NHS Choices - Is sugar the cause of our obesity epidemic?
Sugar hit the headlines last week when the Daily Mail and The Independent led with the quote “Sugar is the new tobacco”. Many news outlets focused on a reported link between high sugar consumption and the rise in obesity and diabetes.
The reports stem from the newly formed campaign group Action on Sugar, whose well-timed press release coincides with New Year's resolutions and January diet crazes.
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Action on Sugar warns that as well as being “a major cause of obesity”, there is “increasing evidence that added sugar increases the risk of developing type 2 diabetes, metabolic syndrome and fatty liver”.
In a separate story, several newspapers also highlighted an expert's perhaps surprising opinion that fruit juice contains so much sugar that it should no longer count as one of the 5 A DAY portions of fruit and vegetables.
"I would support taking it out of the 5 A DAY guidance,” Professor Susan Jebb is quoted as saying.
“Fruit juice isn’t the same as intact fruit and it has got as much sugar as many classical sugar drinks," she said.
What is Action on Sugar?
Action on Sugar is a group of specialists concerned with sugar and its effects on health. It says it is working to reach a consensus with the food industry and the government over:
- the harmful effects of a high-sugar diet
- reducing the amount of sugar in processed foods
It stresses the importance of protecting children from this “public health hazard” and calls for the food industry to “immediately reduce the amount of sugar that they are adding, particularly to children’s foods, and stop targeting children with massive advertising for high-calorie snacks and soft drinks”.
Action on Sugar is supported by 18 expert advisers. Its chairman is Professor Graham MacGregor, professor of cardiovascular medicine at the Wolfson Institute, Queen Mary University of London. Professor MacGregor also chairs Consensus Action on Salt and Health.
What is Action on Sugar calling for?
Action on Sugar believes the link between calories and obesity is caused in part by high sugar consumption, and that not enough is being done to tackle what they call “the obesity and diabetes epidemic”. It says that the right approach is to “target the huge and unnecessary amounts of sugar that are currently being added to our food and soft drinks”. It highlights the work that is already being carried out by food manufacturers to reduce the amount of salt that is added to processed foods.
Salt intake is estimated to have fallen in the UK by 15% (between 2001-2011) and the salt contained in most products in the supermarkets has been reduced by 20-40%. This is calculated to have led to at least 6,000 fewer strokes and heart attack deaths a year, and a reported healthcare saving cost of £1.5billion, according to Action on Sugar.
Action on Sugar says that a similar programme can be developed to gradually reduce the amount of added sugar in food and soft drinks (with no substitution for alternative sweeteners or sugars) by setting targets for foods and soft drinks. Action on Sugar has calculated that a 20-30% reduction in sugar added by the food industry over the next three to five years is “easily achievable”. This, they say, would result in a reduction in calorie intake of approximately 100kcal (420kilojoules) a day for everyone and more in those people who are particularly prone to obesity.
Professor Graham MacGregor said: “We must start a coherent and structured plan to slowly reduce the amount of calories people consume by slowly taking out added sugar from foods and soft drinks. This is a simple plan which gives a level playing field to the food industry, and must be adopted by the Department of Health to reduce the completely unnecessary and very large amounts of sugar the food and soft drink industry is currently adding to our foods.”
How did critics receive Action on Sugar’s claims?
The organisation Sugar Nutrition UK has rejected Action on Sugar’s claims, saying that they "are not supported by the consensus of scientific evidence”.
Sugar Nutrition UK cites a review on sugar and obesity published in 2013 and funded by the World Health Organization, which they say concluded that “any link to body weight was due to overconsumption of calories and was not specific to sugars”.
Sugar Nutrition UK, which is largely funded by sugar manufacturers, also disagrees that reducing the amount of sugar in foods will always result in a reduction of calories. “In most cases the sugar will need to be replaced by another ingredient and the reformulated recipes can contain more calories than the original,” it says.
It also argues that, “the balance of available evidence does not implicate sugar in any of the so-called 'lifestyle diseases', such as diabetes”.
Is sugar really “as harmful as tobacco”?
The headlines comparing sugar to tobacco were prompted by a quote from Simon Capewell, professor of clinical epidemiology at the University of Liverpool, in Action on Sugar's press release.
Professor Capewell said: “Sugar is the new tobacco. Everywhere, sugary drinks and junk foods are now pressed on unsuspecting parents and children by a cynical industry focused on profit not health.”