Public health – some movement?

Two events last week might just bestir the powers that are into action. Although the rhetoric so far on the proposed tax on sugar-laden soft drinks is not encouraging.

Specifically on sugar, a new study was published this week suggesting that, despite the protestations of the industry, sugar actually does have effects on health entirely separate from the effects of the calories that it contains. The research was carried out by Professor Robert Lustig and colleagues – he of the blockbuster Fat Chance: The Hidden Truth About Sugar, Obesity and Disease.

The researchers took 43 children, all of whom had been referred to hospital for excess weight and significant health issues. They then put them on a diet for 9 days in which the added sugar was reduced from 28% to 10% and the fructose from 12% to 4% – but the calorie count remained the same as a result of the addition of other carbohydrates.

At the end of the 9 days, the children had an average drop of 57% in the production of liver fat, while their actual liver fat had reduced by 29%. They also had a reduction of 10% in visceral fat (body fat that is stored within the abdominal cavity around internal organs such as the liver, pancreas, intestines etc) and a 75% loss in pancreatic fat which should never have been there in the first place.

The research has been criticised for being too small a study, for the period of the diet being to short and for not using controls and it will, obviously, need to be repeated and replicated. None the less, it is the first study that has shown that sugar has quite specific effects on the body, especially in the context of fat and obesity, completely independent of its calories.

If you are interested in the ‘sugar question’ then you might want to check out our report on a BSEM  sugar conference a couple of weeks ago, at which Professor Lustig ‘revealed’ his new research ahead of publication. However, there are a number of other very interesting (if also rather technical…) presentations, including one on the fat-based ketogenic diet.

However, the sugar tax also came up in the other public health event last week, the publication of the Fabian Commission on Food and Poverty’s report, Hungry for Change.  The commission had had been chaired by our good friend Geoff Tansey so we had also managed to get a sneak preview of that one!

The core of the commission’s report is their linking of poverty and ‘food insecurity’ (the likelihood that you and/or your family will not have enough to eat, let alone enough healthy food to eat). They want a new cross-departmental minister to focus on household food insecurity and no less than eight of the 14 ‘action points’ in their executive summary relate to minimum incomes, universal credit, full employment and the slow payment of social security benefits.

However, they also, and very rightly, want the government, regulators and consumer bodies to look much more closely at the horribly unfair  ‘poverty premium’ – ‘the additional cost of basic goods and services paid by those on low incomes. For example, this includes the additional cost of part-payments or hiring of kitchen appliances, the additional cost of using a pre-payment meter to pay for energy rather than by direct debit, or the additional cost of transport for those that can only afford to buy single tickets, rather than season tickets.’ The poverty premium also means that you can never afford to save money by bulk buying, that you have to shop at the expensive corner shops because you cannot afford transport to  big supermarkets and, of course, that you can rarely afford to buy ‘healthy food’ as it is more expensive and probably less filling (an apple versus a sugary cake) than mass produced junk food.

More specifically, they also have a go at the old chestnut of the advertising of unhealthy foods to children. And finally, they put their weight behind a tax on sugar-laden soft drinks. However, they take this further than just restricting the amount of sugar consumed:

‘A new pilot tax on sugary drinks would allow the government to measure the change duties can have on food behaviours, measure the effects they have on low-income households, and potentially create new funds to support public health initiatives. Should this pilot be successful, further taxes and duties could be introduced to improve diets and health outcomes.’ Well, that’s bit radical for you….

So, a good and useful report. The question is, will anyone now do anything about it or will it join the many other hundreds of excellent reports providing homes for spiders on dusty shelves? Geoff tells us that there are a number of local initiatives afoot to take it further, so here’s hoping.

Meanwhile, if you want to read the report in full, you will find it here.