The sugar industry and paying scientists

Anahad O’Connor at the New York Times – How the Sugar Industry Shifted Blame to Fat:

The documents show that a trade group called the Sugar Research Foundation, known today as the Sugar Association, paid three Harvard scientists the equivalent of about $50,000 in today’s dollars to publish a 1967 review of research on sugar, fat and heart disease. The studies used in the review were handpicked by the sugar group, and the article, which was published in the prestigious New England Journal of Medicine, minimized the link between sugar and heart health and cast aspersions on the role of saturated fat.

Even though the influence-peddling revealed in the documents dates back nearly 50 years, more recent reports show that the food industry has continued to influence nutrition science.

That last sentence is what gets me. This is going on right now, and has been going on for ages. It’s nothing new, and also it’s what happens in many other industries. Scientists are a little better regarding disclosures of funding now than 50 years ago, but industry is where a lot of research money comes from. An industry finds scientists who are either on their side of the issue or are sympathetic to their issue and funds their research.

What we need to do is to understand the biases and keep them in mind when making decisions on health policy.

Book – First Bite, by Bee Wilson

Bee Wilson – First Bite: How We Learn to Eat

I’m only half way through the book, but it’s very thought-provoking and relevant to us right now, since our toddler is just nearing the age of 3. Chapter 4 on Feeding discusses several styles of feeding children that researchers have divided them into:

  • Uninvolved: low warmth and low demands
  • Authoritarian: low warmth and high demands
  • Indulgent: high warmth and low demands
  • Authoritative: high warmth and high demands

Where ‘warmth’ is described as being the level of sensitivity to the child’s needs. I think of myself as being somewhere between Indulgent and Authoritative. I tend to indulge our son in many of his wants but he tends to be quite good in his ability to accept small indulgences (one or two mini chocolate chips, for example) as sufficient, so it’s never a worry for me. At the dinner table; however, I tend to ask him several times if he wants to try a food, or if he wants to finish his soup or if he’ll have one more bite of something. Especially after he starts getting down from his chair to go play. The danger being that the high demands may skew his liking of certain foods that we serve. Regardless, the take-away is best stated by Wilson:

The art of feeding, it turns out, is not about pushing “one more bite” into someone’s mouth, however healthy the food. Nor is it about authoritarian demands to abstain from all treats. It’s about creating a mealtime environment where – as in Clara Davis’s feeding experiment – those who are eating are free to develop their own tastes, because all of the choices on the table are real, whole food.

 

Simple healthy eating

Aaron E. Carroll for the New York Times, The Upshot – Simple rules for healthy eating:

All of these rules are subtly trying to get you to be more conscious of what you’re eating. It’s far too easy these days to consume more than you think you are, or more than you really need, especially when eating out. I’ve found that it’s impossible to tell any one person how much they should be eating. People have varying requirements, and it’s important for all of them to listen to their bodies to know when they should eat, and when they should stop.

I’ve found that making change is hard. How many times have I started running, only to stop a few weeks later due to illness and not getting back into it when I’m better? But we have made the change in our diets. Slowly and over time (in the last 4-5 years) we’ve made small changes that have resulted in weight loss (30+ lbs for me over that time), reduction in cholesterol levels and overall feeling better about my body image.

On deliciousness

David Chang at Wired – The Unified Theory of Deliciousness:

Joshua told me he wanted to make a version of a Bolognese, the Italian meat sauce. I told him that was fine, but he had to use only Korean ingredients. I often set these kinds of limitations, because I’m a big believer that creativity comes from working within constraints.

Anyway, that meant he would have to find a way of re-creating the sweetness, umami, and pungency of Bolognese without the onions, celery, carrot, tomato paste, or white wine. He ended up using scallions, red chiles, ground pork, and fermented bean paste. Instead of using milk to provide that silky mouthfeel, I encouraged him to add in some whipped tofu. And rather than pasta or gnocchi, he served it with rice cakes that looked like gnocchi. We called it Spicy Pork Sausage & Rice Cakes, and when most people taste it, it reminds them—even on a subconscious level—of a spicier version of Bolognese.

I often find that with our food constraints, much of what we cook tastes the same, and very familiar. This is good in one sense, since by now we know what our son likes and dislikes and can guess whether he’ll like the food or not. But it’s bad in another sense, where I feel that we’re limiting him and not presenting a wider range of flavours and textures the we want him to experience.

Chang’s attempts at recreating familiar foods with different ingredients shows that in some instances he can re-imagine familiar dishes using unfamiliar ingredients. We are trying to do that every time we make a new dish, having to replace ingredients with others that are safe. Unfortunately it’s only too easy to fall back on the tried and true recipes. Time is the overriding constraint.

Aaaannd I bought a pressure cooker…

The madness begins.

I’ve been wanting to get a pressure cooker for at least, oh, 5 years or so but have never built up the courage to plonk down the cash for one. Also, I had to convince my partner to be on board with getting another cooking implement. As if we don’t have enough pots and pans already.

The thing the changed her mind? Canning – or more specifically – pressure canning. In our efforts at preserving more and more of our summer harvest and CSA share foods that we cannot possibly eat when the abundance comes in, canning of the low-sugar and low-acid foods was looking to be a better and better solution.

So, on a whim, I dropped by the local shop to see what they had. There was a sale. And the size and heft and build quality of the unit they had in stock left me very impressed. So there goes $300… I bought the Fissler Vitaquick 8L.  I compared it to the Fagor Innova 8 quart, which they also had in stock, but I didn’t like the fact that it had the rotary knob/switch (another thing to go wrong, imo) and the feel/sound of the switch wasn’t very good. The lid also went on with a nasty scratching sound. Those issues could have just been due to the floor model being kicked around though.

Anyways, so far I’ve cooked chickpeas and a curry with the pressure cooker. So far so good. Next comes pork shoulder.

Canadian Senate Report on Obesity – on sugars

From page 6 of the report:

Sandra Marsden of the Canadian Sugar Institute testified that sugar consumption has declined in recent years, however, as that organization represent the sucrose industry (the sugar extracted from beet and sugar cane), this decline seems to be only associated with sucrose and not all sugars combined.

(Zing!)

The Canadian Sugar Institute says the estimated added sugars* consumption in Canada is approximately 51 – 53 g per day.

A number of witnesses also told the committee that sugary beverages are the primary source of added sugar in our diet and are the primary driver of obesity. They noted that these beverages have little or no nutrient value while being calorie-rich. Further they indicated that these are ‘invisible’ calories as they do not contribute to satiety and are simply added calories over and above food intake. Some witnesses offered testimony that sugar is addictive and that it promotes overconsumption.

Addictive? Interesting.

From page 12 of the report:

At the same time, Manuel Arango, of the Heart and Stroke Foundation of Canada, indicated that as much as 62% of the Canadian diet can be categorized as highly-processed, a percentage that has been rising in recent decades at the expense of whole foods. As a consequence of the increased intake of highly processed foods, sugar consumption has increased dramatically from 4 bounds annually per person 200 years ago to 151 pounds annually per person today.

151 pounds per person is huge. That’s nearly 1 cup of sugar per day. I’m not sure where they get that figure.

The Heart and Stroke Foundation of Canada’s position statement on sugar cites that total sugar intake is 110 g per day, or about 1/2 cup per day.

As mentioned previously, Health Canada’s proposed limit is 100 g per day of total sugars.

Footnotes:
*"Added sugars" is defined as follows:

Sugars and syrups (Statistics Canada Category - Sugar and sugar syrups (from sugar cane or sugar beets), maple sugars, honey. Does not include corn sweeteners.
Corn sweeteners: high fructose corn syrup ("glucose-fructose"), glucose syrup, and dextrose.
Fruit juce/concentrated fruit juice or other ingredients that act as a functional substitute for added sugars.

 

Recommended daily intake of sugars

After reading about the recently released 2015 USDA dietary guidelines (and the controversy surrounding it) I was wondering what the recommended maximum daily intake of sugars was, given those guidelines don’t state a maximum, and neither does the Canada Food Guide. Here’s what I’ve found.

The WHO recommends a daily limit of about 13 teaspoons of added sugars per day

The WHO published guidelines in 2015 on Sugars intake for adults and children, which recommended the following:

  • WHO recommends a reduced intake of free sugars throughout the lifecourse (strong recommendation*)
  • In bnoth adults and children, WHO recommends reducing the intake of free sugars to less than 10% of total energy intake (strong recommendation*)
  • WHO suggests a further reduction of the intake of free sugars to below 5% of total energy intake (conditional recommendation**)

Free sugars include monosaccharides and disaccharides added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.

Notes:
* Strong recommendations indicate that "the desirable effects of adherence to the recommendation outweigh the undesirable consequences". This means that "the recommendation can be adopted as policy in most situations.
** Conditional recommendations are made when there is less certainty "about the balance between the benefits and harms or disadvantages of implementing a recommendation". This means that "policy-making will require substantial debate and involvement of various stakeholders" for translating them into action.

Free sugars do not include the sugars already present in whole foods such as fruit and vegetables.

For a 2000 calorie diet, they recommend that 200 calories come from these free sugars. What is 200 calories in terms of, say, granulated sugar? Based on the USDA Nutrient Database, granulated sugar has 387 calories per 100 g of sugar. So 200 calories is 51.7 g of sugar. Put another way, that’s just about 13 teaspoons of sugar per day (at 4 g per teaspoon of sugar).

As stated above, they further propose that the daily limit be reduced to 5% of total energy intake, so going back to our 2000 calorie diet, that’s 100 calories, or 25.8 g, or 6.5 teaspoons per day. The caveat is that there is less certainty about the benefits from recommending an even lower sugar intake amount.

Health Canada’s proposed daily sugar limit

Currently, Canada’s Food guide doesn’t give a limit for sugar. In June 2015, Health Canada published a set of proposed regulations to amend the nutrition labeling of food products (among other labeling changes). In the proposed regulations, a sugar limit is given:

A DV of 100 g is being proposed for sugar, and the declaration of the % DV for sugar in the NFt would be mandated for all foods. Consumers would be able to use the % DV to determine whether a food contains a lot or a little sugar (as indicated by the rule of thumb footnote), and as a result adjust or limit their sugar intake.

The “% DV” is the daily value amount, based on the recommended daily intake chart (near the bottom of the page).

The proposed 100 g of sugar recommended here is about double the recommendation from the WHO; however, that’s total daily intake, from added and natural sugars. The WHO recommendations only dictate limits on added sugars to foods.

Proposed sugar limit and % DV

I advocate for a 50 g daily intake limit for added sugars. The nutrition labeling should also reflect this 50 g limit and corresponding % DV for sugar. Added sugars are more of a concern than naturally occurring sugars in vegetables and fruit, and nutrition labeling is generally on processed foods – where the added sugars are. However, it should be clear in the guidance documentation that overall limit is 100 g of sugar per day.

Canadian Senate report on obesity – first thoughts

The Canadian Senate report – Obesity in Canada – A While-of-Society Approach for a Healthier Canada was released last week:

There is an obesity crisis in this country. Canadians are paying for it with their wallets — and with their lives.

Harsh and sobering. The infographic is good.

Among the more controversial recommendations:

  • Consider a tax on sugar- and artificially-sweetened drinks
  • Ban the advertising of food and beverages to children
  • Immediately update the food guide without industry influence

Sugar Tax?

The Canadian Taxpayer Federation and the Canadian Beverage Association both denounce the recommended sugar tax, claiming that it doesn’t work. Three comments:

  1. The discussion and promotion of such a tax is very helpful and brings some awareness to the issue of high sugar consumption, whether the tax is implemented or not.
  2. We need to look at the sugar content of all processed foods and see if such a tax should be expanded to cover foods with added sugars/sweeteners, natural or artificial. Even foods such as fruit juices, which give us the liquid without any of the fibre of the fruit, need to be reviewed for inclusion.
  3. As with salt, we need guidelines on the recommended maximum daily intake of added sugars, and the report suggests this in the text.

The CBC hosted a short forum discussion on the sugar tax last week.

Restricting food advertising to children

As for advertising, currently the Quebec Consumer Protections Act protects children (under the age of 13) from any commercial advertising:

248. Subject to what is provided in the regulations, no person may make use of commercial advertising directed at persons under thirteen years of age.

1978, c. 9, s. 248.

249. To determine whether or not an advertisement is directed at persons under thirteen years of age, account must be taken of the context of its presentation, and in particular of

(a) the nature and intended purpose of the goods advertised;
(b) the manner of presenting such advertisement;

(c) the time and place it is shown.

The fact that such advertisement may be contained in printed matter intended for persons thirteen years of age and over or intended both for persons under thirteen years of age and for persons thirteen years of age and over, or that it may be broadcast during air time intended for persons thirteen years of age and over or intended both for persons under thirteen years of age and for persons thirteen years of age and over does not create a presumption that it is not directed at persons under thirteen years of age.
1978, c. 9, s. 249.
The Senate report calls for a study on the effects of this restriction in Quebec, and for implementation of a similar restriction for all of Canada.

Updating the food guide

The call for updating the food without industry influence is fantastic. I’m not sure how realistic this could be, since many non-industry researchers in academia are funded by industry, so does this mean they can’t be involved? The removal of politics from the food guide is one of the questions I’ve always had, in light of the huge ‘push’ for milk/dairy products as our main recommended calcium intake method.

Calcium and milk/dairy allergy

A few more thoughts on yesterday’s post on calcium:

  • While I admit that dairy seems to be some of the most calcium-rich foods, why is dairy pushed so much in the dietary guidelines?
  • Is it a political issue? (i.e., through industry lobbying, economic issues, or something else?)
  • Many people are lactose intolerant (especially many people with non-european backgrounds) so why is milk/dairy listed in such a large amount of foods in many countries’ food guides?
  • While the vitamin D/calcium relationship is well known, does the type of calcium-rich food also matter? Is the calcium from dairy better or worse than from other foods?