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               Sweet
               Misery
               Is sugar
               the new
               fat – and
               will it
               cause the
               next wave
               of heart
               disease?
               Donna
               Chisholm
               reports.




               B
                             y god, we fell like flies in those       prosecution against sugar was British
                             days: 1960s New Zealand – land           researcher Professor John Yudkin from the
                             of full-cream milk and honey. The        University of London, author of Pure, White
                             days when Mum kept the drip-             and Deadly. Heading the case against fat
                             ping from the Sunday roast in the        was American nutritionist Ancel Keys, who
               old Wattie’s fruit can by the oven so she could        initiated the 25-year-long Seven Countries
               fry the chips in it later. The days when you           Study that first confirmed the links between
               got olive oil from the chemist and you didn’t          diet, blood cholesterol levels and heart
               buy it to eat but to soften the wax in your ears.      disease. Eventually, Yudkin would be
               The days when about 7000 of us every year              discredited by his funding from the dairy
               dropped dead from heart disease.                       industry while Keys died in 2006 at the age
                 It wasn’t just us, of course, although as a          of 100, a scientific hero.
               farming nation we had a big appetite for                 Back at home, the Heart Foundation came
               animals. Internationally, doctors couldn’t             along in 1968 and in the 1970s began to
               agree on the cause for the heart disease               spread the message to reduce our dietary
               epidemic, but there were two obvious                   fat intake, stop smoking and up our exercise.
               dietary culprits: sugar and fat. Leading the           In 1972, in Auckland, we got off our chuffs
                                                                      and started running round the bays every
                                                                      year. By the end of the 1970s came the first
                   donna chisholm is north & South’s
                                                                      signals our healthier lifestyle was saving
GETTY IMAGES




                   editor-at-large. pHOTOGRAPHY BY
                   JUSTIN LAMBERT AND ADRIAN MALLOCH.                 lives: heart disease death rates began to fall.

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What to Do About It) and Australian lawyer         make them feel better.
                                                                                       David Gillespie (Sweet Poison), who lost              “Most people don’t eat because they think
                                                                                       40kg by cutting out sugar.                         they have to meet some energy demand.
                                                                                         The theory is attracting followers here          They eat because they’re hungry and part
                                                                                       (see Sugar Free, page 42), which is no sur-        of this hunger is very similar to the with-
                                                                                       prise given New Zealanders are among the           drawal syndrome from drugs of abuse.”
                                                                                       largest sugar consumers in the world: we              So far, so straightforward. But here’s
                                                                                       each scoff more than 39kg every year com-          where we need to explain a little more about
                                                                                       pared to Britons’ 34kg, for example.               fructose. Until recently, it’s been the silent
                                                                                         But with all the conflicting advice, which       50-50 partner, with glucose, in sugar. Most
                                                                                       can we rely on? What is the relationship be-       of us have heard of glucose, but we know
                                                                                       tween sugar and our weight, and sugar and          less about fructose, other than that it’s what
                                                                                       our heart health?                                  makes fruit taste sweet. The fact fructose
                                                                                         The answer is the same as with most              comes from fruit has been largely respon-
                                                                                       relationships: it’s complicated.                   sible for its pristine reputation – but the




                                                                                       P
                                                                                                                                          way it’s been harnessed commercially has,




                                                                                                                                                                                                                                                                                                         ADRIAN MALLOCH
                                                                                                    ublic health physician Simon          in the United States at least, seen it assume
                                                                                                    Thornley has put sugar in the         a new status as obesity villain.
                                                                                                    dock. His waistline has found it         Fructose has been particularly targeted by       Public health physician Simon Thornley.
                                                                                                    guilty and discharged fat, the co-    Robert Lustig, who sheets blame for the obe-
                                                                                                    accused, without conviction.          sity epidemic back to former US President
                                                                                          At Auckland University’s School of Popu-        Richard Nixon, who encouraged farmers
                                                                                       lation Health, where Thornley works as a
                                                                                       research fellow, it’s a polarising position
                                                                                                                                          into industrial-scale production of corn in
                                                                                                                                          an effort to stabilise food prices as part of his
                                                                                                                                                                                              tose intake because it didn’t increase blood
                                                                                                                                                                                              glucose levels. But what they were soon to
                                                                                                                                                                                                                                                 “Most people don’t
                                                                                       but, as we’ve explained, one which is clearly      “war on poverty”. From corn came high-              learn was the downside of fructose: it raises      eat to meet some
                                                                                       influencing a public, if not professional re-      fructose corn syrup (55 per cent fructose and       levels of a type of cholesterol (LDL) – which      energy demand.
                                                                                       think of decades of dietary advice.
                                                                                          Somewhat controversially, within his de-
                                                                                                                                          45 per cent glucose), which was about twice
                                                                                                                                          as sweet and half the cost of sugar.
                                                                                                                                                                                              has been linked to heart attacks – in the blood.
                                                                                                                                                                                                 While Otago University’s world-renowned
                                                                                                                                                                                                                                                 They eat because
                                                                                       partment, Thornley has not only switched to           Soon, in the US, high-fructose corn syrup        nutrition expert Professor Jim Mann accepts        they’re hungry and
                                                                                       a low-sugar diet these past couple of years,       would replace sugar in everything from              that sugar can raise blood levels of triglycer-    part of this hunger
         And they have kept falling ever since. Today,
         they are an astonishing 80 per cent lower than
                                                                Heart disease          but he’s also increased his saturated fats,
                                                                                       changing from skim to blue-top milk, from
                                                                                                                                          pizzas and bread to soft drinks. And because
                                                                                                                                          it was cheap, and we are programmed to like
                                                                                                                                                                                              ides – another chemical compound linked to
                                                                                                                                                                                              heart disease – he says his own work for his
                                                                                                                                                                                                                                                 is very similar to
         they were at their peak in the 1960s. And yet          death rates are an     low-fat yoghurt to the Greek full-fat version,     sweet food – because we need glucose to             PhD thesis 40 years ago showed very large          the withdrawal
         we’re fatter than we’ve ever been, with more           astonishing 80 per     and even frying an egg in butter for               survive and sweetness is an evolutionary            amounts are required before it has that effect     syndrome from
         than a quarter of us considered obese.
           Now, though, it’s predicted the rate of im-
                                                                cent lower than        breakfast.
                                                                                          This year, Thornley co-authored Sickly
                                                                                                                                          signal for food safety – it was soon being
                                                                                                                                          pumped into products that hadn’t been
                                                                                                                                                                                              and Lustig’s description of sugar as toxic is
                                                                                                                                                                                              “over the top”.
                                                                                                                                                                                                                                                 drugs of abuse.”
         provement in heart disease death rates will            they were at their     Sweet, a book which investigated the role of       sweetened before, including sauces, salad              But, he says, very much more sophisti-          Public health physician
                                                                                                                                                                                                                                                 Simon Thornley (above).
         soon start to plateau and even reverse. The            peak in the 1960s.     sugar, and sugar addiction, in global obesity.     dressings and even hamburger meat.                  cated experiments are now being done,
         disease is the same, but its profile is differ-                               Thornley says he was exposed to the “low-             But Lustig goes further than saying we’re        particularly in regard to uric acid, which is
         ent. While smoking rates, blood pressure and
                                                                And yet we’re fatter   fat mantra” at medical school in the 1990s         eating too much fructose and it’s making us         also believed to be important in a range of
         cholesterol levels are all improving, obesity          than we’ve ever        and for the next 10 years he went along with       fat. He contends it’s poisoning us, because         metabolic disorders that lead to obesity and
         and diabetes-related mortality is on the rise.         been, with more        it. He says he ended up packing on 15kg.           of the way the body metabolises it.                 diabetes. It’s those metabolic abnormalities
           Enter the new vanguard of dietary gurus                                        It was while working on techniques to help         Now for a quick lesson in biochemistry to        which can then cause cardiovascular disease.       flavour of syrup-sweetened Coca-Cola for
         telling us we’ve been sold a pup with this
                                                                than a quarter of us   smokers quit that he read Robert Atkins’ low-      learn about the different ways we respond              While Mann says he’s regarded as “one of        example. But as several experts pointed out,
         low-fat message. The real problem, they say,           considered obese.      carb weight-loss book – which fuelled a rash       to fructose, and to glucose. When we take in        the arch-enemies of the sugar industry”, he’s      the difference between the syrup, which is
         is sugar.                                                                     of low-carb diets – and found a reference to       glucose, the pancreas releases insulin to me-       appeared in debates with Lustig in the past        55 per cent fructose, and sugar, which is 50
           Today’s debate echoes that of the 1960s, in                                 an overweight executive addicted to sugar,         tabolise it. Eighty per cent of the glucose we      and says there’s “no evidence whatsoever”          per cent fructose, isn’t that great anyway.
         that the San Francisco paediatric endocri-                                    who experienced symptoms similar to a              eat is used to provide instant energy. About        for Lustig’s theory that sugar, rather than fat,   And we have also fallen victim to the food
         nologist leading this new wave of advice is                                   smoker trying to give up nicotine.                 20 per cent is delivered to and processed by        is the culprit in coronary heart disease. “He      industry’s relentless marketing of “low-fat”
         self-described Yudkin acolyte Robert Lustig.                                     Seven years later, Thornley has taken a         the liver, where most is converted to glyco-        hasn’t got enough evidence to say that, in         food as a healthy alternative – despite the
         Lustig, whose Bitter Truth video on YouTube                                   “what if” idea to develop his hypothesis that      gen and stored for later use. A very small          amounts typically consumed by you and me           fact the flavour lost from fat has been re-
         has attracted nearly three million hits, calls                                sugar – or at least, the fructose component of     amount is converted to fat.                         and people like us, sugar is uniquely bad by       placed by sugar or salt.
         Yudkin a prophet who was “thrown under                                        sugar – is addictive, and our craving for it can      Fructose, on the other hand, does not            virtue of being sugar.” But he does agree that       Whether that’s been a deliberate or
         the bus” by a food industry eyeing big dollars                                overwhelm our satiety response and make us         stimulate the release of insulin – the process      sugar promotes obesity, obesity drives dia-        accidental evil depends on your inter­
         from “low-fat” food.                                                          keep eating when we’ve already had enough.         that signals we’re full. Instead, fructose is       betes and diabetes increases the risk of heart     pretation of events. “A Chinese whispers
           While Lustig’s message has failed to get                                       He says while people often report feeling       absorbed from the small bowel and broken            disease and stroke.                                thing happened,” says former National Heart
         widespread backing from the medical pro-                                      “hypo” – shaky, weak and craving a sugar hit       down by the liver where it is converted mostly         While the infamous high-fructose corn           Foundation director Dr Boyd Swinburn, now
         fession, it’s embraced by a number of influ-                                  – those who aren’t diabetic or on pills to         to fat, or uric acid (which causes gout).           syrup is now ubiquitous in the food chain in       professor of population nutrition at Auckland
         ential authors, including American science                                    lower their blood glucose levels would never          Relatively recently, diabetic groups even        the US, its use has not been widespread here.      University. “Scientists said – and still say –
CORBIS




         writer Gary Taubes (Why We Get Fat: And                                       get truly hypoglycaemic. But sugary food can       advocated their members increase their fruc-        New Zealanders have never embraced the             that a diet relatively high in fat will cause an

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increase in weight. That then got flipped           explain why we just keep eating if we’re full.”
          The Sweeteners                                                                       into a diet low in fat will help lose or              Thornley is keen to do that work, but has




                                                       I
                                                                                               maintain weight, and that got flipped into          been stymied by lack of funding. In the
                                                             f you’ve switched natural         a diet high in carbohydrates must therefore         meantime, he is his own one-person clini-
                                                             sweeteners, from table sugar      be good for you and that got flipped into           cal trial and says he’s finding that the less
                                                             to honey – maybe maple syrup      eating more of the stuff is good for you… So        sugar he eats, the less hungry he feels. “I
                                                             or the even more exotic agave     you had the whole industry push around              used to feel hungry all the time. And while
                                                             nectar – in the belief you’re     low fat, and eat more of this because it’s low      I haven’t dramatically lost weight, I now
                                                       doing yourself a dietary favour,        fat, when it happened to be loaded up with          don’t need to snack all the time.”
                                                       the unpalatable truth remains           sugar. The industry spin on the science,              Instead of a breakfast cereal that’s 30 per
                                                       that it’s not so much the quality       when it got turned into marketing, became           cent sugar, he’ll now have an egg, scrambled
                                                       of a sweetener as the quantity          an overconsumption message.”                        or fried, and he’s given up fruit juice. “I used
                                                       consumed that ultimately finds             Swinburn says studies show that people,          to drink a lot of juice because I thought it
                                                       its way to your waist and hips.         particularly women and women dieters, see           was good for me because it’s natural, but it’s
                                                          Certainly, honey, maple syrup,       a “97 per cent fat-free” product as a signal        also got a very high concentration of
                                                       golden syrup and the family of          that it’s OK to eat more of it. “If people are      fructose.”
                                                       brown sugars (including muscovado,      given two yoghurts for morning tea, and one           The higher fat does seem to be having an
                                                       demerara and rapadura) impart           is labelled low- or no-fat, and then they’re        effect, though. His “bad” LDL cholesterol
                                                       flavour to food and drink that’s        able to eat whatever they want at lunchtime,        has gone up, while his “good” HDL choles-
  getty




                                                       lacking in white “table sugar”.         those who’ve had the low-fat version do the         terol remains high. “But,” he rationalises,
                                                       And there are traces of minerals        calorie count in their heads and eat more at        “low HDL is more strongly associated with
                                                       in brown sugars and maple syrup,        lunch. So it’s not only a metabolic issue, but      heart disease than high LDL.”
                                                       although not in meaningful amounts      a psychological one as well.”                         It’s impossible to discuss Thornley’s
                                                       for nutrition. “Active” manuka             Similarly, Auckland University epidemiolo-       theories without at least a nod to the
                                                       honey has also been shown to have       gist Professor Rod Jackson identifies a prob-       glycaemic index. Most of us have heard of it
                                                       some health benefits – wound            lem with the bastardisation, over the years,        – food with a lower GI rating helps us feel
                                                       healing among them – unrelated          of the “eat less saturated fat” message to a        full for longer. Food with a higher rating
                                                       to its calorific content. Don’t be      simpler one of “eat less fat”. This has meant       causes higher peaks in our blood sugar levels,
                                                       fooled, though. The way our bodies      all fats – even the vegetable fats which don’t      with a corresponding increased release of
                                                       metabolise the molecules in different   harm your heart but are equally calorific –         insulin. In fact, so much insulin can be
                                                       sweeteners may vary, but they’re        have been removed and the only way to com-          released that it causes a kind of rebound
                                                       all sugars and carbohydrates.           pensate for the loss of taste has been to add       effect, gobbling up so much glucose from the
                                                          New Zealand sugar is mostly          sugar, which can also make us fat; or salt,         blood that it takes it below the normal
                                                       sourced from sugar cane, whereas        which can lead to high blood pressure.              baseline – making us hungry again more
                                                       Europe gets the bulk of its supply         “It seems kind of weird that you reduce          quickly.
                                                       from beets. High-fructose corn          your fat intake and get fatter. But I think it’s      Ironically, a teaspoon of sugar is only mod-
                                                       syrup, extracted from corn, is a        possible if the price we’ve paid for eating         erately high in GI with a ranking of 65, com-
                                                       largely American food-ingredient        less fat has been eating more sugar.”               pared to a medium boiled potato with 88.
                                                       phenomenon. Its recent bad                 To Jackson the solution seems simple –           A slice of banana cake weighs in at 47 and a
                                                       press, both for its ubiquity and        replace more of the sugar with non-animal           Snickers bar 41 – mainly because of fats




                                                                                                                                                                                                                                                                                                                 JUSTIN LAMBERT
                                                       high fructose content (see              fats. “If you eat less saturated fat and less       which slow the rate at which foods leave the
                                                       page 37), has seen some food            salt and don’t smoke, the benefits of that          stomach.
                                                       manufacturers switching to other        overwhelmingly outweigh the harms of get-             “GI is useful for differentiating starchy foods
                                                       sweeteners and publicising the          ting fatter. I’m not suggesting fat is good,        in terms of their ability to deliver glucose,”
                                                       fact on their packaging – boldly,       but a lot of other causes of heart disease are      says Thornley, “but as a predictor of the ad-                                                         Dr Boyd Swinburn, professor of population
                                                       as plastered across this box of         more important than being fat.”                     dictive ability of food, it totally misses sugar.”   2008-2009 that suggested our total calorie       nutrition at Auckland University. “The
                                                       shredded wheat breakfast cereal            Jackson is horrified Thornley is increasing        National Addiction Centre director Pro-            intake had significantly declined since 1997.    industry spin on the science, when it
                                                                                                                                                                                                                                                         got turned into marketing, became
                                                       (left) from a US supermarket.           his saturated fat intake while cutting out          fessor Doug Sellman has also recently talked           “It has to be wrong,” says Jackson. “We’ve     an overconsumption message.”
                                                          The best way to get your sweet       sugar, saying the evidence against saturated        about food addiction, particularly junk-food         got fatter and yet our activity levels haven’t
                                                       fix? Dieticians will always champion    fat is overwhelming. However, he believes           addiction, saying it should be recognised as         changed much. What’s happened is that
                                                       fruit, eaten fresh and whole (rather    Thornley’s addiction theory is “an interesting      a medical condition. Likewise, scientists at         since 1997 almost every newspaper every
                                                       than juiced), and naturally sweet       hypothesis that theoretically and biochemi-         the University of Michigan have reported             other day has an article about obesity. It’s
                                                       vegetables such as carrots. One         cally looks important. Maybe we’ve addicted         how foods high in fat and sugar triggered a          become the new tobacco and that would lead
                                                       110g apple, for instance, has 6g        a whole population because we’ve increased          spike in an opioid-like chemical in the brain        people to under-report. I don’t think there’s
                                                       fructose, 3g glucose, 2g sucrose –      the sugar in food.                                  of rats. The stronger the rise in the brain          any doubt we’re eating more of everything
                                                       a total of 11g carbohydrate – but          “We’re talking real generalities, but if we’ve   chemical, the faster the rats raced to eat the       except saturated fat and salt.”
                                                       with the health-bearing benefits of     replaced fat with sugar and sugar is addictive,     sugary food – in this case M&Ms.                       And yet a paper published by the Public
                                                       plentiful vitamins and minerals and     maybe that’s what we’ve done. It kind of fits,        But confounding this whole argument that           Health Nutrition Journal in 2007, of which
                                                       a good dose of dietary fibre, too.      it’s feasible and it’s worth pursuing in more       eating more sugar is making us fat are the           Otago associate professor Winsome Parnell
                                                                                               studies because if it’s true it would help          findings of the National Nutrition Survey in         was the lead author, used the nutrition survey

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data to conclude: “Current sugars or sucrose      weight gain in children and a “low-hanging                                                                                                                            very fast – and makes it likely we wouldn’t
                                                        intake is not associated with body weight         fruit” for public health initiatives. Gerhard                                                                                                                         be told about it anyway. Sanitarium’s nutri-
                                                        status in the New Zealand population.”            Sundborn, an epidemiology research fellow                                                                                                                             tion services manager, Cherry Downing, says
                                                          Jim Mann, who is listed as a co-author in       at Auckland University’s School of Popula-                                                                                                                            while they’re always looking to make health-
                                                        the study, distanced himself from the             tion Health, has written a post-doctoral pa-                                                                                                                          ier options, “we’re up against other manu-
                                                        conclusion when contacted by North & South,       per suggesting an “end game” for sugar-                                                                                                                               facturers who might still be putting certain
                                                        agreeing with us that it would be “totally        sweetened drinks similar to the government’s                                                                                                                          levels of sugar in”. And if the product doesn’t
                                                        misleading” to a lay reader. He says his only     proposal to eliminate smoking by 2025.                                                                                                                                taste good, consumers won’t buy it.
                                                        contribution to the paper had been to include       While the American Heart Association rec-                                                                                                                              The company does provide low-sugar
                                                        a paragraph pointing out that a cross-sectional   ommends a daily intake of just six teaspoons                                                                                                                          cereals, including Weet-Bix, San Bran and
                                                        study such as the nutrition survey, which         of sugar a day for women, nine teaspoons for                                                                                                                          Puffed Wheat. Weet-Bix, which are very
                                                        questioned people about what they’d eaten         men and three for children, we’re eating far                                                                                                                          low in sugar, remain the country’s number
                                                        over the past 24 hours, meant the data could      in excess of that, with a median intake of 24                                                                                                                         one cereal – although Downing acknow­
                                                        not be used to imply cause and effect.            teaspoons for women, 30 for men and around                                                                                                                            ledged many customers would add sugar
                                                          Acknowledgments in the paper say                26 for children. Given a 600ml bottle of soft                                                                                                                         or other sweeteners.
                                                        “secondary analyses” of the nutrition survey      drink contains about 16 teaspoons, eliminat-                                                                                                                             Heart Foundation medical director and
                                                        data was commissioned by NZ Sugar Ltd –           ing just one drink a day could do much to                                                                                                                             former cardiologist Dr Norman Sharpe says
                                                        effectively Chelsea Sugar – which funds the       reduce that consumption.                                                                                                                                              the foundation wouldn’t be collaborating
                                                        NZ Sugar Advisory Service. The service’s            An analysis of international research                                                                                                                               with fast-food chains any time soon in its
                                                        stated aim is to “encourage appropriate use       suggests it’s highly likely sugar-sweetened                                                                                                                           initiatives to reduce sugar, fat and salt.
                                                        and enjoyment of sugar as part of a healthy       drinks are the single largest driver of un­                                                                                          Auckland University                 “It’s a no-win situation. They’ll give a little
                                                        and balanced diet”.                               healthy weight. One major American study                                                                                             epidemiologist Professor         here, then rip you off over there. They’ll put
                                                          Parnell is listed on the service’s website as   reported they accounted for 20 per cent of                                                                                           Rod Jackson: “It seems           in the token salad, but they’re still marketing
                                                                                                                                                                                                                                               kind of weird that you

         Negotiating the                                a member of its advisory panel.
                                                          Parnell says she is not on the company’s
                                                                                                          the weight increase in the US over 30 years
                                                                                                          from 1977. But any attempt to restrict them
                                                                                                                                                                                                                                               reduce your fat intake
                                                                                                                                                                                                                                               and get fatter. But I think
                                                                                                                                                                                                                                                                                it [fast food]. The Heart Foundation worked
                                                                                                                                                                                                                                                                                with McDonald’s in Australia and got badly
         Sugar Maze                                     payroll, but sometimes receives a small hono-     will face a pushback from the industry and                                                                                           it’s possible if the price       burned. They got set up, and McDonald’s




                                                                                                                                                           JUSTIN LAMBERT
                                                                                                                                                                                                                                               we’ve paid for eating
                                                        rarium to cover costs. Asked if there was a       opposition to “nanny state” ideology. John                                                                                           less fat has been eating         used their brand to market their product.
         We asked nutritionists for some                risk that being an adviser for a number of        Key’s government, for example, moved swiftly                                                                                         more sugar.”                     You get families in through marketing some
         dietary advice to guide us                     years to the company could be perceived as                                                                                                                                                                              salad, but the kids are still going to buy the
         through the sugar-fat maze.                    compromising her, she replied: “I don’t care                                                                                                                                                                            rest of the junk. It was a fiasco.”
                                                        what you think about it. I don’t care what any-                                                                                                                                                                            In 2010, Weight Watchers in New Zealand
         Elaine Rush, professor of nutrition            one thinks. My conscience is entirely clear.                                                                                                                                                                            collaborated with McDonald’s and endorsed
         at Auckland University of Technology:          I’ve professionally advised Heinz Wattie’s for                                                                      in 2009 to revoke the Labour govern­ ent’s
                                                                                                                                                                                                                    m         regular Coke. The company referred us to          three of their meals, a move criticised at the
         • Physical activity churns up the             20 years. I am impartial in the advice I give.                                                                      requirement that schools were to sell only        Winsome Parnell for additional comment.           time by Boyd Swinburn. “Make no mistake,
           glucose. You’re better able to process       I don’t think they like all the advice I give.”                                                                     healthy food – a change the Heart Foundation        Food and Grocery Council chief executive        this is about selling more burgers and fries.”
           sugar the more active you are.                 She says the paper in Public Nutrition was                                                                        described as a giant leap backwards.              Katherine Rich says council members, in-             Sharpe says while the Heart Foundation
         • If you gradually cut down sugar, for        not intended for a lay audience.                                                                                      Most recent advances, though, have been         cluding Nestlé, Coca-Cola Amatil, Tasti,          had been very successful in working “under
           example in tea and coffee, your taste          Parnell says she never picks out a particu-                                                                       the result of collaboration rather than           Cerebos, Fonterra and Hansells, are heavily       the radar” with the food industry to reduce
           buds will start to adapt to the change.      lar nutrient as a cause of obesity; obesity re-                                                                     legislation. For example, in 2006, McDonald’s     involved in promoting healthy food mes-           salt in bread – 150 tonnes was taken out of
         • Staff cafeterias can ask vending-           sults from an energy imbalance. “I have not                                                                         and Coca-Cola joined a Counties-Manukau           sages. “I suspect they’re investing more than     the national food supply annually – it was
           machine operators to change the              been convinced by the literature that sugar                                                                         District Health Board “Let’s Beat Diabetes”       the government. Sugar is the focus at the         a slow process and with it went the risk of
           position of products so healthier options    as a nutrient is any more involved in causing                                                                       initiative and trialled the replacement of        moment but it wasn’t so long ago that the         “capture by the food industry”.
           such as water are in first line of sight.    obesity than too much fat. Often the two go                                                                         Sprite with Sprite Zero for six months in all     big discussion was about fat or salt. You can        “Basically, we’re outgunned and outnum-
         • Eating the vegetables on your               together in food anyway.” It was a “gross                                                                           21 McDonald’s restaurants in Counties-            take out as much as you like but eventually       bered.”
           plate first can help to fill you up          generalisation” to say sugar promoted                                                                               Manukau. When consumers didn’t oppose             you find yourself eating cardboard.”                 He admitted the foundation had also been
           and reduce your intake of less               obesity.                                                                                                            the change – or even notice it, it seems – the      Some confectionary companies had re-            burned when it gave a “tick” to Milo in 2008
           healthy food at the same sitting.              Parnell has also been quoted in the past as                                                                       sugar-free drink became the “default”             duced portion sizes “with well-intentioned        when Nestlé simply advised consumers to
                                                        saying banning fizzy drinks from schools                                                                            lemonade served throughout the country.           reasons but the cheap shot is often you’re        use less of it. “The tick is a bit of a trap,” says
         Helen Eyles, public health                     would do nothing to stop the high levels of                                                                           This, and a 40 per cent reduction in sugar      only doing that to save money”. She con-          Sharpe, “because it doesn’t necessarily mean
         nutritionist for the National Institute for    sugar children were getting from powdered                                                                           in McDonald’s buns about the same time,           ceded, however, that smaller portions didn’t      the product is recommended but within its
         Health Innovation at Auckland University:      fruit-flavoured drinks at home.                                                                                     removed 300 tonnes of sugar a year from the       always bring smaller prices. “To embark on        category it’s the healthier choice.”
         • If you’re trying to keep to foods with no     She told North  South that if she were an                                                                        chain’s menus in New Zealand. McDonald’s          a programme that removes sugar is com-               Sharpe says while our declining heart dis-
           more than 10 per cent sugar content,         overweight teen, she’d choose a sugar-free                                                                          told us the same deal isn’t being considered      pletely unnecessary because we’re talking         ease death rates are encouraging, we can’t
           make sure you factor in serving size.        version of a soft drink but she would not gen-                                                                      for Coke and Coke Zero because it believes        about a natural product that’s an integral        afford to be complacent in the face of the
           For example, soft drinks have only eight     eralise for all. “There are many very under-                                                                        the taste is noticeably different.                part of a healthy diet. It has to be all things   obesity and diabetes tsunami looming, and
           grams of sugar per 100 grams, but            weight young people who drink a sweetened         An analysis of international research suggests                      Coca-Cola says while it won’t divulge sales     in moderation.”                                   sugar is an obvious next target. “We have the
                                                                                                          it’s highly likely sugar-sweetened drinks
           the average drink is three times that.       drink. If you took that away, they might fade                                                                       figures, Coke Zero and Diet Coke are now            Rich also suggested we approach Win-            fat down in the diet but sugar is the new fat.
                                                                                                          are the single largest driver of unhealthy
         • A low-GI breakfast such as porridge         away, I don’t know.”                              weight. One major American study reported                         the third and fourth most popular of its          some Parnell for comment.                         It’s all about energy imbalance. Sugar has
           will keep you feeling full for longer than     However, many others in the field have tar-     they accounted for 20 per cent of the weight                      drinks brands and Coke Zero sales increased         Competitive edge is one reason sugar prob-      been substituted for fat and the portion size
CORBIS




                                                                                                          increase in the US over 30 years from 1977.
           a highly processed, sweetened cereal.        geted soft drinks as both a cause of unhealthy                                                                      8.6 per cent last year – a bigger increase than   ably won’t be reduced in food very much or        has gone up and the result is carnage.”

                                                                                                                                                                                                                                                                                 N O R T H  S O U T H | N OV E M B E R 2 0 1 2 | 4 1
Though his wife has since abandoned
                                                                                                                                                      the sugar-free diet because she’s
                                                                                                                                                      pregnant, Marshall says he’s happy to
  Junk Food and                                                                                                                                       keep going. Sticking to the new plan
                                                                                                                                                      has also been made easier by the fact
  Alzheimer’s                                                                                                                                         two of his IT colleagues at Auckland




  W
                                                                                                                                                      University, David Glen and Chris




                                                       Sugar Free
                     hen New Scientist
                     magazine reported                                                                                                                Groom, are on similar programmes.
                     in September on                                                                                                                     Glen says his father recommended the
                     research linking junk-                                                                                                           sugar-free way after reading Gary Taubes’
  food diets and insulin resistance to                                                                                                                Why We Get Fat: And What to Do About It.
  Alzheimer’s disease, it confirmed work                                                                                                              “I laughed at him and said all the research
  done more than 10 years ago by Auckland                                                                                                             says a high-fat diet and meat is not good
  scientist Professor Garth Cooper.                                                                                                                   for you and we should be eating more
                                                       An Auckland couple kick the sweet stuff.                                                       carbs.” But after getting the book himself,
     Cooper and his colleagues from Auckland
  University and Christchurch Medical School                                                                                                          and hearing other experts whose views
  described in 2001 how the “misfolding”, or                                                                                                          he respected give the idea credence, he
                                                                                                                                                      began reducing his sugar and carb intake.




                                                       W
  changing shape of proteins in the pancreas
  of diabetics, mimicked changes in the                                 hen IT professional          his weight ballooning from its usual                While he didn’t have Marshall’s
  brain tissue of patients with Alzheimer’s.                            Donovan Marshall, 34, and    90kg to 115kg. For someone who’s                 prodigious appetite for sweets, Glen,
     He says there’s now widespread belief                              his wife Margo went cold     165cm tall, it was, says Marshall                34, says he often felt hungry on the
  that type 2 diabetes and Alzheimer’s are                              turkey on sugar earlier      “a little on the heavy side”.                    way home and if he was filling up the
  either very similar or “more closely linked          this year, they didn’t give temptation a        The first change was having breakfast          car at a petrol station he’d buy a bag
  than that”. In fact, some researchers now            look-in. They took the chocolate, biscuits,   – although, given that was a Carls Jr            of jelly beans or chocolate. He’d have
  see it as “just another form of diabetes”.           jam, maple syrup and sweets out of their      breakfast burger, it might not have been         three coffees a day with a couple of
     Recent studies have shown up to                   cupboards and gave them all away.             the healthiest option. At work, Marshall         teaspoons of sugar in each, and his
  80 per cent or more of people with                     Marshall says his wife, worried about       swapped Pepsi for water or the sugar-            diet was high in carbs. “I was pretty
  Alzheimer’s have undiagnosed diabetes                their sugar intake and creeping weight        free Pepsi Max, and the chocolate bars           much living on bread and pasta and
  or pre-diabetes, leading some to                     gain, had been inspired by Australian         for nuts and dried fruit. He and his wife        supplementing that with orange juice.”
  dub Alzheimer’s “diabetes 3”.                        author David Gillespie’s book Sweet           used Splenda, a sugar substitute, in                Lured by Subway’s low-fat claims,
     New Scientist called the link                     Poison. He read the book and other            their American pancakes, and a sugar-            he’d have a six-inch roll from the chain




                                                                                                                                                                                                                                                                                                           JUSTIN LAMBERT
  the “ultimate food scare”.                           similar titles before deciding to go sugar-   free maple syrup. Out went the tomato            almost every day. “I’d have that between
     “The world already faces an epidemic              free himself. “I thought it made sense        sauce – 30 per cent sugar – and the low-         12 and 1pm but by 3 o’clock I’d want
  of diabetes. The prospect of a parallel              and it wouldn’t hurt to give it a go.”        fat, but high-sugar yoghurts. Within a           more. My hands would be shaky and
  epidemic of Alzheimer’s is truly frightening.          The reading made him realise just           few weeks, he found his appetite – and           I was very hungry all the time. I was
                                                       how high his sugar intake was. “I have a      sugar cravings – had reduced. So had his         struggling to make it between meals           15kg and then dropped another
     “A preference that started out as a
                                                       sedentary job and I was consuming a lot       weight, and after eight months, he’s down        without feeling shaky and horrible. My        7kg over the next three months.
                                                                                                                                                                                                                                                     “I feel a lot more
  survival mechanism has, in our age of plenty,
  become a self-destructive compulsion.”               of sweet products to keep myself going.”      to 105kg, which considering he hasn’t            blood sugar levels tested normal but            Watching Glen’s progress was colleague         alert in the
     Cooper (North  South’s New Zealander               He’d regularly skip breakfast, and by       given up other carbs or high-fat meals, he       going between meals was getting harder.       Chris Groom, who was so impressed                afternoons and
                                                       mid-morning he was hungry – time for a        attributes entirely to the absence of sugar.     I felt unwell and needed a sugar hit.”        he decided to give it a go too and has
  of the Year in 2004) now splits his time
                                                       Pepsi and a chocolate bar. At lunchtime,        “I feel a lot more alert in the afternoons        Now he has two or three scrambled          eliminated bread, pasta and potatoes
                                                                                                                                                                                                                                                     I can’t eat as much
  between Auckland and the University of
  Manchester, and is trying to find ways to stop       he headed to St John’s, near Auckland         and I can’t eat as much as I used to,” he        eggs for breakfast, and lunch consists of     from his diet. Now an avid reader of             as I used to. The
  the misfolding proteins from killing cells.          University’s Tamaki campus where he           says. “The longer I do it, the easier it is to   cheese, nuts, cold meats and vegetables       ingredient panels, Groom has been taken          longer I do it, the
                                                       works, for a burger from new fast-food        not eat stuff with sugar. The cravings just      including celery, lettuce and tomato.         aback by the sugars in even savoury
  Both sugar and saturated fats are implicated,
                                                       restaurant Carls Jr. A couple of hours        aren’t there.”                                   He’s given up potatoes and kumara.            products, including peanuts and bacon.
                                                                                                                                                                                                                                                     easier it is to not
  he says, particularly in the highly processed
  foods many of us are now eating to excess.           later, the munchies would strike again –        He says that he doesn’t even much like         And, in another change likely to give           He’s lost 10kg in the past six months,         eat stuff with sugar.
     It’s estimated about 240,000 people               time for another couple of cans of Pepsi      the taste of very sweet things now. On a         nutritionists heart palpitations, he’s        and like the others, reports feeling less        The cravings just
                                                       and another couple of chocolate bars.         recent weekend away with his wife, he            switched from skim milk to cream in           hungry. “I think sugar and carbs create
  in New Zealand have type 2 diabetes –
  that figure is predicted to increase by              By the time he got home, he’d need a          thought he’d treat himself to a chocolate        his coffee and from olive oil to butter.      hunger so the less I eat, the less hungry        aren’t there.”
  50 per cent in the next decade without               few biscuits to tide him over to dinner.      mousse. “It tasted incredibly rich, to           “The carb content of cream is very low,       I seem to get. I forget to eat. Before it was    IT professional Donovan
  effective prevention programmes.                       It’s hardly surprising that he found        the point where you had to wash your             but milk, with its lactose, is very high.”    more like a rollercoaster – sugar would          Marshall (above).
                                                       himself packing on the pounds, with           mouth with water to get the taste out.”             In the first two months, he lost           keep you going but then you’d crash.”	

4 2 | N O R T H  S O U T H | N OV E M B E R 2 0 1 2                                                                                                                                                                                                N O R T H  S O U T H | N OV E M B E R 2 0 1 2 | 4 3

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Sweet Misery. Cover story featured in 'North and South'

  • 1. + Cover story Sweet Misery Is sugar the new fat – and will it cause the next wave of heart disease? Donna Chisholm reports. B y god, we fell like flies in those prosecution against sugar was British days: 1960s New Zealand – land researcher Professor John Yudkin from the of full-cream milk and honey. The University of London, author of Pure, White days when Mum kept the drip- and Deadly. Heading the case against fat ping from the Sunday roast in the was American nutritionist Ancel Keys, who old Wattie’s fruit can by the oven so she could initiated the 25-year-long Seven Countries fry the chips in it later. The days when you Study that first confirmed the links between got olive oil from the chemist and you didn’t diet, blood cholesterol levels and heart buy it to eat but to soften the wax in your ears. disease. Eventually, Yudkin would be The days when about 7000 of us every year discredited by his funding from the dairy dropped dead from heart disease. industry while Keys died in 2006 at the age It wasn’t just us, of course, although as a of 100, a scientific hero. farming nation we had a big appetite for Back at home, the Heart Foundation came animals. Internationally, doctors couldn’t along in 1968 and in the 1970s began to agree on the cause for the heart disease spread the message to reduce our dietary epidemic, but there were two obvious fat intake, stop smoking and up our exercise. dietary culprits: sugar and fat. Leading the In 1972, in Auckland, we got off our chuffs and started running round the bays every year. By the end of the 1970s came the first donna chisholm is north & South’s signals our healthier lifestyle was saving GETTY IMAGES editor-at-large. pHOTOGRAPHY BY JUSTIN LAMBERT AND ADRIAN MALLOCH. lives: heart disease death rates began to fall. 3 4 | N O R T H & S O U T H | N OV E M B E R 2 0 1 2 N O R T H & S O U T H | N OV E M B E R 2 0 1 2 | 3 5
  • 2. What to Do About It) and Australian lawyer make them feel better. David Gillespie (Sweet Poison), who lost “Most people don’t eat because they think 40kg by cutting out sugar. they have to meet some energy demand. The theory is attracting followers here They eat because they’re hungry and part (see Sugar Free, page 42), which is no sur- of this hunger is very similar to the with- prise given New Zealanders are among the drawal syndrome from drugs of abuse.” largest sugar consumers in the world: we So far, so straightforward. But here’s each scoff more than 39kg every year com- where we need to explain a little more about pared to Britons’ 34kg, for example. fructose. Until recently, it’s been the silent But with all the conflicting advice, which 50-50 partner, with glucose, in sugar. Most can we rely on? What is the relationship be- of us have heard of glucose, but we know tween sugar and our weight, and sugar and less about fructose, other than that it’s what our heart health? makes fruit taste sweet. The fact fructose The answer is the same as with most comes from fruit has been largely respon- relationships: it’s complicated. sible for its pristine reputation – but the P way it’s been harnessed commercially has, ADRIAN MALLOCH ublic health physician Simon in the United States at least, seen it assume Thornley has put sugar in the a new status as obesity villain. dock. His waistline has found it Fructose has been particularly targeted by Public health physician Simon Thornley. guilty and discharged fat, the co- Robert Lustig, who sheets blame for the obe- accused, without conviction. sity epidemic back to former US President At Auckland University’s School of Popu- Richard Nixon, who encouraged farmers lation Health, where Thornley works as a research fellow, it’s a polarising position into industrial-scale production of corn in an effort to stabilise food prices as part of his tose intake because it didn’t increase blood glucose levels. But what they were soon to “Most people don’t but, as we’ve explained, one which is clearly “war on poverty”. From corn came high- learn was the downside of fructose: it raises eat to meet some influencing a public, if not professional re- fructose corn syrup (55 per cent fructose and levels of a type of cholesterol (LDL) – which energy demand. think of decades of dietary advice. Somewhat controversially, within his de- 45 per cent glucose), which was about twice as sweet and half the cost of sugar. has been linked to heart attacks – in the blood. While Otago University’s world-renowned They eat because partment, Thornley has not only switched to Soon, in the US, high-fructose corn syrup nutrition expert Professor Jim Mann accepts they’re hungry and a low-sugar diet these past couple of years, would replace sugar in everything from that sugar can raise blood levels of triglycer- part of this hunger And they have kept falling ever since. Today, they are an astonishing 80 per cent lower than Heart disease but he’s also increased his saturated fats, changing from skim to blue-top milk, from pizzas and bread to soft drinks. And because it was cheap, and we are programmed to like ides – another chemical compound linked to heart disease – he says his own work for his is very similar to they were at their peak in the 1960s. And yet death rates are an low-fat yoghurt to the Greek full-fat version, sweet food – because we need glucose to PhD thesis 40 years ago showed very large the withdrawal we’re fatter than we’ve ever been, with more astonishing 80 per and even frying an egg in butter for survive and sweetness is an evolutionary amounts are required before it has that effect syndrome from than a quarter of us considered obese. Now, though, it’s predicted the rate of im- cent lower than breakfast. This year, Thornley co-authored Sickly signal for food safety – it was soon being pumped into products that hadn’t been and Lustig’s description of sugar as toxic is “over the top”. drugs of abuse.” provement in heart disease death rates will they were at their Sweet, a book which investigated the role of sweetened before, including sauces, salad But, he says, very much more sophisti- Public health physician Simon Thornley (above). soon start to plateau and even reverse. The peak in the 1960s. sugar, and sugar addiction, in global obesity. dressings and even hamburger meat. cated experiments are now being done, disease is the same, but its profile is differ- Thornley says he was exposed to the “low- But Lustig goes further than saying we’re particularly in regard to uric acid, which is ent. While smoking rates, blood pressure and And yet we’re fatter fat mantra” at medical school in the 1990s eating too much fructose and it’s making us also believed to be important in a range of cholesterol levels are all improving, obesity than we’ve ever and for the next 10 years he went along with fat. He contends it’s poisoning us, because metabolic disorders that lead to obesity and and diabetes-related mortality is on the rise. been, with more it. He says he ended up packing on 15kg. of the way the body metabolises it. diabetes. It’s those metabolic abnormalities Enter the new vanguard of dietary gurus It was while working on techniques to help Now for a quick lesson in biochemistry to which can then cause cardiovascular disease. flavour of syrup-sweetened Coca-Cola for telling us we’ve been sold a pup with this than a quarter of us smokers quit that he read Robert Atkins’ low- learn about the different ways we respond While Mann says he’s regarded as “one of example. But as several experts pointed out, low-fat message. The real problem, they say, considered obese. carb weight-loss book – which fuelled a rash to fructose, and to glucose. When we take in the arch-enemies of the sugar industry”, he’s the difference between the syrup, which is is sugar. of low-carb diets – and found a reference to glucose, the pancreas releases insulin to me- appeared in debates with Lustig in the past 55 per cent fructose, and sugar, which is 50 Today’s debate echoes that of the 1960s, in an overweight executive addicted to sugar, tabolise it. Eighty per cent of the glucose we and says there’s “no evidence whatsoever” per cent fructose, isn’t that great anyway. that the San Francisco paediatric endocri- who experienced symptoms similar to a eat is used to provide instant energy. About for Lustig’s theory that sugar, rather than fat, And we have also fallen victim to the food nologist leading this new wave of advice is smoker trying to give up nicotine. 20 per cent is delivered to and processed by is the culprit in coronary heart disease. “He industry’s relentless marketing of “low-fat” self-described Yudkin acolyte Robert Lustig. Seven years later, Thornley has taken a the liver, where most is converted to glyco- hasn’t got enough evidence to say that, in food as a healthy alternative – despite the Lustig, whose Bitter Truth video on YouTube “what if” idea to develop his hypothesis that gen and stored for later use. A very small amounts typically consumed by you and me fact the flavour lost from fat has been re- has attracted nearly three million hits, calls sugar – or at least, the fructose component of amount is converted to fat. and people like us, sugar is uniquely bad by placed by sugar or salt. Yudkin a prophet who was “thrown under sugar – is addictive, and our craving for it can Fructose, on the other hand, does not virtue of being sugar.” But he does agree that Whether that’s been a deliberate or the bus” by a food industry eyeing big dollars overwhelm our satiety response and make us stimulate the release of insulin – the process sugar promotes obesity, obesity drives dia- accidental evil depends on your inter­ from “low-fat” food. keep eating when we’ve already had enough. that signals we’re full. Instead, fructose is betes and diabetes increases the risk of heart pretation of events. “A Chinese whispers While Lustig’s message has failed to get He says while people often report feeling absorbed from the small bowel and broken disease and stroke. thing happened,” says former National Heart widespread backing from the medical pro- “hypo” – shaky, weak and craving a sugar hit down by the liver where it is converted mostly While the infamous high-fructose corn Foundation director Dr Boyd Swinburn, now fession, it’s embraced by a number of influ- – those who aren’t diabetic or on pills to to fat, or uric acid (which causes gout). syrup is now ubiquitous in the food chain in professor of population nutrition at Auckland ential authors, including American science lower their blood glucose levels would never Relatively recently, diabetic groups even the US, its use has not been widespread here. University. “Scientists said – and still say – CORBIS writer Gary Taubes (Why We Get Fat: And get truly hypoglycaemic. But sugary food can advocated their members increase their fruc- New Zealanders have never embraced the that a diet relatively high in fat will cause an 3 6 | N O R T H & S O U T H | N OV E M B E R 2 0 1 2 N O R T H & S O U T H | N OV E M B E R 2 0 1 2 | 3 7
  • 3. increase in weight. That then got flipped explain why we just keep eating if we’re full.” The Sweeteners into a diet low in fat will help lose or Thornley is keen to do that work, but has I maintain weight, and that got flipped into been stymied by lack of funding. In the f you’ve switched natural a diet high in carbohydrates must therefore meantime, he is his own one-person clini- sweeteners, from table sugar be good for you and that got flipped into cal trial and says he’s finding that the less to honey – maybe maple syrup eating more of the stuff is good for you… So sugar he eats, the less hungry he feels. “I or the even more exotic agave you had the whole industry push around used to feel hungry all the time. And while nectar – in the belief you’re low fat, and eat more of this because it’s low I haven’t dramatically lost weight, I now doing yourself a dietary favour, fat, when it happened to be loaded up with don’t need to snack all the time.” the unpalatable truth remains sugar. The industry spin on the science, Instead of a breakfast cereal that’s 30 per that it’s not so much the quality when it got turned into marketing, became cent sugar, he’ll now have an egg, scrambled of a sweetener as the quantity an overconsumption message.” or fried, and he’s given up fruit juice. “I used consumed that ultimately finds Swinburn says studies show that people, to drink a lot of juice because I thought it its way to your waist and hips. particularly women and women dieters, see was good for me because it’s natural, but it’s Certainly, honey, maple syrup, a “97 per cent fat-free” product as a signal also got a very high concentration of golden syrup and the family of that it’s OK to eat more of it. “If people are fructose.” brown sugars (including muscovado, given two yoghurts for morning tea, and one The higher fat does seem to be having an demerara and rapadura) impart is labelled low- or no-fat, and then they’re effect, though. His “bad” LDL cholesterol flavour to food and drink that’s able to eat whatever they want at lunchtime, has gone up, while his “good” HDL choles- getty lacking in white “table sugar”. those who’ve had the low-fat version do the terol remains high. “But,” he rationalises, And there are traces of minerals calorie count in their heads and eat more at “low HDL is more strongly associated with in brown sugars and maple syrup, lunch. So it’s not only a metabolic issue, but heart disease than high LDL.” although not in meaningful amounts a psychological one as well.” It’s impossible to discuss Thornley’s for nutrition. “Active” manuka Similarly, Auckland University epidemiolo- theories without at least a nod to the honey has also been shown to have gist Professor Rod Jackson identifies a prob- glycaemic index. Most of us have heard of it some health benefits – wound lem with the bastardisation, over the years, – food with a lower GI rating helps us feel healing among them – unrelated of the “eat less saturated fat” message to a full for longer. Food with a higher rating to its calorific content. Don’t be simpler one of “eat less fat”. This has meant causes higher peaks in our blood sugar levels, fooled, though. The way our bodies all fats – even the vegetable fats which don’t with a corresponding increased release of metabolise the molecules in different harm your heart but are equally calorific – insulin. In fact, so much insulin can be sweeteners may vary, but they’re have been removed and the only way to com- released that it causes a kind of rebound all sugars and carbohydrates. pensate for the loss of taste has been to add effect, gobbling up so much glucose from the New Zealand sugar is mostly sugar, which can also make us fat; or salt, blood that it takes it below the normal sourced from sugar cane, whereas which can lead to high blood pressure. baseline – making us hungry again more Europe gets the bulk of its supply “It seems kind of weird that you reduce quickly. from beets. High-fructose corn your fat intake and get fatter. But I think it’s Ironically, a teaspoon of sugar is only mod- syrup, extracted from corn, is a possible if the price we’ve paid for eating erately high in GI with a ranking of 65, com- largely American food-ingredient less fat has been eating more sugar.” pared to a medium boiled potato with 88. phenomenon. Its recent bad To Jackson the solution seems simple – A slice of banana cake weighs in at 47 and a press, both for its ubiquity and replace more of the sugar with non-animal Snickers bar 41 – mainly because of fats JUSTIN LAMBERT high fructose content (see fats. “If you eat less saturated fat and less which slow the rate at which foods leave the page 37), has seen some food salt and don’t smoke, the benefits of that stomach. manufacturers switching to other overwhelmingly outweigh the harms of get- “GI is useful for differentiating starchy foods sweeteners and publicising the ting fatter. I’m not suggesting fat is good, in terms of their ability to deliver glucose,” fact on their packaging – boldly, but a lot of other causes of heart disease are says Thornley, “but as a predictor of the ad- Dr Boyd Swinburn, professor of population as plastered across this box of more important than being fat.” dictive ability of food, it totally misses sugar.” 2008-2009 that suggested our total calorie nutrition at Auckland University. “The shredded wheat breakfast cereal Jackson is horrified Thornley is increasing National Addiction Centre director Pro- intake had significantly declined since 1997. industry spin on the science, when it got turned into marketing, became (left) from a US supermarket. his saturated fat intake while cutting out fessor Doug Sellman has also recently talked “It has to be wrong,” says Jackson. “We’ve an overconsumption message.” The best way to get your sweet sugar, saying the evidence against saturated about food addiction, particularly junk-food got fatter and yet our activity levels haven’t fix? Dieticians will always champion fat is overwhelming. However, he believes addiction, saying it should be recognised as changed much. What’s happened is that fruit, eaten fresh and whole (rather Thornley’s addiction theory is “an interesting a medical condition. Likewise, scientists at since 1997 almost every newspaper every than juiced), and naturally sweet hypothesis that theoretically and biochemi- the University of Michigan have reported other day has an article about obesity. It’s vegetables such as carrots. One cally looks important. Maybe we’ve addicted how foods high in fat and sugar triggered a become the new tobacco and that would lead 110g apple, for instance, has 6g a whole population because we’ve increased spike in an opioid-like chemical in the brain people to under-report. I don’t think there’s fructose, 3g glucose, 2g sucrose – the sugar in food. of rats. The stronger the rise in the brain any doubt we’re eating more of everything a total of 11g carbohydrate – but “We’re talking real generalities, but if we’ve chemical, the faster the rats raced to eat the except saturated fat and salt.” with the health-bearing benefits of replaced fat with sugar and sugar is addictive, sugary food – in this case M&Ms. And yet a paper published by the Public plentiful vitamins and minerals and maybe that’s what we’ve done. It kind of fits, But confounding this whole argument that Health Nutrition Journal in 2007, of which a good dose of dietary fibre, too. it’s feasible and it’s worth pursuing in more eating more sugar is making us fat are the Otago associate professor Winsome Parnell studies because if it’s true it would help findings of the National Nutrition Survey in was the lead author, used the nutrition survey 3 8 | N O R T H & S O U T H | N OV E M B E R 2 0 1 2 N O R T H & S O U T H | N OV E M B E R 2 0 1 2 | 3 9
  • 4. data to conclude: “Current sugars or sucrose weight gain in children and a “low-hanging very fast – and makes it likely we wouldn’t intake is not associated with body weight fruit” for public health initiatives. Gerhard be told about it anyway. Sanitarium’s nutri- status in the New Zealand population.” Sundborn, an epidemiology research fellow tion services manager, Cherry Downing, says Jim Mann, who is listed as a co-author in at Auckland University’s School of Popula- while they’re always looking to make health- the study, distanced himself from the tion Health, has written a post-doctoral pa- ier options, “we’re up against other manu- conclusion when contacted by North & South, per suggesting an “end game” for sugar- facturers who might still be putting certain agreeing with us that it would be “totally sweetened drinks similar to the government’s levels of sugar in”. And if the product doesn’t misleading” to a lay reader. He says his only proposal to eliminate smoking by 2025. taste good, consumers won’t buy it. contribution to the paper had been to include While the American Heart Association rec- The company does provide low-sugar a paragraph pointing out that a cross-sectional ommends a daily intake of just six teaspoons cereals, including Weet-Bix, San Bran and study such as the nutrition survey, which of sugar a day for women, nine teaspoons for Puffed Wheat. Weet-Bix, which are very questioned people about what they’d eaten men and three for children, we’re eating far low in sugar, remain the country’s number over the past 24 hours, meant the data could in excess of that, with a median intake of 24 one cereal – although Downing acknow­ not be used to imply cause and effect. teaspoons for women, 30 for men and around ledged many customers would add sugar Acknowledgments in the paper say 26 for children. Given a 600ml bottle of soft or other sweeteners. “secondary analyses” of the nutrition survey drink contains about 16 teaspoons, eliminat- Heart Foundation medical director and data was commissioned by NZ Sugar Ltd – ing just one drink a day could do much to former cardiologist Dr Norman Sharpe says effectively Chelsea Sugar – which funds the reduce that consumption. the foundation wouldn’t be collaborating NZ Sugar Advisory Service. The service’s An analysis of international research with fast-food chains any time soon in its stated aim is to “encourage appropriate use suggests it’s highly likely sugar-sweetened initiatives to reduce sugar, fat and salt. and enjoyment of sugar as part of a healthy drinks are the single largest driver of un­ Auckland University “It’s a no-win situation. They’ll give a little and balanced diet”. healthy weight. One major American study epidemiologist Professor here, then rip you off over there. They’ll put Parnell is listed on the service’s website as reported they accounted for 20 per cent of Rod Jackson: “It seems in the token salad, but they’re still marketing kind of weird that you Negotiating the a member of its advisory panel. Parnell says she is not on the company’s the weight increase in the US over 30 years from 1977. But any attempt to restrict them reduce your fat intake and get fatter. But I think it [fast food]. The Heart Foundation worked with McDonald’s in Australia and got badly Sugar Maze payroll, but sometimes receives a small hono- will face a pushback from the industry and it’s possible if the price burned. They got set up, and McDonald’s JUSTIN LAMBERT we’ve paid for eating rarium to cover costs. Asked if there was a opposition to “nanny state” ideology. John less fat has been eating used their brand to market their product. We asked nutritionists for some risk that being an adviser for a number of Key’s government, for example, moved swiftly more sugar.” You get families in through marketing some dietary advice to guide us years to the company could be perceived as salad, but the kids are still going to buy the through the sugar-fat maze. compromising her, she replied: “I don’t care rest of the junk. It was a fiasco.” what you think about it. I don’t care what any- In 2010, Weight Watchers in New Zealand Elaine Rush, professor of nutrition one thinks. My conscience is entirely clear. collaborated with McDonald’s and endorsed at Auckland University of Technology: I’ve professionally advised Heinz Wattie’s for in 2009 to revoke the Labour govern­ ent’s m regular Coke. The company referred us to three of their meals, a move criticised at the • Physical activity churns up the 20 years. I am impartial in the advice I give. requirement that schools were to sell only Winsome Parnell for additional comment. time by Boyd Swinburn. “Make no mistake, glucose. You’re better able to process I don’t think they like all the advice I give.” healthy food – a change the Heart Foundation Food and Grocery Council chief executive this is about selling more burgers and fries.” sugar the more active you are. She says the paper in Public Nutrition was described as a giant leap backwards. Katherine Rich says council members, in- Sharpe says while the Heart Foundation • If you gradually cut down sugar, for not intended for a lay audience. Most recent advances, though, have been cluding Nestlé, Coca-Cola Amatil, Tasti, had been very successful in working “under example in tea and coffee, your taste Parnell says she never picks out a particu- the result of collaboration rather than Cerebos, Fonterra and Hansells, are heavily the radar” with the food industry to reduce buds will start to adapt to the change. lar nutrient as a cause of obesity; obesity re- legislation. For example, in 2006, McDonald’s involved in promoting healthy food mes- salt in bread – 150 tonnes was taken out of • Staff cafeterias can ask vending- sults from an energy imbalance. “I have not and Coca-Cola joined a Counties-Manukau sages. “I suspect they’re investing more than the national food supply annually – it was machine operators to change the been convinced by the literature that sugar District Health Board “Let’s Beat Diabetes” the government. Sugar is the focus at the a slow process and with it went the risk of position of products so healthier options as a nutrient is any more involved in causing initiative and trialled the replacement of moment but it wasn’t so long ago that the “capture by the food industry”. such as water are in first line of sight. obesity than too much fat. Often the two go Sprite with Sprite Zero for six months in all big discussion was about fat or salt. You can “Basically, we’re outgunned and outnum- • Eating the vegetables on your together in food anyway.” It was a “gross 21 McDonald’s restaurants in Counties- take out as much as you like but eventually bered.” plate first can help to fill you up generalisation” to say sugar promoted Manukau. When consumers didn’t oppose you find yourself eating cardboard.” He admitted the foundation had also been and reduce your intake of less obesity. the change – or even notice it, it seems – the Some confectionary companies had re- burned when it gave a “tick” to Milo in 2008 healthy food at the same sitting. Parnell has also been quoted in the past as sugar-free drink became the “default” duced portion sizes “with well-intentioned when Nestlé simply advised consumers to saying banning fizzy drinks from schools lemonade served throughout the country. reasons but the cheap shot is often you’re use less of it. “The tick is a bit of a trap,” says Helen Eyles, public health would do nothing to stop the high levels of This, and a 40 per cent reduction in sugar only doing that to save money”. She con- Sharpe, “because it doesn’t necessarily mean nutritionist for the National Institute for sugar children were getting from powdered in McDonald’s buns about the same time, ceded, however, that smaller portions didn’t the product is recommended but within its Health Innovation at Auckland University: fruit-flavoured drinks at home. removed 300 tonnes of sugar a year from the always bring smaller prices. “To embark on category it’s the healthier choice.” • If you’re trying to keep to foods with no She told North South that if she were an chain’s menus in New Zealand. McDonald’s a programme that removes sugar is com- Sharpe says while our declining heart dis- more than 10 per cent sugar content, overweight teen, she’d choose a sugar-free told us the same deal isn’t being considered pletely unnecessary because we’re talking ease death rates are encouraging, we can’t make sure you factor in serving size. version of a soft drink but she would not gen- for Coke and Coke Zero because it believes about a natural product that’s an integral afford to be complacent in the face of the For example, soft drinks have only eight eralise for all. “There are many very under- the taste is noticeably different. part of a healthy diet. It has to be all things obesity and diabetes tsunami looming, and grams of sugar per 100 grams, but weight young people who drink a sweetened An analysis of international research suggests Coca-Cola says while it won’t divulge sales in moderation.” sugar is an obvious next target. “We have the it’s highly likely sugar-sweetened drinks the average drink is three times that. drink. If you took that away, they might fade figures, Coke Zero and Diet Coke are now Rich also suggested we approach Win- fat down in the diet but sugar is the new fat. are the single largest driver of unhealthy • A low-GI breakfast such as porridge away, I don’t know.” weight. One major American study reported the third and fourth most popular of its some Parnell for comment. It’s all about energy imbalance. Sugar has will keep you feeling full for longer than However, many others in the field have tar- they accounted for 20 per cent of the weight drinks brands and Coke Zero sales increased Competitive edge is one reason sugar prob- been substituted for fat and the portion size CORBIS increase in the US over 30 years from 1977. a highly processed, sweetened cereal. geted soft drinks as both a cause of unhealthy 8.6 per cent last year – a bigger increase than ably won’t be reduced in food very much or has gone up and the result is carnage.” N O R T H S O U T H | N OV E M B E R 2 0 1 2 | 4 1
  • 5. Though his wife has since abandoned the sugar-free diet because she’s pregnant, Marshall says he’s happy to Junk Food and keep going. Sticking to the new plan has also been made easier by the fact Alzheimer’s two of his IT colleagues at Auckland W University, David Glen and Chris Sugar Free hen New Scientist magazine reported Groom, are on similar programmes. in September on Glen says his father recommended the research linking junk- sugar-free way after reading Gary Taubes’ food diets and insulin resistance to Why We Get Fat: And What to Do About It. Alzheimer’s disease, it confirmed work “I laughed at him and said all the research done more than 10 years ago by Auckland says a high-fat diet and meat is not good scientist Professor Garth Cooper. for you and we should be eating more An Auckland couple kick the sweet stuff. carbs.” But after getting the book himself, Cooper and his colleagues from Auckland University and Christchurch Medical School and hearing other experts whose views described in 2001 how the “misfolding”, or he respected give the idea credence, he began reducing his sugar and carb intake. W changing shape of proteins in the pancreas of diabetics, mimicked changes in the hen IT professional his weight ballooning from its usual While he didn’t have Marshall’s brain tissue of patients with Alzheimer’s. Donovan Marshall, 34, and 90kg to 115kg. For someone who’s prodigious appetite for sweets, Glen, He says there’s now widespread belief his wife Margo went cold 165cm tall, it was, says Marshall 34, says he often felt hungry on the that type 2 diabetes and Alzheimer’s are turkey on sugar earlier “a little on the heavy side”. way home and if he was filling up the either very similar or “more closely linked this year, they didn’t give temptation a The first change was having breakfast car at a petrol station he’d buy a bag than that”. In fact, some researchers now look-in. They took the chocolate, biscuits, – although, given that was a Carls Jr of jelly beans or chocolate. He’d have see it as “just another form of diabetes”. jam, maple syrup and sweets out of their breakfast burger, it might not have been three coffees a day with a couple of Recent studies have shown up to cupboards and gave them all away. the healthiest option. At work, Marshall teaspoons of sugar in each, and his 80 per cent or more of people with Marshall says his wife, worried about swapped Pepsi for water or the sugar- diet was high in carbs. “I was pretty Alzheimer’s have undiagnosed diabetes their sugar intake and creeping weight free Pepsi Max, and the chocolate bars much living on bread and pasta and or pre-diabetes, leading some to gain, had been inspired by Australian for nuts and dried fruit. He and his wife supplementing that with orange juice.” dub Alzheimer’s “diabetes 3”. author David Gillespie’s book Sweet used Splenda, a sugar substitute, in Lured by Subway’s low-fat claims, New Scientist called the link Poison. He read the book and other their American pancakes, and a sugar- he’d have a six-inch roll from the chain JUSTIN LAMBERT the “ultimate food scare”. similar titles before deciding to go sugar- free maple syrup. Out went the tomato almost every day. “I’d have that between “The world already faces an epidemic free himself. “I thought it made sense sauce – 30 per cent sugar – and the low- 12 and 1pm but by 3 o’clock I’d want of diabetes. The prospect of a parallel and it wouldn’t hurt to give it a go.” fat, but high-sugar yoghurts. Within a more. My hands would be shaky and epidemic of Alzheimer’s is truly frightening. The reading made him realise just few weeks, he found his appetite – and I was very hungry all the time. I was how high his sugar intake was. “I have a sugar cravings – had reduced. So had his struggling to make it between meals 15kg and then dropped another “A preference that started out as a sedentary job and I was consuming a lot weight, and after eight months, he’s down without feeling shaky and horrible. My 7kg over the next three months. “I feel a lot more survival mechanism has, in our age of plenty, become a self-destructive compulsion.” of sweet products to keep myself going.” to 105kg, which considering he hasn’t blood sugar levels tested normal but Watching Glen’s progress was colleague alert in the Cooper (North South’s New Zealander He’d regularly skip breakfast, and by given up other carbs or high-fat meals, he going between meals was getting harder. Chris Groom, who was so impressed afternoons and mid-morning he was hungry – time for a attributes entirely to the absence of sugar. I felt unwell and needed a sugar hit.” he decided to give it a go too and has of the Year in 2004) now splits his time Pepsi and a chocolate bar. At lunchtime, “I feel a lot more alert in the afternoons Now he has two or three scrambled eliminated bread, pasta and potatoes I can’t eat as much between Auckland and the University of Manchester, and is trying to find ways to stop he headed to St John’s, near Auckland and I can’t eat as much as I used to,” he eggs for breakfast, and lunch consists of from his diet. Now an avid reader of as I used to. The the misfolding proteins from killing cells. University’s Tamaki campus where he says. “The longer I do it, the easier it is to cheese, nuts, cold meats and vegetables ingredient panels, Groom has been taken longer I do it, the works, for a burger from new fast-food not eat stuff with sugar. The cravings just including celery, lettuce and tomato. aback by the sugars in even savoury Both sugar and saturated fats are implicated, restaurant Carls Jr. A couple of hours aren’t there.” He’s given up potatoes and kumara. products, including peanuts and bacon. easier it is to not he says, particularly in the highly processed foods many of us are now eating to excess. later, the munchies would strike again – He says that he doesn’t even much like And, in another change likely to give He’s lost 10kg in the past six months, eat stuff with sugar. It’s estimated about 240,000 people time for another couple of cans of Pepsi the taste of very sweet things now. On a nutritionists heart palpitations, he’s and like the others, reports feeling less The cravings just and another couple of chocolate bars. recent weekend away with his wife, he switched from skim milk to cream in hungry. “I think sugar and carbs create in New Zealand have type 2 diabetes – that figure is predicted to increase by By the time he got home, he’d need a thought he’d treat himself to a chocolate his coffee and from olive oil to butter. hunger so the less I eat, the less hungry aren’t there.” 50 per cent in the next decade without few biscuits to tide him over to dinner. mousse. “It tasted incredibly rich, to “The carb content of cream is very low, I seem to get. I forget to eat. Before it was IT professional Donovan effective prevention programmes. It’s hardly surprising that he found the point where you had to wash your but milk, with its lactose, is very high.” more like a rollercoaster – sugar would Marshall (above). himself packing on the pounds, with mouth with water to get the taste out.” In the first two months, he lost keep you going but then you’d crash.” 4 2 | N O R T H S O U T H | N OV E M B E R 2 0 1 2 N O R T H S O U T H | N OV E M B E R 2 0 1 2 | 4 3