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Posted

August 03, 2018 06:06:57

The declare

Alison Watkins, the group managing director of Coca-Cola Amatil, has argued towards a sugar tax, emphasising that regardless of a fall within the consumption of added sugars since 1995, weight problems charges have continued to rise.

A sugar tax, subsequently, wouldn’t cut back weight problems in Australia, she wrote in an opinion article printed in The Australian in Might. The reply, as a substitute, lay in a mixture of food regimen and bodily exercise, she argued, but the general public debate was targeted on food regimen.

In mounting her case, Ms Watkins implied there was an inverse causal relationship between sugar consumption and weight problems.

“Sugar consumption is down however weight problems is up,” she wrote.

“It is the identical within the US: weight problems has greater than doubled since 1990 whereas sugar consumption fell. Clearly, neither sugar, nor drinks sweetened with sugar, have been the most important explanation for this weight problems rise.”

Noting that “simply 2 per cent of the typical Australian’s kilojoule consumption comes from mushy drinks”, she drew her argument to an in depth, saying there was little proof that sugar taxes labored and {that a} tax, if launched in Australia, would probably generate “little or no return in weight problems discount.”

Is sugar consumption down? And have weight problems charges in Australia risen regardless? RMIT ABC Truth Test investigates.

The decision

Ms Watkins’s declare is spin.

Sure, the consumption of added sugar, significantly of carbonated drinks, has fallen because the mid-1990s. In the meantime, weight problems charges have certainly continued to rise. However this isn’t the total story.

In trying to place the case towards a sugar tax, Ms Watkins paints an incomplete image of the hyperlink between sugar-sweetened drinks and weight problems, ignoring the load of scientific proof.

Authoritative analysis reveals a constant affiliation between a excessive consumption of sugar-sweetened drinks and weight problems. Certainly, analysis reveals that adolescent boys, who’re the largest customers of sugar-sweetened drinks, even have the quickest charges of weight acquire.

Ms Watkins refers to the truth that simply 2 per cent of the typical Australian’s kilojoule consumption comes from mushy drinks.

However “mushy drinks” refers solely to carbonated drinks, not the total gamut of obtainable sugar-sweetened drinks, together with sports activities drinks, iced teas and fruit juices.

Anna Peeters, an professional in weight problems and diet at Deakin College, advised Truth Test that to have the ability to clarify divergent tendencies in sugar consumption and weight problems charges it was obligatory to think about consumption patterns amongst teams of individuals, in addition to the inhabitants as a complete.

This was as a result of total averages might masks elevated consumption of sugary drinks amongst a selected group, which may very well be underpinning an increase in weight problems.

In her article, Ms Watkins additionally refers to an Australian Bureau of Statistics evaluation displaying a relative lower within the consumption of added sugars in folks’s diets between 1995 and 2011-12, however she doesn’t point out important caveats the ABS connected to its evaluation.

Nor does she point out that regardless of the decline, annual gross sales of soppy drinks elevated considerably over the 50 years to 1999, or that market analysis reveals whole gross sales of sugar-sweetened drinks proceed to develop, albeit at a slower fee.

Additionally, she doesn’t point out that Australia’s consumption of sugary drinks per capita exceeds the World Well being Organisation’s advisable vitality consumption from sugars.

The connection between sugar consumption and weight problems

The first drivers of extra weight acquire and the relative significance of dietary components in weight problems stay contentious.

Nevertheless, there may be rising concern that the consumption of added sugars, particularly within the type of sugary drinks, can result in weight acquire, in addition to an elevated threat of kind 2 diabetes and heart problems.

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This has led to the introduction of sugar taxes in almost 30 nations and there have been calls from public well being advocates for Australia to comply with go well with.

Whereas there are famous deficiencies within the statistics accessible on meals provide and sugar consumption in Australia, many research have proven a robust affiliation between sugar consumption and weight acquire.

A 2013 examine commissioned by the World Well being Organisation and printed within the British Medical Journal discovered a “clear optimistic affiliation” between excessive consumption of sugars and physique fatness. The examine concerned an exhaustive evaluation of obtainable proof.

One other examine, which systematically reviewed proof from 2013 to 2015, got here to the identical conclusion.

A 3rd examine reported that cumulative proof from trials and research was “ample to conclude that common consumption of sugar-sweetened drinks causes extra weight acquire and these drinks are distinctive dietary contributors to weight problems and sort 2 diabetes.”

So far as Truth Test was capable of set up, none of those research was funded by the sweetened drinks trade and the authors of all three papers reported no conflicts of curiosity.

Kathryn Backholer, a senior analysis fellow with the World Weight problems Centre at Deakin College, advised Truth Test that each one three research constituted respected and dependable analysis performed by lecturers famend of their subject of experience.

How fats are Australians?

In 2014-15, 63 per cent (nearly two-thirds) of Australians have been obese or overweight, with extra males being fatter (71 per cent) than girls (56 per cent).

Twenty years earlier, 57 per cent of Australian adults have been obese or overweight.

Amongst kids and adolescents aged 5–17, the speed of obese and weight problems was 27 per cent, up from 21 per cent in 1995.

Youngsters 10–17 have been considerably extra prone to be obese and overweight than their counterparts 20 years earlier.

Chubby and weight problems are measured by the physique mass index (BMI), an index of weight-for-height. For adults, the WHO defines obese as a BMI of 25 and higher, and weight problems as 30-plus.

The Coronary heart Basis supplies a free on-line device for calculating an individual’s BMI.

Is the consumption of added sugar falling?

Truth Test requested Dr Backholer to evaluate the ABS evaluation utilized by Ms Watkins to argue that sugar consumption has been falling since 1995.

The ABS evaluation in contrast sugar consumption knowledge from surveys performed in 1995 and in 2011-12. It confirmed the typical proportion of dietary vitality from sugar fell from 12.5 per cent in 1995 to 10.9 per cent in 2011-12.

As accurately famous by Ms Watkins, the decline was pushed by a 6 per cent drop for adults and a 23 per cent drop for kids.

However the ABS listed key caveats, together with that variations in meals coding, classification and methodology, made a real side-by-side comparability between the 1995 survey and the 2011-12 survey unattainable.

Moderately, the examine supplies a comparability on a relative foundation; that’s, a comparability of the proportion of vitality from sugar, quite than precise grams of sugar consumed.

Moreover, the ABS famous a big under-reporting of the quantities of meals eaten by folks in each diet surveys, significantly the 2011-12 survey.

Ms Watkins doesn’t point out this in her article. She additionally doesn’t acknowledge two additional qualifying factors when referring to the ABS evaluation.

Firstly, that outcomes from each the 1995 and 2011-12 surveys present mushy drinks, vitality/electrolyte drinks, cordials, fruit juice and fruit juice drinks are the most typical supply of added sugars in folks’s diets — and that food regimen is a serious contributor to weight problems.

Second, that sugar consumption exceeded the World Well being Organisation’s advisable vitality consumption from sugars. Added sugar consumption might have fallen, however Australians are nonetheless consuming far an excessive amount of.

Dr Backholer mentioned the premise of Ms Watkins’ argument was primarily based on ecological analysis (observational examine analysed at inhabitants stage, quite than particular person stage), which represented the weakest kind of proof.

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Anna Peeters, professor of epidemiology and fairness in public well being at Deakin College, described Ms Watkins’ argument as an “ecological fallacy”.

She mentioned “an ecological affiliation would by no means trump a causal affiliation and we’ve plenty of papers displaying a causal affiliation between sugar consumption and weight acquire.”

What’s the advisable day by day consumption of added sugar?

The World Well being Organisation recommends adults and kids cut back their day by day consumption of added sugars to lower than 10 per cent of their whole vitality consumption.

It says an extra discount to beneath 5 per cent — about six teaspoons a day — would offer extra well being advantages.

One in two Australians (52 per cent) often exceed the 10 per cent WHO advice, in response to 2011-12 ABS knowledge from its Australian Well being Survey.

The truth is, Australians consumed, on common, 60 grams of sugar per day — the equal of 14 teaspoons.

Teenage boys (aged 14-18) consumed probably the most added sugar, averaging 22 teaspoons a day, whereas the highest 10 per cent of male youngsters consumed at the least 38 teaspoons a day.

Teenage boys

Australians are huge customers of sugar-sweetened drinks, in response to the Australian Nationwide Preventative Well being Company.

Certainly, Australia is among the many prime 10 nations on the earth for per capita consumption of sugary drinks, with 1.6 billion litres offered in 2011.

Consumption ranges have elevated dramatically over the previous 5 a long time and stay excessive, though there are indicators that consumption could also be levelling off or declining barely.

Beverage trade gross sales knowledge reveals that between 1997 and 2011 gross sales of sugary drinks rose 5 per cent, largely attributable to will increase in gross sales of vitality drinks, iced teas and sports activities drinks.

Concurrently, Australians shifted away from fizzy drinks, gross sales of which have been down 11 per cent.

Confronted with declining gross sales, Coca-Cola Amatil, one of many greatest bottlers of sugary drinks, is amongst a number of beverage firms which have dedicated to decreasing sugar throughout the trade by a mean of 20 per cent by 2025.

Within the meantime, though consumption of sugary drinks total is falling, it continues to rise amongst adolescent boys.

The ABS survey knowledge revealed that, of those that consumed sweetened drinks the day earlier than being surveyed, the median quantity of sugar-sweetened drinks consumed amongst adults was the equal of a daily can (375 ml), with males ingesting greater than females.

Considerably, for boys aged 14-18, nearly a 3rd of their whole sugar consumption got here through sugar-sweetened drinks, with mushy drinks and flavoured mineral waters the largest contributors.

Tim Gill, of the College of Sydney College of Medication, advised Truth Test that whereas sugar consumption might have fallen in Australia, teenage boys as a bunch have been ingesting far too many sugar-sweetened drinks.

“That’s the group the place we’re seeing the quickest charges of weight acquire,” he mentioned.

Professor Gill, an professional in weight problems and diet, mentioned weight acquire in younger kids was slowing, particularly in NSW, but it surely continued to extend in older kids and adults.

He mentioned NSW knowledge confirmed that between 2010 and 2015, charges of obese and weight problems didn’t considerably improve amongst kids in main college, however did improve considerably amongst adolescents in secondary college (from 22 per cent in 2010 to 27.four per cent in 2015).

Teenage boys and their excessive consumption of sugary drinks are the nub of the issue. Whereas added sugar consumption could also be falling when it comes to inhabitants averages, it isn’t falling amongst sub-groups resembling teenage boys, for which weight problems charges are rising the quickest.

If sugar consumption is down, why are weight problems charges rising?

Deakin College’s Professor Peeters mentioned there have been a number of explanations for the “obvious paradox” of declining sugar consumption and rising weight problems charges as outlined by Coca-Cola Amatil’s Ms Watkins.

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If sugar consumption amongst a wholesome sub-group fell, it might symbolize an total discount in sugar consumption.

But when one other sub-group was nonetheless ingesting too many sugary drinks, then weight problems charges might proceed to rise.

Professor Peeters defined that imbalances in food regimen and sugar-sweetened beverage consumption have been excessive in Australia.

“The query is what are … attainable causes for this obvious paradox? One essential one is inhabitants averages disguise loads of element.

“So, think about if all of the reductions in sugar consumption — which is certainly taking place for sugary drinks — are by the extremely educated, already-healthy weight inhabitants. Then we might see each a discount in inhabitants sugar consumption and ongoing will increase in weight problems in poorer, much less educated teams.”

She mentioned one other rationalization was that overweight folks could also be reducing again on their sugar consumption however their weight drop was not ample to maneuver them out of the overweight class or to counterbalance the variety of folks nonetheless changing into overweight.

Sydney College’s Professor Gill mentioned Ms Watkins’ argument {that a} sugar tax was pointless given a decline in sugar consumption and rising weight problems, was a “fallacious argument”, much like that mounted in a now infamous educational paper titled The Australian Paradox.

This paper, whereas not particularly a couple of sugar tax, highlighted diverging tendencies in sugar consumption and weight problems charges. However the paper was discredited after it was discovered the authors didn’t take into account the results of imported meals containing sugar.

“An important argument … just isn’t whether or not sugar and mushy drinks are the most important explanation for weight problems,” mentioned Professor Gill.

“An important factor is to know that for those who cut back your mushy drink consumption and for those who cut back your consumption of sugar, then you definately cut back your weight.”

Principal researcher: Sushi Das

@sushidas1

[email protected]

Sources

  • Alison Watkins, The Australian, Sugar tax isn’t any remedy for weight problems, Might 7, 2018
  • Lisa Te Morenga, Simonette Mallard, Jim Mann, British Medical Journal, Dietary sugars and physique weight: systematic assessment and meta-analyses of randomised managed trials and cohort research, January 15 2013
  • F. B Hu, Weight problems Opinions, Vol 14, Problem 8. P606-619, Resolved: there may be ample scientific proof that lowering sugar-sweetened beverage consumption will cut back the prevalence of weight problems and obesity-related ailments, August 2013
  • Maria Luger et al, Weight problems Details, The European Journal of Weight problems, Sugar-sweetened drinks and weight acquire in kids and adults: a scientific assessment from 2013 to 2015 and a comparability with earlier research, December 14, 2017
  • Sanjay Basu et al, American Journal of Public Well being, Vol 103, No. 11, Relationship of soppy drink consumption to world obese, weight problems and diabetes: a cross-national evaluation of 75 nations, November 2013
  • ABS, Australian Well being Survey, Consumption of added sugars: a comparability of 1995 to 2011-12, July 13, 2017
  • ABS, Australian Well being Survey: Vitamin First Outcomes – Meals and Vitamins, 2011-12, Cat. 4364.0.55.007
  • Australian Nationwide Preventive Well being Company, Weight problems: sugar-sweetened drinks, weight problems and well being, 2014
  • Levy GS and Shrapnel WS, Vitamin & Dietetics, Journal of the Dietitians Affiliation of Australia, Vol. 71, Problem 3, Quenching Australia’s thirst: a development evaluation of water-based beverage gross sales from 1997 to 2011, September 2014
  • NSW college bodily exercise and diet survey (SPANS), 2015
  • Wavne Rikkers et al, BMC Public Well being, Developments in sugar provide and consumption in Australia: is there an Australian Paradox? 2013
  • World Well being Organisation, Sugars consumption for adults and kids guideline, 2015
  • Australian Institute of Well being and Welfare, An image of obese and weight problems in Australia, 2017
  • OECD-FAO Agricultural outlook, 2015
  • ABS, Australian Well being Survey: consumption of added sugars, Cat 4364.0.55.011, 2011-12
  • The position of drinks within the Australian food regimen, a secondary evaluation of the Australian Well being Survey: Nationwide diet and bodily exercise survey (2011-2012)
  • Michael Brissenden, ABC, 4 Corners, Tipping the scales, April 30, 2018

Subjects:

sugar,

adolescent-health,

diet-and-nutrition,

health-policy,

australia

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