Tue, Aug-06-19, 01:29
The thing about fat is how much it is costing us
From The Australian
August 6, 2019
The thing about fat is how much it is costing us
Next to the architecture, a striking memory of a recent three-months stint in Chicago was how overweight so many Americans are. It is, after all, the home of deep-dish pizza and the global headquarters of McDonald’s, whose large soft drink cups could comfortably accommodate goldfish.
Almost 40 per cent of American adults are obese, more than anywhere else. It’s less than 5 per cent in Japan. It is one of the reasons US life expectancy has fallen for three years in a row, given the array of health problem obesity underpins, especially diabetes~, which afflicts more 30 million Americans, and cancer.
But let’s not be too quick to scoff at slow-moving Americans; Australians are not far behind. Figures last year showed one in three of us was obese, compared with one in five in 1995, according to the Australian Institute of Health and Welfare. And obesity rates are projected to keep rising in Western countries, according to the OECD Obesity Update 2017.
With such statistics comes a minefield of costs and burdens to our economy.
Fifty years ago we put a man on the moon, yet we still can’t decide if cereal and banana or bacon and eggs make a healthier breakfast. Nutrition, and the science that underpins it, is unacceptably confused, especially given the researc~h funds invested in it.
So the debate about whether sugar is healthy to consume is noisy and ongoing.
In the 19th century, doctors started attributing obesity and diabetes to excessive sugar consumption, both of which were prevalent among the wealthy. A British medical textbook in 1923 singled out carbohydrates as the source of obesity and diabetes.
“Over the next thirty years, a series of misconceptions propagated by just a few very influential diabetes specialists would come to exonerate sugar almost entirely as a cause of diabetes, let alone the primary cause,” wrote American journalist Gary Taubes in his 2016 book, The Case Against Sugar.
Until the past couple of decades, fat was demonised. The food pyramids we grew up with had bread and pasta in the “eat more” group.
Obesity, conveniently for sugar manufacturers, became an almost moral issue: it was all about calories in, calories out — all calories were the same. “This thinking renders effectively irrelevant the radically different impact that different nutrients — protein, fat, and carbohydrate — have on metabolism,” Taubes wrote.
At the University of Sydney, though, sugar is back. A top nutritionist there, Jennie Brand-Miller, whose books have sold millions of copies, has written: “There is an absolute consensus that sugar in food does not cause diabetes.”
In her controversial paper The Australian Paradox, Brand-Miller argues the consumption of sugar has been falling in Australia while obesity rates have been rising.
So sure is the nation’s oldest university about the health benefits of sugar that it has been running full-page advertisements, pointing out its researchers “have discovered that a low-protein, high-carb diet can delay chronic disease and help us live a longer and healthier life”.
Meanwhile, the latest government guidelines say the evidence that “the association between the consumption of sugar-sweetened drinks and the risk of excessive weight gain has strengthened”.
Economics at least has the excuse it can’t run experiments on animals or people. You’d think nutritionists, with decades of opportunity to do both, might have worked out who was right by now.
In my experience, dumping potatoes, cereal, pasta and sugar for bacon, eggs, green vegetables and steak leads to weight loss. Certainly, remote indigenous communities, blighted by shocking rates of obesity and sugar consumption, provide a good example, with Aborigines and Torres Strait Islanders almost four times likelier to have diabetes. A 2013 study found 61 per cent of remote Northern Territory Aborigines’ diet was carbohydrates, half of which was sugar. That’s far more than the national average of 38.3kg of sugar a year each.
It’s not fair to blame individuals for becoming fat if experts can’t agree on what’s healthy. Finding out definitively would be a good idea for taxpayers, too, who fork out more than $20 billion a year in additional health costs. In 2015, about 125,000 weight-loss procedures were billed to Medicare in public and private hospitals. That year, about a tenth of all hospital~isations were related to diabetes.
Perhaps obesity receives less attention because decision-makers incline to affluent areas where it is less of an issue and gyms proliferate.
Ignoring Sydney University research, many governments do blame sugar. The British Conservative government joined almost 30 countries last year in imposing a tax on sugary drinks. Similar proposals here have been slammed as nanny state overreach. Former chancellor of the exchequer George Osborne told me in 2017 that conservatives were right to embrace sugar taxes.
“The overwhelming evidence was sugar was doing enormous damage to kids’ health,” he said. “Taxes are things that discourage behaviour, so reduce tax on things we want — like business — and increase it on the things we don’t.”
Back in a 2007 column, I mocked a tax on sugary drinks, suggesting a tax on obese people might be more efficient. “Everyone would submit an official body mass index report with their annual tax return. The (tax office) would make the fat tax calculation for you. It would be a progressive tax: the fatter the taxpayer, the higher the tax,” I wrote.
Nevertheless, taxing food and drinks that damage people’s health — and so imposing a great cost on the health system — has merit. The problem is government rarely uses such revenue to cut other taxes. Tobacco excise has been lifted far beyond the point of economic or moral justification, crushing the disposable incomes of poor, addicted smokers rather than reducing smoking rates.
If sugar is as damaging as some suggest, eating well without it should be much easier, including consolidating the mishmash of hearts, stars, ticks and dietary tables that confuse as many consumers as they help.
Adam Creighton, Economics Editor
Adam Creighton is an award-winning journalist with a special interest in tax and financial policy. He was a Journalist in Residence at the University of Chicago’s Booth School of Business in 2019.