Are Mums really United in their love of Margarine?

The Australian Heart Foundation has found a new and even more devious way to entangle itself with the interests of the processed food industry. Its new “Mums United” campaign pretends to be a grassroots movement for healthy living. But it walks like a margarine advertisement and quacks like a margarine advertisement, so guess what it I think it is.

The Heart Foundation’s “Mums United” campaign asks mums to “change the shape of Australia.” No earth moving equipment is required so I suspect they mean they’ll change the shape of Australians. Apparently ‘Dads’ are not up to the task (or is it just that in the Heart Foundation’s world ‘mums’ do all the shopping?).

Putting aside its deeply patronising premise, mums can get going with their ‘fat-busting’ using some tips from the Heart Foundation. Tip #2 is to make sure mums use margarine instead of butter.

The campaign was only launched last month, but already it has received impressive media coverage and has a facebook group with over 4,500 followers. Selin Tas posted a link to her blog post which says “We finished our [Mum’s United] meeting pledging never to purchase butter again”.

And Selin is not the only one. The facebook page is full of mums posting stories of how they have organised groups of fellow mums and sworn off butter. The casual reader could easily come to the conclusion that the Heart Foundation has tapped into a throbbing artery of desire (among Australian mummy bloggers) to change the health of a nation (or at least to eat more margarine).

Except that (rather like the construction of sausages) it is better not to look too closely at the process. It turns out that Mums United is an advertising campaign.  Roberta Donovan, marketing director of the Heart Foundation explained to an advertising industry magazine “our campaign galvanises Mums into being part of an ongoing movement – one that sees Australians work together to achieve a healthy weight for the nation.”

The social media and word of mouth campaigns are being run through “conversation marketing agency” Soup. Their website tells us that they gave mummy bloggers “a $10 voucher” and asked them to “hit the supermarket and buy margarine instead.” Soup tells us that the “results were outstanding; most [mummy bloggers] reported ... they have since made the switch to margarine ...”

And Soup’s largesse doesn’t end there. Many of the bloggers report that Soup has sent them up to $350 of shopping cards to distribute as prizes to any readers who sign up to their facebook pages or comment on their Mums United blog posts.

It all sounds like a bonanza for the mummy bloggers and their readers (and at least according to Soup, its working). I asked the Heart Foundation who was paying for all of this. They told me that there are several social media campaigns being run by Soup on their behalf but they refused to say who was picking up the tab for any of them. All they would say is that companies entitled to use the tick can optionally get involved in “co-operative marketing” programs (like Mums United).

And this is by no means the only example of “co-operative marketing.” Last year the Heart Foundation was involved (judging by the prominent use of their logo) with a series of infomercial-type advertisements put together by Goodman Fielder (the manufacturer of Meadow Lea). The commercials featured a cardiologist who told us “what saturated fats can do to your child’s health”. He then goes on to suggest that we should switch to a margarine spread made with plant seeds.

You can still see the ad on a website called Spread the Facts which is “brought to you by Goodman Fielder” and which highlights the Heart Foundation’s recommendation that we swap margarine for butter.

The cosy relationship between margarine makers and the Heart Foundation is not new. In 2001, Bill Shrapnel (then a consultant nutritionist to Unilever Australia, maker of Flora margarine) pointed out that “Modern nutrition advice is one of the most negative influences on margarine consumption.” At the time, the Australian Healthy Eating Guidelines asked people to eat a low fat diet and this negatively impacted on margarine sales (as it is a visible source of fat).

But as Bill pointed out, things were improving (for the margarine manufacturers) because the Heart Foundation had just started recommending “an increase in the polyunsaturated fat content of the Australian diet of between 80 and 100 per cent.” He then suggested this represented “a rare opportunity” and that “[p]erhaps ... margarine companies should consider assisting the Heart Foundation in its educational activities about dietary fats.” It looks like they listened to that very sage marketing advice.

The only trouble is that they Heart Foundation’s own analysis of the evidence does not support its “co-operative marketing.”  It is not hard to come away from the current campaign with the impression that eating less fat is good for your weight. But the Heart Foundation’s most recent (2003) position statement on the subject says exactly the opposite - “Dietary fat is not an independent risk factor for the development and progression of overweight and obesity. [my emphasis]”

And there’s absolutely no evidence that switching polyunsaturated fat for saturated fat will have any effect on weight whatsoever. That stands to reason. They are both fats, and they both deliver 9 calories per gram. As far as our digestive system is concerned they are identical.

Margarine can be legally sold in this country. And margarine companies are entitled to use every (legal) marketing tactic to sell their product. But why is our Heart Foundation rolling around in the marketplace with them? Why are they sneaking through the back alleys of the internet whipping up mummy blogger campaigns with gift cards? And why are they happy to create an impression about health benefits which they know not to be true? 

The Heart Foundation’s tick program generates money for a charity and I guess that’s a good thing. But it comes with a heavy price. Co-operative marketing means the Heart Foundation’s health halo is sullied by commercial interests. It means (whether they intend it or not) that the Foundation becomes a spokesperson for the processed food industry. And the result is that the foundation is less an independent umpire and more a player from the other team wearing the umpire’s uniform.

So do us all a favour Heart Foundation and give your tick (and the phoney campaigns that come with it) the flick.

Let those who cause the pain, pay the tax

Sugar causes tooth decay.  No sane scientist would argue that simple statement.  It is about as controversial as saying day follows night.  But treating tooth decay costs Australians $7.7 billion a year.  Why are we not looking to the folks who sell sugar to help pay for that?

Certainty is a hard thing to come by in science.  It is very rare indeed to find a group of scientists agreeing without exception to a cause and effect relationship.  But there are some examples.  You will not get a fight from anyone if you say that antibiotics cure most bacterial infections.  And you’ll encounter even less resistance if you say that smoking causes lung cancer. 

The statement that sugar causes tooth decay is even more certain.  The statistics are clear.  Populations exposed to sugar for the first time go from ‘background’ levels of decay (of around 4 cavities per 100 teeth) to ‘modern’ levels of around 24 cavities per 100 teeth.  The mechanism is known and the science is uncontroversial.  Not even Coca-Cola dares deny that sugar and tooth decay go together like peas and carrots.

Researchers have known since the 60s that tooth decay is caused by a little chap called Streptococcus Mutans (S. Mutans).  It is one of the two to three hundred species of bacteria that inhabit our mouths.

Like most bacteria, S. Mutans loves a good feed of sugar.  As it chomps down on the sugar molecules it produces lactic acid as a waste product.  It’s that lactic acid that does the damage to our teeth.  But under normal circumstances we are up to the task of protecting ourselves and avoiding tooth decay.  Our saliva quickly neutralizes the acid and we regenerate any damaged enamel.

This is fine if the only sugar in our diet is glucose or carbohydrates that are converted to glucose (which is almost all of them).  But, if there is some fructose available as well as glucose (oh, such as in table sugar – half glucose and half fructose), then through a quirk of evolutionary biology, S. Mutans has the upper hand.

S. Mutans can build itself a saliva proof home if fructose is also present.  We call this little anti-saliva shield, plaque.  Plaque binds S. Mutans to each other and to the tooth enamel.  It traps the lactic acid against the tooth surface, protects it against the waves of saliva and gives it time to eat through the enamel.

If you really want to rot teeth, the most effective way is to give S. Mutans a constant wash of sugar solution (like soft drink or fruit juice) between meals.   Eating sugar at mealtimes still works but it is nowhere near as effective.

S. Mutans has really enjoyed our change in diet in the last few decades.  The amount of fructose laden, soft drink, juice and flavoured milk we drink has risen from virtually nothing prior to the Second World War to almost 1 litre per person per day.  Consumption of soft drink alone has more than doubled in the last 30 years.  And with this our need for dental services has also risen exponentially.

Every now and then politicians bow to public anger over the rising cost of dental services and mumble indistinctly about perhaps fixing the problem.  Do they suggest limiting sugar consumption? Don’t be silly.  How about asking the sugar purveyors to pick up the bill?  Think again. 

No, the politician’s answer is to make it our problem.  First they try the chemical band-aid of dosing us all with fluoride, then, when that barely dents the costs, they reach for our wallet. The most recent go-round was Kevin Rudd’s ill-fated Denticare scheme, which suggested increasing the medicare levy by 50%. Heaven forbid a processed food manufacturer be presented with the bill. 

Sugar rots teeth.  The evidence is abundantly clear that, but for a constant wash of sugar between meals (topped up with some nice sticky fruit snacks), we would barely need to visit a dentist at all.  So why are we not asking the folks who cause the problem to pay the bill?  Or better still, stop creating the problem? 

We have no difficulty asking the purveyors of cigarettes to kick in for the costs of treating the disease they cause.  So why is the political response to the cost of dentistry a tug of the forelock and a scurry to collect more tax from us (whether we consume sugar or not)?

To be sure, $7.7 billion is a large bill to present to anyone.  It represents about two and a half times the entire annual revenue of the Australian sweetened beverage industry.  But it is also about 30 times the income tax they paid.   Is it really fair that an industry contribute so pathetically to the cost of the damage they cause?

This is not a sin tax in disguise.  It is repugnant for food nannies to attempt to make us healthy using the blunt instrument of taxation.  If sugar is bad enough to require (at least) $7.7 billion of reparation every year then we should be removing it from the food supply.  The level of harm it does is out of all proportion to its utility (is there any?). 

But our governments clearly don’t have the moral and intellectual steel to bite that bullet.  So let us at least insist that the most obvious part of the damage being caused (the part about which there can be no argument) be paid for by those profiting from our misery. 

It's time to stop drinking the Kool-Aid of Public Health Dogma

One of the big complaints about research on fructose (the dangerous half of ordinary table sugar) is that many of the studies are done on rats, not humans.  But a pair of recent studies have shown that sugar is just as dangerous for primates (including us) as it is for rats.

People defending our right to continue eating sugar (‘in moderation’ of course) frequently waggle their fingers at the studies and say just because it kills a rat doesn’t mean it will harm a human.  One defender of the white stuff, Dr Jennie Brand-Miller, recently went so far as to suggest that sugar doesn’t do us any direct harm at all.

There’s a good ethical (and legal) reason that human studies are few and far between.  The ones that have been done have inevitably resulted in immediate harm to the human subjects.  A study where the expected outcome is to harm the participants makes lawyers nervous.  I guess that’s why you don’t tend to see studies on what happens if you don’t open the parachute.

But the science needs to be done.  There really is no other way to combat the incessant ‘sugar in moderation’ chant of the processed food industry and its toadies.  Thankfully a few US Universities are prepared to push the envelope.

Just last week a team from Vanderbilt University’s paediatrics department published the results of their year-long study into the effects of fructose on Rhesus Monkeys.  Their stated aim was to “induce insulin resistance” (the first step on the path to Type II Diabetes) in a primate using the same methods which are so successful in rodents.

The Vanderbilt folks chose Rhesus monkeys because they are physiologically similar to us and they develop the same chronic diseases that we do (and they are far less picky than humans about being locked in cages for 12 months).  Dr Bremer and his team studied a group of 29 adult male monkeys aged from 12-20 years (approximately equivalent to human ages of 36-60).

At the start of the study, all the monkeys had perfectly normal blood glucose levels and were otherwise fit and healthy.  The diet for the duration of the study was standard monkey lab chow (designed to give them all the nutrients they need in a healthy mix which is 59% Carbohydrate, 30% Protein and 11% Fat).  They were also given access to up to 500ml per day of Kool-Aid.  The monkeys could consume as much (or as little) of the food and Kool-Aid as they wanted.

Kool-Aid is a fruit flavoured powdered sugar drink mix sold in the US.  The closest Australian equivalent is Tang (which is really just Kool-Aid with a multi-vitamin chucked in).  The Kool-Aid delivered up to 75g of pure fructose a day to the monkeys.  I say ‘up to’ but the reality was that the monkeys drank the Kool-Aid and then topped up their calories with chow.  They weren’t going to leave any of the good stuff in the tin.

Unfortunately for our furry friends, they were never healthier than when they hadn’t drunk the Kool-Aid.  Four of them developed Type II diabetes between 6 and 12 months after starting.  The rest of them were well on their way to the same destination (with blood glucose and insulin readings that would have had them on the latest anti-diabetes drugs if they had been humans).

They put on weight (an average of 9% of their starting weight), the percentage of their body which was fat increased by 15%, they ate more of everything, exercised less and their blood lipids were a mess.

Their fasting triglycerides (a strong risk factor for heart disease) increased by a whopping 87%, HDL (good) cholesterol decreased and LDL (bad) cholesterol increased (by 14% each).  In other words these critters were also on the fast track to a heart attack.

The experiment would have been better if they’d had 29 monkeys eating nothing but chow to compare the results to.  But there is no evidence to suggest that monkeys on a standard lab chow diet ordinarily develop these symptoms (and certainly not in less than a year).

The researchers set out to give diabetes to a group of primates (with an almost identical metabolism to ours).  All they did was allow them access to a sugar which is plentiful in our food supply.  They didn’t test chemicals on them.  They didn’t inject them with drugs.  They just fed them with the same stuff we give our kids.  And they achieved their aim – four had diabetes and the rest were on their way – in less than a year!

Still not enough to get you to step away from the Froot Loops?  Still not ready to believe, ‘till they do this to humans?  Then you’re in luck, because a human study has also just been released.

This time, a team at the University of California convinced 48 healthy (human) adults to consume four cans of soft drink a day for two weeks (about the same as one in 20 Americans do every day of their lives).    Some of the soft drinks were sweetened with glucose, some with fructose (the two halves of sugar) and some with High Fructose Corn Syrup (55% fructose, 45% glucose).

And guess what?  That’s right, the result was exactly the same as for the monkeys.  The blood fat measurements (which point to heart disease) started going in the wrong direction for the fructose and HFCS groups (and nothing happened to the glucose group).  No-one was given diabetes, but it was just a 2 week study.

Try as they might, researchers have never been able to get results like these by feeding people fat or stopping them from exercising.  But these latest studies could barely be more definitive on whether there is danger in that thar can of soda.

Eat fructose and the only question is when you will develop diabetes and heart disease.  If you happen to be a Rhesus Monkey (well done, you, for being able to read this) you have as little as six months, if not, you might get a bit longer.  But have no doubt, it will happen.

The Glycemic Index has passed its use-by date

The glycemic index (GI) is not just bad science, it has a dangerous loophole big enough to drive an ice-cream truck through. Its time it went to the place where old (and wrong) public health messages go to die. 

Wendy’s Chocollo (with waffle cone), Bulla Light vanilla ice-cream, Nestle Milo, Uncle Toby’s Choc Chip Crunchy Muesli Bar and CSR LoGiCane Sugar all have something in common. Yes, they’d all look pretty good on the dessert menu, but they also share something else. The owners of each of these products (and almost a hundred others like them) have paid for the right to display a GI Symbol.

Much like its more famous cousin (the Heart Foundation tick), the GI Symbol is designed to guide confused consumers towards “healthier choices” in the supermarket.

The symbol alerts us to foods which have a low glycemic index. The GI is a measure of the amount that a food affects our blood sugar levels. Our body converts most of the carbohydrates in our food to blood glucose. This causes a spike and then a decline in the amount of glucose we have in circulation.

But not all foods are equal. Some (like glucose) spike our blood sugar levels more quickly than others (like potatoes). This is because the carbohydrates in some foods are more quickly converted to blood sugar than others.

The glycemic index of a food is measured by comparing the way a healthy person’s blood sugar level responds (over a 2 hour period) to 50g of glucose and how they respond to 50g of carbohydrate in the food being tested (let’s say boiled potatoes). If the tested food produces an effect which is 70% of the one measured for the glucose then it is said to have a GI of 70. A low GI food is one which has a GI of 55 or less (meaning that the blood sugar response is 55% of that of pure glucose over a two hour period).

The theory goes that if we could make sure we were eating just the foods which have a low impact on our blood sugar, then we would keep our blood sugar levels more even (and presumably somehow be more healthy as a result). I say presumably because there is a real scarcity of credible evidence that the GI of a food has any measurable (positive) health impact.

GI may be a pointless academic exercise but it is not a harmless one. It has a hidden danger in that the carbohydrate it assigns the lowest (and therefore the best) rating is fructose (it has a GI of 19). Fructose is a very sweet tasting (almost twice as sweet as sugar) carbohydrate that does not produce a significant blood sugar response.

When this little quirk of fructose was first discovered (in the early 1980’s) it was pronounced a miracle sugar for people with diabetes. They could have sweets just like everyone else and their blood sugar would never spike as long as the sweets were made with fructose. Even some sugar was ok too (because, being half fructose, it also has a low(ish) GI).

Diabetes organisations the world over happily advised diabetics they could eat sugar or, even better, pure fructose. Unfortunately for sweet tooths everywhere, by about 2001, it was becoming abundantly clear that the ‘no free lunch’ rule applied (or was it no free pudding?). Fructose was even more dangerous for diabetics than sugar.

It turned out that the reason fructose didn’t have a big glycemic index was because it is converted to fat (by our liver) and not circulating blood sugar (like just about every other carbohydrate). Telling diabetics (or anyone else, but particularly diabetics) to consume a substance that was immediately converted to fat was a very bad idea (verging on the culpably negligent).

The American Diabetes Association quietly withdrew its recommendation in 2002, but the message never got through to Australia. The Australian Diabetes Council tell us they “want to end the myth that sugar causes diabetes”, apparently because sugar-free diets aren’t “much fun.”

And the folks selling the Low-GI stickers (the GI Foundation – a collaboration of University of Sydney, Diabetes Australia and the Juvenile Diabetes Research Foundation) still tell us it is “best to ignore the sugar content of a food and instead focus on the food’s GI.” A director of the GI Foundation (Sydney University nutritionist Jennie Brand-Miller) even went so far as to say recently that “Unlike saturated fats, trans fats, salt and alcohol, sugar doesn't actually do any direct harm to the human body.”

For the last decade (at least), the research on fructose (and sugar) has shown again and again that exactly the opposite is true. Fructose consumption is a causal factor in obesity, heart disease, hypertension and Type II Diabetes. It is implicated strongly in cancer growth and it is highly likely to be behind the explosion in the number of cases of chronic kidney disease and fatty liver disease.

That all sounds pretty harmful to me. So perhaps that is why the American Heart Association recommended (after reviewing all the evidence in 2009) that Americans needed to dramatically reduce their sugar consumption. Men should consume no more than 9 teaspoons of sugar a day (about a can of soft drink’s worth). That’s less than half the current (vague) Australian recommendation (of about 23 teaspoons a day).

Just like skinny leather ties and big hair, the glycemic Index seemed like a good idea in the eighties. It held out hope (for a dessert filled future) to millions of diabetics everywhere. But science eventually found out what was really going on (as it usually does) and the world moved on.

In Australia we got stuck on the notion that GI should work (and to this day stubbornly refuse to acknowledge the fructose loophole). The food industry leapt on the marketing power of a ‘healthy label’ that meant they could still use as much sugar as they wanted. Positions became entrenched. Reputations were built. And as a result we now have folks like the GI Foundation and the Australian Diabetes Council telling us there’s nothing wrong with eating sugar.

This would all be mildly entertaining if we weren’t talking about real people with very real (and very life-threatening) problems. Every day in Australia nine people lose a limb to Type II diabetes (and 275 more people develop the disease). Every day the number of obese children grows like never before in human history. Every day the number of new cases of chronic kidney disease sets a new benchmark.

The science says all of this misery (and lots more) can be traced back to eating sugar. So how about we stop playing ducks and drakes with quaint scientific notions (that protect the processed food industry from having to face reality). How about we start caring about the people who follow the advice they see on a packet of food. How about we face the truth about sugar and demand that those we pay to care - do.

How Fructose makes us Unhappy.

We don’t know what causes depression and we certainly don’t know how to cure it. But some interesting new research suggests that there may be a very strong link between depression and what we shove in our gobs.

Depression is a catch-all diagnosis for a spectrum of illness affecting our mood. The spectrum covers everything from a mild bout of feeling down through to the most severe Major Depressive Disorder.

We can become depressed because things aren’t going well. If having your cat run over doesn’t alter your mood (one way or the other depending on how you feel about cats I guess) then you were probably built by aliens. But the science suggests how long we stay depressed has more to do with biochemistry than the state of Fluffy’s road-safety skills.

Food makes us happy (I know, you’re shocked at this revelation). Even seeing food improves our mood. This is because the anticipation of a feed, fires up the hormones responsible for how we feel.

The sight (or smell) of food gives us a squirt of the pleasure hormone, dopamine. Dopamine focuses our attention, makes us think more clearly and helps us move faster and more effectively. It’s an important signal to our body that we are in for something good and we need to pay attention. And that was probably pretty handy in times gone by (when dinner was on the hoof rather than in the burger box)

Once we actually start eating, serotonin kicks in. The serotonin makes us feel happier and less stressed. We relax, our mood improves (Fluffy will still be road kill, but we’ll feel better about it) and our minds can turn to less important things than eating (such as sex - the anticipation of which will give us another dopamine hit and the aftermath of which will give us a nice relaxing serotonin hit). While the cliché that the way to a man’s heart is through his stomach may be the G-rated version – it is largely accurate.

Researchers have known for a long time that severe depression is strongly associated with an inability to properly absorb serotonin in the brain. No (or low) serotonin absorption makes it much harder for us to come back from unhappiness. And this can translate into anxiety and depression if it’s sustained for long enough.

The primary anti-depressant drugs available in Australia (Cipramil, Luvox, Prozac, Lovan, Aropax and Zoloft) all work by targeting the serotonin system.  They give the brain more time to absorb the serotonin. Some other drugs (Ecstasy, Amphetamines and LSD) work by enhancing the amount of serotonin we produce (but you might find it tricky to get a prescription for them).

If all is well with our hormone system then severe depression should be an extremely rare disease. But it’s not. Most studies suggest that one in ten of us is suffering some form of depression at any given time. So it won’t come as too much of a surprise to discover that one in every 30 GP consultations in Australia is now about depression.

Depression is a major chronic health problem and it is getting much worse at a very rapid rate. Something is messing with our serotonin system and the evidence is starting to mount that the something is fructose.

Fructose is the only carbohydrate which produces a significant spike in our cortisol levels. Cortisol is our stress hormone. It’s terribly handy for confrontations with unexpected bears (for example) because it ramps up dopamine (to focus the mind and sharpen the movements). It also rapidly increases the amount of dopamine we can absorb. But it does so at the expense of our ability to absorb serotonin.

We like dopamine. It is our reward drug. Frequent hits of fructose mean frequent hits of dopamine. This leads inevitably to fructose addiction and that is exactly the mechanism used by other man-made opiods (like nicotine and cocaine). The trouble is that it seems the upregulating of dopamine at the expense of serotonin can become hard-wired if we allow it to go on for long enough. And once we’re addicted, we cant help but let it go on for long enough.

We don’t run into that many bears on a daily basis (well, I don’t). Fructose was once about as common as a bear encounter, but is now embedded in almost every processed food we buy. And it has an addictive quality as powerful as nicotine (so it isn’t exactly going to harm sales now is it?).

We are now on a constant drip of fructose. That means we are on a constant cortisol (and therefore dopamine) high. This in turn continuously impairs our ability to absorb serotonin, the one substance that can turn our mood around.

Fluffy will still become a bumper sticker if he chooses an inopportune moment to cross the freeway and that will probably be a downer. But the science is suggesting that how quickly (or if) we bounce back from that may depend (to a large extent) on how much fructose we are eating.

In an environment of non-stop fructose infusion, the wonder is not that one in ten of us is depressed, it’s that nine in ten of us aren’t (yet).


I'll be talking more about the link between Fructose and Depression at the upcoming conference on Happiness and its Causes - June 16-17 at the Brisbane Convention Centre.

How Diabetes drugs stop us losing weight (and do nothing but delay the inevitable)

Drug companies have a solution to Type II Diabetes unfortunately their ‘solution’ will make us almost as fat as their wallets (and won’t change the outcome).  The real solution is much simpler and you don’t need to buy anything from anyone to implement it.

Our body is a machine that runs on a fuel of pure glucose.  When we eat carbohydrates (like fruit, vegetables, bread, pasta and rice) our liver converts the starch in those foods to glucose.  Almost every cell in our body can burn (or oxidise to be more precise) the glucose to create energy. 

Managing the fuel (glucose) levels in our blood is therefore pretty important to our wellbeing.  The level of glucose is managed by two primary hormones.  We release insulin when blood glucose goes up and glucagon when it drops. 

The insulin helps cells access the glucose in the blood and either use it (if they need it) or turn it into fat for storage.  Either way, a primary function of the insulin is to lower the amount of glucose in our bloodstream.  If blood sugar stays high for a long time, damage starts to occur in places where we have lots of small blood vessels, such as our kidneys, our eyes and eventually our hands and feet.

Glucagon does the same thing in reverse.  The combination of the two hormones working together means that normally our blood glucose levels stay in tight range regardless of what (or when) we eat.

Sometimes we can become resistant to insulin.  This simply means that cells do not respond as efficiently as they should and glucose stays in our blood for too long.  

Doctors can tell when we are insulin resistant because our blood glucose levels remain too high for too long after eating.  But (at least at first) there are no real symptoms that we have the problem.  And so a majority of people who are insulin resistant don’t know it.

If you remain insulin resistant for long enough, at certain levels, you will be declared to have Type II Diabetes.

Our body usually responds to insulin resistance by pumping up the insulin levels until the glucose is cleared.  If we ask our body to run on overdrive like that for years, for most of us, our pancreas (the insulin maker) will pack it in and we will need to get daily insulin injections to live.

One carbohydrate (and only one) does not work this way.  Fructose is not normally converted to glucose and does not trigger an insulin release. It is instead converted to saturated fat by our liver.  So for a long time, fructose was prescribed as a perfect sugar for Type II Diabetics.  Unfortunately it looks like that cure is turning out to be the cause of the disease. 

Last week, the American Heart Association issued a scientific position statement which makes it clear that they are satisfied that fructose does indeed create dangerous levels of circulating fats (called triglycerides).  The statement went further and warned that the creation of triglycerides is directly linked to the onset of the insulin resistance which leads to Type II Diabetes.  In other words, fructose consumption is likely to be a significant cause of Type II diabetes.

The primary source of fructose in the Australian diet is sugar.  So the obvious cure for Type II Diabetes would be to tell people to stop eating sugar.  But there is no money in telling people to not eat something.

No, if you are diagnosed with Type II Diabetes in Australia today you will be put on drugs to sort you out (after a perfunctory nod to ‘lifestyle interventions’).  

The standard treatment for high blood sugar (and therefore diabetes) is a prescription of ‘eat less fat and exercise more’. When that doesn’t work (as it almost never does) the prescription is changed to a combination of drugs.

There are a few different types of medication but the ones most commonly used in Australia work by stimulating the body to produce more insulin.  The drugs squeeze that little bit more insulin out of our pancreas to help clear the blood sugar. As you might expect, putting the pancreas on overdrive eventually results in it conking out completely. Then the only option is to start injecting insulin every day.

Unfortunately a side effect of the drugs is weight gain. Insulin does clear glucose from the bloodstream,  but if the cells don’t need the glucose, they just turn it into fat.  Giving people more insulin (or giving them drugs to force them to produce it themselves) simply channels sugar out of the bloodstream and converts it into body fat.

Using drugs to force insulin resistant person to make more insulin just moves the immediate problem from the bloodstream to the tummy (or bot-bot). And even then it only works until the pancreas packs it in anyway.  Removing the cause (fructose) would be infinitely more effective but if the drugs remain part of the prescription while that is going on, motivation will soon be a problem (because it will be very difficult to lose weight).

We need a new approach to treating insulin resistance.  We need an approach based on the science rather than one based on a drug manufacturer’s bottom line.  People diagnosed as being insulin resistant (or ultimately Type II Diabetic) should be told the truth about sugar and then told how to remove it from their food supply. 

When this happens (and only when this happens) will we start to make a real difference in the progress of a disease that is responsible for more than 9 limb amputations a day in Australia and is our 6^th biggest killer (heading for #1 with a bullet).

Selling the ‘cure’ with the disease

Nestle has shown the way forward. It simultaneously sells the cause of obesity (sugar based confectionary and breakfast cereals) and some of the most popular ‘cures’ (Jenny Craig, Optifast shakes and Lean Cuisine frozen meals). But now a vitamin pill maker is taking it one step further by putting the disease and the (suggested) cure all in one delectable gummi bear shaped package.

Last month Pharmacare Laboratories released (what it undoubtedly hopes is) a game changer in the children’s vitamin supplement market. Its Nature’s Way Vita Gummies embed vitamins in delicious sugar filled gummies. And just for good measure they have former Olympian (and now Biggest Loser host) Hayley Lewis pushing them on the teev.

Shouting about the vitamin benefits of a food while blithely ignoring the other 99.99% of the product is not a new tactic in the processed food industry. Streets want every child to get their ‘afternoon calcium’ (and Vitamin B12 and Phospherus) from their Paddle Pop Moos. They proudly proclaim every single ice-block has the calcium of ‘1 Glass of Milk’ but leave the fact that it is 20% sugar to the small print.

Nestle would rather the kids get their daily calcium (and magnesium) from its (Heart Foundation approved) Milo Duobreakfast cereal (30% sugar) or a nice (Heart Foundation approved) chocolate Billabong (18% sugar). Really health conscious kids are encouraged to get “50% of their wholegrain target” by chomping on some Uncle Toby’s Oats, So Tasty for Kids (30% sugar).

For that after breakfast snack, Kellogg’s wants you to feed your young iron-men Nutrigrain Bars and perhaps give the other kids some nice (Heart Foundation Ticked) K-Time Twists (both 37% sugar). And don’t even get me started onLCM’s (also 37% sugar) and their schoolyard commercials.

I guess you could (almost – at a very big stretch) justify that kind of marketing if there was any evidence (whatsoever) that the average Australian needed any more of those Vitamins or minerals. Vitamin supplements have only been part of our food supply since just before the second world war. Prior to that our Grandparents and their grandparents managed to struggle through life without any supplementation at all.

The need for vitamins only arose because two hideous diseases reached epidemic proportions in the early part of the 20^th century. In south-east Asia beriberi was rampant because (it turned out) Europeans had started using steam driven mills to turn brown rice into white rice (and in the process stripping out Vitamin B1). And at almost the same time in the southern United States pellagra was inflicting mass agony because Europeans had decided that treating raw corn with lime (a process the Indians had used for millennia to activate the Vitamin B3) was a waste of time and money.

South East Asians derived almost all their nutrition from rice at the time and poor farmers in the southern United States derived almost all of their food from corn. Messing with those two fundamental food sources resulted in mass deficiencies which led to disease. The only other two significant deficiencies which have (in modern times) resulted in widespread disease are scurvy (if you happen to be locked in a boat without access to anything but dry biscuits and rum for six months) and rickets (if you use too much sunblock).

The reality is that the overwhelming majority of people living in Australia today have no more risk of being functionally deficient in any vitamin than I do of becoming the Queen (of England that is). Our bodies are extraordinarily efficient at extracting exactly what we need (and no more) from our food (mostly from meat) and excreting the excess. If you are inclined to the I’ll-top-em-up-just-in-case persuasion, the research suggests you are just flushing your money away.

One of the most thorough (but by no means, not the only) recent studies was the Physicians Health Trial. In that study, 14,641 US doctors were followed for 10 years while they took either Vitamin E or Vitamin C supplements, the two vitamins which are heavily promoted as having anti-oxidant (and therefore heart disease related) benefits.

Half of the doctors were actually taking placebos instead, but neither they nor the folks assessing the results knew which was which. The double blind (no-one knew who was taking what), randomized nature of the trial (together with its large size and long duration) means that it is very high quality evidence.

The point of the trial was to figure out whether the supplements had any effect at all on heart disease and stroke outcomes among the participants. And what they found would have been very disappointing for the supplement industry indeed. There was exactly no difference between the heart disease outcomes for any of the groups.

The Vitamin E folks had just as many heart attacks as the Vitamin C folks. And they had just as many as the folks taking nothing. The resounding conclusion from the study is that if any of the participants had been paying for their vitamins, they would have been well and truly wasting their money (for ten long years). While we certainly need Vitamin E and Vitamin C, it seems shoving more of it in our mouths changes absolutely nothing (except the bank balance of the folks selling the supplement).

Similar high quality trials on Vitamin D, Calcium and Vitamin B supplements have arrived at exactly the same conclusion – don’t waste your money. And as the makers of Berocca have just discovered, making claims to the contrary can get your expensive advertising campaign banned.

Despite our extraordinarily efficient efforts at mining food for nutrients, we can damage our ability to use the vitamins and minerals we do absorb. Sugar consumption interferes with copper metabolism which can result in impaired muscle growth (in children) and problems with vein and artery wall formation. It also leads to impaired iodine absorption (and therefore thyroid hormone production) and degrades our Chromium stores (which leads to insulin resistance and Type II diabetes) just to name a few of its more delightful features.

Vita-Gummies (at 23c a throw) are about 8 times the price of garden variety gummi bears (which are aren’t laced with precursors to expensive urine) but they do contain just as much life sapping sugar (something which unfortunately ends up around our waist and not down the drain).

Selling ice-creams and lollies as health food (to children and their parents) when they are in reality a package of pure sugar is unbelievably perverse. Engaging the services of Hayley Lewis’ hard earned reputation to do it is just plain deceptive.

Unfortunately nobody is breaking any laws telling us that a sugar loaded sweet (with a vitamin chaser) is good for us. And so the marketers go to town. But where do we draw the line? Chocolate coated carrot shavings, sold as Vegies the Kids Will Love (no, Nestle that is not a suggestion)? This pathetic game must stop. It’s time for truth in labelling. Surely our children are worth that much.