Big Fat Lie

Marie Claire Magazine - September 2012

Tabitha Lasley

Compared to my friends, I was considered the healthy eater. I drank orange juice instead of Coke. I ate brown bread instead of white. I exercised three times a week. But I was always overweight, all my life. After trying and trying to lose weight I went to see a dietician who told me I was pre-diabetic. She said if I didn’t change my eating habits, I’d be diabetic in a few years.’

Kim Whitaker, a 28-year-old hotelier from Cape Town, is like many South African women. Obesity has reached pandemic proportions here. A 2010 survey found that 61 per cent of South African adults are overweight or obese. It led pharmaceutical company GlaxoSmithKline to conclude that the country is ‘slowly eating itself to death’. Meanwhile, the International Diabetes Federation predicted a 27 per cent rise in diabetes by 2030. By then, seven million people in South Africa will live with it. In 15 years’ time, they reckon the incidence of diabetes will equal current rates of HIV infection in sub-Saharan Africa.

Why is this happening? For dietician Priya Seetal, a nutrition information officer for the South African Sugar Association, that’s an easy question to answer: ‘Weight gain occurs when we eat more kilojoules than we burn.  When we eat too much and don’t do enough physical activity to burn it off we gain weight.  The reason obesity has risen dramatically over the past 50 years is that we’re eating more kilojoule-dense foods, our portion sizes are bigger, we do more desk work and we’re spending more time in front of the TV.’

Seetal’s response is the industry standard.  It places responsibility firmly with the individual.  We get fat because we ingest more kilojoules than we expend. If we weren’t so lazy, or so greedy, we’d be slim. But surely if it were that simple, Kim, with her sensible eating and regular exercise, would be able to manage her weight?

Think of the most conspicuously effective diet of the decade, the Atkins, where dieters can theoretically consume a huge number of kilojoules, in the form of fatty meats, cheese, cream and oil, yet still lose weight. More recently, Princeton University researchers in the US found that rats fed on HFCS (high fructose corn syrup, a sweeter, cheaper alternative to sugar) gained more weight than those eating either table sugar or fat, even when their overall kilojoule intake was the same. Clearly, not all kilojoules are created equal.

More significant is the fact that respondents in the GlaxoSmithKline (GSK) survey claimed to be buying healthy food 52 per cent of the time. GSK put this down to people being ‘in denial’. But what if there were another explanation? What if rather than being in denial, or weak-willed, or throwing carrot cake into their trolleys and telling themselves it counted as one of their five-a-day, people were diligently filling their shopping baskets with food they believed to be healthy? It’s possible. Because, as it turns out, much of the dietary advice proffered over the last 30 years has been a big, fat lie.

During the Seventies, scientists were busy trying to pinpoint the causes of heart disease. American nutritionist Ancel Keys thought it was saturated fat, British scientist John Yudkin blamed sugar. Opinion came down on Keys’s side, and the US government started issuing guidelines in line with his advice. With this seismic shift came the creation of a whole new range of products: diet food. Diet yoghurts, crisps, cookies, spreads.  Diet dressings, desserts, cool drinks, sauces. They were all extremely low in fat. But that didn’t make them healthy.

‘When you take the fat out of the food, it tastes like cardboard,’ explains Dr Robert Lustig, an endocrinologist and expert in childhood obesity. ‘The food industry knew that. So what did they do? They added sugar instead.’

It was only in the Eighties that scientists started noticing people were getting fatter despite the ubiquity of diet food. By 1989 some 14 per cent of women had a BMI of over 30 (the threshold for obesity), up from 1,8 per cent in 1966. Cutting fat out of the equation obviously wasn’t working. Academics started wondering if Yudkin hadn’t been right all along. But by then, it was too late. Keys’s low-fat dictum had metastasized, and spread across the Western world. Sugar was everywhere.  

Lustig says Keys’s approach has proved ‘disastrous’. Statistics bear this out. It’s not just that figures for obesity and diabetes have gone through the roof since the Seventies (children in the US are now so fat, they have the dubious distinction of being the first generation on record to have a lower life expectancy than their parents). There’s also the 2012 Harvard University study that found that men who drink sweetened drinks are 20 per cent more likely to have a heart attack, and the 2008 UC Davis research that found such drinks increase visceral fat – the dangerous sort that shores up around vital organs. There’s the news that in America, a country with comparable levels of obesity to South Africa, 23 per cent of teens already have pre-diabetes. Never mind the numerous indications that fructose (a key component of table sugar and HFCS) is actually toxic in the doses we’re taking, rotting up the cardiovascular system and overloading the liver.

Jean-Marc Schwarz, a nutritional biochemist at Touro University California and San Francisco General Hospital, describes the ‘tsunami’ effect a soda or even a seemingly innocuous glass of orange juice can have on the body: ‘You get a huge wave of sugar, which the liver then has to deal with. If you eat an orange, you have the pulp which delays absorption and regulates that flow. But the more processed your food is [eg, orange juice], the bigger that wave is to the liver.’

Fructose, says Schwarz, is the sugar most readily converted into fat. Once it hits the liver, it’s exported into the bloodstream and turned into VLDL triglycerides. These ‘balls full of fat’ increase small dense LDL particles, which cling to the arteries, shipping cholesterol around the body and causing cardiovascular disease. We’ve basically been felled by the very move we hoped would protect our hearts.

Kim’s own experience echoes this research. About 18 months ago, her dietician recommended she cut out sugar completely. She now eats a diet rich in nuts, green vegetables and oily fish, avoids processed foods and barely drinks alcohol.

‘At first it was really difficult. I didn’t realise just how much sugar there is in everything. But my body has changed completely. I’ve lost 11 kilos. I used to drink about eight cups of coffee a day. Sometimes I’d have to nap in the afternoon because I was so exhausted. Now I’m off sugar, I have so much energy.’

Yet Seetal still believes the sweet stuff can be ‘part of a healthy balanced diet’. Her advice? That we restrict ourselves to ‘a teaspoon or two of sugar in tea or coffee’ and reserve ‘cakes, puddings and biscuits’ for special occasions. Which sounds sensible. And would be, if only cakes, puddings and biscuits were the sole items that contained sugar. Unfortunately, it’s in almost every processed product you can think of. It’s far easier to list the foodstuffs that don’t contain it.

‘Stealth sources of sugar include sauces, bread, fruit-flavoured yoghurt, teriyaki sauce, peanut butter, milk and fruit juices,’ says Jeff O’Connell, author of Sugar Nation: The Hidden Truth Behind America’s Deadliest Habit and the Simple Way to Beat it. ‘Tropicana juice has 22 grams of sugar per serving. Granola bars appear healthy but they’re not much different from candy bars. The same goes for “breakfast bars”. A single Health Valley Cereal Bar contains 14 grams of sugar.’

Nor do food companies make it especially easy to spot these generous extra helpings:

‘They hide it,’ says Lustig. ‘There are 56 names for sugar*, so you don’t even know you’re eating it when you’re eating it. The University of North Carolina did a study recently that showed that of the 600 000 food items available in US supermarkets, 80% are laced with added sugar. It’s hard to find things that aren’t. It requires an enormous effort on an individual’s part. It requires looking at a lot of labels and it requires knowing all 56 names.’

It’s not just these covert tactics that make it hard to go cold turkey though. Increasingly, research is showing that people can, and do, get hooked on the stuff.

‘MRI studies have found that the brain’s pleasure centres light up for sugar much as they do for cocaine and other drugs,’ says O’Connell. ‘Similarly, a tolerance develops. You need more and more to achieve the same effect.’

‘Everyone will agree it’s habituating,’ adds Lustig. ‘People will tell you they have symptoms of sugar withdrawal the same way anybody addicted to street drugs would have withdrawal. (They also) have decreased dopamine receptor density in the reward centre of the brain, just like you see with cocaine.’

Lustig believes fructose drives insulin resistance, which in turn suppresses the action of leptin, the hormone that tells our brains when we’re full. The brain thinks it’s starving, so reaches for more, creating an endless feedback loop of desire and consumption. His work has fired fierce debate over whether sugar is truly addictive, or just habit-forming. For her part, Seetal is sceptical.

‘A study conducted by Professor David Benton in 2010 examined the possibility of being addicted to sugar,’ she explains. ’He was able to show that there is no evidence that the addictive behaviour seen in animals exists in humans.’

Reassuring as that sounds, it’s worth noting that Professor Benton’s study was funded by the World Sugar Research Organisation. Seetal also cites a study of his that shows we’re more likely to lose weight by following a diet that contains some sugar, as opposed to one that forgoes it altogether. Money for this research came from the Sugar Bureau.

‘Anyone taking money from the Sugar Bureau is automatically suspect,’ says Lustig. ‘Dr Benton has a bent, and it is clear from his writings. He shouldn’t be the spokesperson for the other side.’

‘When you look at scientific publications, it’s always good to know where the money is coming from,’ agrees Schwarz. ‘(Beverage companies) do fund studies and they have scientists working on their behalf. They are desperate, because the latest information is very damaging.’ 

Evidently. Seetal is swift to point out that a separate body, the International Food Information Council (IFIC) concurs with Benton’s findings in both cases. Yet on closer inspection, the neutral-sounding IFIC reveals itself to be not so neutral after all. Its website is vague about funding, though it contains an admission that the organization is ‘supported primarily by the broad-based food, beverage and agricultural industries’. In fact, it’s bankrolled by a number of companies with very vested interests: Kraft, Kellogg’s, Burger King Corporation, Coca-Cola, McDonalds, PepsiCo.

Such frantic dissembling has led Schwarz and others to draw comparisons between the food industry today and the tobacco industry 50 years ago. Their positions are roughly analogous: they’ve both been forced to fight rearguard action in the face of mounting evidence that their products are killers. But, says Lustig, the connection goes beyond even that.

‘It’s the same people. Altria is Philip Morris [the parent company of Marlboro, Virginia Slims and Benson & Hedges], who owned Kraft General Foods. R.J. Reynolds [Tobacco] owns Nabisco [whose brands include Oreo and Ritz Crackers]. Basically, they’re in the business of selling substances that keep you coming back. They’ve been through this before. It’s the exact same fight. But now we know how to win it. Because we won it with tobacco.’

The struggle to get tobacco companies to tell the truth was a long, hard slog. It’s safe to assume this battle will be similarly tough, and that the human cost will be high. For every success story like Kim, there’ll be another who’s bought the food lobby’s old line that it’s fat people who are at fault. While there’s still a chance that we’ll believe them, they will continue to try and sweet talk us into eating sugar. It is vitally important, now more than ever, that we refuse to listen.

Marie Claire

Marie Claire

Jeff O’Connell, Author of Sugar Nation:

‘Immediately eliminate sugary soft drinks.  Stop eating fast food.  Limit processed foods especially those with ingredients ending in -ose, which is code for added sugar. Consume lean protein sources, vegetables, fruit and nuts.’

Jean Marc Schwarz, US Food Scientist:

‘Fruit is the original “packaging” for sugar. Something like an apple, that you have to chew on, is fine. Just don’t repackage it to make juice.’

James Duigan, Health and Wellness Expert:

‘Brown rice and vegetables are great sources of carbohydrate. I don’t think you can eat too much broccoli, asparagus and spinach. Don’t fear fat: full-fat foods that are close to their natural state are better than the diet versions. Good fats like avocados, nuts and oily fish, I eat freely. And read the labels. If sugar’s in the top three ingredients, you know there’s a lot in there.’ *some names for sugar include: Fructose, sucrose, corn syrup, honey, agave syrup, dextrose, evaporated cane juice, fruit juice concentrates, cane sugar, corn sweetener, maltose, barley malt, dextran, maltodextrin, mannitol, molasses, muscovado, panocha, sorbitol, treacle, diatase, ethyl maltol, diatastic malt, galactose.’