A little note from Warren

One of the real benefits of writing is that you often get to hear from new and interesting people. My piece about the Australian Heart Foundation last week inspired quite a few folks to plunge electronic quill into digital inkwell and dispatch missives in my general direction.

Leigh Sturgiss, executive director of the New Zealand Obesity Action Coalition tipped me off about another heart foundation having a bit of form in this area. She told me about the biffo involving Nestle across the ditch. Apparently in the Land of the Long White Cloud, even Nestle Milo is considered tick-worthy. The New Zealand Heart Foundation bestowed one of its ticks (identical in design, purpose and use to its Australian equivalent) on a ‘food’ which is 47.6% sugar.

The tick was featured as part of a national TV ad campaign in August last year telling people they could now say ‘Yes to Milo’. All sorts of people managed to get hot and bothered about that. Nutritionists stomped their feet and (not unreasonably) asked how on earth a product which is half sugar could get a heart foundation tick. The heart foundation leapt to Nestle’s defence and pointed out that if the product was consumed in small amounts and with low fat milk then it was ok. Strangely relying on children to consume chocolate in small amounts and seek out low fat milk as a strategy didn’t seem to placate the malevolent protesters.

But it’s all ok now, you see Nestle decided to drop the tick from Milo packaging at the end of April this year. "We just decided to pursue a different strategy”, said Nestle’s Maurice Gunnell and added (somewhat enigmatically) “... it served its purpose.” The ‘different strategy’ appears to have something to do with affixing Australian Heart Foundation ticks to the likes of Fruit Fix (72% Sugar), Milo B-Smart (with ‘only’ three quarters of the sugar of full strength Milo) and Billabong Ice-Blocks (to name a few).

Another correspondent who I shall call Warren was deeply troubled by my ignorance of the facts about sugar and saddened by my suggestions concerning the Australian Heart Foundation. Wozza is unusually shy for a member of his profession. You see he is a card carrying practitioner of the dark arts of public persuasion (PR and Corporate Communications). He marked his email ‘eyes only’ for me. Nevertheless he made some points (I’m sure entirely on his own behalf) which I feel should be discussed more publicly, so I’ll refer to them in a general sort of a way.

Oh, I almost forgot, a quick glance at Warren’s web CV (you know the one you didn’t know you had until you googled your own name) suggests a company he founded was once employed by none other than the Australian Heart Foundation to assist with, ah, communication advice. But I’m sure that had nothing to do with his need to express his anger at last week’s piece.

After affectionately describing the article as a load of nonsense, Woz went on to tell me a thing or two about sugar consumption. He concluded that there is ‘LESS sugar available in prepared food than ever before’. Really Woz? Ever?

At the start of the Second World War the average Australian consumed less than a third of their sugar from processed food (the rest they added themselves). By 1993, almost three quarters of their sugar was put in their food before they bought it. Even if our ‘two lumps in the cuppa’ habits had not changed in that time, food manufacturers made sure that our total sugar consumption grew significantly. The average Aussie now gulps down almost a kilo of sugar a week, but much like an industrial game of ‘Where’s Wally?’, I challenge you to find it.

Remember, of course, that even if you could track the sugar (from processed foods) down, you wouldn’t be able to add Fruit Fix to the list. The sugar in those little fellas is ‘all natural fruit sugar’ and is not included in the 50 kilo (per person per year) total for cane sugar consumption.

Warren then let me into a little secret. You see as well as being a master of the fifth estate, he’s right up on all the science on sugar metabolism (well at least until 2000, he concedes). He says the science doesn’t back me up and he ‘defies’ me to present substantiation. I know it’ll come as a bit of a surprise to Warren, but science didn’t stop in 2000. The boffin’s have managed to add quite a bit to the pile of human knowledge in this area in the last nine years.

Since many of my dear readers have probably got some interesting grass to watch growing or some newly moist paint to observe drying, I won’t enumerate the (over 3,000) studies on which I rely. I can however recommend a very tidy summary of some of the more pithy ones in an excellent round-up paid for by the University of California, the American Diabetes Association and the US Department of Agriculture. Woz, you’ll find that in your November 2002 copy of the American Journal of Clinical Nutrition. Oh, sorry, too recent for you isn’t it? Well here’s a link for your edification.

For the medically inclined, there’s an even nicer (but more estoric) summary in the January 2006 edition of Nature’s Journal of Clinical Practice: Nephrology.

All of this begs the obvious questions. Why is it left to a flak (that’s the technical term for Wozza’s profession) and lawyer (that’s the technical term for my profession) to debate the science? Why is the heart foundation missing in action? Why are they (and their NZ Confederates) handing out ticks to high sugar children killers? Why can’t Warren afford the cover price of a (truly excellent) book which summarises all the recent science?

Now this probably isn’t the reply that Woz had in mind when he sent his little ‘eyes only’ note. But I take particular exception to folks (who have a reasonable chance of being a mouthpiece for someone else) wanting to have secret discussions with me about the science. Warren, if you’ve got something to say, there’s a comment section at the end of the article. If you are saying it on behalf of someone else then direct them to the same section. Let’s have no more little private notes handed round the class behind the teacher’s back.

Also published in Crikey

Things that Tick me off

Why is the Australian Heart Foundation handing out ‘ticks’ to confectionary?

Over the last few weeks I’ve been having a bit of a go at Nestle. I’ve been worried that when they tell children that their Fruit Fix confectionary is equivalent to ‘1 Serve of Fruit’, they may be misleading the little dears (and their mummies and daddies). The product is almost three quarters sugar and while that makes it a candidate for lolly of the year, I think it’s a bit of stretch to market it as ‘natural and nutritious’.

When Nestle wrote back and protested their innocence, I was a little surprised that they didn’t wheel out the one obvious defence they did have to my assertions. Surely they could accuse me of outrageous plundering of public sensibilities by simply pointing to the little red tick on the front of the box? You see, our little fruit flavoured friends have been ‘tick approved’.

That’s right, none other than the Australian Heart Foundation has certified Fruit Fix as tick worthy.

I immediately dashed off an email to the heart foundation to check that it was true (you can’t be too careful in these days of dodgy emails and made-up utes - or was that made-up emails and dodgy utes?). And blow me down if it wasn’t so. They explained that the reason that Fruit Fix had earned their stamp of approval was that:

“Fruity [sic] Fix’s sugar content comes entirely from sugars that occur naturally in fruit - they are not added sugars. In order to earn the Tick on this type of food, the product must be at least 95% fruit. [their emphasis]”

Now, I suspect (like a lot of consumers), you’ve never really looked into what a heart foundation tick means. I’ve just assumed that they are hard to get and a product that has one must be really good for me. I mean if the heart foundation gives it a tick, it must mean it’s good for (at least) my heart, right?

The heart foundation website does certainly encourage that perception. They proudly report that ‘The Tick is the Heart Foundation's guide to help people make healthier food choices quickly and easily’ and ‘Tick foods offer not only a healthier choice but truth in food labelling too.’

They’ve also done quite a bit of research on how we perceive the tick. The data tells them that they’ve been very successful in promoting the tick as a brand that consumers respect and value as a stamp of approval for healthy foods. Thirty percent of us actively look for products with a tick and 78 percent regularly or sometimes use the tick when shopping for food.

With that kind of marketing firepower behind it, you can be sure that any manufacturer aiming at the kiddy market would give their left arm, leg, well anything, to have the tick stamped on the label. A mother that walked past a tick certified snack for little Johnny and chose a plain ol’ unticked bar instead would have to be certifiable herself, surely?

But that kind of power brings a truckload of responsibility. We trust the heart foundation to guide us through the maze of food labels and health enhancing claims (from ‘iron man food’ to ‘50 % more calciYUM’). We believe the Australian Heart Foundation when they tell us a food is ‘a healthier choice’. We pay that bit extra based entirely on their assurance that we can do no better for Muffy and Geronimo. All we ask in return is that they be right.

When the heart foundation started handing out ticks twenty years ago, science knew very little about how our bodies process sugar. One of the core hormones involved wouldn’t even be discovered for another five years and many of the critical studies were not even a gleam in the researcher’s eyes. The evidence linking sugar to heart disease was still thin on the ground. So it’s easy to understand how the criteria for the allocation of a tick might not pay too much attention to sugars.

But today, the science is done, the evidence is in and it’s unequivocal. Sugar consumption is the most significant factor in the accelerating incidence of heart disease, diabetes, obesity and a raft of associated illnesses. In that context, to certify as safe, a product which is almost three quarters sugar is outrageous. This is even more so, when the certifying organisation knows how much we rely on their stamp of approval.

There is no ‘added sugar’ in Fruit Fix, but that does not mean there is no sugar. Sugar is sugar is sugar. No sane chemist would argue that a sugar molecule that once formed part of a piece of sugar cane is any more or less ‘sugar’ than one which was part of an apple or a banana or a strawberry. It doesn’t come as too much of a shock if a marketer (with a product to sell) is deliberately misleading when they justify high-sugar products on the basis that fruit was in some way involved in their construction. It comes as a mighty big surprise (and somewhat of a disappointment) when a self-appointed watchdog does the same.

I had always believed (like most of us, I suspect) that the Australian Heart Foundation was a powerful force for good in ensuring we are all eating better. But, for the tick program to retain any relevance, the heart foundation must ensure that it is up with the latest science. And it must guard against abuse of the program by those skilled in making semantic arguments. Whacking a tick on a children’s food product that has more sugar than a Mars Bar (simply because its sugar came from fruit rather than cane) is at best irresponsible and at worst, child abuse.

Correction to Fruit Fix Post

I’m nothing if not responsive to reader requests. Richard Andersen has written to express some concerns about my recent post on Uncle Toby’s Fruit Fix bar. Richard is General Counsel (a lawyer) for Nestle Australia Ltd and he says that Nestle is worried that you might have misunderstood some things in my post. So in the interests of clarity and fairness, in this post, I’ll go through each of Nestle’s concerns and correct the record.

Righto, off we go – Nestle says that I “represent[ed] ... that the Fruit Fix Strawberry variant contains only strawberries ... The front of pack clearly describes the product as ‘... apple, strawberry and grape snack’, which you have failed to mention in your post.”

Well true enuff Richard, you’ve got me there mate. I didn’t recite the front label of the pack. I just went ahead and referred to the product by the name Uncle Toby’s used to describe it on their site (I didn’t actually buy a packet of the stuff!). So for the record folks, Fruit Fix Strawberry is an apple, strawberry and grape snack. It does not under any circumstances contain just strawberries, so don’t go thinking it does.

Richard then says that Nestle is concerned that comparing the sugar content of a strawberry to a fruit fix is misleading because Fruit Fix also contains apples and grapes. I don’t want anyone being mislead so here is the full comparison (including apples and grapes - SFF is Strawberry Fruit Fix):

Protein: Strawberry 1% Apple 0% Grape 1% SFF 1.3%

Fat: Strawberry 0% Apple 0% Grape 0% SFF .5%

Sugar: Strawberry 4.6% Apple 10.4% Grape 15.5% SFF 72.7%

Fibre: Strawberry 2% Apple 2.4% Grape .9% SFF 7.3%

The highest sugar concentration is 15.5% which is still a long way from 72.7% so I’m not sure what point Nestle is trying to make. Even if Strawberry Fruit Fix contained nothing but grapes, you’d still need to eat almost half a kilo of them to get as much sugar as 100g of Fruit Fix, but there you go, full disclosure.

Next Nestle was concerned that I “... make an inference that additional sugar has been added to the product ... The product uses fruit puree and juice, which are inherently high in natural fruit sugars”. Notice how they underlined the word natural, I think it must be a magic word. Lawyers always underline magic lawyer words.

I can’t see where I have suggested that sugar is ‘added’ in the original post. But just in case anyone is confused, I unequivocally state that I don’t think any ‘additional sugar has been added to the product’. There’d be barely any room for anything else if they did, given all the sugar that’s already there.

No, I’m happy to accept Nestle’s word that the sugar in Fruit Fix comes entirely from fruit. Nestle seems to think that a molecule of sugar that was in some way associated with a piece of fruit in a prior life is an entirely different kettle of fish than one which found its genesis in a piece of sugar cane (like grapes, sugar cane is about 15% sugar in its natural state). I think this must be some sort of grass-ism (sugar cane is a grass). Nestle appear to believe that fructose molecules from fruit come from a better neighbourhood than those from grass. Apparently once being part of a piece fruit earns them the special label ‘natural’ as opposed to those (I guess) unnatural ones which were once part of a piece of sugar cane.

Nestle also takes exception to me suggesting that they are telling lies by emblazoning their product with ‘1 Serve of Fruit’ and advertising the product as a healthy and nutritious snack. They point out that unlike me, Nestle have carefully ensured they know the legal definition of the word ‘fruit’.

Silly old me. You see when someone says ‘1 Serve of Fruit’, I think of an apple or maybe a banana. But that’s where I’ve gone wrong according to Nestle. No, what I should be doing is reaching for my handy copy of The Australian Guide to Healthy Eating where I will discover (once I drill down to the fine print) that fruit juice and fruit puree are also considered to fit the definition of ‘fruit’. Since Fruit Fix is made from both of those ingredients, it is therefore ‘fruit’.

So when you define the words just the right way, Nestle is telling God’s honest. Personally I think it would be more honest to emblazon the box with ‘Five to Sixteen equivalent serves of sugars that were once part of a piece of fruit’ but I can see how the Nestle marketing people might not go for that.

Unfortunately Nestle didn’t give me their definition of ‘healthy and nutritious’ so I’ll just have to rely on common sense for that one. I take the phrase to mean the food will promote good health (or at least not bad health). And this is where Nestle and I will have to disagree on the ‘truth’. Nestle maintains that a food which is almost three quarters sugar (and the majority of that, fructose) promotes good health. But there over 3,000 published studies which say exactly the opposite.

The latest one (published just last month in the Journal of Clinical Investigation) reported on a study at the University of California where 32 overweight and obese people were persuaded to try a 10 week diet which was either 25 percent fructose or 25 percent glucose. Fructose and glucose are the two sugars that bind together to make table sugar. So ‘sugar’ is half fructose and half glucose (yes, even when it comes from fruit rather than cane).

The people on the fructose diet ended up with increased (1.5kg) abdominal fat, higher triglyceride levels (which leads to heart disease) and 20 percent higher insulin resistance (which leads to Type II Diabetes) after just 10 weeks! None of this happened to the group on glucose.

The University of California research is just the latest in a long line of studies which say the same thing. Sugar (or at least the fructose half or it) is highly dangerous to humans. And there is no shortage of research which shows that fat in the blood (the higher triglyceride levels) from fructose leads to obesity, heart disease and type II diabetes.

The ‘sugar’ in the Fruit Fix is likely to contain significantly more fructose than table sugar, coming as it does from condensed fruit juices. So Nestle are telling parents that it’s good to feed their kids something which consists of large amount of a substance which has been proven to cause obesity, heart disease and diabetes (to name a few of the problems). That does not fit my definition of ‘healthy and nutritious’, so in that sense I believe Nestle is lying when it says that Fruit Fix is a ‘healthy and nutritious’ alternative to fruit.

I guess to lie you must know that what you’re saying is not true. And I have assumed that Nestle would be aware of the research on fructose. I do sincerely hope that their defence (as one of our biggest food suppliers) is not that they weren’t aware of the dangers of sugar.

It’s a free country. Nestle has just as much right to sell high sugar, fruit flavoured confectionary as the next guy (actually a Mars Bar, for example, has considerably less sugar – ‘just’ 55.3%). What they should not do is tell us that it is a healthy and nutritious snack while they’re at it.

Why Iodine is being added to your Daily Bread

You may not know it but you need iodine in your life. No, I’m not talking about the brown tincture that your mum smeared all over your bloodied knee, although it’s closely related. The iodine you need even more than that is the kind you eat as part of your diet. You don’t need a lot (about one teaspoon over your lifetime) but it is vital, particularly in the few months before the world is blessed with your presence.

Iodine is used by your thyroid gland to manufacture a couple of hormones (with inconsiderately long names which have thankfully been abbreviated by the research community to T3 & T4). If a pregnant woman’s thyroid gland can’t get enough iodine to make these hormones then there will be disastrous consequences for her baby.

Thyroid hormones are critical for the creation of the protective coating of nerves (called myelanation) which is most active in the period from 22 weeks gestation to just after birth. A range of recent studies show conclusively that even if the mother is only moderately iodine deficient, the child will suffer a reduction in IQ of between 10 and 15 points. Severe iodine deficiency will result in significant mental retardation.

The research on iodine deficiency is well established and is the driver behind the creation of ‘iodised salt’. But in the last decade or so we’ve become a bit too good for plain old salt (rock salt only please) and the alarm bells are starting to ring. Iodised Salt is now less than 10% of all salt sales.

But even if you have a perfectly adequate amount of iodine in your diet you may still be unable to produce enough of the thyroid hormones. Guess how (c’mon it’s not that hard, you’re reading a blog about fructose)? That’s right, just make sure your diet is high in fructose (sugar for the newcomers).

A series of studies published in the eighties by the US Department of Agriculture show that fructose creates a copper deficiency. And a bit more research (from Russia) in the nineties shows that a fructose induced copper deficiency sharply decreases iodine hormone (T3 & T4) production by the thyroid gland.

So even if she has plenty of iodine in her diet, if a pregnant woman’s diet also has plenty of fructose, she’s playing Russian roulette with her child’s IQ (‘scuse pun).

The combination of a high fructose, low iodine diet is starting to have a real impact on Australian women. A recent update to 2001 research out of Westmead hospital in Sydney suggests a 50% increase in thyroid hormone deficiencies in Australian pregnant mothers.

But don’t worry, the Government is on the case. Are they banning fructose? Are they suggesting pregnant mothers take iodine supplements? No, of course not. Their solution is exactly the same as the solution for tooth decay. They’ll mass medicate. From October 2009 all bread sold in Australia will come with a free dose of iodine.

Now don’t get me wrong. I don’t know any mother that wouldn’t give both her arms to ensure her baby had the best possible start in life. And as far as I can discern there is no downside to having too much iodine (at the levels we are likely to be getting). But the research suggests that if we keep increasing fructose in our diet, then no matter how much iodine we put in the bread, we won’t be able to convert it to the hormones pregnant mothers need.

The problem is that, just as with fluoride and now with iodine, the knee jerk response to problems created (at least in part) by overconsumption of sugar is to pull the ‘mass-medicate’ lever. How long will it be before the Government decides the best option for high cholesterol or blood pressure or diabetes is to mass medicate. How about depression? Before you know it there’ll be more medication than bread in our daily bread.

Why is the Government so reluctant to take a proper look at what the research says is the common cause to all of these ailments? I hope it’s going too far to suggest that Big Sugar is pulling the strings. I believe firmly that you should not ascribe to conspiracy that which can be adequately explained by incompetence. But I think all the good marketing work Big Sugar is doing (just to move product) may be operating to muddy the waters for those charged with looking after our health.

It’s time to cut through the spin and look to the underlying cause before we once again reach for the band-aids.

How to Win a Race

I must admit to being a bit of rowing tragic.  I don’t actually row, but rather like former PM John Howard (with cricket), I talk a good game.  So as I meander through the online world of sugar research, papers about rowers naturally attract my attention. And when I see one that seems to provide a magic bullet for off-the-scale performance improvement, I’m very interested.

You might have missed it but the January 2006 edition of the Journal of Sport Science carried an interesting little study on US female college rowers.  The study was trying to see if there was any truth to the old wives tale doing the round of ‘sports nutritionists’ that ribose supplements would enhance athletic performance.

For a while, researchers have known that giving a simple sugar called ribose to heart patients after surgery can help with their recovery, but studies on healthy people had shown no particular benefit (and sometimes quite a bit of danger, but that’s a story for another day).

The rowing study decided to test out the theory on rowers by giving them 10g of ribose dissolved in one cup of water (250ml) before and after training for an eight week season.  Like all good studies they had a control group which they decided to give the same amount of glucose instead.

The researchers then recorded the racing times for the crews over 2,000 metres (a standard race distance for that level of rower).  The ribose group’s performance did improve (by 5.2 seconds) over the season.  But that’s about what you’d expect from 8 weeks of training.  So bad news for the ribose supplement crowd. 

The really interesting news was in the control group (on glucose).  They improved on average 15.2 seconds over the distance.  Three times as much!  Just by giving them a bit of glucose in water.  Now if you don’t think that sounds like much you’ve obviously never sat and waited that long for your crew to finish after the first boat crosses the line.

To give some perspective on that time difference, a different study on US female college rowers looked at what difference a rower’s experience made to how well she rowed.  They concluded that someone with 3 years of rowing experience at college level would on average row 2,000 metres 32 seconds faster than a girl with no experience.  Against that background, over 15 seconds from a glass of glucose water before and after training looks like a very big deal. 

A different study (not about rowers, so I almost missed it) out of Greece (to be published in the June 2009 edition of International Journal of Clinical Practice) suggests that the fructose in traditional sports drinks may lead to low potassium levels (particularly if caffeine is also present such as in cola and guarana drinks) and this in turn could lead to muscle wasting.  This is on top of all the other great things the fructose does for you.

Drinking sugar water before and after sport is not a new invention, but what these studies suggest is that if that drink is 2 teaspoons of glucose (dextrose) in a cup of water, then significant performance improvements could be expected.  Athletes (and tragics) of all types should take note.