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  #1   ^
Old Fri, May-11-18, 16:48
Grav Grav is offline
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Default Malhotra, Schofield, Lustig: overcoming opposition from vested interests

A new report appeared on my Facebook feed this morning from Aseem Malhotra, Grant Schofield and Robert Lustig:

The science against sugar, alone, is insufficient in tackling the obesity and type 2 diabetes crises – We must also overcome opposition from vested interests

It's a six page PDF so I won't cut and paste it all here, but much of it reads so similar to what I researched myself earlier in the year that it's kinda scary, but in the best possible way. Particularly their recommendations:
Quote:
We offer the following public health interventions to reduce sugar consumption, all of which are evidence-based and all of which were successful in curbing tobacco use. This suite of recommendations reflects an evidence-based, broad, socio-ecological approach to creating environments which help move society in the direction of food environments where sugar is no longer ubiquitous:

1. Education for the public should emphasise that there is no biological need or nutritional value of added sugar. Industry should be forced to label added and free sugars on food products in teaspoons rather than grams, which
will make it easier to understand.

2. There should be a complete ban of companies associated with sugary products from sponsoring sporting events. We encourage celebrities in the entertainment industry and sporting role models (as Indian cricketer Virat Kohli and American basketballer Stephan Curry have already done) to publicly dissociate themselves from sugary product endorsement.

3. We call for a ban on loss leading in supermarkets and running end-of-aisle loss leading on sugary and junk foods and drinks.

4. Sugary drinks taxes should extend to sugary foods as well.

5. We call for a complete ban of all sugary drink advertising (including fruit juice) on TV and internet demand services.

6. We recommend the discontinuing of all governmental food subsidies, especially commodity crops such as sugar, which contribute to health detriments. These subsidies distort the market and increase the costs of non-subsidised crops, making them unaffordable for many. No industry should be provided a subsidy for hurting people.

7. Policy should prevent all dietetic organisations from accepting money or endorsing companies that market processed foods. If they do, they cannot be allowed to claim that their dietary advice is independent.

8. We recommend splitting healthy eating and physical activity as separate and independent public health goals. We strongly recommend avoiding sedentary lifestyles through promotion of physical activity to prevent chronic disease for all ages and sizes, because ‘you can’t outrun a bad diet’. However, physical (in)activity is often conflated as an alternative solution to obesity on a simple energy in-and-out equation. The evidence for this approach is weak. This approach necessarily ignores the metabolic complexity and unnecessarily pitches two independently healthy behaviours against each other on just one poor health outcome (obesity). The issue of relieving the burden of nutrition-related disease needs to improve diet, not physical activity.
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  #2   ^
Old Sat, May-12-18, 04:01
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JEY100 JEY100 is online now
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Thanks Grav, this is brilliant.

DietDoctor added links to the newspapers worldwide that have already done articles on their manifesto.

https://www.dietdoctor.com/experts-...type-2-diabetes
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  #3   ^
Old Sat, May-12-18, 04:15
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Love it! Like tobacco, the processed foods industry will have to come up with something else to do.

It's no surprise that as these companies pivoted to recognize the problems with tobacco, they created junk food instead; they are all interconnected; and all spent decades studying addiction.
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  #4   ^
Old Sun, May-13-18, 03:54
M Levac M Levac is offline
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Quote:
1. Education for the public should emphasise that there is no biological need or nutritional value of added sugar. Industry should be forced to label added and free sugars on food products in teaspoons rather than grams, which
will make it easier to understand.

Agree with first part, disagree with second part. A "better understanding" doesn't come from using a vague unit of measure like a teaspoon, but by using a standard unit of measure like the gram. This also applies to "% of daily requirement", which also appears right next to the Xg number for added sugars on the nutritional label, as if somehow added sugars was a nutrient and had a daily requirement, which is absurd, if we accept the first part of that suggestion above.

The nutritional label itself must be changed or replaced with something more accurate and more representative of what's in the box. For example, one that indicates the % of weight of actual food in the product. From this, we'd have to devise a conventional food classification table. With tobacco, there's no need for any of this, we're just not confused in any way about the nature of tobacco, i.e. it's not air, it's not food, it's not water, it's not medicine, it's not essential, and so forth. Nevertheless, tobacco label indicates quantity of what is believed to be the most dangerous element inside like tar and nicotine for example. With food, there's obvious confusion. Case in point, ask anybody what food is, we'll get a thousand different answers. Proof, there's hundreds of diet books. Further proof, there's tens of thousands of "food" products (claimed to be edible and nutritious by the nutrition label), yet only a handful of actual ingredients, and even fewer actual raw foods on the grocery shelves by comparison. Further proof, there is no curriculum in any school on this planet that teaches what food is, and what is not food. The only curriculum teaches the official guidelines, and we know all about those.

As I'm writing this, I just came up with a brilliant idea about food. It occurs to me that our entire knowlege about food is in fact empirical, just like it's ever been historically with our ancestors. Our parents taught us what food was - edible - and what was not food - inedible. This mechanism still exists and we are still bound by its simple rules (the authority teaches the facts of survival because it's his biological duty to do that, and those facts are derived from direct experience), but it's been usurped to instead push what is otherwise inedible like grains and sugar. The mechanism has been usurped, but the underlying truth doesn't support any of it - the things we're told to eat aren't actually food by any measure. So, we get all kinds of embelishments to convince us that it is food, like the nutritional label that lies on its face when it states the nutritional value of sugar as a % of daily requirement on a label that indicates nutritional value. It doesn't matter that for sugar, it says "n/a", what matters is that sugar is indicated by a nutritional label such that sugar is deemed to be food.
Quote:
6. We recommend the discontinuing of all governmental food subsidies, especially commodity crops such as sugar, which contribute to health detriments. These subsidies distort the market and increase the costs of non-subsidised crops, making them unaffordable for many. No industry should be provided a subsidy for hurting people.

That's it that's all. Nothing else need be done really. Do this for all crops, not just sugar. Let actual production costs influence retail price, to in turn influence consumption. Before industry, that was the single most effective means to influence consumption of anything. The greater the production cost, the lower the consumption. With industry, it retains its effectiveness due to incentive for profit by carrying production costs to retail.

An effect of the above will be to illustrate the unmistakable luxury status of expensive "food" products, which was in fact the situation before industry and subsidies. From that point forward, it will be that much easier to illustrate the true non-food status of those luxuries. Then from there, nobody will need to be convinced of anything, which means that any further argument against those luxuries - it's not food because of such and such - will be accepted with little or no opposition. Then from there, when you're hungry and all you got is 5$, you'll go for the actual food, not for the luxury.

The other side of the coin is that imports of same products must be taxed to same luxury level.
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  #5   ^
Old Sun, May-13-18, 12:51
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It's worth noting that the co-authors of this report are from all over the world: Malhotra is from the UK, Schofield from New Zealand and Lustig in the States. The circumstances in each part of the world are all slightly different from each other when it comes to what drives their list of recommendations.
Quote:
Originally Posted by M Levac
Agree with first part, disagree with second part. A "better understanding" doesn't come from using a vague unit of measure like a teaspoon, but by using a standard unit of measure like the gram. This also applies to "% of daily requirement", which also appears right next to the Xg number for added sugars on the nutritional label, as if somehow added sugars was a nutrient and had a daily requirement, which is absurd, if we accept the first part of that suggestion above.

The nutritional label itself must be changed or replaced with something more accurate and more representative of what's in the box.

In NZ and the UK, nutrition labels already include a "per 100g" column, which the States lacks. So that would be an obvious improvement in transparency just by introducing that there. The teaspoon idea comes from the Public Health Collaboration in the UK.

Here in NZ, we have another front-of-packaging labelling system called the Healthy Star Rating, where the label on the back is basically condensed to a 1-5 star number indicating the product's supposed overall healthiness. Problem with this of course, is that the formula is based on standard guideline recommendations, so something like a bottle of cream gets 1 star because of the saturated fat, while many brands of grain-based cereal get 4+ stars.

So I personally support the teaspoons of sugar idea as not just a way to reinforce the particular issue with sugar to the general public, but here it would also presumably replace the HSRs as well.

Quote:
Originally Posted by M Levac
That's it that's all. Nothing else need be done really. Do this for all crops, not just sugar. Let actual production costs influence retail price, to in turn influence consumption. Before industry, that was the single most effective means to influence consumption of anything. The greater the production cost, the lower the consumption. With industry, it retains its effectiveness due to incentive for profit by carrying production costs to retail.

Again, the situation with food subsidies varies depending on where you are in the world. It's not a problem here in NZ, we abolished them in 1984 (unless anything has since been re-introduced that I'm not aware of). But certainly I agree that it's a massive issue in the US which would be quite the hurdle to overcome one day.
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  #6   ^
Old Sun, May-13-18, 13:23
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Ms Arielle Ms Arielle is offline
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i applaud the effort to change the foods in our "SWD" standard world diet, but fail to see the effects.

tobacco was rooted out because their own emails leaked the fraud they were committing. Now the tobacco is just sold abroad rather than here. Is that really change ? Or just shifting the burden?

I have met with school lunch director, who is not an em ployee of the school but runs the subcontracted food service.

Their criteria is to meet federal government standards. As long as apple juice is equal to a whole apple, not enough will effectively change. I also ran into issues with classroom provided junk food. My only anssweer as a mother in charge of feeding myself and 2 kids is to eat at home, and make a bagged lunch.

PS. My kids dont buy school milk.

The recommendations I applaud, if only it could actually happen. Grass root support is usually how to make greatest strides to change government policies.

I depend on the grassroots effects of this forum to keep me charging in the right direction.
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  #7   ^
Old Sun, May-13-18, 16:14
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GRB5111 GRB5111 is offline
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Quote:
Originally Posted by Grav
But certainly I agree that it's a massive issue in the US which would be quite the hurdle to overcome one day.

This is a massive hurdle as farm subsidies and the Supplemental Nutrition Assistance (SNAP) program, formerly known as food stamps, and interwoven into the economy and welfare to primarily benefit the food producers under the US Department of Agriculture and manufacturers. The recipients are used as a symbol of public welfare beneficiaries, but the food acquired is usually the least expensive available. Therefore, the "Nutrition" in the acronym must be taken very loosely, as one can purchase any "foods" under this welfare program, healthy or not. With no recognized sound nutritional education one can rely on today, the majority of foods purchased under this program are not healthy. Given that it's tightly coupled with the agriculture and food manufacturing economy, there is no easy way to correct this program. Elected officials' campaign successes are measured to a large degree by how much they support this program based on the demographics of where they live.
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  #8   ^
Old Sun, May-13-18, 17:47
M Levac M Levac is offline
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Quote:
Originally Posted by Grav
The teaspoon idea comes from the Public Health Collaboration in the UK.

Here in NZ, we have another front-of-packaging labelling system called the Healthy Star Rating, where the label on the back is basically condensed to a 1-5 star number indicating the product's supposed overall healthiness. Problem with this of course, is that the formula is based on standard guideline recommendations, so something like a bottle of cream gets 1 star because of the saturated fat, while many brands of grain-based cereal get 4+ stars.

So I personally support the teaspoons of sugar idea as not just a way to reinforce the particular issue with sugar to the general public, but here it would also presumably replace the HSRs as well.

I'd like to avoid sounding contentious here but it's very important that units of measure be standard, especially when there's several different fields being discussed like the science of sugar, the economics of sugar, the politics of sugar, the health effects of sugar, the use of sugar at home (how we measure it when we use it in a recipe), and so forth.

Where, besides at home when we measure how much to use in a recipe for example, is the teaspoon used as unit of measure? In the official guidelines. In my mind, everything I know about the guidelines tells me that's the worst argument I can have in favor of using the teaspoon as a unit of measure of food in the context of discussing the health effects of that food. I mean seriously, aren't we all trying to get as far away from the official guidelines as we can?

Overall I agree with the suggestions. Maybe I am being too contentious here. I guess what I really want is that a list of suggestions be as good as I can think of.
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  #9   ^
Old Sun, May-13-18, 20:01
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Numbers 2 through 5 cause a pain in my Libertarian streak.

Tell people the truth, stop taking what amounts to payoffs to write bad guidlines, stop requiring government entities (school lunch for one) to adhere to the bad guidelines, stop subsidizing crap foods.

No need for new taxes, no need to tell private businesses what to put on sale or who to have as sponsors, or who to accept as advertisers.
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  #10   ^
Old Mon, May-14-18, 00:58
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Quote:
Originally Posted by M Levac
Where, besides at home when we measure how much to use in a recipe for example, is the teaspoon used as unit of measure? In the official guidelines. In my mind, everything I know about the guidelines tells me that's the worst argument I can have in favor of using the teaspoon as a unit of measure of food in the context of discussing the health effects of that food. I mean seriously, aren't we all trying to get as far away from the official guidelines as we can?

The only association I personally make with the teaspoon measure is at home. It's precisely that scenario that I think makes things easier to quantify for most people, particularly those who are unwilling/unable to pay sufficient attention to the rest of the label on the back of the product. For a typical home-based consumer, it's an easy, relatable measure. And if there was one thing that was to be highlighted in this way on the front of packaging, is there anything more important than sugar? Personally I don't think so.

The presence of any teaspoon type references in the official guidelines, to me, is not an automatic reason to oppose the idea outright. The guidelines do actually tell us to limit sugar, just not by as much as we wish it did, and they have other issues that I think are even further removed from what a typical low-carb follower would support, e.g. that grains are healthy and that saturated fat is bad, etc.

Quote:
Originally Posted by M Levac
Overall I agree with the suggestions. Maybe I am being too contentious here. I guess what I really want is that a list of suggestions be as good as I can think of.

I'd like to think we can all agree on this.
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  #11   ^
Old Mon, May-14-18, 01:10
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Quote:
Originally Posted by GME
Numbers 2 through 5 cause a pain in my Libertarian streak.

Tell people the truth, stop taking what amounts to payoffs to write bad guidlines, stop requiring government entities (school lunch for one) to adhere to the bad guidelines, stop subsidizing crap foods.

No need for new taxes, no need to tell private businesses what to put on sale or who to have as sponsors, or who to accept as advertisers.

While I'm not inherently opposed to the idea of taxation, I do agree that it'd be a bit silly to introduce a tax for as long as there are subsidies still in place. Otherwise the consumer is effectively being taxed twice. I definitely think there's a certain order in which I would want to tackle certain issues depending on specifically where we're talking about tackling them.

Again, circumstances are somewhat different in different parts of the world. The idea of a sugar tax I think would have a lot more traction in places like New Zealand for example than in the States, because there are no such subsidies in NZ. In addition, NZ already has similar taxes on things like cigarettes and alcohol, so for us a sugar tax is really not such a big leap as it might seem elsewhere.

But I guess that only makes the point about abolishing subsidies that much more important in places where they do still exist. By all means give the free market its opportunity to sort things out naturally. That, plus the right sort of changes to the guidelines to introduce some official endorsement of the LC WOE, might be all that is actually needed to induce real societal change, without the need for taxation at all. And I wouldn't mind in the slightest if that actually turned out to be the case.
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Old Mon, May-14-18, 06:08
M Levac M Levac is offline
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There's another possible solution. Mandate higher salaries for sugar employees.

The way money works is by an act of Law. I won't go too deep here but the point is that the value of currency is determined by both Law-enacted fixed prices for certain essentials like milk and butter (here in Canada at least), and Law-enacted minimum wages (also here in Canada at least). Various representative associations also mandate minimum wages like Comite Paritaire Des Employes D'edifices Public (people who clean and maintain public places, that kind of thing) here in Quebec.

And, mandate higher retail/gross prices for resources specifically in the context of production, distribution, transport. For example, fuel for machinery used in production of sugar. Rental of this machinery. Parts, and so forth. Electricity for processing factory.

With salaries, if we accept the premise that sugar is bad for us, it does two good things, not just one. Besides obvious first-level benefit for employees, a subsequent effect of increased salaries for a pool of employees is increased local economic activity where these employees reside. With resources, it also does two good things, as the higher costs drives improvements in efficiency, which then transfers to other similar productions. One possible improvement is electric machinery and transport vehicles (as a side note, Tesla recently unveiled an electric semi), which then benefits elsewhere (pollutants, noise, etc).

This must be done in direct (like minimum wage, not tax) salary control, and can be done in direct (like fixed essentials retail prices, not tax) and/or indirect cost (tax) control.

A priori, lower consumption of a thing results in lower income for whomever produces that thing. As a producer faced with this, I'd choose the most profitable option, if profit is possible. As a population faced with this (both as consumers of the thing, and employees of those producers), I'd choose the greatest number of benefits rather than the greatest single benefit. If somebody's gonna profit from this, I'd prefer the greatest number of people.
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  #13   ^
Old Mon, May-14-18, 06:22
M Levac M Levac is offline
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It occurs to me that sugar is widely used in processed food products and that's the bulk of our consumption of sugar, and there's lots of employees there. So, we can extend to include all processing factories that use sugar as ingredient. While I'm at it, we can include all retail outlets that sell sugar, whether pure in a bag or as ingredient in food products.

Not tax. Just higher salary and higher resource costs.

Solution for producer, processor, retail owner - fire employees, or get rid of sugar. In this case, getting rid of sugar also rids of obligation to pay higher salaries and higher resource costs.

When you think about it for a second, that's like everybody and everywhere.
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  #14   ^
Old Mon, May-14-18, 08:41
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GRB5111 GRB5111 is offline
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This is a complex issue, and it's heartening to know some health experts are trying to resolve it. However there are several things proposed that won't necessarily change things at all, and I'm speaking from the perspective of this issue in the US. Other countries will have different circumstances.

What won't work:
1) Taxes
2) Wage control
3) Banning products, commodities

What could work:
1) Sound nutritional science embraced by the government, medical communities, and acknowledged by food producers, manufacturers.
2) Freedom of choice based on awareness of #1.
3) Social pressure and pressure at the cash register on food producers, manufacturers, and medical communities to provide products and services supporting the new Dietary Guidelines for Americans (DGA) that will lend credibility to the new science with supporting guidelines.

In a free-market society, purchase decisions are made by product quality, cost, and availability. Freedom of choice allows consumers to purchase what they need based on their preferences, awareness of product quality (to include whether it's actually good for health), and affordability. Note that affordability is usually last when one is addicted to a product like tobacco, as the addiction overrides a normal elasticity of demand curve in these cases. In other words, addicts tend to ignore cost when purchasing these substances. This applies to processed carbs as well, as I can state with conviction that i'm a recovered carb addict, and price never would stop me back in the day.

So, we can propose taxes and penalties, but what really caused the massive rejection of tobacco in the US was the fear of death from cancer. The medical community overwhelmingly communicated the message that tobacco use was fatal, and it worked. The same can be said for carb consumption following the Standard American Diet and following the previous versions of the DGA. Unfortunately, there is much disagreement among the nutritional science, medical, and pharmaceutical communities with food, as they each have vested interests that are in conflict with the ability to form and distribute a unified, powerful message to the public. It's this confusing message that enables people to rationalize that every type of food is safe in moderation. In other words, there is no common message embraced by the very authorities the public tends to find credible.

It's interesting to note that when the Food Pyramid was released in 1978, Americans adapted and followed it faithfully. When it became MyPlate, same thing. Americans listen and adapt their food consumption choices to whatever is recommended by the authorities. Americans are compliant when it comes to health, to their detriment considering the dietary recommendations since 1978. It's appalling that we're in this situation, but I'm convinced that the "authorities" will not readily change due to massive conflicts of interests. It must happen with an ever increasing knowledge base of healthy eating touted by new authorities who can speak of new scientific findings supporting a change in a healthy way of eating. It's happening today, but very slowly, as there are many touting different ways of eating based on mythical science and hidden and not so hidden agendas. Yes, it's a mess, but if people pay close attention, they'll see the fog is lifting slowly with more authorities starting to transition to sound science and healthy eating experiences proving the ability to recover health through lifestyle changes.
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  #15   ^
Old Mon, May-14-18, 16:41
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Quote:
Originally Posted by M Levac
Agree with first part, disagree with second part. A "better understanding" doesn't come from using a vague unit of measure like a teaspoon, but by using a standard unit of measure like the gram. This also applies to "% of daily requirement", which also appears right next to the Xg number for added sugars on the nutritional label, as if somehow added sugars was a nutrient and had a daily requirement, which is absurd, if we accept the first part of that suggestion above.



The problem with using grams as the primary unit of measure is that in a country which uses imperial measurements for most things, it's actually quite vague to the general public. Do they even know what a gram is? Can they visualize it, or is it just some mysterious unit of measure that they have no idea what it looks like? What does a gram of sugar look like anyway? Other than scientists (who deal with metric measurements) those living in an imperial measurement country wouldn't be likely to be able to describe what the volume of one gram of sugar looks like.

But a teaspoon isn't quite as vague sounding to someone who lives in a country which uses imperial measurements. Granted, when they think of teaspoons, they're probably thinking about how many heaping spoonfuls of sugar they scooped from the sugar bowl into their coffee, instead of a measuring teaspoon (which is much smaller - probably closer to what fits in a demi-tasse spoon, instead of a sugar shell spoon), but at least speaking of sugar content in terms of teaspoons gives thos who have no idea what a gram of sugar looks like, some concept of just how much sugar there really is in that candy bar they managed to scarf down in 3 minutes.
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