I note that BMC Public Health journal now is investigating the veracity of your extraordinarily faulty Australian Paradox paper, in response to this letter.

It’s the same in the UK – we only make about 2.5M tonnes of sugar and have done so since ~1980 and the population is fairly steady at 50-60m. Obesity has of course grown exponentially in the same time frame.

Check out Gluconeogenesis.

To recap:

FAOStat data are congruent with ABS apparent consumption data for the period 1980 – 1999. During this period, rates of overweight/obesity nearly doubled from 37% to 60%. Green Pool used the ABS apparent consumption method and extended the data to 2011 and confirmed the overall downward trend. FAOStat data are now available to 2010, and is congruent with the Green Pool analysis. FAOStat data is therefore not guesswork.

With respect to the volume of nutritively sweetened soft drinks sold over the 1994-2006 period, this is a common misunderstanding. The composition of nutritively sweetened beverages changes constantly as manufacturers introduce new varieties and new flavour variants of existing varieties. Consequently, the sugar content of nutritively sweetened beverages changes over time. Figure 6 in The Australian Paradox (http://www.mdpi.com/2072-6643/3/4/491) shows clearly that the total amount of added sugar (tonnes) in soft drinks decreased from the mid 1990′s to the mid 2000′s.

Boyd Swinburn is entitled to his opinion but it does not mean that he is correct.

I’d like to add my take on the ‘Paradox’ paper. The authors of this paper assert that the consumption of refined sugar has decreased in Australia since 1980, over the same time frame that rates of obesity have increased. They propose that a literal interpretation of this association suggests that reductions in sugar intake may have contributed to the rise in obesity. The authors’ conclusion that refined sugar consumption has decreased over 30 years is based on FAO data, national sales figures of sweetened beverages and surveys of children’s drinking preferences.
Assessing what and how much Australians eat is difficult and every method of assessment has well documented limitations. Take for example FAO data, which is the lynch pin on which the authors’ proposition is based. FAO does not collect data itself but collates what is provided by the Australian Bureau of Statistics (ABS). In the case of refined sugar, ABS data includes how much sugar is grown in Australia, imported, exported, used in industry, lost during storage or transport etc. From this it is calculated how much is available for human consumption. By dividing the amount of refined sugar available in Australia from this calculation by the population, the FAO arrives at an average figure of sugar availability for every Australian. The figure of availability for consumption is not equivalent to the amount consumed. This is clearly stated on page 32 in the ABS document APPARENT CONSUMPTIONOF FOODSTUFFS 1997–98 AND 1998–99, which states, “This publication contains detailed statistics on the apparent consumption of foodstuffs in Australia. Estimates of total consumption and per capita consumption are included. In the context of this publication, ‘consumption’ is not ‘intake’. Apparent consumption data for most items are derived using information relating to the supply and utilisation of foodstuffs. Limitations inherent in this approach mean that the data are an approximate estimate of foodstuffs available for consumption by persons in Australia, after allowing for other uses and losses.”

Consumption data can only be assessed by dietary methods that aim to determine what people actually eat. Such methods include food frequency questionnaires, 24-hour food recall, food records etc.
 The authors miss this fundamental distinction. They mistakenly use FAO data as indicating consumption rather than availability, when they assert, “In Australia …… per capita consumption of refined sucrose decreased by 23% …. from 1980 to 2003.”

It’s important to note the difficulty in accurately assessing how much refined sucrose Australians are consuming or indeed, how much is available for consumption. The ABS recognized this and in 1999 stopped collecting and publishing availability data for refined sucrose. FAO, however, kept publishing Australian sugar availability data until 2003. In the absence of ABS data on which to base their estimates, the figures produced by the FAO, and quoted by the authors, are guesswork. This is further evidence of the inaccuracy of the author’s conclusion regarding refined sucrose consumption.
The second part of the authors’ proposition that refined sucrose consumption has decreased in Australia revolves around figures for consumption of just one out of a myriad of sources of refined sucrose ie sweetened beverages. However, data used by the authors from beverage sales provided by grocery stores contradicts their proposition. The authors’ own figures for reported sales data of nutritively sweetened drinks, provided by Australian grocery stores, were 96 mL/day/person in 1994 and 125 m/L/day/person in 2006. This indicates an increase in consumption of refined sucrose in beverages over this time, not a decrease.The use of unsupported FAO data, mistaking availability for consumption with actual consumption and misinterpreting sales figures is evidence that the authors’ belief in Australians having reduced their consumption of refined sucrose since 1980 is clearly flawed. Health reporter for the SMH, Mark Metherell, interviewed Boyd Swinburn for his opinion on the study’s findings. http://www.smh.com.au/national/health/research-causes-stir-over-sugars-role-in-obesity-20120330-1w3e5.html He reports, ‘Professor Swinburn, who is the director of the World Health Organisation collaborating centre for obesity prevention at Deakin University, says the study’s summary of the data as showing ”a consistent and substantial decline in total refined or added sugar by Australians over the past 30 years” belies the facts ”and is a serious over-call in my opinion”. His conclusion is that ”the ecological trends of sugar and obesity are pretty well matched and I do not believe there is any paradox to explain”.’

Regards, Jennifer

Conflict of interest?

I know Greenpool call themselves independent, but when all they are doing is manipulating numbers, with no actual hard data to go on, it really does make one suspicious that they found the result they were looking for.