The BMJ Today: Sugar the bogeyman and slim boy fat

TJackson_09I stopped adding sugar to my tea when I was a teenager. Up until then (which was sometime in the mid 1970s), I had been wont to fill the cup with several heaped spoonfuls. I regularly covered my morning Weetabix with a glacier of granulated. And I drank a can of Coca-Cola or Pepsi (not the diet version) every schoolday with my packed lunch (I was not the only boy to do so, and mine was a stuffy, pompous institution founded in 1553).

Most days I ate crisps, sweets, and cake plastered in icing sugar, and my detestation of any type of sport or exercise was almost pathological. When I started to think a bit more about health, and started drinking orange juice with my morning cereal, it came from a packet in powder form (Kellogg’s Rise & Shine) and had to be mixed with water. And yet I remained as skinny as a stick insect until my late 20s.

Perhaps I was an outlier, but I don’t think my sugar intake was particularly unusual in the 1970s, and obese children seemed a rarity. And the only warning that I can remember about sugar was that it could rot our teeth (and I have the fillings to show for it). Although John Yudkin’s book Pure, White and Deadly about the dangers of sugar had been published in 1972, it faced public rebuttal and instead the Ancel Keys’ low fat hypothesis held sway. Fat was fast becoming the enemy.

Fast forward forty years, and we are in the middle of the war on sugar (and its various allies in the obesity crisis). I have been following the conflict for some time, which has been keeping me rather busy, as rarely a day goes by without some new report, study, or general cri de coeur about the white stuff. Two reports due out today are expected to make recommendations about our sugar intake, one from the Scientific Advisory Committee on Nutrition and one from Public Health England.

But while the case against sugar is mounting (clearly added sugar provides nothing but empty calories), can we really lay the blame for the obesity epidemic so squarely on one macronutrient? At a press briefing yesterday, as reported in today’s The BMJ, one scientist said it would not help people much if they were left with the impression that reducing sugar was the answer. Oxford professor Susan Jebb, who chairs the government’s responsibility deal with the food and drinks industry, said, “We’ve got to help consumers put all of these isolated pieces of news and isolated pieces of science together.” Pitching “one nutrient against the other” was “not helpful,” she said, and called for a portfolio of policies.

I too am looking for a portfolio of approaches. Since I stopped being a stick insect, I grew podgy, and have spent the past 10 years trying to tackle it. I have gone low fat, low carb, I have given up sugar, I have taken up pasta, I have given up pasta, I have given up beer, I have gone to the gym, I have given up the gym, I have rejoined the gym, I have started intermittent fasting, the 5-2 diet, the 8 hour diet, the wine diet, the beer diet. But as each piece of new evidence about what really makes us fat and what makes us slim fits into place, I am convinced that the elusive six pack is getting nearer and nearer.

Trevor Jackson is a deputy editor, The BMJ.