In 1972, when John Yudkin wrote Pure, White and Deadly: How Sugar is Killing Us and What We Can Do to Stop it, his theories were ridiculed by the food industry and ignored by the medical profession. Media commentators portrayed him as a crank, on a par with macrobiotic food eaters, vegans and organic farmers, whose advice could not be taken seriously.
Now it seems that sugar is indeed killing us. Findings from the National Health and Nutrition Examination Survey of 31,147 adults in the US (1988-2010), published in the Journal of the American Medical Association in March, show that people who consumed 17-21 per cent of their calories as added sugar had a 38 per cent greater risk of death from cardiovascular disease (CVD) compared with those who consumed just 8 per cent of their calories as sugar.
The risk of CVD tripled for adults who consumed a quarter or more of their calories as sugar.
Everyone needs daily calories to stay healthy, and the number varies from person to person depending on their age, height, sex and activity levels.
An average adult needs 2,000 calories a day that preferably should come from cereals, fruit, vegetables, fish, meat, and other foods containing little or no free sugars.
Free sugar is added to food by manufacturers, chefs, cooks and consumers. A gramme of sugar contains four calories, so the new research means that adults who consume fewer than 160 calories (40g) of added sugar every day reduce their risk of CVD.
Adults who derive 340-420 calories (85-105g) a day from added sugar are much more likely to develop heart disease, and people consuming 500 calories (125g) a day from added sugar triple their risk.
Easy to exceed A quick trip to my local supermarket shows how unbelievably easy it is to exceed 40g of added sugar. Breakfast bars contain 37g of sugar per 100g. Sugary cereals have an average of 35g of sugar per 100g.
Most of these are labelled as high in vitamins and calcium to lull the customer into thinking they are eating healthily.
Sauces are loaded with sugar: sweet chilli has 44g per 100g and pickles 20g. Most low-fat yogurts contain up to 15g of sugar. An interesting finding from my field trip is that cereals, yogurts and other foods have misleading labels saying the recommended daily amount of sugar is 90g a day.
Since 2004, the WHO has recommended that no more than 10 per cent of adults and children’s daily calories should come from added sugar.
Adults should consume no more than 50g of added sugar every day and children no more than 30g. The sugar content of one glass of pure orange juice and a yogurt, which most parents would consider healthy, exceed the WHO recommended daily limit for children. Add a peanut butter sandwich (11g of sugar per 100g) and beans on toast for tea (7g) and your child is well on their way to CVD. A single serving of a sugary drink exceeds the 10 per cent child limit.
In March, the WHO recommended that the amount of daily calories that should come from added sugar should be a “more ideal” 5 per cent.
This means that adults should consume no more than 25g of sugar a day and children no more than 15g if they want “additional health benefits”.
One serving of a sugary breakfast cereal exceeds the new child limit. The 5 per cent guideline is consistent with the new CVD research.
New guidelines
Implementing the new guidelines will require a seismic shift in food production and consumption. Food and drinks industry lobbyists will insist that sugar is not the problem and that consumers need more education. This is true.
Consumers need to know how to analyse food labels and resist being manipulated by misleading advertising. Has anyone noticed the huge increase in TV advertising of children’s food directed at parents?
Irish Healthy Eating Guidelines from the Food Safety Authority say "sugar needs to be limited" and "not too much, not too often": this advice is no help at all.
A sugar tax is desperately needed but a spokesperson from the Department of Finance says there are no plans to introduce one in the next budget.
So, it’s every shopper for themselves. From now on just don’t buy any food or drink with added sugar. It’s as simple as that.
Dr Jacky Jones is a former HSE regional manager of health promotion drjackyjones@gmail.com