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A soda a day keeps the doctor in pay: soft drinks and diabetes

Recent research linking soft drinks to type 2 diabetes reminds us, once again, that we are what we put in our mouths. This large study from Europe found drinking a 12 ounce (about 355 ml) can of soft drink…

Drinking one can of soft drink a day is linked to a 20% increase in the risk of developing diabetes. Damien Ayers

Recent research linking soft drinks to type 2 diabetes reminds us, once again, that we are what we put in our mouths. This large study from Europe found drinking a 12 ounce (about 355 ml) can of soft drink, or soda, a day was associated with a 20% increase in the risk of developing diabetes. This same effect has previously been observed in populations from the United States, Finland and Singapore.

If this is a real effect, as increasingly looks to be the case, it has massive implications. Half of eight-year-olds in the United States already drink this amount of soda, and teenage males consume more than double that. In conjunction with soft drink consumption among American adults, this represents tens of millions at risk of diabetes in the United States alone. Hundreds of millions more people are affected in other developed and developing countries worldwide.

There’s an obvious reason why soft drink consumption causes diabetes – more sweetened drinks equal more calories, which equals weight gain. Excess weight is the single most important factor in the global diabetes epidemic. While soft drinks may have effects on diabetes independent of obesity, this latest study (again) implicates weight gain as a key factor.

The study’s apparently anomalous finding of an association between diet sodas and diabetes likely reflects “reverse causation” – a phenomenon whereby people switch to diet soft drinks once they start to get the health problems caused by regular ones. So it’s the development of disease that’s causing people to drink diet soft drinks, not the diet soft drinks causing disease.

The real concern is that soft drinks are just the tip of the ice cube when it comes to diet-related ill health.

Like much of the rest of the world, Australians now consume vast amounts of processed foods purchased at major retailers and restaurant chains. Invariably high in salt, sugar or fat, these products have very clear and extremely serious consequences for health.

Where rats and mosquitoes were once the carriers of disease, it’s now the tobacco and alcohol industries and the major food and beverage corporations that are the purveyors of global ill health. Convenience, cost and corporate profits now rule at the expense of physical well-being.

The heart of the problem is that commercial success for these industries is public health disaster. This is a catastrophic failure of the market. As a New York Times investigative reporter and author of Salt Sugar Fat: How the Food Giants Hooked Us so convincingly described on ABC TV’s Lateline, these foods and drinks are designed to achieve the “bliss point” at which consumption is maximised. Solely in pursuit of profit, and regardless of the adverse effects they might cause.

The health problems attributable to unhealthy food and drink are widely recognised. The World Health Organization recently agreed the goal of a 25% reduction in preventable deaths by 2025. Six out of the eight targets defined to deliver this objective are aimed at lifestyle–based problems, and only two cover clinical management issues.

In Australia, the government’s solution to diet-related disease is the Food and Health Dialogue, an initiative that brings the food industry, government and non-governmental organisations together to improve the food supply and reduce diet-related ill health. The initiative relies on the voluntary participation and self-regulation of the food and beverage industries to achieve its goals.

Its priorities are food reformulation on sugar, salt, fat, energy, fibre, wholegrains and fruit and vegetable content, as well as consumer nutrition education and standardisation of portion sizes issues. In the four years since it was established, it has managed to reach targets for salt reduction in a handful of food categories. No substantive action has been reported on any other nutrient, and has been achieved for education or portion size.

Given there is a $100 billion business at the table that perceives itself at risk from the dialogue’s goals, the lack of progress isn’t really surprising. Why would businesses that maximise margins and shareholder value by adding sugar salt and fat to their products seriously engage in any such initiative? The bigger, unanswered question is why government hasn’t acted faster or more effectively when there’s so much at stake.

As a first step, the food and beverage industries must be removed from the policy-setting table. Like tobacco and alcohol, the conflicts are just too great and the public health problems too large. And just as for tobacco, the end game has to be regulation that controls the food and beverage industry – until that happens there will be no decline in diet-related ill health.

Industry will of course argue that it’s all about personal choice and individual responsibility. And that it’s not the role of the state to interfere with what people desire. It will use its massive influence and enormous marketing budget to talk up its success stories and sweep its failures under the carpet.

But sooner or later the problems will get too big to hide, the outrage too great and a significant step forward will have to be taken. We no longer buy industry’s arguments for tobacco and one day we won’t for soft drinks. Let’s just hope it doesn’t take us 50 years, half a million premature deaths, and a hundred billion health-care dollars spent on diabetes before we achieve this.

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115 Comments sorted by

  1. Jason Thompson

    logged in via Twitter

    "Half of eight-year-olds in the United States already drink this amount of soda, and teenage males consume more than double that. In conjunction with soft drink consumption among American adults, this represents tens of millions at risk of diabetes in the United States alone".

    I'm not entirely convinced that this is an accurate statement given that the study in question was concerned with adult consumption (mean age was 55 years) and did not comment on risk from consumption in childhood or teenage years at all http://link.springer.com/content/pdf/10.1007%2Fs00125-011-2182-9.pdf

    I used to drink far more than that as a child and teenager but I was also playing a lot of sport. Exercise drops off it later years, so does (should) consumption.

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Jason Thompson

      Jason is right - the analysis in the article, no doubt affected by the word limit, gives a potentially misleading picture of the actual study results.

      (disclaimer: I actively promote healthy, balanced diets including fresh foods, am no fan of soft drinks and recommend against excessive consumption of any particular dietary component. I do not support exaggeration or over-simplification of research findings. No need to accuse me of being in cahoots with Big Food or Big Pharma - that is definitely…

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    2. Gary Cassidy

      In reply to Sue Ieraci

      Hi Sue,

      What you're saying should be considered, although it is valid to report end points without diluting the results by normalising intermediates that are affected by the protagonists.

      For example, consider a trial where subjects were fed higher amounts of polyunsaturated fats in place of saturated fats or carbohydrates with CHD/CVD as endpoints. If HDL, LDL and triglycerides were normalised before reporting the endpoints, then the conclusions would be different than if no normalisation occurred.

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    3. Sue Ieraci

      Public hospital clinician

      In reply to Gary Cassidy

      Gary - I'm not sure I understand what you mean.

      What I was saying, as was Jason, was that the research referred to in the article doesn't actually say what the title and the discussions say that it does.

      In other words, the studies referenced did not show that having one can of soft drink a day had any more than a vanishingly small association with the incidence of diabetes in adults; and the data did not cover children at all.

      The European data was not reporting any sort of intervention - it was a database trawl combined with survey and blood tests, with data analysis looking for associations that were likely to have occurred more frequently than chance.

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    4. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      Thanks for your insights, Dr Sue. One of the problems for public health is that too many commentators get themselves tangled in the details of "the science" and miss the forest for the trees.

      Importantly, the National Health and Medical Research Council - after wading through a decade's worth of incoming global research - confirmed in February that added sugar in food and drinks - and especially in sugary softdrinks - is a menace to the health of both children and adults: http://www.abc.net.au/news/2013-02-19/sugar-re-think-an-evidence-based-decision/4527312?section=business

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  2. John Doyle
    John Doyle is a Friend of The Conversation.

    architect

    One reason governments are not acting as arbiters in this dispute between our best interests and business profit imperatives is that governments opted out of funding research. Reagan's dictum that the problem was big governments changed the landscape and research shifted to the private sector. Now we are seeing what the results are as a consequence
    So any calls to separate or at least impartially vet industry research are welcome.
    BTW. there is now concern that feeding bees HFCS is one cause of the colony collapse epidemic. The nutrient value of honey to bees cannot be substituted by nutrient free HFCS so bees are more vulnerable to disease.
    Great, isn't it?

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  3. Gary Cassidy

    Interesting article, thanks.

    "the government’s solution to diet-related disease is the Food and Health Dialogue.... The initiative relies on the VOLUNTARY participation and self-regulation...", however, "business at the table that perceives itself at risk from the dialogue’s goals"

    Common sense tells me that this wont work.

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  4. Henry Franceschi

    Director, NCD Treatment Centers

    The devil is in the details and some key details here beg for clinical clarification.

    I agree that “we are what we put in our mouths.” Emphasis has to be placed on “we” and the fact that it is "we" who emit the behavior of putting things in our mouths that leads to a disease to which we are genetically susceptible and under unique sociocultural conditions leads to diabetes. That makes diabetes (1) a personal behavior and choice problem, and (2) one that it is our sole responsibility to control…

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    1. George Crisp

      Medical Practitioner

      In reply to Henry Franceschi

      ..ignoring completely the fact that diabetes is very "socially patterned" - The poorer and more disadvantaged you are the greater the risk.

      Human behavior is highly influenced and determined by social norms, by urban design by marketing etc. Pretending we can all make logical and fact based decisions and fly int he face of environmental pressures to do the opposite is ideologically driven and false.

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    2. Sue Ieraci

      Public hospital clinician

      In reply to Henry Franceschi

      "Because farm-dwelling Australians – and Germans, and Swiss and Americans – who live on a farm and grow their own food, raise their own chickens and only drink water, and never buy more than salt to use on the farm, they do not develop chronic diseases at the same rate as their urban counterparts."

      Farm-dwelling Australians must "buy more than salt to use on the farm". According to the National Rural Health Alliance, "Females living in rural and remote Australia are 1.3 times more likely to report diabetes than those living in major cities, whereas rural males are slightly less likely to report the condition. Hospitalisation rates for diabetes were two and three times higher in remote and very remote areas, respectively, than rates in major cities. Similarly, mortality due to diabetes was two and four times higher in remote and very remote areas, respectively, than rates in major
      cities (AIHW 2008). "

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  5. Judith Olney

    Ms

    Thank you Bruce, an excellent article, we have indeed set the foxes in charge of the hen house.

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  6. Corinne Cowper

    general layabout

    I agree we have put the fox in charge of the hen house on the Food and Health Dialogue. A can of soft drink is just liquid confectionery. In our house the only stuff that comes out of a food manufacturing plant is the occasional tin of tomatoes or beans. Everything else in our house is made from real ingredients in our kitchen.

    I'm finding if I eat something that has been manufactured I feel the effects of it - extra thirst, niggling pain in the gut - so when I see trolleys loaded up with packaged sauces, pre-prepared meals and other stuff like that I wonder what's happening to these people. Apart from the ingredients, I don't trust food manufacturers for their ethical standards. Things like hygiene, standard of ingredients, added preservatives and colourings. The food manufacturers are selling the sizzle not the steak so they can maximise their profits. They don't want curbs on them - that would reduce their profits.

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  7. David Stewart

    Writer, civil engineer at Self-employed

    Here we have another study which shows that contemporary eating patterns are leading to disease I am forced to the conclusion that this poor health outcome is a cultural issue and it should not be side-lined as a medical problem. How many of these studies are needed? In the 21st century humans can and do eat manufactured products which are not true foods. The evidence is established and broadly understood (Michael Pollan, Matthew Evans and many others) and we should not any longer be regarding…

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  8. rory robertson
    rory robertson is a Friend of The Conversation.

    former fattie

    Thanks for your piece, Professor Neal. Very interesting. But why should we take seriously your thinly documented claim that sugary softdrinks are a key driver of T2 diabetes?

    After all, the University of Sydney most-distinguished, influential and highest-profile nutritionists have documented that "There is absolute consensus that sugar in food does not cause diabetes" (Slide 36 in http://www.australianparadox.com/pdf/22Slideshowaustraliangoestoparadoxcanberrafinal.pdf ).

    Indeed, sugar "doesn't…

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    1. Corinne Cowper

      general layabout

      In reply to rory robertson

      So, Rory, if you are a 'former fattie', what did you do to change that? There could be a clue to what in fact is the story of obesity and how to combat it.

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    2. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Corinne Cowper

      Hi Corinne. Yes, I'm a "former fattie" and next I'd like to join your ranks as a "general layabout", but at this stage my mortgage won't let me. You are spot-on in saying what I did provides "a clue to what in fact is the story of obesity and how to combat it".

      Indeed, it provides a very big clue. And what did I do? Not much: I simply took David Gillespie's advice and stopped eating sugar. The effect was profound and long-lasting: soon after sugar was evicted, my long-lost appetite control…

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    3. John Doyle
      John Doyle is a Friend of The Conversation.

      architect

      In reply to rory robertson

      Rory,
      I wasn't a "fattie" but about 15 kg overweight. My BMI was still in the twenties. I was like you influenced by David Gillespie, first hearing him speak on Margaret Throsby's interview about a year ago.
      I was already on board re fructose having seen Dr Bob Lustig's You tube video "The Bitter Truth".
      But reading "Big,Fat Lies" did it for me.
      I started buying coconut oil and using it in cooking, having big steak and eggs breakfasts, giving up cereals and so on. It worked a treat.

      Like you…

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  9. Geoff Parker

    CEO - Australian Beverages Council at Australian Beverages Council

    When industry has a seat at the table of any solutions' framework, it's labelled as biased and conflicted. When it's not at the table, it's labelled as negligent and irresponsible. Having seen some very real results when there is a committed tripartite approach to dealing with big problems, experience tells me ALL parties need to 1) be there and 2) be committed.

    What doesn't help the discussion moving forward are sensationalist analogies of tobacco being the same as soft drink or any other [insert…

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    1. Gary Cassidy

      In reply to Geoff Parker

      Right there is a perfect example of industry crap and manipulation.

      "My 11 year old gets one cigarette is bad but one can of soft drink isn't"
      One cigarette (once off) is probably not "bad", one a day is probably not so good, one can of soft drink is not so good for diabetes risk.

      "Nor is one pizza or one mars bar, in moderation, as part of a healthy, active lifestyle"
      Read - It's not our product, it's theirs!

      "Continuing to demonise one food, or one nutrient does nobody any good."
      Soft…

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    2. John Doyle
      John Doyle is a Friend of The Conversation.

      architect

      In reply to Geoff Parker

      Geoff, I think this change of attitude towards sugar and fat is only going to work if it gets momentum from the "bottom up". Organisations like yours are only going to start changing their traditional supporting role for industry when the "writing on the wall' makes it necessary.
      "What else can you be doing" will become obvious, even if it isn't yet. As said below, to most citizens support for a container deposit scheme is a no brainer. So you can help by starting there. That might show a modicum of independent thinking on your Council's part.
      As long as your Council can't show some disconnect from industry your organisation is only semi-serious about change. Sort of irrelevant.

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    3. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Geoff Parker

      Yes, Geoff, the problem of overweight and obesity is so "extremely complex and multi-factorial" that simply removing added sugar from one's diet is sufficient, for many, to prompt profound reversals in their trends towards obesity and diabetes.

      Happily, for many, there is a simple solution to what you claim is an "extremely complex and multi-factorial" problem: stop eating and drinking added sugar. Yes, Geoff, for many, it is that simple.

      Readers, while industry spindoctors are still spinning…

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    4. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      I wonder how many "former fatties" there really are - who read the populist books, accepted that "fructose is poison", cut out all added sugar and became dramatically healthier.

      It would be good to know whether this approach really works for a lot of people, other than the main proponents. If there is evidence to show that it does (beyond people commenting here), the rest of us might be convinced.

      If obesity is indeed more complex than that, we might have to think more broadly.

      The US has…

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    5. Judith Olney

      Ms

      In reply to Sue Ieraci

      I would think Sue, that (a) eat a low calorie diet, would be quite compatible with cutting out excess sugar.

      I guess people could give it a go, and if they lose weight, then thats great, and if they stay off the sugar, and keep their weight off, that is also great. It's not as if cutting out all excess sugar is actually going to harm anyone, so "fatties" have got nothing to lose really, except the fat, and they might actually save some money that they would have otherwise wasted on junk food and drinks.

      I'm not sure what the NWCR means by (b) eat a routine diet, does this mean an unvarying diet, either in content or portion size?

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    6. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Geoff Parker

      Geoff Parker, CEO of the Australian Beverages Council, I wonder if you would care to comment on:

      (i) The market leader in the global beverage industry having implicitly conceded that sugary softdrinks are a particular menace to public health, as suggested by Professor Neal in his piece above. As I mentioned yesterday, the WSJ has reported that "Coca-Cola Co. (KO) plans to offer low- and no-calorie drinks in every market in the world and put calorie counts on the front of all drinks it sells…

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    7. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      That is interesting, Dr Sue. I will have a look at that US registry, and also keep an eye out for other information as it emerges, including some scientific research along those lines that I am funding.

      In his profoundly important history of nutrition science - "Good Calories, Bad Calories" aka Good Science, Bad Science - journalist/scientist Gary Taubes documents more than a century of scientists and doctors overseeing successful weightloss involving groups on low-carb diets like this one: (scroll down) http://www.australianparadox.com/pdf/why-we-get-fat.pdf

      Have you read "Good Calories, Bad Calories", Dr Sue? If you haven't then I think you should, as should others here who are yet to have the pleasure. Actually, I reckon that showing up to public discussions on nutrition science and anti-obesity diets without having read GCBC is somewhat akin to showing up to friends' houses for group dinners without a bottle of wine and without having read the day's papers.

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    8. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      Actually, I think that showing up to public discussions on nutrition science and anti-obesity diets without having read a physiology text book is like turning up to teach someone to drive without having read the road rules.

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    9. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      Thanks for your insightful response to my query, Dr Sue. So I'll assume you have not read Taubes's history of what real scientists have learned time and time again over the past century about reversing obesity and diabetes. Again, I suggest that you and others here do yourselves a favour and read Good Calories, Bad Calories, if you haven't already.

      Readers, here's a flavour of the incompetence Taubes has documented in "Good Science, Bad Science":

      "Atkins's diet is both the ultimate manifestation…

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    10. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to rory robertson

      Oops, sorry, I've just noticed! Apologies, one and all, for somehow managing to post the same post twice, back to back. I know I have a tendency to repeat myself - time and time again, month after month - but that really was a complete accident. It was a simple if careless error. That's the problem with self-published pieces written and posted in a hurry on the web: quality control tends to be left behind in the rush.

      All the more reason why serious scientists should ensure their paper moves…

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    11. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      rory robertson - there's no point addressing your questions to me.

      If you want to understand carbohydrate metabolism, I suggest you read a physiology textbook.

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    12. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      Dr Sue, as you know, I was less interested in advice from you on "carbohydrate metabolism" than in your assessment of the competence and scientific integrity displayed by the University of Sydney - your alma mater - in the Australian Paradox scandal.

      (i) Several times I have encouraged you to confirm that the authors' own charts pointing up do not point down - in particular, within the 1980 and 2010 timeframe in Slides 13-20 at http://www.australianparadox.com/pdf/22Slideshowaustraliangoestoparadoxcanberrafinal.pdf

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    13. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      rory robertson - there's no point addressing your questions to me.

      I expect tens of thousands - if not hundreds of thousands - of people have passed through Sydney University since I studied there.

      If you don't want to understand carbohydrate metabolism, I suggest you stop commenting in this area.

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    14. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      I agree, Dr Sue. There is no point in addressing questions to you. Your interest in scientific integrity is a profoundly lame two-speed model:

      (1) amusingly, you march up and down the internet "correcting" the plebs - "non professionals" - on debatable points; yet
      (2) you run a mile from criticising research misconduct by senior "scientists" at the University of Sydney, your alma mater.

      You have no problem with the blatantly incompetent, self-published Australian Paradox paper, with its…

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    15. Chris Saunders

      retired

      In reply to rory robertson

      You see how it is Rory surely? Why are you attacking one of the few medics out of possible thousands who gives more than a toss for us ‘plebs’ by engaging in the conversation here. I know you are outraged and somewhat peeved over what you are doggedly pursuing, but it seems you are attempting to silence anyone who does not bow to your authority on the subject. Not really a scientific approach at all. We all have our aberrations and I am sure yours is forgiven, but to alienate people willing to engage is possibly counterproductive in the pursuit of truth.

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    16. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Chris Saunders

      Chris,

      I ask no-one to "bow to [my] authority on the subject". I merely am asking far and wide how it is reasonable for the University of Sydney's senior scientists - and its senior management - to continue to disingenuously defend the negligent, self-published and false Australian Paradox "finding", with further false information.

      Extraordinarily, the University of Sydney still refuses to concede the obvious:

      (1) most of the available evidence - in the authors' own published charts…

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  10. Bruce Neal

    Chair, AWASH and Senior Director at George Institute for Global Health

    Interesting comments. A few further thoughts:

    1. The science - I agree, this study isn't perfect. But its unlikely to be completely wrong. There are large and august bodies that have reviewed the totality of the evidence and thats what you need to look at. Not just this study, not just one University's views (I am also at the University of Sydney!) but all the applicable data. The recently reported Global Burden of Disease study is a good place to start. Sugar sweetened soft beverages clearly…

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    1. Jason Thompson

      logged in via Twitter

      In reply to Bruce Neal

      These conversations always seem to get lost between levels of specificity parties are trying to address.

      For those interested in broad-based policy and population health, of course it makes sense to restrict and curb the influence of vested interests that are harmful when applied at a population level. The argument is so easily countered, however, by examples of individuals who 'eat / smoke / drink / litter / gamble / whatever' in moderation and should have the right to do so. If you shouldn't impinge on an individuals' right to choose their poison, how can you impinge on an entire population's?

      I think we need to get better at asking industry to keep their eyes up and explain or account how they 'benefit' (or not) the health of populations, not just individuals (e.g., 11 year-olds on a once-off).

      Once they begin talking about individuals, we've lost the argument.

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    2. Sue Ieraci

      Public hospital clinician

      In reply to Bruce Neal

      Bruce - in general I agree with the principles of your argument, but you've lost me when the article suggests that 350mls of soft drink a day will make a child diabetic. (I appreciate that's not exactly what you said, and you may not have chosen the title, but this is what your article strongly suggests.)

      Soft drinks are not really part of my life, and I'm no fan of excess sugar, but I have to agree with Geoff Parker that the odd soft drink for a child is much more benign than the odd cigarette…

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    3. Chris Saunders

      retired

      In reply to Sue Ieraci

      Whether you want to accept David Gillespie’s argument about how fructose bypasses the hypocampus (the appetite controller) and consequently goes straight to the liver and lays down fat is up to you, and if any scientist thinks it important enough maybe one day they will be able to disprove his arguments.
      But if you just take into account that sugar represents unnecessary extra calories surely that is of interest in itself when someone wants to lose weight. Sugar is half glucose and half fructose…

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    4. Gary Cassidy

      In reply to Sue Ieraci

      Good morning Sue,

      RE" "the article suggests that 350mls of soft drink a day will make a child diabetic"
      I guess that is a matter of perspective. To me your interpretation sounds pretty extreme (something you're often critical of). I read from the article that if a can of soft drink a day raises diabetes risk in 90kg grown men, then the implications for a 30kg child are potentially disastrous - not every child all the time, but a significant proportion. You and Geoff Parker may ask where is the evidence that a can of soft drink a day is harmful to children. I ask where is the evidence that a can of soft drink a day is NOT harmful to children, particularly a group of less active children.

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    5. Judith Olney

      Ms

      In reply to Chris Saunders

      Well said Chris, I would like to add that most ordinary people do not look to scientists to give them ideas on how to lose weight, they look at what other ordinary people have done, (as you have suggested here with your family), and if they are people that they trust, then they will try their ideas. This is a problem in some ways because it leaves people vulnerable to the less ethical weight loss program pushers, but then again, there has been so many lies and misinformation from the fat making industries…

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    6. Judith Olney

      Ms

      In reply to Gary Cassidy

      Agree Gary, and I would also like to ask where the evidence is of any harm to people if they don't consume soft drinks, or excess sugar?

      Seems to me its a win/win all round for people, they are at less risk of diabetes and other diseases, less risk of becoming overweight or obese, less risk of damaging their teeth, and save money be not buying this rubbish food and drinks. Where is the downside for people?

      There is a downside for the multinational corporations, but they can cry me a river, they have caused so much ill health and misery in this world, with their lies and greed, and complete lack of ethics and morals, that I wont be shedding any tears for them.

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    7. Sue Ieraci

      Public hospital clinician

      In reply to Gary Cassidy

      Hi, Gary,

      I was combining the title "A soda a day keeps the doctor in pay: soft drinks and diabetes" with this part of the article: " This large study from Europe found drinking a 12 ounce (about 355 ml) can of soft drink, or soda, a day was associated with a 20% increase in the risk of developing diabetes." and "Half of eight-year-olds in the United States already drink this amount of soda, and teenage males consume more than double that."

      If you think my interpretation sounds "pretty extreme", then what is your interpretation of what I have quoted?

      It doesn't make sense to compare weight gain in children as a proportion of adult body weight - when children are growing and active. Yes, of course there is an issue with overfed and inactive children - but that's not the same as saying one can of soft drink a day will make your kid diabetic.

      Gary - did you drink soft drink as a child or teenager?

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    8. Sue Ieraci

      Public hospital clinician

      In reply to Judith Olney

      "most ordinary people do not look to scientists to give them ideas on how to lose weight, they look at what other ordinary people have done"

      Most "ordinary people" are not responsible for advising entire communities - they can take advice from whosoever they choose, and don't have to differentiate correlation from causation, nor even have to understand anything about digestion or metabolism.

      For the professional communities that need to discover and disseminate evidence on which to base advice…

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    9. Sue Ieraci

      Public hospital clinician

      In reply to Chris Saunders

      Chris - David Gillespie's "fructose is poison" argument doesn't need more research - the physiology of fructose metabolism is already well-defined. The problem is that he has taken that metabolic pathway information and misinterpreted and over-simplified it.

      The body cannot distinguish between "natural" fructose (as in fruit and vegetables) and "added" fructose - the molecule is the same. In addition, a relevant review article says this:

      "Conventional clinical trials and ecological studies…

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    10. Judith Olney

      Ms

      In reply to Sue Ieraci

      I have read the books written by Gillespie and Taubes, and while I don't agree with everything they have written, there is nothing advised in their books that would actually cause any harm, in fact most of the advice and ideas in their books are excellent for people who want to get the rubbish out of their diets, live a healthier lifestyle, and lose excess fat. The fact that they may, (and I say may because it has yet to proven that they are wrong), get some of the details wrong is really not that…

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    11. Gary Cassidy

      In reply to Sue Ieraci

      RE "If you think my interpretation sounds "pretty extreme", then what is your interpretation of what I have quoted?"
      My interpretation is that POTENTIALLY this amount of soda is a health hazard for a significant proportion of kids drinking this amount of soda. I ask myself - where is the research proving that this amount of soda is not a health hazard, particularly for less active children.

      RE "Gary - did you drink soft drink as a child or teenager?"
      Not so much. More so in adulthood, up until…

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    12. Sue Ieraci

      Public hospital clinician

      In reply to Judith Olney

      "Please don't try and make out the scientists and health professionals diet advice makes them accountable, they seem to have gotten it wrong on sugar,""

      When have scientists or health professionals advised excess sugar consumption? Quite the reverse, in fact.

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    13. Judith Olney

      Ms

      In reply to Gary Cassidy

      Its interesting Gary, that many of the public health campaigns use the message of completely stopping a behaviour such as the "every cigarette is doing you harm" , no alcohol is best when pregnant" etc.

      I agree with these messages, but they are extreme, particularly when people know that one cigarette is highly unlikely to kill a person, and that a pregnant woman who drinks a glass of wine, in the main is not going to harm her baby. IMO these messages are given because those designing these campaigns…

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    14. Judith Olney

      Ms

      In reply to Sue Ieraci

      Its not a matter of advising excess sugar consumption Sue, its a matter of watering down the message so that it simply gets ignored, See my post above in reply to Gary.

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    15. Sue Ieraci

      Public hospital clinician

      In reply to Gary Cassidy

      Gary - our perspectives clearly differ.

      As a health service provider, I am held accountable for the advice I give. I don't think it is ethical to mislead people, even to get them to improve their habits. So, I could lie to someone and say they had a shadow on their XRay (if they didn't) and get them to stop smoking, which might dramatically improve their health status - but I don;t think it's OK to do that. Do you?

      I also have a different perspective because, although I am not a dietitian…

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    16. Sue Ieraci

      Public hospital clinician

      In reply to Judith Olney

      "For me its not about the nitty gritty of the science, its about the overall message, the big picture."

      Without the "nitty gritty of the science", how do we know what causes the big picture?

      Did we know the harmful effects of cigarette smoking by intuition, or through the science? Would we have been able to fight the tobacco industry without science?

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    17. Chris Saunders

      retired

      In reply to Sue Ieraci

      I thank you very much for referring me to the article “Fructose metabolism in Humans”. I found it valuable and interesting. I can understand that you are not willing to jump either way in this conversation when so much about the metabolism of glucose/fructose is unknown. The study’s discounting of a sugar/diabetes connection and also of a connection with non alcoholic fatty liver puts closure on some hypotheses in this regard. I also recognise that David Gillespie’s hypothesis is a simplification…

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    18. Judith Olney

      Ms

      In reply to Sue Ieraci

      No Sue, we wouldn't be able to fight the tobacco industry without science, and I'm not saying that the science has no place in health, in fact I think the opposite. What we have seen though is the junk food industry using the science to dilute the message to the public about how dangerous their products are, just like the tobacco industry did for many years.

      I also think that if you are a health care professional, or a nutritionist or dietitian, the nitty gritty details of the science are going…

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    19. Sue Ieraci

      Public hospital clinician

      In reply to Chris Saunders

      Thanks, Chris - a couple of things:

      First, I don't think nutritionists are saying "all sugars are equal" = they know the metabolic pathways better than most of us. That's why the advocate balance. We need some carbohydrates to go into lipid production because the body can't function without lipids.

      Second, the science around GI comes from diabetic research - it's about trying to regulate carbohydrate release into the bloodstream in the presence of an unresponsive insulin secretion system. In…

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    20. Judith Olney

      Ms

      In reply to Sue Ieraci

      <"The "people who are claiming a non sugar diet alone worked for them. " could be taken at their word, but their methods and results have not been verified. There is also a natural bias amongst posters here - who is going to specifically post that they read Gillespie and tried for a couple of weeks but failed?">

      Not verified? What do you mean Sue, not verified by you, or some other professional? Not written up in a scientific journal, in a peer reviewed paper? What is the "natural bias" you are…

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    21. Sue Ieraci

      Public hospital clinician

      In reply to Judith Olney

      I get that you don't need anyone else's verification, Judith, but public health messages do need to be based on verified information. Most people aren't being dishonest with their anecdotes, they just cant distinguish correlation from causation.

      Please self-experiment all you want - just don't write a book of pseudo-science telling everyone else to do the same thing.

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    22. Judith Olney

      Ms

      In reply to Sue Ieraci

      I was asking what you meant by not verified Sue, I didn't say anything about not needing anyone else's verification. I require verification of the science and results before I experiment on myself, as any thinking person would, but as the science is either non-existent or wrong in many areas of nutrition, I tend to not trust what I am told by those that just go along with the accepted principles without question, as many in the scientific community do. There are various reasons why some accepted…

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    23. Gary Cassidy

      In reply to Judith Olney

      Hi Judith,
      Yes, extreme public health messages are used often. I suspect because they work.
      Sue is correct that it is unhelpful (and possibly detrimental) for public health authorities to use extreme messages when there is not the evidence to back up the assertions (i.e. telling people that smoking will cause you to grow warts all over your face is probably not a good message).
      In regard to soft drinks (and sugar in general), in the current context of obesity rates and level of sugar consumption…

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    24. Gary Cassidy

      In reply to Sue Ieraci

      Hi Sue,
      RE: "Although I often drank them as a child, as most people did"
      I don't know about that one Sue, The first half of your statement may be true but I don't agree that kids have always often drank soft drinks. Besides, because something was done in the past it doesn't make it an ok thing to do. Particularly when the environment has changed.
      As a parent of young children I see first hand how much exposure kids are having to junk food. Consider this example - Last summer I received an sms…

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    25. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Gary Cassidy

      Gary re "I see it as no accident that my children are healthy, lean, and happy". Ditto for my kids, except on the latter when I turn off the TV or say no to ice-cream. On the need for better nutrition education, I've had a go at converting the new Australian Dietary Guidelines into a Class Talk that provides useful information for kids, parents and teachers: http://www.australianparadox.com/pdf/talktoyear3boys.pdf

      Readers, note that added sugar is the only foodstuff for which the NHMRC cited new
      stronger evidence of a need for reduced consumption.

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    26. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      Dr Sue, there you go again pretending - or maybe actually believing - that David Gillespie got everything wrong when he wrote that, for many everyday people, removing sugar/fructose is a powerful path to better health.

      Awkwardly for you, Dr Sue, there is a growing nucleus of scientists globally tending to ridicule your mistaken view that sugar/fructose is not a key driver of global obesity and diabetes.

      Your strongest argument so far has been that David Gillespie does not have a medical or…

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    27. Judith Olney

      Ms

      In reply to Gary Cassidy

      Hi Gary, I have no problem with people like Sue wanting evidence, but the nit picking over percentage points, and such, is not useful to the discussion on the whole. I look at those type of arguments as playing gotcha, and its seems to be ego driven, rather than being intended to provide information towards a deeper discussion.

      When the accepted wisdom of what constitutes a healthy diet are wrong, arguing over the details of the accepted wisdom is just shuffling deck chairs on the titanic…

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    28. Gary Cassidy

      In reply to Judith Olney

      Hi Judith,
      RE "making food something people feel they have to know every molecular detail about, before deciding whether they should eat it or not"
      The advise that has been given in the past has ripped food apart. it has turned food into this nutrient and that nutrient. It has made food about calories, chemicals, and fat, and protein, and starch, and sugar, and omega 3's, and photochemicals .... It has led to food confusion. This confusion has emanated from our nutrition advisory bodies, and has…

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    29. Judith Olney

      Ms

      In reply to Gary Cassidy

      I absolutely agree with your assessment Gary, and this pretty much sums up what Michael Pollan was talking about in the video, and what I have been trying to say, although I am far less eloquent. I have just downloaded the book "In Defense of Food" and its next on my reading list.

      I also became very confused about all the conflicting information coming from scientists and health authorities, when I was looking at ways to improve my health, I have noticed this confusion in many people I meet and…

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    30. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Judith Olney

      Michael Pollan's latest book is "Cooked". It arrived at home on Friday and looked so good that I quickly wrapped it up and gave it to my wife - an enthusiastic cook - for Mothers' Day. Now I have to wait to read it. So I intend to get a copy of "In Defence of Food" next time I walk past a bookshop. Thanks for the tip, team anti-"diabesity".

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    31. Judith Olney

      Ms

      In reply to rory robertson

      I'll keep my eye out for that one Rory, I think its important to look at a lot of different points of view on the issue of obesity, diet and health. Sometimes the best information can come from the most unlikely of places. I became very skeptical of the accepted wisdom of health authorities on the subject of diet and health a number of years ago now, and daily it seems, that my skepticism was justified.

      It makes me very happy to see people are starting to wake up at long last, well some of them anyway.

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    32. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Judith Olney

      Yes, Judith, many conventional sources of information have turned out to be a disaster for public health. On the critical links between obesity, diabetes, diet and health", the information retailed by the most-influential nutritionists at the University of Sydney has been worse than useless.

      If you think that is excessively strong language, readers, I can assure you that I chose my words carefully. This is serious. Let me explain.

      On this tread, Professor Neal (of the George Institute…

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    33. Sue Ieraci

      Public hospital clinician

      In reply to Gary Cassidy

      Gary - you may be reading too much into my statement.

      "I don't agree that kids have always often drank soft drinks" Neither do I. Did I say "always"?

      Contrary to what you imagine, my education in nutrition started long before medical school - it started with my parents, supplied by our back garden.

      I agree with you totally about the nutrition of children, and have lived in the same way. I just don't favour absolutes and extremes.

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    34. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      Awkwardly for you, Dr Sue, there is a growing nucleus of scientists globally tending to ridicule your mistaken view that sugar/fructose is not a key driver of global obesity and diabetes.

      Dr Sue, your story so far is that David Gillespie "misinterpreted and over-simplified" key facts, because he's a bit clueless - after all, it's all so complicated and Gillespie does not have a medical degree from the University of Sydney, like your super-competent self.

      Perhaps, Dr Sue, you can explain…

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    35. Gary Cassidy

      In reply to Sue Ieraci

      "Gary - you may be reading too much into my statement."

      A symptom of non-specific generalised messages such as "Eat xyz in moderation" ;-)

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    36. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      ''For years, we have heard messages about watching our saturated fat intake. But in reality, sugar is the real cause of our expanding waistlines.''

      Rory - after all those reams of writing, have you still not understood that saturated fat is about coronary disease risk not weight loss?

      The nutrition profession has NEVER advised people to substitute the saturated far energy with sugar, Never. If that is why you became a ''fattie'', why do you blame nutritionists? Did a dietitian advise you to subsstitute excess saturated fat with an excess of sugar?

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    37. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      Dr Sue, save your overconfident nonsense for someone else. Any link between saturated fats and heart disease is much less credible than you apparently realise. Indeed, the supposed link between saturated - and especially animal - fats, cholesterol and heart disease is a part of the incompetence in modern nutrition science that "professionals" like you have swallowed hook line and sinker: http://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html?pagewanted=all&src=pm

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  11. Chris Saunders

    retired

    Please Neal can you assist? I have a problem understanding the findings of the first study having only read the abstract. They claim an association between sugar sweetened soft drinks and diabetes. After adjustments “they found association of artificially sweetened soft drinks became statistically not significant”. They also stated “Juice and nectar consumption was not associated with type 2 diabetes incidence.” What is the juice and nectar they are talking about? And was this finding after adjustments?

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  12. Bruce Neal

    Chair, AWASH and Senior Director at George Institute for Global Health

    Hi Chris
    The proposition in the paper is:
    1. Sugar sweetened soft drinks incresase diabetes risk, most likely through an effect on BMI. Not everyone will get diabetes, but on average, the iimplication is that regular consumtion will increase the risk.
    2. Artifically sweetened doft drinks are associated with an increased risk of diabetes, most likely because people who get diabetes (from drinking sugar sweetened soft drinks or for other reasnos) choose or switch to artificailly sweetened soft…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Bruce Neal

      Except, Chris and Bruce, that the first paper did not show that effect.

      As I said above:

      "After further adjustment for energy intake and BMI, the association of sugar-sweetened soft drinks with type 2 diabetes persisted (HR 1.18, 95% CI 1.06, 1.32), but the association of artificially sweetened soft drinks became statistically not significant (HR 1.11, 95% CI 0.95, 1.31)."

      HR is hazards ratio - essentially the ratio between the incidence of the control or baseline population (defined as 1.0) and the test group incidence. The CI stands for Confidence Intervals - a statistical measure of where the true value is likely to lie. So, a HR of 1.18 with CI of 1.06 to 1.32 means that there is almost NO difference at all between the diabetic group and the control group.

      In other words, this study showed that, when you controlled for total energy intake and obesity (BMI), the effect of drinking or not drinking one sweetened drink per day was vanishingly small.

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  13. Bruce Neal

    Chair, AWASH and Senior Director at George Institute for Global Health

    Hi Sue
    I don't agree with your interpretation I am afraid. Here's why:
    1. Increased BMI is almost certainly on the causal pathway between consuming soft drinks and getting diabetes - soft drinks begets excess energy begets increased BMI begets diabetes. If you adjust for something on the causal pathway of course the strength of the association between what you start with and what you finish with is attenuted in the process. Indeed, if adjusting for it does attentuate the association it gives…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Bruce Neal

      Thanks, Bruce.

      Yes, soft drink can contribute to overall excess energy, but the issue is in isolating a single source of energy in an overall diet.

      I agree that 18%, if that is the true figure, is significant across a population. With a low CI of 1.06, however, the effect could actually be 0.6%.

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    2. Bruce Neal

      Chair, AWASH and Senior Director at George Institute for Global Health

      In reply to Sue Ieraci

      A hazard ration of 1.06 represents a 6% increase not a 0.6% increase. Even 6% is potentially huge when you are talking about a disease as massively prevalent and incident as diabetes. But remember, the correct point estiamte and CIs are those without adjustment for BMI, which is on the causal pathway. B

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    3. Gary Cassidy

      In reply to Sue Ieraci

      Hi Sue,

      1.06 actually represents a 6% increase in risk. However, if it were reasonable to choose the lower CI bound as the actual increase risk to the population, then it would also be valid to choose the upper bound of 32% increase (or any other random number within the confidence intervals). Since the purpose of developing a risk ratio is to provide a quantity, some number must be provided - this is the most likely (statistically speaking) value (1.18 in this case for the BMI adjusted analysis…

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  14. rory robertson
    rory robertson is a Friend of The Conversation.

    former fattie

    Good morning Professor Neal, Dr Sue and Gary. From your detailed conversation yesterday, I can see that you all are quite good with numbers. I wonder if you can, please, help me with a little puzzle, not to say paradox. Actually, it's just a simple calculation, but I need someone competent to cross-check my answer and workings, please.

    So here's the question: "Calculated in terms of grams per person per year, what is 12, 402, 000,000 grams in total over four years, shared between about 20 million…

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    1. Chris Saunders

      retired

      In reply to rory robertson

      Yes Rory, I think you have the maths right. It's a division not a multiplication. (300/ 2 = 150) But I wish you would do something about that stutter.

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    2. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Chris Saunders

      Yes, Chris, I am right in identifying that "~600 g per person per year" error. The correct figure is as you say ~150 g per person per year. I'm not sure, Chris, about any stutter; perhaps what you identify in me as a stutter will disappear after University of Sydney Vice-Chancellor Dr Michael Spence apologises to taxpayers - especially those interested in improved public health - for publicly supporting seriously faulty research that his "scientists" self-published and then used in an attempt to…

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  15. John Doyle
    John Doyle is a Friend of The Conversation.

    architect

    A good overview of this food crisis is to see this video by Michael Pollan.
    http://youtu.be/c31cAdYUvT8
    This conversation has become a good example of his definition of the debate as "nutritionism" a consequence of which is to have good versus bad foods.
    The industry's most successful campaign was against "bad" [saturated] fats but also it's most spectacular failure he says.

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    1. Judith Olney

      Ms

      In reply to John Doyle

      Thank you for posting this video John, everyone should see this, absolutely excellent.

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    2. John Doyle
      John Doyle is a Friend of The Conversation.

      architect

      In reply to Judith Olney

      If anyone is interested, tonight [Monday 13/5] on SBS at 8:30 is a program "The Truth about Fat"
      "Convinced there is more than a lack of self control at play, surgeon Gabriel Weston sets out to discover why the british population is, on average, getting fatter"

      Already from the above video we know quite a bit; it is the epidemic of snacking, with poor nutrient foods, that set it off after 1980.
      Let's see what this doco says.

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    3. Sue Ieraci

      Public hospital clinician

      In reply to John Doyle

      For readers who want to know what the evidence actually shows, it's worth reading this review article in Lipids 2010 by Micha and Mozaffarian: " Saturated Fat and Cardiometabolic Risk Factors, Coronary Heart Disease, Stroke, and Diabetes: a Fresh Look at the Evidence."

      You can access the full paper at http://link.springer.com/content/pdf/10.1007%2Fs11745-010-3393-4.pdf

      "Based on the best evidence from human studies, replacing SFA with PUFA (e.g., vegetables, vegetable oils) lowers CHD risk, whereas replacing SFA with CHO has no benefits."

      Again, the nutrition profession has not "got it wrong" about the association of saturated fat intake with coronary disease. If they have erred, it is in failing to foresee that their "low fat" message might be interpreted as "replace calories with sugar" - a message they have never promoted.

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    4. John Doyle
      John Doyle is a Friend of The Conversation.

      architect

      In reply to Sue Ieraci

      Of course the nutrition profession has got it wrong ,Sue.
      Did you read the whole report or just the conclusion? Didn't you see the study is full of mixed messages? Also if you bothered to look you would find hundreds of studies that contradicted these conclusions.Here they don't spell out what is a PUFA, except to say "vegetable oils" which literally cannot be true.
      Yes Sue, you are on a loser here. The nutrition profession got into bed with government and industry and sacrificed their integrity.
      By the way did you look at the videos I recommended?
      Yes or No?

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    5. Gary Cassidy

      In reply to John Doyle

      Hi John,

      Thanks for the link to the Michael Pollan lecture. Enjoyed it very much. It reminds me, I must re-read In Defense of Food.

      "The one diet that reliably seems to make populations sick is this western diet. What an achievement for civilisation!"

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    6. John Doyle
      John Doyle is a Friend of The Conversation.

      architect

      In reply to Gary Cassidy

      Even in today's Sydney Morning Herald there is an article about him, showing his eminently good sense.
      He points out that meals we prepare at home will always be healthier than fast food or convenience foods.

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    7. Sue Ieraci

      Public hospital clinician

      In reply to John Doyle

      Did I read the entire paper that I referenced, John? Of course. Did you? If you did, you seem not to have understood it.

      On what basis do you not accept the evidence that reduction in saturated fat intake (without replacing the energy with CHOs) reduces coronary disease?

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    8. Sue Ieraci

      Public hospital clinician

      In reply to John Doyle

      John Doyle, you keep repeating the mantra you have heard that "the nutrition profession got it wrong". Unfortunately, YOU have it wrong.

      Firstly, the association between saturated fats and coronary disease was not "invented" by the nutrition profession - the data came from a number of large population-based epidemiological studies - as outlined in the review article I referenced before.

      Secondly, the nutrition profession never advised people to substitute saturated fats with sugar - this has…

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    9. John Doyle
      John Doyle is a Friend of The Conversation.

      architect

      In reply to Sue Ieraci

      What you say, Sue doesn't change a thing. Obviously you have a closed mind and are not amenable to having to own up that the nutrition profession has got "it" wrong.
      Why do you have to be a professional in the fields of medicine to see what is obvious to every man or woman in the street?
      That we have an obesity epidemic
      How can you say the nutrition industry has not got it wrong when they are a responsible party in this poor health epidemic?
      They have been in bed with industry and vested interests…

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    10. Chris Saunders

      retired

      In reply to Sue Ieraci

      When I limited the amount of saturated fat and increased the amount of fibre and water in my diet, my intention certainly was to follow recommended dietary guidelines and to have a healthy diet.
      When I gave up sugar, my intention was to lose weight without in the process depriving myself of any essential vitamins, minerals etc which could not be obtained in any other foods. When I limited fibre and consequently water intake my intention was to stop trying to eat something which I found (painfully…

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    11. John Doyle
      John Doyle is a Friend of The Conversation.

      architect

      In reply to Chris Saunders

      Chris,
      For my money Sue is just "rearranging deck chairs on the Titanic"
      In your personal quest what did you do to limit saturated fat? Did you give up on butter and choose margarine, for example? How did you make up for not eating sugars if you also gave up on the flavour of saturated fats?

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    12. Sue Ieraci

      Public hospital clinician

      In reply to Chris Saunders

      Hi, Chris - thanks for your comments, and your reasoned approach.

      Your approach - to limit saturated fats for coronary health and to limit added sugars for weight and diabetes risk, is entirely rational - and is also exactly what the nutrition profession advises.

      I have a different view of Rory's obsession with a single paper from Sydney University. I don't think Rory understands the context and development of scientific research in general - which is not all high quality, but accumulates over…

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    13. Judith Olney

      Ms

      In reply to John Doyle

      I've just finished reading "In Defence of Food" by Michael Pollan, and he makes it very plain just how wrong nutritionists have gotten the science, I am amazed that anyone can still accept the rubbish science that has led to the current state of human health, in regards to what we eat.

      Scientists in the main are very conservative in their views, but something has gone badly wrong in the food science industry. It has become all about the money, and not about health at all.

      There are a huge…

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    14. Chris Saunders

      retired

      In reply to John Doyle

      No margarine, never could stomach it. Retained the butter but only a smear on toast, made cakes with olive oil and stopped making desserts mostly custards/puddings. Rather disgruntled I used low fat milk on morning oats or cereal and in coffee. That certainly took the enjoyment out of them. Stopped eating chips and deep fries and pizzas.
      Since the sugar diet I replaced breakfast cereal and sugar with a crumpet with butter and a rasher of bacon. Also have limited coffee to one cup a day (mostly) and have it with two dessertspoonfuls of whipped cream; they are made for each other. Two slices of cheese with lunch most days. Found that I wanted this fat when not having the sugar, but was not lured by the deep fries etc. I also found it easy to give up pasta and bread which assisted the weight loss. And I did not miss their digestive process.

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    15. John Doyle
      John Doyle is a Friend of The Conversation.

      architect

      In reply to Chris Saunders

      That's not poles apart from my diet. I just eliminated as best I could all sources of industrial PUFA's, but I get some in olive oil and krill oil capsules as well as the little in all saturated fats/oils. I use coconut oil [now there's a vegetable oil for you!!!] for all frying. I only touch full fat milk but consumption is down to 1 litre a week. I have no problem with deep frying but it's not an everyday occurrence. I eat lots of greens, mushrooms, tomatoes, also eggs and grass fed beef.
      I stopped sugar 2 years ago first switching to xylitol and now if I need bulk for recipes I use glucose powder and as a sweetener a little maple syrup. I feel much better, and lighter, for it all. And it all tastes really good!

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    16. John Doyle
      John Doyle is a Friend of The Conversation.

      architect

      In reply to Judith Olney

      Well that's right Judith.
      When apologists for the current state of nutritional science can't even acknowledge the other side's work and won't even look at the videos out there it's hardly a ringing endorsement for them.
      It does seem that in spite of pressure to support vested interests more and more people in the community are reading labels and sorting simple from complicated lists of ingredients and buying around the edges of the supermarkets. Taking things into their own hands.

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    17. Chris Saunders

      retired

      In reply to John Doyle

      For celebratory birthdays, we use the dextrose and butter for the birthday cake. Apart from two pieces of fruit a day, I don't have sweet things. I don't want to awaken the sugar tooth.

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    18. Judith Olney

      Ms

      In reply to John Doyle

      What I don't understand John, is why there is even an argument, if getting the sugar and and processed crap, out of a persons diet is a good thing, then why even try to counter this message?

      You would think that health professionals would be endorsing the work by Pollan, Taubes, and Gillespie, not seeking to tear them down.

      The only reason I can see for not supporting these good health messages, is because its bad for business. If people work out how much better their health can be, by cutting…

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    1. John Doyle
      John Doyle is a Friend of The Conversation.

      architect

      In reply to Dina Ralt

      I also saw something today about that.
      While the idea seems laughable, if they really wanted to help they could make a giant difference, but living as we do in a world of spin, it's going to be difficult not to laugh.
      In any event it shows that they are feeling pressured by the relentless grass roots campaign against sugar. And well deserved too considering what fat Sugar did to John Yudkin's work.

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    2. Dina Ralt

      logged in via Facebook

      In reply to John Doyle

      The problem is that diet drinks contributes to obesity as well and it is hard to believe that they will suggest to drink water.

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  16. rory robertson
    rory robertson is a Friend of The Conversation.

    former fattie

    Readers, as Professor Neal argues above, it has become increasingly clear in the past decade that modern rates of consumption of added and concentrated sugar - sucrose and fructose, especially in sugary drinks - are a major driver of global trends to obesity and diabetes, the greatest public-health challenge of our times. Yet National Diabetes Week (14-20 July 2013) has just been and gone again without much happening: http://www.australianparadox.com/pdf/Sugary-Drinks-Ban.pdf

    In an effort to…

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