In recent years there has been an astonishing trend. As obesity rates have soared so too have gym memberships, fitness regimes and low-fat diets.
For too long we have held up the misguided notion that excessive calorie consumption, allied to low activity levels, is the sole cause of weight gain. But calories aren’t the real issue — the real issue is sugar.
Compare a handful of almonds and a glass of Coca-Cola. Both may contain 160 calories, but they will have a totally different effect on our system. A lot of the calories in the almonds pass through the body undigested. Some will be metabolised and not laid down as fat. But the sugar in Coca-Cola is instantly absorbed and made into fat as a result of the insulin we secrete to reduce the sugar glut. It is the speed of absorption that causes damage, obesity and addiction. This is not obvious from any advisory label or nutrition information and should be more widely known.
Smoothies have a similar problem. An apple will contain fibre — this reduces sugar peaks in the body and the instant absorption of sugar through to the liver. But when an apple is pulped for a smoothie all this fibre is removed, effectively creating a soft drink.
The problem began when we demonised fat. If you remove fat from a food, it tastes awful. The food industry addressed this by adding sugar. As programmes such as Jamie’s Sugar Rush point out, even healthy foods now have incredibly high sugar levels. A glass of AriZona iced tea, for instance, has eight and a half teaspoons of sugar, a small bottle of VitaminWater has five teaspoons, while something called POM Wonderful juice has 15 teaspoons. Even a tiny serving of healthy-looking Dorset Cereals honey granola has two teaspoons of added sugar.
Consistent peaks and troughs of sugar levels have a profound effect on the body. They create addiction and dependency. Scarily enough, when given a choice between sugar water and cocaine, lab rats actually chose sugar water. So not only are we creating a nation of obese people, we’re also making them into addicts of the least nutritious food group of them all.
As a doctor, I keep hearing the narrative that we can’t afford the NHS. I think the narrative should be that we can’t afford the cost of a poor public health policy on sugar. Instead of spending thousands per patient on bariatric surgery on a relatively unfair case-by-case basis, we should put aside a modest amount of money for health education and implementation of a tighter upper limit on daily sugar consumption. Spend a few pennies now to save thousands of pounds in years to come — it makes perfect sense as a Department of Health “efficiency saving”.
Lower socioeconomic groups are often most guided by cost. By introducing a sugar tax, we could discourage people from over-consuming a harmful product that is known to cause disease. The revenue could fund other initiatives to improve health outcomes, for example subsidising fresh food in schools, as they do in Italy. All of these themes Jamie Oliver has suggested and I can only applaud him for even beginning to try.
We know that sugar causes obesity — we have enough evidence to justify this argument. Unfortunately, however, we are in a phase where the competing interests are clinging on to whatever they can while they provide “alternative” explanations and solutions that maintain the status quo, much like Big Tobacco in the 70s and 80s. In this light maybe the “Sugar is harmful” advisory on food is not as far off as we think.