Back in the 1960s a slogan denouncing sugar as "pure, white and deadly" was propounded by the late John Yudkin, then Professor of Nutrition at the University of London. He emphasised the virtues of eating meat and dairy products and claimed sugar was a factor in heart disease and strokes and should be avoided. While Prof Yudkin made enemies of the powerful sugar lobby, some of his research funds came from the dairy industry.
Understandably, the sugar industry was at pains to refute Prof Yudkin's claims.
Saturated fat may have become public enemy number one in the diet and health stakes, but there is still a niggling at the back of many people's minds that sugar is not all that good for you. Sugar consumption in many countries has levelled off, so, given the world surplus of sugar in the past five years, it's not surprising that the sugar industry has been tried to alleviate this niggle.
In many countries the industry has been running campaigns promoting sugar as energy-giving and part of a healthy diet to encourage us to eat more, according to a 2000 survey in PROSI (Public Relations Office of the Sugar Industry) magazine of sugar promotions in 11 countries, mainly in Europe .
But some of us are eating more sugar.
The National Nutrition Survey of 1997 showed New Zealanders ate 20g-30g more sucrose per head per day than in 1989 .
Jane Dodd, of Network Communications which provides PR and nutrition consultancy services for the New Zealand Sugar Company, said the report they put out in November last year, in association with the New Zealand Nutrition Foundation, was to correct some of the public misinformation about sugar.
"It's certainly not to encourage consumption, far from it. It's to correct some myths and teach people how to use it.
"I've heard criticism from people about other sugar industries, but our stance is about educating people," she said.
During the 1980s a flurry of research tried to see if sugar could be implicated in modern ills such as coronary heart disease, diabetes and cancer, according to Professor Jim Mann of the human nutrition department at the University of Otago. He was recently made a Companion of the New Zealand Order of Merit for services to science.
"Apart from dental caries, sugar could not be implicated directly in coronary heart disease, diabetes, etc etc, but there was a big 'But' - and it's much harder to prove this - if sugar is involved in obesity, then of course it is implicated in coronary heart disease and diabetes and cancer and you name it, albeit indirectly."
Camps were divided on whether sugar contributed to the global obesity epidemic that was becoming worryingly obvious to health professionals.
"I admit in the early 1990s I was a bit fence-sitting - there are people who say this chemical pathway doesn't work, there was this cross-section epidemiological study, but on the other hand, obesity is increasing, fat intake is coming down and it couldn't all be explained by a reduction in physical activity, although that was questioned. There's something peculiar going on here and it was all a bit of a mystery," Prof Mann said.
In 1997, Prof Mann was a member of a WHO/FAO (World Health Organisation/Food and Agriculture Organisation) expert consultation which produced a report on Carbohydrates in Human Nutrition.
When they were meeting in Rome there was political pressure from a Latin American, sugar-producing country which threatened to replace its sugar cane fields with cocaine if the experts came out against sugar in the report, he said.
"We were very upset about this. We had our deliberations and at the end, came out with the recommendation - and the wording was very important - that we could not find a direct link between sucrose and heart disease and diabetes and so on, however - and this was very important - excess energy from any source could contribute to obesity, and QED, if something contributes to obesity, of course it's contributing to heart disease and diabetes and all that. It was a very clear statement," he said.
However, the sugar industry regarded the report as a turning point. PROSI magazine No 382 said it "completely exonerated sugar from causing any disease (cardiac, obesity, diabetes etc) except dental caries (and this was controllable with proper dental hygiene) and pointed out that sugar was a carbohydrate like any other and as such as not metabolised into fat, unlike fat itself.
The findings of this authoritative report gave new impetus and credibility to promotional campaigns".
Selected parts of the report, or the draft report which was published on the FAO web site, were widely quoted by the sugar industry, including the report commissioned by the New Zealand Sugar Company last year:
" . . . eating sugar does not cause obesity, diabetes, cardiovascular disease, hyperactivity, cancer, micronutrient deficiencies, and is only one factor in causing dental caries. Sugar is a tasty, low-cost energy source that helps make a variety of foods more palatable and desirable.
Efforts to limit sugar intake to low levels are generally unnecessary." The last two sentences had Prof Mann spitting tacks.
"We never said it was a tasty, low-cost energy source and all that. I went berserk and screamed and shouted. One of the things we teach students now is you have to be very careful about draft things on web sites," he said.
The offending sentences were not in the final (1998) WHO/FAO report, but are still included in the New Zealand industry's (2001) information. Jane Dodd says when the new WHO/FAO report comes out they will update it.
A new WHO/FAO Expert Consultation, this time on Diet, Nutrition and the Prevention of Chronic Diseases - obesity, type 2 diabetes, cardiovascular diseases, cancer, dental diseases and osteoporosis - was held in Geneva in January this year. It evaluated new scientific evidence and its recommendations emphasised integrated prevention and control of these diseases by targeting three main risk factors: tobacco, unhealthy diet and physical inactivity.
Prof Mann was again a member.
Since the mid-'90s when the previous report was done, further research had shown that eating too much sugar could be implicated in weight gain, Prof Mann said.
The new WHO/FAO report refers to the "American paradox" (because that is where it is most obvious) - the fact that in some countries the percentage of fat in the diet has decreased but obesity has increased.
"There's a whole collection of evidence if you start piecing it together, going back to the 1960s. And where it actually comes to light, is some people put up their triglycerides in response to a moderate intake of sugar.
Triglycerides are a very good marker for people who have syndrome x or insulin resistance factor," Prof Mann said.
Syndrome x, a term coined by Gerry Reaven of Stanford University in the late 1980s, refers to a collection of abnormalities such as high triglycerides, high cholesterol, high blood pressure and insulin resistance that can lead to diabetes and is a major cause of heart disease. It is increasingly prevalent in societies eating Western diets.
According to Prof Mann, insulin resistance stems from the hypothesis of the thrifty gene which enables people who carry it to conserve their energy - an evolutionary advantage for our ancestors but not for modern humans with sweet, fatty fast food and sedentary lifestyles.
However, genetic tendencies can be counteracted by appropriate diet and exercise.
Research by Victor Zammit, of the Hannah Research Institute in Ayre, Scotland, showed that sugary foods, particularly those containing fructose (the sucrose molecule is half fructose and half glucose) could be as damaging as saturated fats in leading to syndrome x. A damning report of this and other related research in last year's September 1 issue of New Scientist concludes that one day 42the industry may be forced to pay damages similar in scale to those awarded against the tobacco industry today42 to consumers made fatally ill by eating their products.
A draft of the new WHO/FAO report for global prevention and control of non-communicable diseases is now on the WHO web site for comment.
It seeks to redress any confusion caused by the previous report and definitely advises caution in sugar consumption. It recommends that free sugars, which are added by the cook, consumer, or manufacturer or sugar from honey, syrups and fruit juices, should be less than 10% of total energy consumed, he said.
The draft report is a powerful call to governments and health authorities to take broad action to prevent and reverse the exploding epidemics of obesity, diabetes and other non-communicable diseases in both developed and developing countries. Its recommendations range from education and effective labelling of foods, especially of fats, sugars and sodium, to encouraging small local farmers and ensuring the plentiful supply of fruit, vegetables, whole grain cereals and fish at affordable prices to the whole population, stringent codes of practice on advertising of sugar-rich items especially to children, and taxes on items high in free sugars and in fats and/or of low nutritional value. The taxes could help fund health promotion and research.
"The interesting thing is the [food] industry have given up the fat battle now," Prof Mann said.
"They've decide they're never going to win the fat battle to say fat's good for you, so they are really gunning for the sugar thing and are investing millions of dollars to try and rubbish the story I've just put to you now. I'm sure the sugar industry are employing hundreds of people with PhDs to be bombarding WHO. It will be a terrifically difficult for WHO to decide how to deal with their submissions."
WHO has already had about 300 submissions on the new report, most of them saying it should not say anything bad about sugar, he said.
