controlling how much food we take in.

This hormone dysfunction causes us to store too much fat in our cells, but the body is not aware the fat is there and keeps demanding food. Our appetite control system thinks we are starving even while we have more than enough fat being packed away (usually in very unsightly places).

A growing child can’t fight hormone driven appetite demands with willpower. And we can’t control weight gain with willpower either.

When an obese person restricts the amount of food they eat, they are not changing the underlying error in the appetite control system. The body thought it was starving before the diet, now it’s really starving. It will not use the fat store to satisfy its need for food because the hormonal disruption means it doesn’t even know it’s there.

The hormones will force the body to sacrifice muscle and even organs to make up for the missing calories. And the whole time, the dieter will feel like they are starving to death. No wonder no-one can stay on a diet (long term).

Obesity is a symptom of appetite control dysfunction, but it is not the only one. Heart disease, type II diabetes, kidney disease and dementia (to name just a few) are all symptoms of the same underlying disorder. And just like symptoms of any disease, not everybody has all the symptoms appear at the same time.

Not all Kidney disease suffers are obese (but most are). Not all heart disease victims are obese (but most are). And 15 percent of Type II Diabetes suffers are not overweight.

We are frequently told that the ‘cure’ for most of these diseases is cure the ‘disease’ of obesity (and the way to do that is to eat less and exercise more). But that is the same as being told to take panadol to ‘cure’ a toothache. It will (temporarily) eliminate (or reduce) a symptom, but it does absolutely nothing for the underlying cause.

Recent studies have proven beyond doubt that we can induce all of the symptoms of appetite hormone disruption in humans by simply feeding them the fructose half of sugar. The cluster of ‘symptoms’ of the fructose appetite disruptor is currently costing our health system more than $60 billion (three times our defence budget) a year. And it is costing individuals much more than that (in quality of life) every single day.

But so far there is no sign that those in charge of our health dollars are prepared to look any further than the ‘panadol cure’.

The plan is to keep telling fat people they are fat because they make ‘poor choices’. The plan is to tell people to control hormones with willpower. And the plan is (apparently) to continue to support the explosive growth of industries which take our money to ‘cure a disease’ (when all they are doing is masking a symptom).

Lap-banders, shake-sellers, liposuction merchants and wellness providers will continue to lobby government for more and more public money. And (when they give in) health bureaucrats will justify the expense with (increasingly) bellicose demands that we trim down. But the science says we can expect that Plan to have just as much success as it has in the last four decades (during which overweight and obesity rates have doubled).

A change of course will be a great embarrassment to many eminent ‘health professionals’, but change course we must. So as you flip through the avalanche of calorie reducing diets from the New Year health gurus remember panadol doesn’t cure rotten teeth. And we will not cure obesity until we start treating it as a symptom rather than a disease.

How Fructose makes you AGE.

noreply@blogger.com (David Gillespie) — Fri, 24 Dec 2010 05:55:00 +0000

The fructose half of sugar causes irreversible cellular damage. And this damage may just be the thing which links most of the diseases of the Western World (oh, and makes us prematurely elderly as well). But there is a way to limit the damage. No its not a drug (although plenty of people are trying to find one). All you have to do is stop eating sugar (<gasp>).

Enzymes control chemical reactions in our body. If we need a sugar (like glucose or fructose) to be attached to a protein for some purpose, the appropriate enzyme will make sure the sugar gets attached to exactly the right part of the protein (or fat). The process of attachment is called glycosylation and we are only just beginning to understand the enormous array of uses our body has for glycosylated proteins (such as fending off disease and even inhibiting the development of Type II diabetes).

It is however possible for sugars to accidentally attach themselves to proteins without an enzyme’s help. When that happens, the process is called glycation. Glycation can result in sugars being attached in all sorts of unpredictable (and haphazard) ways.

Glycation happens by accident and is really only likely to happen when our blood sugar levels are high (the more sugar molecules there are floating around the more likely some of them are likely to crash into a protein). The good news is that in normal circumstances glycation is reversible. As soon as blood sugar levels drop, most of the sugars and proteins will disengage and no harm is done.

But if blood sugar stays high (as is the case with someone who is diabetic or pre-diabetic), the sugar-protein combo will undergo a series of reactions that will result in the creation of an Advanced Glycation End-product (AGE).

All sugars can form AGE’s, but the glucose half of sugar is the least reactive of all sugars. This is a good thing because it is the primary sugar in our bloodstream. The bad news is that the fructose half is ten times more reactive than glucose.

Eating sugar gives us a big shot of fructose and a big (and immediate) increase in AGE production. Making things much worse, fructose consumption also leads to an increase in insulin resistance. Over the long term the insulin resistance creates an environment where our blood glucose levels are persistently elevated. And this creates a second major source of AGE’s.

If your doctor suspects you of being diabetic, they will often test your HbA1c (or A1c for short) level. The test measures the level of a glycated form of haemoglobin (the protein which transports oxygen in your blood). A high A1c level indicates that there are significant AGE levels. That is taken as a sure sign that your blood sugar is persistently too high.

Our body’s 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 like John Farnham on a comeback tour.

AGE’s are junk, litter on our body’s interstate highways. But this is not a burger wrapper chucked out the window. This is more like the (exploding) roadside litter our troops encounter in Afghanistan. AGE’s are dangerous because they bond easily (and randomly) to each other and to other proteins in a process called cross-linking.

AGE’s accumulate pretty much everywhere in the body, but in some places they do much more damage than others. When they pile up in the lens, cornea and retina of the eye they result in cataracts and macular degeneration (the leading cause of blindness in Australia). They also accumulate in the fine tubules of the kidneys - resulting in loss of kidney function.

They cross-link the collagen which otherwise gives our arterial walls (and our skin) their elasticity (hence the term, hardening of the arteries and the ‘aging’ of the skin). They cause the oxidation of LDL cholesterol particles, making them much more likely to become trapped in arterial walls (leading to heart disease and stroke). And they accumulate in the brain.

Neurons ideally last a lifetime. This means they are much more likely to accumulate AGEs. When researchers start looking at the tangles of twisted proteins which accumulate in the neurons of Alzheimer’s patients, they discover AGEs in abundance. This is likely to be the reason why other researchers have picked up on the association between Alzheimer’s (and other dementia) and high blood sugar.

Observational and controlled studies have linked fructose consumption to Type II Diabetes, Heart Disease, stroke, blindness, kidney disease and even Alzheimer’s (to name just a few of the more delightful ones). AGE research has come a long way in the last decade (and is still in its infancy), but it might just provide a unifying mechanism which explains why the incidence of these diseases is exploding in the Australian population – we eat way too much fructose.

So if aging slower (than you otherwise might) will be top of your to-do list in the New Year, you could buy a tub of hand cream sourced exclusively from the sweat of left-handed, French, mermaids – or you could just ease back on the fructose this Christmas.

If only we could fix obesity with passion alone

noreply@blogger.com (David Gillespie) — Thu, 02 Dec 2010 10:50:00 +0000

I don’t know of anyone who brings as much passion to the obesity problem as Jamie Oliver. He has a talent for whipping (normally docile) politicians into action for a good cause. It’s just a pity the advice Jamie is dispensing is so unlikely to change anything.

Last month, Jamie Oliver announced his first foray into correcting the diets of Australians. He plans to set up his ‘first’ Australian Ministry of Food (MoF) operation in Ipswich, just outside sunny Brisbane. The Ipswich MoF will host classes which allow up to 14,000 folk a year to sign up for (what is essentially) a home economics class once a week (over 10 weeks). The punters pay $10 for the lesson but they get to keep whatever they cook (not necessarily an advantage in my case).

Jamie’s MoF Australian ‘manifesto’, tells us that there will be an “extra 6.7 million obese Australians by 2025” and this demonstrates “an urgent need for action!” The cause (according to the Naked Chef) is that we have “a complete lack of cooking knowledge.”

Apparently cooking skills “used to be passed down” but now “women go out to work” and we no longer have compulsory cooking lessons in school. So “about two generations” have missed out on acquiring cooking skills. In a nutshell, Jamie believes that “there’s a serious lack of knowledge about food and cooking, and the result is the modern-day epidemic of obesity and bad health.”

But, will teaching “single parents, young mothers, teenagers, families and older people” to cook, fix the problem? Many more Australians (around 4 million on a good night) than will ever darken the door of Jamie’s MoF have been learning to cook over the last few years. They’ve been watching a little show called Masterchef. And just in case you don’t think anyone is paying attention, a quick look at Coles’ cash register receipts will swiftly change your mind.

The company's sales data (as reported by Smart Company) reveals that it achieves massive sales increases on everything from pistachios (up 125%), red cabbage (up 89%) to fillet steak (up 56%) the day after the ingredients feature on the show. And the drive to cooking your own food is much stronger and deeper than that. Coles attributes much of its sales growth to people discovering that it’s cheaper to eat at home than in a restaurant (who knew?).

But figures released yesterday suggest that all that home cookery has had no visible effect on our trouser size. The Health of Queenslanders report shows 61 per cent of adults (an increase of more than 14 per cent in the preceding eight years alone) and 26.9 per cent of children in Queensland are now obese or overweight.

In 2009, Jamie established the first MoF in the Yorkshire town of Rotherham and shortly afterwards opened shop number two in nearby Bradford. The aims (and the ‘manifesto’) were almost identical to the Aussie version (which will be the third site in the world).

Rotherham was set up as part of a TV Series and then funded (to the tune of £130,000 a year) by the British Government (for two years). Bradford is costing the local council £120,000 a year. And while thousands of people have attended learn to cook classes in both places, Rotherham is clearly not convinced it’s worthwhile. In September, the government refused to commit to renewing the funding when it expires in March 2011.

There’s no obvious scientific foundation to Jamie’s claims. He doesn’t cite any studies of the relationship between cooking skills and obesity (or indeed any science which might support his case at all).

There is however plenty of science to say that sugar consumption is the cause of obesity (and much much more). Just yesterday, yet another in a long line of studies was released. This one, published in the prestigious Journal of the American Society of Nephrology reviews the recent clinical and experimental evidence and concludes that excessive amounts of fructose (one half of sugar) plays a significant role in high blood pressure, diabetes, obesity, and chronic kidney disease.

More than three quarters of the sugar we eat is buried in foods we would never attempt to make ourselves. Soft drinks, Breakfast Cereals, Muesli Bars, Confectionary and packages sauces and condiments. And nothing about Jamie’s program will change that reality.

Oliver’s ‘home ec’ teachers are not showing us how to replace the softdrink (or fruit juice) we have with the home cooked meal or the packaged breakfast cereal (or muesli bar) we feed the kids. They’re focused on Carrot Salad and Lemon Rice.

When Jamie does stray out of the salad aisle, things get pretty sugary, pretty fast. The Mega Chocolate Fudge Cake (featured in the Ministry of Food TV Series) serves up 120g (30 teaspoons) of sugar, 200g of Chocolate and 100g of Fudge.

There’s no plausible reason why cooking something yourself would result in weightloss and there’s no credible evidence that it does. But that hasn’t stopped the Queensland Government handing over 2.5 million taxpayer dollars to set up the MoF in Ipswich.

Jamie Oliver might as well be telling us that wearing a foil hat will reduce our waist size for all the effect the MoF is likely to have on obesity. And that’s a pity.

Oliver is a blur of energy, with an extraordinary ability to prise open government coffers in the name of health. Imagine what could be achieved if his efforts were backed by science.

We need more than good intentions to stop Diabetes.

noreply@blogger.com (David Gillespie) — Wed, 10 Nov 2010 23:25:00 +0000

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 6^th 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?

DAA decides lawyers are the answer

noreply@blogger.com (David Gillespie) — Tue, 09 Nov 2010 05:57:00 +0000

The week before last, I said that dietary advice emanating from Australia’s “peak body of dietetic and nutrition professionals” (the DAA) needed to be treated with caution. I pointed out that the DAA is the recipient of significant sponsorship from the food industry. I went on to say that this may inevitably lead to (at least the perception of) a conflict of interest.

The DAA’s considered response it seems is to threaten me (and Google, my blog provider) with an injunction. No, not an injunction about anything I said in the article. They sent in the legal beagles (with teeth barred and threats aplenty) because I used their logo to illustrate the blog post.

There are many things worth fighting about, but the use of the DAA logo on a blog post doesn’t make the cut. So, of course I have immediately removed the offending object (see below).

But DAA, here’s a tip for the next time you have a concern about anything I do - asking nicely usually works better than sending threats of injunction (and costs an awful lot less). Perhaps if you spent a little less on lawyers, you wouldn't need the food industry sponsorship (just sayin).

Do we really want our Nutrition advice sponsored by the Food Industry?

noreply@blogger.com (David Gillespie) — Thu, 28 Oct 2010 05:39:00 +0000

The Dietitians Association of Australia (DAA) is just like a union for dietitians. And like all unions, its priority is to represent the interests of its members. So when it starts handing out advice on what to eat we should be cautious. We should be especially cautious when that advice is funded by some of Australia’s most powerful food companies.

In Australia there is nothing to prevent anybody declaring themselves to be a dietitian (or a nutritionist). The barrier to entry is the price of a stack of business cards.

Other professions have managed to protect themselves (and their customers) by requiring qualifications and the observation of professional standards. Some professions have even managed have the barriers enforced by law (because when a lawyer or a doctor stuffs up the results can be catastrophic).

One of the primary roles of the DAA is to perform this ‘professional’ function for dietitians. It has created a certification process which produces Accredited Practising Dietitians (APD). And it has successfully lobbied to ensure that Medicare and private health fund rebates are only payable for APD services. In short their message is, make sure your dietitian is an APD.

One of the main sources of work for APDs is referrals from doctors (often just after they diagnose you with pre-diabetes and advise you to adjust your lifestyle). The nature of the work is telling people what they should eat. So a food company would be mad not to help the DAA. And help they certainly do.

The DAA’s list of corporate sponsors reads like a who’s who of the Australian food industry. Kellogg’s, Nestle, Unilever (the maker of Street’s Ice Cream and Flora margarine to name a couple of its brands), Nutricia (baby formula makers), Jalna yoghurts and the Meat and Livestock Association all feature prominently on the list of corporate ‘partners’.

That corporate support is significant. The DAA’s annual report reveals that (in 2009) advertising and sponsorship ($686,249) was the third largest source (after membership dues, $1.5m and seminar fees $833k) of revenue for the association. If the money from the food industry weren’t there, it’s likely each of the 4,100 members of the DAA would be facing considerably higher fees.

The DAA’s partners help with much more than mere cash. For example, Kellogg’s is a big supporter of the DAA’s (or is it the other way round?) National Breakfast Week, a campaign to ensure we eat breakfast (guess what features prominently). Kellogg’s also helps run the DAA Media Program, which “seeks to provide accurate nutrition and health information to the Media.”

The DAA’s policy on accepting sponsorship is that it “will not be influenced in any statements, positions or opinions by its commercial agreements.” And we would expect no less, but the same policy adds a somewhat cynical twist by saying that that DAA will take on sponsorship only where the “benefits for DAA outweigh any assessed risks.”

The fructose half of sugar is a dangerous (and addictive) addition to our diet that helps to sell many of the products made by the DAA’s corporate supporters. So what is the DAA’s position on sugar?

In May this year, a DAA press release trumpeted “Sweet truths: Eating sugar may not make you fat.” The release reported on a ‘study’ presented to DAA’s annual conference by DAA spokesperson, Dr Alan Barclay.

Dr Barclay reported that “consumption of fructose has decreased by nearly 20 per cent in Australia since the early 1970s, while overweight and obesity has doubled.” He went on to say “Much to everyone’s surprise, it looks as if, unlike in the US, sugar is not the culprit here ...”

What the DAA’s press release did not say was that Dr Barclay is employed by Glycemic Index Ltd, an outfit that collects a royalty on CSR sugar sales. The DAA also neglected to mention that the sugar consumption figures presented by Dr Barclay stand in stark contrast to similar numbers maintained by the Australian Bureau of Agricultural and Resource Economics (a government department). ABARE seems to think that Australian domestic sugar consumption has more than doubled since the mid-eighties.

I suspect Dr Barclay would say his employer’s relationship with CSR doesn’t influence his view of the science about sugar. And I’m sure the DAA would say the same about all of its sponsors. But I prefer messages about the safety of sugar not to be sponsored by the folks who make billions out of selling it.

Australians don’t like people in positions of trust accepting kickbacks. We constantly worry whether drug companies are trying to influence our doctors. We demand that lawyers refuse to act on both sides of a real estate purchase. And we even get our undies in a twist at the thought of our PM accepting a dodgy ute.

We trust the DAA (and our Medicare and health insurance premiums pay its APD’s) to tell us what to eat. In that context, accepting significant payments from the food industry is a flagrant conflict of interest.

I don’t know whether the DAA just hasn’t caught up with its reading on sugar or whether the money is colouring its advice. But the existence of significant food industry sponsorship should cause all Australians to discount anything the DAA says about nutrition. And that is a disgraceful state of affairs for Australia’s “peak body of dietetic and nutrition professionals.”

How about we stop Kidney Disease?

noreply@blogger.com (David Gillespie) — Thu, 07 Oct 2010 22:34:00 +0000

What will put the most Australians in hospital this year? Car accidents? No way. Heart attacks? Nup. Cancer? Not even close. No, it’s Kidney Disease. But a series of recent studies suggest there is a very simple way to turn that statistic around.

Chronic kidney disease is now responsible for more than 1 in every 7 hospitalisations. And that rate has gotten very bad, very quickly. Between 2001 and 2008, hospital admissions for kidney dialysis alone increased by 71 per cent.

The news is even worse for indigenous Australians. At the end of 2007, they were being treated for kidney disease at six times the rate of the rest of the Australian population. This is why the number hospitalisations in the Northern Territory increased by an incredible 120 per cent (almost 20 per cent per year) in the same period.

The NT has another interesting claim to fame (aside from Croc Dundee). According to Coca-Cola it has the highest per capita consumption of Coke in the world. Increasingly the science is starting to suggest that is more than a mere co-incidence.

We don’t know what causes most forms of kidney disease and we certainly can’t cure it (other than by replacing the kidneys). But there is a line of studies going back over half a century that suggest the answer (to the mystery of the cause and the cure) might lie in something called uric acid.

Uric acid is a waste product created when we digest red meats. Like most waste products circulating in our blood stream, it is removed from our systems by our own little pool filter system, the kidneys.

Simply put, the theory goes that if you have too much uric acid, you end up clogging the filters in the kidneys and (over time) this degrades their capacity to work at all. There’s a line of rat studies you couldn’t jump over to prove exactly that cause and effect relationship. But rats process uric acid differently to humans (and other higher primates) so there’s always been a question mark about those studies.

In 2008, a major study conducted by the Vienna University went a long way to answering the question in humans. In that study 21,475 (initially) healthy subjects were tracked for 7 years. Their uric acid levels were compared to the occurrence of kidney disease. The outcome was an unequivocal correlation. The higher a person’s uric acid levels, the higher their likelihood of developing kidney disease. Full stop.

If eating meat was the major cause of increased uric acid production, you’d expect to see a steep increase in the amount of meat we eat over the last few decades (to go along with the sharp rise in kidney disease). But according to the CSIRO, our red meat consumption has been steadily falling since the 1970s.

It turns out though, that there’s another truly excellent way to increase the amount of uric acid in a human’s bloodstream. Feed them sugar.

In 1989, the US Department of Agriculture’s carbohydrate research team proved that they could cause a significant spike in uric acid levels just by feeding people the fructose half of sugar (it is half glucose and half fructose) at the levels (then) normally consumed by the average US citizen (20 per cent of calories – exactly the same as the current Australian suggested intake).

A much larger 2008 study of 4,867 US school children (unsurprisingly) found the same strong association between increased sugary drink consumption and uric acid levels. And an analysis published in the same year took that further by linking sugary drink consumption with the onset of kidney disease in adults using a similarly large database of results.

Uric acid is a by-product of the way our livers metabolise fructose. And unlike meat, sugar (and therefore fructose) consumption figures have all been one way traffic (up, big time) in the last five decades.

While all of that evidence is strongly persuasive, it isn’t proof. No-one has purposely fed a large group of people fructose (and kept it away from a similar group) to see which ones died of kidney disease first. But I rather suspect, sadly, we are inadvertently conducting our own little experiment on the indigenous population.

Aboriginal and Torres Strait Islanders consume around twice as much sugar-sweetened soft drink as the rest of us (which is very high because Australians are in the top ten per capita consumers in the world anyway). So (given their high indigenous population) it’s no wonder the Northern Territory featured so prominently in Coke’s statistics. And it’s even less wonder (given what the science is saying about fructose) that it features so prominently in our kidney disease statistics.

Kidney disease is massively debilitating. The only effective ‘treatment’ is getting hooked up to a dialysis machine three times a week. Meanwhile the number of people needing that treatment is growing at the rate of 6 per cent every year. The only ‘cure’ is replacing the kidneys (if you’re lucky enough to get to the head of the transplant queue (currently the wait is about four years) before you die.

Kidney disease is now killing more Australians than either breast or prostate cancer and more than twice as many as die on the roads every year. But the evidence is mounting that there is a very simple preventative measure. Don’t eat (or drink) sugar.

So how about we give that a go before the next generation destroys their kidneys too?

Is Nestlé fattening us up just so it can sell us diets (that don’t work)?

noreply@blogger.com (David Gillespie) — Tue, 21 Sep 2010 22:24:00 +0000

Nestlé is the world’s largest food company. Headquartered in Switzerland, it operates 456 factories and employs 283,000 people worldwide. Much of its business revolves around making us fat. And since that side of the business is doing so well, it has decided to branch into the diet industry too.

Nestlé is the name behind a vast range of sweeties (Kit Kat, Wonka, Smarties, Aero, Violet Crumble and Allen’s Sweets to name just a few) and their range of ice-cream is second to none (Peter’s, Dixie, Skinny Cow and Connoisseur are all part of the portfolio)

They also do a nice range of sugar filled ‘health food’. Including things like Fruit Fix (72% sugar), Nesquik (99% sugar), Milo (46% sugar), muesli bars (up to 31% sugar) and a huge range of cereals (under the Uncle Toby’s brand), boasting healthy gems like Healthwise (30% sugar) and Oats Temptations (34% sugar).

It’s perhaps a little less well known that Nestlé is also the company behind some of the biggest brands in the weightloss industry. They own the Optifast diet shakes promoted strongly by the doctors at the Wesley Hospital Weightloss centre, the Musashi brand of shakes and supplements for serious gym junkies and even the Lean Cuisine range of frozen diet meals.

I found all of those brands by looking (carefully) at the Nestlé web site. But strangely I didn’t find any mention of their biggest weightloss business - Jenny Craig. That’s right, Jenny Craig, the little ole diet outfit founded in Melbourne in 1983 (and purchased by Nestlé in 2006 – for over $800 million) is now one of the biggest weightloss corporations on the planet.

The science on sugar consumption is unequivocal. Eating large amounts of sugar is the most effective way to pile on the unwanted kilo’s. It’s also the most effective way to ensure you’re a candidate for heart disease and a list of other conditions that doesn’t bear thinking about.

By definition, Nestlé’s diet products and Jenny Craig programs are sold to people who are overweight. So Nestlé is selling those people a “cure” to a condition which was in no small part caused by consumption of Nestlé’s own products.

Ok, so Nestlé has spotted a growing (pun intended) market and made sure it’s got the products to address the need. Their shareholders would be disappointed if they didn’t do this. But its ethically dubious (putting it mildly) to sell people a substance which makes them fat and then sell them the ‘cure’ (without at least telling them you are the same people doing the selling).

If the cure doesn’t actually work (and the purveyor knows this) then we are well on the track to outrageously unethical (if not downright immoral) corporate behaviour. So, does Jenny Craig work?

A systematic review of the published research (on commercial weightloss programs) conducted in 2005 revealed that of the 1,500 available studies only 10 (!) met the inclusion criteria relating to study quality (because many studies are very short term, very small studies usually sponsored by the entity selling the diet). The researchers couldn’t find a single credible study of Jenny Craig and, of the rest, only one was a high quality, multi-site randomized trial.

That trial (of Jenny Craig’s primary competitor, Weight Watchers) found that if you could convince people to stick to the diet for two years (less than three quarters did), they lost a whole 3 kilograms (they started at an average of 94 kg and ended at 91kg after two years! – where do I sign up?). And for that privilege the dieters paid US$167 every three months (or US$445 per kg lost – which by the way is significantly less than an equivalent Jenny Craig diet would cost).

Granted, that study was based on Weight Watchers and not Jenny Craig, but it seems this astounding lack of success is not a one-off observation.

A 2007 UCLA review of 31 credible long term weight loss studies found that most people on calorie restricting diets (such as that promoted by Jenny Craig and Weight Watchers) initially lost 5 to 10 percent of their body weight. But they also found that the majority of people regained all the weight (plus a bit more) within 12 months. Sustained weight loss was found only in a very, very small minority of participants.

In the computer software industry, a persistent conspiracy theory about anti-virus software manufacturers has always bubbled just below the surface of acceptable dinner party chit chat. The theory goes that most of the worst viruses are in fact written by secret skunkworks sponsored by Antivirus software makers (the people being paid to get rid of them). By constantly creating new viruses, the need for their cures grows exponentially.

The software virus theory has never been proven (and probably never will be). But when it comes to what we put in our mouths, exactly that kind of thing is going on right before our eyes (if we care to look).

Sugar is a highly addictive substance that sells product. A food maker will always want to have more sugar than the product next to theirs on the shelves. Unfortunately it has the side-effect of making us fat.

If having a sugar loaded product means the customer gets fatter, then (from Nestle’s perspective) that’s another market opportunity. If the cure to the fatness is only temporary (and doesn’t cure the addiction to sugar), so much the better. Then you’ve got both sides of the business generating repeat income for each other.

Maybe Nestlé knows all this (and plans things this way) or maybe they’re just lucky, but whether Nestlé knows it or not, selling the disease and a non-cure sure isn’t hurting their (expanding) bottom line.

Why we shouldn’t put up with sportspeople advertising sugar.

noreply@blogger.com (David Gillespie) — Thu, 02 Sep 2010 07:45:00 +0000

I’m not very good with subliminal advertising, but (apparently) eating sugar makes you look like Eamon Sullivan – which I guess would be good. Or perhaps it just makes you take your clothes off – not so good (in my case). Either way, the latest CSR sugar advertisement sends a pretty damn ('scuse French) irresponsible message about sugar.

The purpose of the ad is to sell CSR sugar. And so I guess the reason they didn’t use a nude Matt Preston (for example) was that they wanted us to believe that eating CSR sugar would give us (or our significant other) abs like Eamon’s.

Maybe I’m just jumping to conclusions. Maybe Eamon always noods-it-up for a spot of baking (although I can’t say I noticed that when he won Masterchef). But there’s no shortage of research to tell us that eating sugar (in our birthday suit or fully clothed) is the single least effective way to get a washboard stomach.

And you don’t need to look too hard to find that science. Even CSR’s own website warns us “There is some evidence to suggest that [the fructose half of sugar] is handled differently in the body and may be associated with obesity and other health issues.”

Eamon must have missed the memo (that sugar makes you fat) because when asked about his role in the advertisement, he is quoted as responding “statistics showed that while obesity rates were rising, sugar consumption was falling.”

Really? What statistics would those be? The only ones I could find show exactly the opposite (a consumption increase of over 50 per cent since 1990). But that data is maintained by the Australian Government’s Bureau of Agricultural and Resource Economics (ABARE) – what would they know?

Eamon went on to say “the CSR sugar in the ad was in fact low-GI.” Well, yes (maybe), but all sugar is low(ish) GI. And the worst for making you fat and sick (pure fructose) is the lowest of the lot. In fact it is one of the lowest GI carbohydrates known to man.

That alone should make us suspicious of the use of the GI rating at all. GI Symbols lost any credibility when they started turning up on packets of pure sugar. They are a symbol of nothing more than the food manufacturer’s willingness to give up profit (they pay a percentage of sales for the right) in return for our gullibility.

CSR should know the GI Symbol is a spurious health claim and it knows its product is dangerous (to human health). It admits as much on the website. This is why it doesn’t make any claims to the contrary in its ad (lawyers can be so annoyingly literal about these things). It just leaves it to us to use our imagination and imply benefits which are never actually claimed.

CSR’s candid admission as to the dangers of fructose is far more than any tobacco company ever managed (before they were forced to). We banned cigarette advertising at sporting events almost 20 years ago because we didn’t want our kids accepting an association between cigarettes and sport. For exactly the same reason we shouldn’t put up with CSR pushing its way under Eamon’s healthy halo.

Sugar will not make you look like Eamon. CSR knows it, (hopefully Eamon knows it) and you know it too. So let’s stop this farcical advertising before someone gets hurt.

Sugar accelerates cancer growth

noreply@blogger.com (David Gillespie) — Wed, 25 Aug 2010 02:00:00 +0000

Cancer is our biggest killer (yep, even worse than heart disease). And sugar consumption has been in the frame as a cancer risk for a while now, but a study released last week appears to have put the matter beyond doubt (at least for pancreatic cancer).

A 2002 a study tried to find which food had the greatest association with pancreatic cancer, and fructose (remembering sugar is half fructose and half glucose) got first prize.

The study conducted by the US National Cancer Institute identified 180 cases of pancreatic cancer from among 88,802 women who were monitored for 18 years as part of the Nurses’ Health Study. Women who were overweight and sedentary and had a high fructose intake were shown to have a 317 per cent greater chance of developing pancreatic cancer.

A 2006 study published by the Karolinska Institute in Sweden decided soft drinkers were in significant jeopardy, and had warnings for anyone eating sugar at all.

In the Swedish study, the researchers were able to demonstrate that the risk of developing pancreatic cancer was directly related to the amount of sugar in the diet. The people who said that they drank soft drinks twice a day or more were 90 per cent more likely to develop pancreatic cancer than those who never drank them.

And then a study published in February this year found that we are 87 percent more likely to contract pancreatic cancer if we have two cans of soft drink a week (about 10 grams of sugar a day on average).

These were all population studies. And while they are good for suggesting there may be a problem, they give no clue as the possible mechanism. Why does consuming fructose mean you are at greater risk of pancreatic cancer?

Last week a study out of the University of California (UCLA) nailed down the likely reason. In the study, human pancreatic cancer cells were exposed to solutions of pure glucose and pure fructose in the lab.

Sugar is half glucose and half fructose. The researchers knew that consistently high blood-glucose levels (such as that suffered by a Type II Diabetic) will accelerate the growth of cancerous cells. They also knew that eating fructose directly increases circulating fatty acids which reduces the effectiveness of insulin in clearing the blood of glucose.

The persistently increased blood glucose leads to type II diabetes and feeds cancer. But in this new study, the researchers were trying to determine whether fructose had a more direct involvement in cancer growth.

To find out they tagged the sugars with radioactive carbon (so they could see what the cells were doing with them). What they found was that the fructose was metabolised very differently by the cancerous cells.

Cancer is out-of-control cellular reproduction. The fructose was being used by the cells to create a much higher output of the genetic material which cells need in order to divide and proliferate (nucleic acids used to make DNA and RNA).

The difference between glucose and fructose appeared to be that while both could be used for energy, only one supplied significant quantities of the building materials for tumour growth. A tumour treated with fructose grew much more aggressively than one in a bath of glucose.

Having lots of fructose in the diet appears to create a perfect environment for cancer growth. The persistently high blood glucose caused by the metabolism of fructose by the liver (into fatty acids), provides fuel. And the fructose itself provides the DNA and RNA required for multiplication. What a perfect storm!

Studies of cells in a lab setting are not overly persuasive on their own. There are a lot of checks and balances in a living organism that simply do not exist when you isolate one type of cell. But these tests on pancreatic tumours combined with the strong line of population studies (coming to pretty much the same conclusion) is worth paying attention to.

These studies are all on cancer of the pancreas, the organ most involved with detecting the presence of sugar in the blood. But according to the authors of the study there is no reason that the observations about fructose should not apply to any kind of cancer.

In 2007 almost one in three (29 per cent) deaths were caused by cancer. Breast cancer (the biggest cancer for Australian women) incidence has increased by 32 per cent in the last two decades. And the incidence of prostate cancer (the biggest cancer for men) has more than doubled in the same timeframe.

There is no higher priority in our health system than slowing (or stopping) the accelerating trend in cancer suffering. This study suggests that sugar (a major component of the average Australian diet and the primary source of fructose) is directly implicated.

Fructose is not a disinterested bystander in the development of cancer. Our renegade cells use it directly (and significantly) to accelerate their reproduction. There is no sane reason for fructose (and therefore sugar) to be part of our diet. And there is no sane reason for the health hierarchy not to be saying exactly what I am saying – stop eating sugar immediately!

Why is the Heart Foundation in Denial over Fat?

noreply@blogger.com (David Gillespie) — Tue, 10 Aug 2010 23:50:00 +0000

The Queensland Institute of Medical Research (QIMR) last week released the results of a 16 year study that says full-fat dairy reduces the risk of heart-related deaths by sixty-nine per cent. But rather than applauding the new work, the Heart Foundation put up the shutters. Are they worried the emperor has no clothes or is money the real problem?

The study (published in the prestigious European Journal of Clinical Nutrition) followed the dairy consumption of 1,529 adult Australians aged 25-78 years. The participants were asked about their dairy intake on three occasions (1992, 1994 and 1996). The results were then cross-matched to National Death Index data between 1992 and 2007.

The data showed a significant relationship between the consumption of full fat dairy and heart disease deaths. But not the one you might think. The people who consumed full-fat dairy had a sixty-nine per cent lower risk of death by heart attack than those gritting their teeth and gulping down low-fat milk.

The QIMR study comes on the back of a significant US study on heart disease risk published in April. In that study a group of 6,113 average American adults was divided into five groups based on their sugar consumption.

One of the groups was a standout on many of the traditional measures for heart disease risk. They had the lowest fat consumption (just 28.9% of total calories – the Heart Foundation recommends keeping it under 35%). They had the lowest saturated fat consumption (just 9.7% of total calories). And they had the lowest cholesterol intake by a country mile (only 238mg).

This group were poster children for the low-fat lifestyle. There was just one little problem, their blood work was awful. On average the folks in the low-fat group had by far the worst blood cholesterol and triglyceride (blood lipid) readings of all five groups. And they weren’t just bad, they were time-to-order-some-drugs bad.

Just like the QIMR participants, the people doing everything right (from a fat consumption perspective) were the ones most likely to end up dead from a heart attack. Interestingly (in the US study), they were also the one’s eating the most sugar.

It’s all well and good to notice correlations like that, but to have any value as a scientific observation, there has to be plausible explanation for why it might be so. A pair of studies published in 2000 and 2007 may just provide that explanation.

In June 2000, Dr Krauss and his team over at the Lawrence Berkeley National Laboratory, Department of Molecular Medicine at UC-Berkeley published the results of experiments they had been doing on low-fat diets.

LDL cholesterol (or ‘bad cholesterol’) particles come in a range of sizes. People can be divided into two main groups according to which size is most common in their blood. Some people have mostly large LDL particles (Pattern A) while others have mostly small ones (Pattern B). Pattern B are the ones who tend to die from heart disease.

Which pattern you are is largely a matter of genetics. But Dr Krauss found a way to convert a perfectly healthy Pattern A person to Pattern B (heart attack waiting to happen). Just put them on a low-fat diet.

Then in 2007, some researchers in Switzerland found another way to convert Pattern A to Pattern B – have the patient consume sugar. So it seems the two most excellent ways of ensuring a high risk of heart attack is to either be on a low-fat diet or eat lots of sugar.

If that was what you were aiming for, you wouldn’t find it too tricky. The vast majority of low-fat foods are higher in sugar than their full-fat brethren. Eating a low fat diet kills two (fat) birds with the one stone. Slurping up a Diet Yoghurt lowers your fat intake and increases your sugar intake – all at the same time – how efficient.

Faced with the latest evidence from a high quality Australian research team (at QIMR), the Australian Heart Foundation didn’t suggest the issue needed investigation. They didn’t even pretend that they might look at the research and its implications.

No, (rather like the Church of England faced with Darwin’s theory of evolution) they responded to the new evidence with outright denial. In a story about the study which aired last week, a Heart Foundation spokesman said “we strongly recommend to people to have no fat or low fat products in their diet.”

Perhaps the Heart Foundation is in denial because it fears a sudden change of course (after decades of touting the ‘low-fat’ message) might scare the horses (that would be, um, oh that’s right, us). Or perhaps there are more sinister motives leaching out of the stack of money it makes from endorsing low fat (and often high sugar) products with the tick program.

Let’s not forget there are real lives at risk every single day in the battle against heart disease. The Heart Foundation is one of the primary (and most trusted) providers of advice on heart health. For that reason, it receives significant financial support from the Australian public on the understanding that it has our best interests at heart (pun very much intended).

The evidence is mounting that the advice being dispensed is just plain wrong, but the Heart Foundation seems unable see it. If the obvious commercial conflict can’t be resolved then the tick program needs to go. The Australian public needs to hear the truth about what causes heart disease – a low fat diet, lots of sugar or both.

Calorie Labelling is all about making Politicians look good - not you.

noreply@blogger.com (David Gillespie) — Wed, 28 Jul 2010 05:02:00 +0000

The Victorian government is forcing fast food restaurants to tell us how many calories are in their meals. Premier Brumby says this will “drag back” the “runaway train” of Type II Diabetes. But the science says there isn’t any real point to showing us how many calories are in a burger (or anything else). And the evidence (from places that have already been there, done that and bought the T-shirt) is that it doesn’t make the slightest bit of difference to what we eat anyway.

Most food contains 4 calories of energy per gram of food. The exceptions are fat (which has 9 calories per gram) and alcohol (which has 7). So a difference in the calorie content of two similar weights (or serves) of food really is just another way of saying one has more fat than the other (or more booze, but I don’t think anyone is worried about that at Macca’s).

We are exceedingly efficient at using our calories. The 150 calories in a glass of apple juice would let us ride a bicycle 8 km, but the same energy (in petrol) would only push a car 250 metres.

Our appetite control is also exceedingly efficient at making sure we don’t consume more calories than we need. Our hormones are so sophisticated they can even tell the difference between fat calories and calories from everything else (and adjust accordingly).

The science says sugar contains an appetite hormone disruptor (called fructose). With sugar in our diet, our bodies can no longer tell when we have had enough calories. Sugar gives our bodies permission to keep on eating and we don’t stop until we are physically restrained by the size of our stomach (or jeans). When that problem, well, passes, our broken appetite control gives us permission to keep eating until we’re stuffed again.

The result is that we are eating way too many calories, but fabulous as they are, our hormones can’t read a calorie sticker slapped on a board out the front of a KFC (even assuming any of us really knew how many we were supposed to be eating anyway). Our broken appetite control is the reason that Diabetes (and obesity) is a run-away train, not a lack of calorie labelling.

Because all a calorie really measures is (relative) fat content, the processed food industry isn’t all that bothered about calorie labelling. They’ll happily slap a calorie count on a can of soft drink (full of appetite hormone disruptor) because they know it comes out looking pretty good next to an equivalent quantity of milk (soft drink – 150 calories v unflavoured milk – 240 calories).

The sugar in the soft drink will make us want to eat more of everything but it’s the milk (which actually fills us up) that comes out looking sorry on a government mandated calorie counting sign. Sugar is effectively invisible on that sign. Indeed they could add more of the addictive substance and not materially affect the calorie count (especially if they use it to replace fat).

The Victorian plan is a straight copy of the calorie labelling laws enacted in New York City in mid 2008. But a Yale and New York University study on the effect of the laws (completed in October last year) showed the effect was exactly - nothing.

The researchers interviewed customers at multiple restaurants in four fast-food chains (McDonald’s, Wendy’s, Burger King and KFC). They collected 1,156 receipts from customers two weeks before the laws were introduced and four weeks afterwards. A similar population in a state without the law was used as the control.

The locations were chosen because of a high proportion of obesity and diabetes among poor minority populations. So if Premier Brumby’s runaway train theory was correct, these were exactly the people who should react to the signs.

In New York and in the control city, the average customer ordered a meal with 825 calories before the laws came into effect. Afterwards the New York customer had bumped their order up to 846 calories but the control customers were still ordering the same.

People were ordering more calories after signs were introduced! While that’s probably just a statistical anomaly, there’s certainly no suggestion the signs had any effect at all on what people ordered.

Never ones to be troubled by evidence of effectiveness, other states are now piling on to the Victorian bandwagon. The South Australian and New South Wales Governments think it’s a terrific idea and are rushing to implement.

Laws like this fit all the criteria for high visibility politics, so our elected representatives are drooling over them. Every time we walk past a Government mandated calorie sign (and ignore it) we can be reminded how much our politicians are looking out for us.

Everybody wins. The Pollie looks like he cares about our welfare and is on the job. The Nutritionists cheer them on because they are being listened to. And the food manufacturers know it won’t affect sales anyway.

The only loser is – well, ah – us. We will still get fatter and still get Type II Diabetes (but everybody knows those fat chickens will come home to roost on someone else’s watch) – bon appétit!

Are Sugar and Palm Oil really part of a “balanced breakfast?”

noreply@blogger.com (David Gillespie) — Wed, 23 Jun 2010 03:52:00 +0000

Nutella has the nutrition profile of a chocolate bar (and that’s probably an insult to the chocolate bar). But according to their latest advertising, we are supposed to be feeding it to our kids as part of a “balanced breakfast.”

The ad says Nutella contains “premium Hazelnuts, cocoa and the goodness of milk” (cue artistic shots of milk, nuts and cocoa pouring out of the sky). The actual ingredient list looks a little more like this

sugar (50%), palm oil (called “Vegetable Oil” on the label), hazelnuts (13%), skim milk powder (8.7%), fat-reduced cocoa powder (7.4%), emulsifier (soy lecithin), flavouring (vanillin)

I guess a shot showing ribbons of sugar, palm oil and hazelnuts is less artistically appealing (no matter how much more accurate it would be).

In 2008, a remarkably similar advertisement in the UK provoked 53 complaints to the Advertising Standards Authority (ASA). People said that the ad was misleading because it did not make clear that the product was high in sugar and fat.

The ASA agreed and found that as the ad had only mentioned hazelnuts, skimmed milk and cocoa powder (when in fact it had a high sugar and fat content) it was indeed misleading. The Authority decided therefore that the advertisement should no longer be shown on British television.

Of course (when similar complaints were lodged regarding an almost identical commercial here) the Australian equivalent of the ASA decided there was nothing wrong with the ad because it “carefully” used the phrase “balanced breakfast” rather than saying it was a “healthy” breakfast.

On the basis of that reasoning, soft drinks could be advertised as a part of a healthy (sorry, I mean balanced) breakfast for children because they contain (quite a lot of) water.

(Australian) Industry self-regulation clearly leaves a little to be desired. So I’ll be putting all my complaints via the ACCC in future. They may take longer but at least they appear to get it right in the end.

I very much doubt that anybody suffers under the impression that a chocolate bar is a healthy breakfast for children (or anybody else). But chocolate bar purveyors are not flooding our screens with ads suggesting they are.

Nutella contains (cumulatively) lethal amounts of sugar and palm oil (which has been implicated in the destruction of Orang-utan habitats). I’m struggling to think of a food less suitable for consumption at all, let alone as part of a ‘balanced’ breakfast for our children.

If they must advertise the stuff then at the very least, Ferrero (the maker of Nutella) should be forced to emphasise the real ingredients rather than a highly selective cherry-picking of the healthier ones (used largely for flavouring).

You can’t blame Ferrero for giving this a go. Clearly (in Australia, at least) they are within their rights. But we need more than a toothless tiger (with a propensity for legalistic interpretation) ‘safeguarding’ our ability to make informed choices.

If Ferrero is allowed to advertise sugar and palm oil as “skimmed milk and (fat reduced) cocoa”, what else is being pushed at us with (legally finetuned) definitions hiding behind the advertising puff? We deserve better.

The Heart Foundation Tick or the Coles Tick, which is worth less?

noreply@blogger.com (David Gillespie) — Tue, 08 Jun 2010 03:08:00 +0000

The Heart Foundation is getting its undies in a twist about Coles using a tick in their branding. But consumers might be healthier if they let the Coles tick guide their purchases.

Heart Foundation healthy weight director Susan Anderson complains “we receive many calls and emails from outraged shoppers who have been tricked by phony ticks.” And Senator Nick Xenophon wants to call in the Feds, saying “Coles is being deceptive and the ACCC should investigate.”

Incidentally Nick isn’t worried about the consumer accidentally choosing an unhealthy food. He explains his real concern is that consumers will think the product is Heart Foundation approved and “that is fundamentally unfair to the Heart Foundation. “ Oh, ok, good point. We wouldn’t want to endanger their licensing revenue.

A major study released in April showed definitively that when it comes to Heart Disease (presumably the primary concern of the Heart Foundation), sugar consumption was (by far) the strongest indicator of risk. So how do the products which bear the Heart Foundation Tick stack up in the sugar stakes?

Nestle’s Fruit Fix Bars proudly bear the Heart Foundation tick but are around 72% sugar. However a tick-free Mars Bar is only 58% sugar. I guess they’d need to top it up a bit to earn a ‘tick’?

Other high sugar products proudly bearing the tick include Nestle’s Billabong Ice Blocks (23% sugar), Nestle’s B-Smart Milo (32% Sugar), Kellogg’s K-Time Twist Bars (38% sugar), and Nestle’s Nesquik Plus (60% sugar). It looks like letting the Heart Foundation tick guide you through supermarket aisles could land you in very high sugar territory indeed.

But what of the claim that Coles is leading healthy-food seekers astray with their tick? We all eat breakfast cereals, so the brekkie aisle is a good place to do some comparison shopping.

Coles make a few breakfast cereals emblazoned with their tricky ticks. They are Rolled Oats (no sugar), Wheat Biscuits (less than 1% sugar) and Corn Flakes (10% sugar). Nothing too dreadful there (even if the corn flakes could have less sugar).

But the Heart Foundation endorsed list of breakfast cereals includes Australia’s tenth most sugary cereal (Kellogg’s Just Right - 32% sugar) and the 12^th most sugary (Nestle’s Healthwise for Heart Health - 30% sugar). Following the Heart Foundation down the cereal aisle could fill your breakfast bowl with at least three times as much sugar as opting for the Coles tick.

The good news is that if you are prone to ticklexia, you’re in much safer territory from a sugar (and therefore heart health) perspective. Although you probably want to be a little bit careful. Coles have ticks on shaving cream and laundry powder too.

Even when you venture out of the supermarket, the Heart Foundation can be treated as fairly consistent warning of high sugar content. Over at the much-maligned Macca’s the tick approved meals are some of the higher sugar options on (the non-pudding part of) the menu.

A tick-approved Seared Chicken Sweet Chili Wrap, Garden Salad and Italian Dressing will serve you up 4 whole teaspoons of sugar (quite a bit for a salad really). But a plain old Big Mac will add ‘just’ 1.5 teaspoons of sugar to your day. And a Filet-o-Fish, piles on a mere half teaspoon.

The Heart Foundation happily endorses high sugar products because unlike its US counterpart (and in the face of overwhelming science), it considers sugar a harmless (even necessary) addition to our diet. In response to one of my earlier rants, Susan Anderson even told Cardiology Update “Although associated with tooth decay... eating sugar itself is not clearly associated with other health problems.”

I had always believed (like most of us, I suspect) that the Australian Heart Foundation was a powerful force for good in ensuring we all ate well. We trust the Heart Foundation to tell us the truth, not what is commercially convenient for its clients.

The science on sugar says it is lethal. We wouldn’t tolerate our doctor taking payment from sugar manufacturers in return for recommendations. So why should we tolerate it from the Heart Foundation. Whacking a tick on a children’s food product (like Fruit Fix) that has more sugar than a Mars Bar is at best a conflict of interest and at worst, negligent.

So, please Heart Foundation, let’s have less media hype about Coles (using a logo vaguely reminiscent of the tick) and a lot more media hype about the lethal effects of sugar. I know that will hurt your income stream but is that really what’s important here?

Also published in Crikey (subscription required). You can also read the Heart Foundation's response here (about half way down the page - no subscription required).

Why the first law of thermodynamics has no place in human nutrition

noreply@blogger.com (David Gillespie) — Sun, 23 May 2010 09:12:00 +0000

The first law of thermodynamics says that energy can’t be created or destroyed. Many people (wrongly) think Sir Isaac Newton worked this one out, but it seems it was more likely a Welsh lawyer (score one for the lawyers!).

It’s a law about physical forces that unifies a lot of previous theories that related to heat and mechanical energy. In the nutrition and diet industry, it usually looks more like “energy in must equal energy out” or just “the energy balance equation”. They will even sometimes do an actual equation (I guess to make it look more scientific).

Weight Gain (Energy Balance) = Energy In (Food) – Energy Out (Exercise).

The First Law has been hijacked by the nutritionista because it kinda sounds like it should apply to dieting. As a result it is used more today in human nutrition than in any other domain of human endeavour. The First Law is quoted every time you watch or read any information on diet products, exercise or weight loss programs. And the government throws it your face even more regularly than that.

We are told the only way we can lose weight is to either consume less energy (calories) or burn more energy (by exercising). Fat has almost twice the calories per gram as protein or carbohydrate. This is why fat is often the target of calorie restriction hysteria. Gram for gram you can eat almost twice as much of a carbohydrate and not unbalance your equation.

Sounds logical, right? And I guess that’s why this simple message has so much traction with advertisers.

The only problem is that it is utter nonsense.

The First Law certainly says that when we gain weight there will be an accompanying increase in the number of calories consumed (or decrease in the number burned). It is an equation and in equations each side must equal the other, but that does not necessarily mean that increased calorie consumption causes the weight gain.

It is equally logical to say that gaining weight is the driving force in the equation. In other words, weight gain causes us to consume more calories.

When a child grows they increase their body size and weight. These growth-hormone driven changes cause the child to consume more calories, not the other way around. Not even the most rabid nutritionist would suggest that feeding a 10 year old like an 18 year old would help you get past those awkward teenage years more quickly.

Growth happens because our hormone clock says it should. Calorie consumption just keeps up (so that the energy balance stays, well, ... balanced). We are perfectly happy to explain the equation that way when we talk about people who grow vertically. We’re even happy to accept that pregnant women gain weight (other than the baby of course) because hormones tell their bodies to fill the baby-pantry.

Eating is the way we put on weight, it isn’t the reason we put on weight. When a car accelerates, it does so because it has access to more petrol. The petrol doesn’t cause the acceleration, but it does enable it.

But for some reason when Norm grows horizontally, causation is magically reversed. Nutritionists lurch from physics into psychiatry and the cause suddenly becomes laziness or sloth (or both).

Just like height gain, weight gain is caused by hormones, but this time it is hormonal dys-function. The fructose half of sugar causes us to become resistant to our main appetite suppression hormones (insulin and leptin). When this happens our appetite is not shut-down when it should be and we just keep eating. And just like a Toyota with a stuck accelerator, our weight accelerates out of control.

Once we understand that weight gain is caused by hormonal dysfunction (a stuck accelerator) many (previously) mysterious things become clear.

A diet that asks you to consume less calories by exercising willpower is doomed to failure. Imagine how successful you’d be if you asked a child to exercise some willpower and stop growing. Fighting hormones with willpower is about as effective as paddling upstream with a barbed-wire paddle. Perhaps this is why the best indicator that you will be heavier in five years is being on a diet now.

Lap band surgery restricts the fuel supply without the need for willpower. It’s like clamping a fuel line in the car analogy. Less fuel gets through for a given squeeze of the accelerator. But our bodies are nothing if not adaptive, so they just ramp up the demand for calories (they push harder and longer on the accelerator). Perhaps this is why a lap-band driven ‘remission’ lasts only 10 years (at best).

Exercise burns so few calories that very few people can commit the time (or willpower) required for it to seriously affect energy balance. But even if they could, using more energy just increases the demand for energy (any gym junkie could tell you that). Lumberjacks eat more than office workers because they exercise more.

Diets, surgery and exercise do not affect the cause of weight gain (which is the hormonal dysfunction created by fructose) and so, they don’t work. Yet they remain the only targets of the billions spent ‘combating’ obesity in this country. All because the nutritionista hold true to a law of physics which has been misapplied to nutrition for the past 60 years.

When nutritionists first started guessing what made us fat, only one of the four major appetite hormones had been discovered. Then, it was (almost) acceptable to squeeze the square peg of a physics law into the round hole of human biochemistry. But those days are long gone and so too should be our tolerance for that kind of guesswork.

Many careers have been built on propagating this nonsense and there are many who will fight hard to protect it. But that should not be an excuse for inaction in the face of a human health disaster of truly epic proportions (pun intended).

How to spend a fortune on health and achieve nothing (aka the Budget Edition)

noreply@blogger.com (David Gillespie) — Wed, 12 May 2010 03:53:00 +0000

The budget contained a blizzard of announcements on health. And most of them are focused on preventing chronic disease. But the reality is that they will have approximately the same effect on chronic disease (and cost twice as much) as the home insulation program – nada, nil, nothing and nix.

Chronic disease is a priority because (as the budget papers point out) the big three (heart disease, diabetes and cancers) ”account for 70 per cent of health care expenditure ... [and] 50 per cent of GP consultations.” And these costs are projected to blow out to (really) unsustainable levels in the next two decades.

And the reason for all this chronic disease trouble? Well, that’s easy, we’re all ‘too fat’. According to the papers, “[the number of fat people] has significantly increased over the last 25 years [with] 68 per cent of adult men 55 per cent of adult women [now being] overweight or obese.”

You’ll no doubt be relieved to discover that the Government knows the cause all this fatitude and (even better) knows what to do about it. You see it’s all down to ‘lifestyle factors’. Translation: we eat too much fat and we don’t do enough exercise.

But the Government’s not just going to sit back and wait for the bills. They’ve got a four (no, not a five) year plan and it goes like this:

2010

Grants for “healthy lifestyle programs” in the community
“Public Awareness campaigns”

2011

Create Medicare Locals (GP centres) for delivery of preventive primary health care
More Public Awareness campaigns
More grants for healthy lifestyle programs in the community
States given money to implement healthy lifestyle programs in workplaces and schools
Awards for excellence in promoting healthy lifestyles

2012

Finish installing Medicare Locals
Money for more nurses and diabetes treatment
More Public Awareness campaigns
More grants for healthy lifestyle programs in the community
States given more money to implement healthy lifestyle programs in workplaces and schools

2013

More Public Awareness campaigns
More grants for healthy lifestyle programs in the community
States given more money to implement healthy lifestyle programs in workplaces and schools
Bonus payments for States that show we lost weight

That’s right, the plan is to nag us to death (or more precisely, to nag us to health). If you want to know what a “public awareness” campaign looks like when it’s at home, you need look no further than the recent “Measure Up” ads and posters.

According to a recent evaluation of that campaign, it was wildly successful. Now, by successful they don’t mean that there is any evidence that it had any effect on obesity or chronic disease. No, what they mean is that 91 per cent of us saw it.

The ads successfully told us we are too fat and we should do something about it. And thank goodness we have them because without all that advertising, we’d be forced to well, ah ... use a mirror?

The government is backing up these ads with loads of new lifestyle programs and money for GPs to target ‘primary prevention’. You won’t be able to visit a doctor, go to work or enter a school without being nagged about your ‘lifestyle’.

Last September, the Royal Children’s Hospital in Melbourne published the results of a study into exactly how effective that kind of nagging is. The research team asked 66 general practitioners to administer advice “targeting change in nutrition, physical activity, and sedentary behaviour.” The advice was in accordance with the national healthy living guidelines.

In the study, 258 obese Melbourne children were randomly assigned to either an intervention or a control group. The children in the intervention group saw their GP four times over a 12 week period and received all the recommended advice about nutrition and exercise. The kids in the control group lived life as normal without any nagging from their doctor.

Twelve months later, the researchers checked in with the kids to see what difference it made. The result was that the counselling “did not improve BMI, physical activity, or nutrition in overweight or mildly obese 5-10 year olds.” The researchers went on to note that “and it would be very costly if universally implemented.”

In stark contrast, there are over 80 studies (and counting) which show that taking the simple step of reducing the availability of sugar sweetened beverages (soft drinks and juices) has a dramatic effect on obesity and chronic disease. This kind of evidence seems to have escaped the research powers of our health hierarchy. Because even in the face of unequivocal proof that the advice we give our children doesn’t work, we’re lining up for more of the same.

Telling people to exercise more and eat less fat is immensely costly (as the budget has just proven) and the evidence says it doesn’t work. But it appears that we are not about to let those details get in the way of a campaign designed to convince us the Government is doing something about health.

The definition of insanity is doing the same thing over and over and expecting a different outcome. Let’s stop the insanity on health.

Help! We’re running out of Smokers.

noreply@blogger.com (David Gillespie) — Tue, 04 May 2010 06:04:00 +0000

What would we do without smokers? Until last Thursday, their dirty little habit tipped $7 billion a year into Australia’s tax coffers.

And now the little nudge Kevin gave the price on Friday will mean that over the next four years smokers will be sending a total of $33 billion to the tax man (go team). In the same time frame, Kevin’s new mining tax will have raised just $12 billion (as long as the resource boom holds up).

Even better than that (as any pollie worth his salt, well knows), whacking smokers is an exceedingly popular blood sport. Almost 90% of Australians are in favour of raising ciggy taxes. So in political terms smoking taxes are as close to free money as you’ll ever get.

In return for their generous contribution to nation building our nicotine addicted brethren ask very little. They cost the health system just $0.3 billion per annum (largely because they have the good grace to die quickly and inexpensively). And they don’t mind being treated like lepers as long as we let them keep smoking somewhere (even if they do have to take a cab to the designated smoking zone).

So it’s a good thing smokers are happy to continue to pay all that moolah because (‘reformed’ or not) by 2033, the Australian health system will be costing up to $295 billion every year (up from the $94 billion it currently costs). To put that in perspective, last year the total tax take for the entire country was a mere $338 billion.

If it weren’t for smokers, the queues at our hospitals would already be a helluva lot longer. Unfortunately smokers are not a renewable resource (for tax dollars). Every time we increase the tax, a few more (clearly less patriotic ones) give up. Since 1980, we’ve mined the revenue base down from 34% to just 19% of adults.

Worse than that, there is a very high likelihood that they swap their expensive (and taxable) addiction for a tax free addiction like sugar. A series of rat studies out of Princeton University over the last six years, have suggested that nicotine and sugar share the same (neurological) addiction pathways. Which might explain why smokers tend to hit the sweets when they give up.

Since people willing to have their brain hacked open while they suck on a lolly have been a little thin on the ground, we’ve had to be happy with animal studies. But advances in scanning technology are meaning that more and more human studies are starting to appear. And these studies are telling us exactly the same thing. Sugar is just as addictive as nicotine in humans.

Getting people addicted to sugar is not a good thing for our ailing health system. Sugar addicts develop lifelong diseases like Type II Diabetes and Heart Disease. These chronic conditions are currently managed (and not cured) with a continuous supply of very expensive medication. And ultimately end with people occupying expensive acute beds for very long periods.

The health budget is a runaway tram because of the accelerating blowout in these chronic (and largely preventable) diseases. By 2033 Type II diabetes alone is likely to cost a billion (or so) more to treat every year than we currently prise out of the smokers.

Taxing smokers until they quit provides a great band-aid for the sugar induced blowout in health. But what happens when we’ve converted them all to sugar addicts? How do we pay for the health system they will desperately need? Who do we tax then?

Ooh here’s a thought, how about we stop feeding people sugar instead? Nah, you’re right, that’s a silly idea, we’ll probably just tax the sugar instead.