We are barking up the wrong tree by blaming sugar for the obesity epidemic, says Professor Jennie Brand-Miller of the University of Sydney’s Charles Perkins Centre.
In a new paper, published in the American Journal of Clinical Nutrition, Brand-Miller and colleague Dr Alan Barclay say that over the course of 30 years there has been a “downward trend” in the availability and reported consumption of added sugars and sweeteners among Australians.
At the same time there has been a steep rise in the incidence of obesity.
To put it in perspective, in 1980 10 per cent of Australian adults were obese. Now, about 60 per cent of adults are either overweight or obese.
If the trajectory stays the same, by 2025, almost 80 per cent of all Australian adults will be overweight or obese.
While sugar consumption has been widely blamed (and is the reason for the proposed sugar tax), Brand-Miller believes that the blame is misguided.
In their study, based on United Nations data, ABS data, national beverage industry and grocery sales figures as well as research into Australian consumption trends, they found that reported intake of confectionary – including chocolate, licorice, sweets and health bars – rose 47 per cent in men and 43 per cent in women, but that total added sugar intake fell about 18 per cent for men and 4.5 per cent for women.
“If you take the average consumption of Australians, two years and over, we’re consuming about nine per cent of our energy as added sugar and that falls below the target which is mentioned in most Dietary Guidelines around the world – the level that is considered commensurate with good health is 10 per cent of energy,” Brand-Miller says.
“What other groups are doing is focusing on the extreme consumers and they are definitely consuming more than 10 per cent… and we still need to get the message through to them.”
But, she adds: “It makes no sense to me to give messages out to the whole population when it’s only extreme groups that need attention.”
It doesn’t change the fact that our waistline, as a nation, is expanding and diet is hugely problematic.
Less than half of all Australian adults meet the dietary guidelines for the recommended daily consumption of two or more serves of fruit, while 93 per cent do not eat the recommended five serves of vegetables.
Brand-Miller says that it’s true that our intake of “discretionary” foods is too high (accounting for about one third of our daily energy intake ), whether it’s coming from sweet foods like cakes or chocolates or “not sweet” foods pizza and other fast food.
“We’re treating each day a bit like it’s a party,” she says, before clarifying: “Our total added sugar consumption has declined… but we’re still consuming too much of certain classes of food.”
Brand-Miller argues that obesity is “a complex issue” and focusing on one factor is “a recipe for failure”.
“It’s not the energy we consume, it’s the energy we don’t expend that is the problem, but we’re just at levels that I call pathologically low levels of expenditure,” she says. “We have so many excuses to just sit – from going to work to coming home to sit and watch Netflix from 6 o’clock to 11 o’clock instead of being active.”
Our lack of movement, along with the fact that we’re eating “a little bit more than we need” every day, stress and a lack of sleep explains our obesity epidemic, Brand-Miller argues.
Besides there’s also the genetic issue.
“Obesity starts before we’re born,” Brand-Miller says. “A lot of research is showing that the weight of the parents at the time of conception is the biggest modifiable contributor to the obesity epidemic – so it starts even before you get the sperm and the egg together – there are marks on the genes, marks on the DNA which tune the appetite of the fetus up, so those children are born bigger than they should be and those babies are growing into overweight children and overweight adults and you have a vicious generational cycle.”
The focus on sugar then, is only one part of the picture. “We’ve been barking up the wrong tree,” she insists.
Dr Rosemary Stanton, a visiting fellow at the University of NSW School of Medical Sciences, questions the sugar consumption statistics (as others have previously).
“Jennie’s figures may or may not be correct – it’s always hard to tell and consumption data is difficult to collect especially when we know people specifically under-report foods high in fat and/or sugar,” Stanton says.
“My take on this is that we are still consuming too much sugar.”
Average consumption for Australians is 60g per day – 14-15 teaspoons (a teaspoon is 4g but the figures have been rounded), Stanton says, citing the latest ABS statistics, and suggesting that a sugar tax is a way to start tackling a big problem bit-by-bit.
“It’s easy to do, it will send a useful message and those health authorities without a conflict of interest throughout the world recommend it. Why wouldn’t you do it?”
She does however agree with Brand-Miller that sugar is one of many issues creating a health crisis.
“Jennie is correct that we also need to tackle other problems,” Stanton says.
Dr Joanna McMillan agrees.
“The authors are not saying sugar is not at all to blame – rather that our current singular isolation of sugar as the key problem is wrong,” McMillan says. “We absolutely must stop this tendency to blame one thing instead of looking more holistically at both dietary and lifestyle factors.”
For their part, Brand-Miller and Barclay would like to see blame attributed more evenly to include alcohol, refined starches and saturated fat.
“A coordinated approach to lowering intakes of all discretionary foods and beverages is needed to balance energy intake with energy expenditure,” they conclude in their paper. “The current findings warrant consideration by other nations in their efforts to identify effective interventions for obesity prevention.”