Saturday, July 18, 2015

Are the diet dictators worse than the Greenies?

They are at least just as bad. They do start out with a lot in common psychologically. Both think they are wiser than the "herd" but have such a lot of trouble proving it that they have to resort to wild and unproven claims in an attempt to substantiate that. And they need to impose their crazy ideas on the rest of us as some sort of validation for those ideas. So the Greenies want to make electricity increasingly unavailable to us and the diet police want to make sugar increasingly unavailable to us. It's Fascistic extremism in both cases and totally unwarranted by the evidence in both cases. The latest pontification below, showing just how extreme these guys can get. If you have a single can of fizzy drink, you are allowed no more sugar in any form that day:

Britons need to halve the amount of sugar they eat to prevent an obesity epidemic, a report will warn today.

In a bleak assessment, a government advisory body will tell ministers that the country is facing a health crisis that could cripple the NHS unless people slash their sugar intake. The report will raise questions about whether ministers should heed calls to impose a tax on sugary foods and drinks.

The new guidelines, from the Scientific Advisory Committee on Nutrition, mean that men and women should consume no more than seven teaspoons of added sugar a day – equal to less than a single can of Coca-Cola.

Research by the food industry-backed British Nutrition Foundation suggests that hitting the new target will mean cutting out almost all fizzy drinks and making crisps and chocolate bars a ‘once or twice a week’ luxury, rather than an everyday snack.

Ministers are divided on a sugar tax, with some urging David Cameron to drop his opposition to it before the Government publishes its obesity strategy in the autumn.

A Cabinet source said previous attempts to persuade the food industry to reduce sugar levels had produced only limited success.

‘The truth is that these deals with industry can only take us so far,’ the source said. ‘Most people already eat more than the recommended amount. If we are going to halve that, we are going to have to do something dramatic.’

The British Medical Association this week called for a swingeing 20 per cent tax on sugary drinks. The move would raise the price of a one-litre bottle of Coke from £1.50 to £1.80. The BMA said poor diet was killing 70,000 people a year and costing the NHS £6billion.

A similar tax has been introduced in Mexico, but the jury is still out on its impact.

Today’s report, drawn up by a committee of experts, is designed to shock the Government, the food industry and individual shoppers into action. Following a review of 600 scientific studies, it will warn that sugar plays a critical role in the obesity crisis. It will link sugar intake with the rising number of cases of type 2 diabetes, and will say there is a direct link between sugary drinks and childhood obesity.

Public Health England is studying the potential effectiveness of a sugar tax. The body may also recommend a clampdown on advertising and in-store promotions of fizzy drinks and other sugary products.

Existing guidelines say added sugar should make up no more than 10 per cent of people’s diets. This is equal to 70 grams a day for men (about 17 teaspoons) or 50g for women (about 12 teaspoons).

Four to eight-year-olds can have 12g (three teaspoons) per day, while older children and teenagers should consume no more than 20 to 32 grams (five to eight teaspoons).

Today’s report will call for this target to be slashed to just 30g for all adults, equal to about seven teaspoons of added sugar, or a single can of Red Bull. The figures for children and teenagers are expected to be cut proportionately.

The term covers sugar added during preparation or cooking as well as sugar in honey. Sugar in milk and in whole pieces of fruit and in fruit juice is excluded at present.

Experts believe that getting anywhere near the target will require a revolution in eating habits.

A Government source said Mr Cameron was committed to tackling obesity, and is taking personal oversight of the new obesity strategy. ‘But the Prime Minister does not believe a new tax is the answer,’ the source added. ‘We will not solve this problem by slapping new taxes on the shopping baskets of working people.’


So what about all that research evidence that lies behind the condemnation of sugar? There is essentially no such evidence. It is in fact virtually impossible to reach sound scientific conclusions on the matter. Most of the "evidence" is epidemiological and I can see no epidemiological way of disentangling total sugar consumption from total calorie consumption. People who eat and drink a lot of sugary stuff probably eat and drink a lot of everything. And it could be the total calorie consumption rather than the total sugar consumption that gives rise to any effect. But researchers go on gaily ignoring that problem. The big bugaboo for the sugar crusaders is sugar-sweetened soft drinks (SSD). So let us look at that:

As a 2008 survey of the research findings concluded: "Most studies suggest that the effect of SSD is small except in susceptible individuals or at high levels of intake. Methodological weaknesses mean that many studies cannot detect whether soft drinks or other aspects of diet and lifestyle have contributed to excess body weight.

So the following conclusion from a 2006 survey of the evidence is no surprise either: "The equivocal evidence on this topic makes it difficult to draw firm conclusions regarding the role of SSB in the etiology of obesity. Many of the prospective and experimental studies are of unsatisfactory methodological rigor." [SBS stands for sugar-sweetened beverages].

I could go on (See also here, here, here and here for example) but you get the idea. The whole claim that sugar is particularly likely to cause obesity is an act of faith. The data is against it. And, fortunately, reality does not change. It is only the opinions of self-inflated intellectuals that change. The only way to reduce obesity is to reduce total calorie consumption and, if that's too hard, so be it.

But what about other bad effects that are often claimed for sugar? Does it, for instance cause heart disease? We are told that it does but let's look carefully at one of the most recent studies saying so. It will give us a good up-close look at what the summarizers are talking about when they speak of the inconclusiveness of existing sugar research

Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults

Quanhe Yang et al

Importance: Epidemiologic studies have suggested that higher intake of added sugar is associated with cardiovascular disease (CVD) risk factors. Few prospective studies have examined the association of added sugar intake with CVD mortality.

Objective: To examine time trends of added sugar consumption as percentage of daily calories in the United States and investigate the association of this consumption with CVD mortality.

Design, Setting, and Participants: National Health and Nutrition Examination Survey (NHANES, 1988-1994 [III], 1999-2004, and 2005-2010 [n = 31 147]) for the time trend analysis and NHANES III Linked Mortality cohort (1988-2006 [n = 11 733]), a prospective cohort of a nationally representative sample of US adults for the association study.

Main Outcomes and Measures Cardiovascular disease mortality.

Results: Among US adults, the adjusted mean percentage of daily calories from added sugar increased from 15.7% (95% CI, 15.0%-16.4%) in 1988-1994 to 16.8% (16.0%-17.7%; P = .02) in 1999-2004 and decreased to 14.9% (14.2%-15.5%; P < .001) in 2005-2010. Most adults consumed 10% or more of calories from added sugar (71.4%) and approximately 10% consumed 25% or more in 2005-2010. During a median follow-up period of 14.6 years, we documented 831 CVD deaths during 163 039 person-years. Age-, sex-, and race/ethnicity–adjusted hazard ratios (HRs) of CVD mortality across quintiles of the percentage of daily calories consumed from added sugar were 1.00 (reference), 1.09 (95% CI, 1.05-1.13), 1.23 (1.12-1.34), 1.49 (1.24-1.78), and 2.43 (1.63-3.62; P < .001), respectively. After additional adjustment for sociodemographic, behavioral, and clinical characteristics, HRs were 1.00 (reference), 1.07 (1.02-1.12), 1.18 (1.06-1.31), 1.38 (1.11-1.70), and 2.03 (1.26-3.27; P = .004), respectively. Adjusted HRs were 1.30 (95% CI, 1.09-1.55) and 2.75 (1.40-5.42; P = .004), respectively, comparing participants who consumed 10.0% to 24.9% or 25.0% or more calories from added sugar with those who consumed less than 10.0% of calories from added sugar. These findings were largely consistent across age group, sex, race/ethnicity (except among non-Hispanic blacks), educational attainment, physical activity, health eating index, and body mass index.

Conclusions and Relevance: Most US adults consume more added sugar than is recommended for a healthy diet. We observed a significant relationship between added sugar consumption and increased risk for CVD mortality.

JAMA Intern Med. 2014;174(4):516-524. doi:10.1001/jamainternmed.2013.13563.

The conclusion seems plain enough, does it not? It is not. It is a good example of weasel words. The key issue is HOW GREAT is the effect of consuming a lot of sugar. And the conclusions don't address that: For a good reason. The effects they found were TRIVIAL -- as trivial as the tiny degree of global warming over the 20th century.

To see how trivial the effect is, note first one thing: They divided people into quintiles (fifths) in their analysis. And the effects observed were negligible except for the most extreme quintile.

How do we judge negligibility? The Federal Reference Manual on Scientific Evidence, Second Edition says (p. 384): "the threshold for concluding that an agent was more likely than not the cause of an individual's disease is a relative risk greater than 2.0." It was only the highest quintile of sugar consumption that just squeaked in to meet that criterion. There was some interesting effect only for people who were huge sugar consumers but for most people sugar did no harm.

And who were the extreme sugar users? We are not told. Quite likely they were people at the lower end of the socio-economic status range. And such people are in general known to be less healthy anyway. So it may not have been sugar which did the harm. In short, there is NOTHING in this study which proves sugar is harmful. Even if we accept their incautious assumptions, their data shows that sugar is harmless for four fifths of the population. And examining 600 similar studies is not going to improve on that. The sugar scare is as big a fraud as global warming. It's just another way to give highly educated people a feeling of importance and wisdom.

Posted by John J. Ray (M.A.; Ph.D.).

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