I was doing a home visit to see Sylvia, an older lady whose illness prevented her from leaving her home. Her daughter greeted me at the door. "Thanks for coming doctor. Can I get you a cuppa? Milk and sugar?". "Yes please, but no sugar thanks, I'm sweet enough". Those that know me well, family colleagues or patients, are all too aware I'm definitely not "sweet enough". But that aside, I just don't like sugar in my tea! Not so the vast majority of the population it seems. January has seen the usual rush of miracle diet offers and, unusually this year, a full frontal attack on sugar. The press reported this new "demonisation" of sugar and claimed we, as a nation, are addicted to sugar. Suddenly "low-fat" is yesterday's story. Sugar is the "new tobacco" and campaigners are calling for government action, a tax on sugary drinks and a complete ban on sugar from our diet. That, the campaigners claim, will stop the obesity epidemic and save the health of the nation. But will it really?
Now I have some sympathy with this story. Everybody knows too many of us, two thirds of the adult population, are overweight or obese, and that leads to type 2 diabetes, high blood pressure, heart disease and strokes, and some forms of cancer. Now, there's no doubt that excessive consumption of sugar is part of the problem. It's everywhere. The popularity of low-fat foods has caused the food manufacturers to add sugar to fill the gap, prolong shelf life and make their food products more appealing. Just a shame "appealing" has to equate to "unhealthy". Our sweet tooth has grown so much that even the fruit we now buy is sweeter than it was a generation ago. While I know we do consume too much sugar, in drinks, processed foods, even soups and breads, I don't think it can, or should be removed altogether. It would be a brave (and foolish) government that tried to do that. But less would be good. My main problem with this new campaign is that by focussing completely on sugar, by demonising it, they let fat off the hook. But they also fail to highlight the importance of physical activity. A lack of physical activity in our children is at least as much to blame as excessive fat and sugar intake. The plain truth is we need to tackle all three: sugar, fat and exercise.
In my experience any "diets" which focus too narrowly on cutting out one type of food or doing one type of exercise are doomed to failure. We are much more complicated human beings than that. It's all about balance.
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