The BMJ Today: Sugar, kids, and cranberry cake

What should we eat? And to what extent can doctors influence the diet of their patients? Last week, NICE recommended that doctors send their overweight patients to Weight Watchers or similar schemes because of their proven effectiveness.

But every time I read an article on what we should be eating, I come back to the simple advice from author Michael Pollan: “Eat food. Not too much. Mostly plants.”

By food, he means something your grandmother would recognise as food, and not “edible food-like substances” you can find in today’s supermarkets. In his book, Food Rules: An Eater’s Manual, he inveighs against today’s eating habits. “What an extraordinary achievement for a civilisation: to have developed the one diet that reliably makes its people sick!” He also rails against processed food, saying: “If it comes from a plant, eat it; if it was made in a plant, don’t.” And he says that food products with a huge number of ingredients are likely to be too refined and bad for you.

I was reminded of this last week when my husband and I were on an airplane coming back from the US. The slice of cranberry and orange cake that we were given had about 25 ingredients in it, whereas when my husband makes his cranberry and orange cake, it contains only eight. And you can guess which tastes better.

At least two more articles, recently published on, relate to food. A Research paper from Ruth R Kipping et al, from the University of Bristol, looked at a school based intervention aimed at increasing physical activity, and fruit and vegetable consumption in children. Called Active for Life Year 5 (AFLY5), the programme comprised teacher training, 16 lessons, and 10 child-parent interactive homework activities. Unfortunately, it was found to be ineffective in its main outcomes, though children in the intervention group did report indulging in less screen time at weekends, eating fewer snacks, and drinking slightly fewer high energy drinks.

On the subject of high energy drinks, elsewhere in the journal professor Simon Capewell, professor of public health and policy at the University of Liverpool, says that sugar sweetened drinks should carry obesity warnings. He wants the UK to follow the example of California where the Senate Appropriations Committee is deliberating a bill that will require drinks manufacturers to place the following label on all sweetened non-alcoholic drinks: “STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes and tooth decay.” Capewell thinks that such labels would be supported in the UK.

Continuing on the issue of sugary drinks, professor Terence Stephenson, chair of the Academy of Medical Royal Colleges and the subject of this week’s BMJ Confidential, thinks that such drinks should be taxed to combat obesity. He recently promised to lose 5 lbs (2.3kg), although he is not overweight, to prove he is serious about the issue.

And in case you think that all public health campaigners are miserable killjoys, Stephenson’s remark on the role of alcohol in his life will dispel such a myth. He replied: “I am on record as saying that I sometimes drink enough to sing but not enough to fall over.”

Annabel Ferriman is news editor, The BMJ.