Sugar took centre stage in Auckland this week, with the FIZZ conference that focused on the role of policy in reducing consumption of sugar sweetened beverages in the population, and the first Low Carb Down Under (LCDU) Auckland symposium, which saw a mix of Australian and New Zealand advocates speak about the reduction of carbohydrates in the diet.
I enjoyed the FIZZ conference, particularly the first day as both Richard Johnson (Fat Switch) and Robert Lustig (Sugar: the bitter truth) presented on biological mechanisms that clearly show the unique role that fructose has on adversely affecting our health. What a coup for the organisers to be able to bring them over to New Zealand. Perhaps most exciting (from a geeky, academic perspective) was a virtual punch up between Rod Jackson, a professor at University of Auckland, and Rob Lustig. Prof Jackson didn’t take kindly to Lustig’s assertion that nutrition public health initiatives have failed in the past. Prof Jackson views butter as the most ‘poisonous’ substance in the NZ diet and took the opportunity on the last day as the moderator of the final panel discussion to mention again that (contrary to Lustig’s comments) we’ve been successful at reducing saturated fat intake in our diets (odd, as we were there to talk about policy initiatives targeting sugar sweetened beverages, not about saturated fat). Anyway – as an aside, NZ consumption of saturated fat (and overall dietary fat) has reduced over the last 20 years… but at what cost? It hasn’t resulted in better health outcomes overall. Total cholesterol levels have reduced, but this is alongside increased prescription of cholesterol lowering drugs, reduction in smoking prevalence and better access to health care. All the while obesity, pre-diabetes, diabetes, neurological disorders, cancer, stroke and mortality from chronic conditions continues to climb. It seemed that Prof Jackson’s comments were directed more towards those in the audience who were going on to speak at the LCDU symposium the enxt day – many of whom advocate the exact opposite of what Prof Jackson has spent his academic career promoting. Unfortunately we (the audience) did not get the opportunity to ask questions of the panel at the end of the conference – perhaps because it included the GM of Coca-Cola Oceania on it. Now this is nothing personal – Paul Fitzgerald seems like a nice enough guy and it’s likely he personally wants to promote health – but why include him (and Coca-cola) in the panel? Despite what they say, they are in the business of making money and driving sales, not reducing them.
Of course, there were other, brilliant speakers at the FIZZ conference, and I think it’s a fantastic initiative to target sugary beverages as a first step to reducing sugar intake in the New Zealand food supply. However, there was a real disconnect between sugary beverages and sugar overall. To come out of a lecture talking about sugar and the effects on our liver, to then go and load up our plate with sushi, sandwiches and enjoy ginger crunch for afternoon tea was just wrong, quite frankly. Sugar is sugar – be it from juice, soft drinks, cakes, slices and the refined carbohydrate from bread that is broken down into sugar in the body and pumped into the bloodstream quicker than you can say “pass me that serviette.” To serve this type of food to people at a health conference is wrong on all levels but particularly because many people attending are part of the health sector who take these messages forth into the community. This suggests that sugary beverages are unique in themselves at promoting health problems beyond that of sugar containing foods which they don’t – they just increase the amount of sugar in the diet overall. To assume that people attending have the background knowledge and understand that is, in my opinion, wishful thinking.
The LCDU one day symposium had an entirely different feel to it – the speakers were a mix of both academics (mostly NOT in nutrition) and practitioners (doctors, nutritionists, dietitians) and included Sarah Wilson (a highlight for most of us sitting there). It was organised by Simon Thornley and Rod Tayler and was the first of its kind in New Zealand. The audience was entirely different – there were a handful of health professionals but most were along to either learn more or (more likely) reaffirm what they have experienced both health and diet-wise from following a low carbohydrate diet. I suspect that the symposium was more a case of preaching to the choir rather than enlightening people. That’s not to take anything away from the overall day at all – it was brilliant that most standing up there were not only sharing their clinical experiences and academic knowledge, but their personal stories. Among them were Cliff Harvey with his foray into low carbohdyrate diets back when it was considered bro-science and he was listening to Celine CDs (which I suspect he still does). Dr Troy Stapleton’s diagnosis of Type 1 diabetes as an adult and moving to a ketogenic diet after being unable to control his blood sugar with conventional diabetes recommendations. Dr Caryn Zinn, and her shift as a registered dietitian from conventional nutrition recommendations to a lower carbohydrate approach. This shift, in my opinion, will perhaps have the most impact in the lower carbohydrate movement given her academic background and her profession. Who better to disseminate this to the dietetic and wider health professional population than one of their own? Most importantly, the main message from all speakers was the push for real food. It was really good to see Niki Bezzant, the editor of the Healthy Food Guide, along at LCDU. The magazine takes a ‘moderate’ approach and, while it has an academic board whereby scientific experts are on hand to vet articles for accuracy, the academic world largely ignores evidence from both an anthropological and evolutionary standpoint and from clinical and personal experiences – two important elements that fill in many gaps where epidemiological studies fail, as highlighted by Grant’s talk. If anything, I hope the message that ‘it’s about real food’ – something that was advocated by all of the speakers – may have resonated enough for the magazine to start exploring what we (at AUT) and the speakers are advocating. Yes, it’s against ‘conventional nutrition messages’ but doesn’t that just highlight further that ‘conventional nutrition’ has to change?
What was missing, then, from the LCDU symposium? The people who I feel would have benefitted being there the most. The health professionals at the FIZZ conference who advocate for a reduction in sugar beverages but view cutting sugar as an extreme approach. The academics at the FIZZ conference who don’t acknowledge an evolutionary perspective or the mounting evidence of improved health outcomes at the individual level, just because they haven’t occurred as part of a clinical trial. The dietitians and nutritionists at the FIZZ conference who take the ‘everything in moderation’ approach and see no problem with telling people to eat processed refined carbohydrate as part of a ‘healthy balanced diet.’ All of the speakers at LCDU had similar, if not the same academic and clinical training as the mainstream health sector. They’ve taken a different approach because they realise that, by doing what they’ve always done, they will only get the same result. And it’s just not working. A tax on sugar sweetened beverages is a good start but we need to think bigger. If there is going to be any impact on overall health related to reducing sugar intakes then we need to advocate for more.
(For those who are tired of me pontificating on nutrition as a philosophy and are really only reading this for a practical tip of two: follow the link on this page to Rob Lustig’s you tube lecture and watch it if you haven’t already. And dry those plastic bags you use to take your food to work on your window):