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The sugar industry, heart disease research and corruption

A couple of weeks ago, JAMA published a paper (http://archinte.jamanetwork.com/article.aspx?articleid=2548255) which demonstrated that back in the 1960's, the sugar industry paid research scientists to downplay the link between consumption of sugar and risk of heart disease (our number one killer). Additionally, saturated fat was targeted as the one to blame (something we all know from classic advice distributed by dietitians, doctors and so on). While not too surprising, it's really so very disappointing.

As I've said in many talks I have given, I am not a scientist (and found lab work incredibly dull despite respecting scientists greatly). I am, however, a clinician and see the real-time impacts of dietary choices. I have always been immensely confused by the lack of emphasis on reducing sugar intake in order to lower blood fats and decrease risk of heart disease. It is absolutely evident when working with patients, that improving the quality of dietary carbohydrates, as well as ensuring adequate healthy fats are present in the diet, has a great impact on disease markers which can lead to heart disease.

The disconcerting exposure of the JAMA article leads us to question whether five decades of nutrition research has been largely shaped by the sugar industry? And beyond that, how much can we ever trust nutrition research funded by any industry which clearly has the quite natural business motives of wanting to continue to sell its products? Back when this original corruption occurred, medical journals did not need to declare the funding sources of their research - these days they do. While I'm glad funding needs to be declared, I'm not sure it helps to remove bias at the bottom line.

Much has been written about the influence of the food industry on the development of nutrition guidelines, such as the eatwell plate and so on. Not to mention large payouts by companies such as Coca Cola to help downplay the link between sugar consumption and obesity. In the case of the JAMA article, one of the scientists who was paid by the sugar industry (Mark Hegsted) actually went on to become the head of nutrition at the United States Department of Agriculture (where dietary guidelines are born!). The mind boggles. And money talks (we know this).

To be clear about how the science (which spanned the five decades following this pay out by the sugar industry) influenced dietary guidelines - people were encouraged to move from high fat foods to lower fat foods which were typically higher in sugar. This advice penetrated every kind of food environment from governmental to Weight Watchers and supermarkets. This advice didn't really work: we can all look around us and see we're not getting any slimmer or much healthier in comparison to the 1960's. As a dietitian who works in obesity, I can tell you we're absolutely overrun and it shows no sign of slowing down.

What happened was a disgrace, and what continues to happen (perhaps in more subtle but no less damaging ways) remains a disgrace. Nutrition research should be publicly funded only - and dietetic/nutrition associations should ban funding by any food industry or company. There is no way that any company in their right mind will fund research which will end up ruining their business - it's basic common sense!

But putting corruption aside, because it will sadly always be there (there are always people who put money above all else): we haven't just lost common sense in terms of how we run nutrition science, we've lost it in terms of our own relationships with food. Replacing high fat foods with high sugar foods doesn't address the real problem. Arguing about whether we need to blame fat or sugar ignores the essence of why we are in this situation.

The real problem is processed food - adulterated, nutritionally empty substances we can chew and swallow but don't bring us wellness. They are cheap to make with a large profit margin. Our sole nutritional aim for this generation should be to remove processed foods from our diet. The impact on the rates of chronic diseases would be immense, and the money saved to be spent on genetic diseases would be a precious gift.

What should we be replacing our processed foods with?

There's no doubt our eating culture is polarised. I see this daily as I oscillate between anorexia and obesity in clinic. Deliciously Ella and thousands like her, display complicated, beautiful plant based meals on Instagram and book shelves which serve us lies, intimidation and exhaustion along with their nutrient density (unintentionally I am sure). What I want to shout from the rooftops is this: To be well and eat well you don't need to spend hours making gorgeous bowls of exotic vegetables and soaked legumes; you just need simple, natural foods where you control the sugar, salt or fat added. I worry for the patients I have who feel they're failing if they don't cook a complicated meal each night after a long work day. Spending three hours chopping and cleaning up is simply not sustainable when working full time and raising children. A couple of boiled eggs, some steamed veg from the freezer and a slice of sourdough rye bread is a great meal, takes two seconds and is cheap. Save complicated dishes for when it feels fun and for when you have time to enjoy the preparation.

If you feel stuck, work with a good nutritionist or dietitian to help boost you on your way to eating a diet which works for you. Make sure it is individualised, suits your schedule and personality, and consists of food which is as unadulterated as possible. Watch how much this improves your health, without any need for a guideline to show you the way.

Have a lovely week all :-)