I can’t get enough of the sugar issue these days. Not the post-Christmas treats staring at me from my pantry but whether or not sugar is making us fat. It’s not just me. Since the BMJ published its excellent series on sugar last week, the blogosphere has been busy discussing the issue. Is this issue relevant to The Bridge series? You should know by now that I’m a little obsessed with the (often dilapidated) bridges between academia and policy. What I find fascinating about this story is role of industry in this bridge – or ‘tridge’, a new word I’ve encountered, see photo below.
So why has the link between sugar and obesity received so much attention, after being ignored for so many years? One reason is that the WHO commissioned a new review on the effects of sugar consumption on body weight to update its nutritional recommendations. When the WHO tried to do the same in 2003, the sugar industry pressured the US Congress to end US WHO funding if the WHO published the conclusions it wanted to – that added sugars should not account for more than 10% of a person’s diet. National governments refer to WHO recommendations when developing their nutrition guidance, meaning pressure from the sugar industry in the USA led to a worldwide focus on fat, not sugar, as the main cause of obesity. Score one for the sugar industry.
This time around, the WHO had to be whiter than refined sugar when revising their recommendations. The effects of 2003 still linger – one of the BMJ’s article’s painstakingly cautious and qualified-laden final sentences states that it is ‘reasonable to conclude that advice relating to sugars intake is a relevant component of a strategy to reduce the high risk of overweight and obesity in most countries’. Looking at the evidence, though, the message is much starker – sugar is making us fat.
Where are the researchers?
There has been a small group of researchers continuing to make the link between sugar and obesity. John Yudkin, author of Pure, White and Deadly, was the main proponent of the link between sugar and coronary heart disease and type 2 diabetes. Despite making these claims for 50 years, Yudkin was largely ignored. But a few bridges, in the form of social media and an articulate translator, changed the debate. In 2012, Professor Robert Lustig picked up the anti-sugar baton, suggesting in Nature that sugar should be taxed in the same way as alcohol. Lustig’s 2009 90-minute YouTube lecture ‘Sugar: The Bitter Truth’ has also had a substantial impact. Seen by over three million, it demonstrates how academia can take on industry – for free. Lustig is “willing to insist publicly and unambiguously, when most researchers are not, that sugar is a toxic substance that people abuse”.
Journalist Gary Taubes has also been key in making this issue accessible to those outside nutritional science, showing how the sugar industry ensured government agencies dismissed health claims against their products. Taubes explains how the sugar industry has controlled the debate around obesity, shifting the blame from sugar to fats.
How can academics hope to compete with the power of the food and drink industry, who continue to influence health policies? When the US government considered a federal tax on sugary drinks, the American Beverage Association spent $7 million on a campaign against this. Industry might have millions to spend on PR but academics have valuable tools: evidence, research, social media and that important little thing called ‘trust’.
If the stranglehold of the food industry is to be challenged, academics need to use the best tools they’ve got. When Coca-Cola releases advertisements stating that they want to help address obesity, academics should study how serious these claims are. Will Coke really change their secret formula or increase prices or donate to health services that are dealing with an obesity epidemic? Or will they simply reduce the size of their drinks? When companies signed up to the coalition government’s Calorie Reduction Pledge, the small print showed what the commitment really meant – smaller bottles. The policies and actions of those manufacturing our food need serious academic analysis. And this needs to happen concurrently – there’s no time to wait around for long-term effects.
Bridges need to be built quickly these days.
Dr. Tammy Boyce (@TamBoyce) works with DECIPHer as a Knowledge Exchange consultant.