Studies have linked heart diseases to sugar and metabolic diseases, which can increase risk of death
Nisha Kumari believes quitting sugar is one of the best decisions she has ever taken (name changed). “It helped me lose 17 kilograms in less than four months,” says the 28-year-old Delhi resident. While she had been exercising for a while, her paradigm shifted when she visited dietician Sapna Puri. She recommended Kumari to quit not only table sugar, but even fruits, vegetables and dairy products with natural sugar. Puri warns table sugar is a source of “empty calories” that provides only energy and no nutrients, making one fat.
The Indian Sugar Mills Association (ISMA), however, sees nothing wrong in sugar, especially added sugar which is what most junk foods and sugary treats are made of. In a recent letter to Delhi-based non-profit Centre for Science and Environment (CSE), ISMA says sedentary lifestyle and not sugar is responsible for obesity. Abinash Verma, director general, ISMA, asks why sugar from other sources like potatoes, rice and carbohydrate-rich foods are never questioned.
ISMA also discredits the World Health Organization (WHO) which in 2015 said that the human body should not receive more than 10 per cent of the calories from added sugar. The most common added sugars are regular table sugar and high-fructose corn syrup that is widely used in processed food. WHO says reducing sugar intake to below 5 per cent, or six teaspoons per day, provides health benefits.
The ISMA letter says only three to four small and “not significant” countries have accepted the WHO recommendations which is not “backed with proper evidence”. ISMA’s claims “are misleading and scientifically incorrect”, says Shweta Khandelwal, nutrition epidemiologist and associate professor at the Public Health Foundation of India, a research group in Delhi.
There are enough studies that link heart diseases to sugar. Some even suggest that sugar can cause metabolic diseases even without causing obesity. One study published in the journal of American Medical Association, JAMA Internal Medicine, in April 2014 shows a significant association between having sugar other than what’s naturally present in fruit and vegetables and the increased risk of death from cardiovascular diseases, in the US. It says even one sugar-sweetened drink a day increases the risk.
The study, led by Quanhe Yang, senior scientist with US public health institute Centers for Disease Control and Prevention, analysed the national health and nutrition survey data of 31,000 people between 1988 and 2010. It then calculated the risk of dying using national death data.
“Our analysis suggests that participants who consumed greater than or equal to 10 per cent but less than 25 per cent of calories from added sugar… had 30 per cent higher risk of CVD (cardiovascular) mortality; for those who consumed 25 per cent or more of calories from added sugar, the relative risk was nearly tripled,” the authors wrote.
The association was independent of body weight, cholesterol level, physical activity, blood pressure, smoking and alcohol consumption—all factors to watch out for to avoid heart disease.
The letter to CSE says the Food Safety Standards of India (FSSAI) should not implement its April 2017 draft Food Labelling Regulations that calls for a red mark on the packs of food items where added sugar is responsible for more than 10 per cent of the total energy. ISMA says sugar is “not harmful” and the FSSAI move will “send a wrong message” to the consumers.
The industry body, instead, recommends “full information about the composition of the product, along with the calories and nutrients from each item within”. Amit Khurana, programme director, food safety and toxins at CSE, insists the FSSAI move is an essential step to inform consumers about high sugar content. “Pictorial warnings will address the barriers of language and literacy in India.
Countries like Chile have shown how warning labels on unhealthy foods have helped limit their consumption. It is time Indian food industry supports the warning labels and the draft food labelling regulation,” he says.
On march 6, ISMA conducted a day-long “Sugar and Health Workshop” in Delhi to debunk some “myths surrounding the sweet stuff”. The event, says its press release, was attended by experts from India and abroad who decided that “there is no scientific base or research establishing that sugar is the key cause of non-communicable diseases”. The experts also allegedly questioned the WHO recommendation.
“Businesses that sell products that might be bad for public health tend to follow the “playbook” used by the tobacco industry: deny responsibility, cast doubt on the science, fund favourable science, promote self-regulation, lobby government,” says Marion Nestle, author of Food Politics, and professor of nutrition, food studies, and public health at the New York University.
The practice can be dated way back to 1967 when the US sugar trade association paid a group of researchers at Harvard University to exonerate sugar of coronary heart disease. In 2015, the New York Times uncovered the “cosy relations” between Coca Cola and researchers who minimised the effects of sugary drinks on obesity. In 2016, Associated Press carried a story exposing how the US candy lobby funded a research that made the outlandish claim that children who eat candy tend to weigh less than those who don’t.
“These are normal business practices that require exposure by the press, and the government should view all industry-funded studies with scepticism,” says Nestle.
(This article was first published in Down To Earth's print edition dated June 1-15, 2019)
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