In February 2013 the official advisory body on nutrition In Australia issued its latest version of the Australian Dietary Guidelines. The report produced by the National Health and Medical Research Council (NHMRC) includes new stringent advice on the consumption of sugar (1). The public is recommended to:

“Limit intake of foods and drinks containing added sugars such as confectionary [sic], sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks”

Compare this with the advice 10 years earlier in 2003:

Consume only moderate amounts of sugars and foods containing added sugars”

The advice on alcohol is:

If you choose to drink alcohol, limit intake”

So in effect the Australians have decided that sugar should be regarded in the same way as alcoholic beverages.

In reaching this position the Council recognized that the case for limiting sugar intake had become much stronger in the last few years. Consequently there is now convincing evidence that the consumption of sugar sweetened soft drinks (SSBs) is a key factor leading to excessive weight gain in children.

In the period leading up to the preparation of this report there was a serious attempt to cast doubt on the evidence relating to the damaging effects to health of excessive sugar consumption.

A research group in the University of Sydney published a paper which claimed that as the incidence of obesity continued to increase there was actually a decrease of 23% in the total amount of sugar being consumed in Australia between 1980 and 2003. As a result it was concluded that sugar could not possibly be responsible for the growing incidence of obesity, a phenomenon referred to as the Australian Paradox (2).

In an article in “The Australian” Bill Shrapnel, a dietitian and deputy chairman of University of Sydney Nutrition Research Foundation claimed that there was no evidence to justify the recommendation to restrict the intake of sugar (3). In fact he challenged the Council to produce the relevant information. His colleague Professor Jennie Brand-Miller focusing on sugar, distracts attention from saturated fat, salt and alcohol. They both contend that policy is based on myth and that there is no science to support the advice on sugar.

Following these public statement an independent economist, Rory Robertson decided to take an interest. Prior to this he had successfully lost 10 kg simply by restricting his intake of sugar. His experience helped to convince him that sugar (and fructose in particular) is the key to solving the obesity issue. In his view the conclusions of the University of Sydney researchers just did not ring true and so he studied the Australian Paradox paper.

In his opinion the conclusion is demonstrably false for the following reasons:

  • Some of the data presented shows clearly that over the period under consideration the trend is up not down
  • The primary source of their preferred indicator was abandoned as unreliable by the Australia Bureau of Statistics 10 years previously because it was decided that it was impossible to measure how much sugar was imported as it was already present in many thousands of manufactured products
  • The authors failed to mention official information on “sugar availability” which gives a reasonably good estimate of sugar consumption and is relatively high in recent years
  • National dietary surveys, coupled with on data food imports and industry information on soft drink consumption all indicate a high level of sugar consumption.

Robertson concluded:

All in all, we are left with a clear sense that there is no “Australian Paradox”, just an idiosyncratic and unreasonable assessment – and avoidance – of the available sugar data by those who coined the phrase” (4).

Details of the Robertson objections were published in “Business Day” and as a result the journalist Michael Pascoe received a communication from Jennie Brand-Miller (5). In this she claimed that the recent high values of “sugar availability” were caused by the fact that sugar required as a feedstock for the manufacture of ethanol, which is used as a fuel. She wrote that:

“Sugar availability takes no account of food wastage, use in animal food, beer and alcohol fermentation, or in non-food industrial use, and we cannot assume that a steady portion is lost in this way. Globally, raw sugar is an important ingredient for ethanol production. In Australia, ABARE data show that ethanol production as a biofuel for transport rose from 42 million litres to 209 million litres (almost four-fold) from 2005 to 2009.”

It was stated that the increase in ethanol production would require about 14 kg per head if 100% of raw sugar was used to make it. The reply continued:

Although there are no firm figures for how much raw sugar is presently being used for ethanol production, supplies of C-molasses alone are not adequate, and the absolute amounts are likely to be increasing”

Michael Pascoe commented:

“There’s a good reason why there are “no firm figures” – sugar is not used for ethanol production in Australia, as the most cursory of Google searches on Australian biofuels would show.”

In Australia fuel ethanol is produced from red sorghum and waste products from sugar and starch production.

Pascoe then informed the Professor of his findings and she accepted that he was correct.

At this point he assumed that the authors would correct or retract the original paper but instead published the same misrepresentations of the key facts in “Australian Paradox Revisited.”

More recently a group of academics at the University of Western Australia has conducted a detailed examination of the available data on sugar supply and consumption over the last 20-30 years(6). In particular they set out determine if there is sufficiently robust data to support the existence of an Australian Paradox.

They considered that it was essential to find out how much sugar was contained in manufactured products, especially those which had been imported. It was found that if all forms of sugar in the diet are taken into account, which includes sugar contained in processed foods and drinks as well as refined sugar, there was a steady increase in imports between 1988 and 2010. Although there were also exports these were small when compared with the imports. In 2010 there was an estimated

6 g of sugar per capita per day in highly processed food products exported from Australia compared with 30 g of sugar per capita per day imported into the country via similar products.

The FAO data used in the Australian Paradox paper did not include information on sugar present in imported products. The paper concluded when the data on imported food is included that the consumption of sugar was increasing in parallel with the increasing incidence of obesity. This clearly undermines any claim for the existence of an Australian Paradox.

The University of Sydney has conducted an investigation into allegations by Rory Robertson. The report has just been published and I will go through it and report on it shortly.

REFERENCES

  1. http://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55_australian_dietary_guidelines.pdf
  2. http://www.australianparadox.com/pdf/OriginalAustralianParadoxPaper.pdf
  3. http://www.theaustralian.com.au/news/health-science/a-spoonful-of-sugar-is-not-so-bad/story-e6frg8y6-1226090126776
  4. http://www.australianparadox.com/pdf/DitchingSugar27032012.pdf
  5. http://www.smh.com.au/business/pesky-economist-wont-let-big-sugar-lie-20120725-22pru.html
  6. W Rikkers et al (2013) http://www.biomedcentral.com/content/pdf/1471-2458-13-668.pdf