In a few short years sugar has replaced fat as the main dietary villain and the lay media is full of horror stories about the role that sugar plays in chronic disease. Scientific reviews of the role of sugar, health and disease by leading nutrition agencies tell a different story, finding sugar is fairly benign with respect to chronic disease. However, dietary quality may be affected at very high intakes of sugar.
Who are the experts?
During the last seven years there have been two comprehensive assessments of the role that sugar plays in health, one in Europe and one in the United States. One review was conducted by the European Food Safety Authority (EFSA) and published in 2010. In relation to nutrition, EFSA provides the most up-to-date and comprehensive scientific advice to support EU policy makers in their decision making process in the field of nutrition. EFSA’s advice on nutrient intakes provides an important evidence base to underpin nutritional policies, the setting of diet-related public health targets and the development of consumer information and educational programmes on healthy diets.
Limiting saturated fat intake has been recommended for decades as a way of lowering the risk for coronary heart disease. However, this recommendation needs to be revised following recent findings that saturated fat and carbohydrate confer the same risk for heart disease. Now the best advice is to replace saturated fat with unsaturated fat.
In the beginning: the Seven Countries Study
The Seven Countries Study shaped the thinking of a generation of nutritionists. In this famous study the diets in fifteen cohorts of subjects in seven countries were examined and the risk for various diseases was estimated over time. The most compelling finding was the positive association between dietary saturated fat and the risk for coronary heart disease – the lower the intake of saturated fat, the lower the risk for heart disease.
The draft Australian Dietary Guidelines were recently put out for consultation and after a four-year gestation we might have expected a highly polished report, clearly communicating the latest evidence-based nutrition. The reality was very different. The draft Australian Dietary Guidelines report was a very strange document with nutrition science jostling awkwardly with motherhood and ideology. Some important areas of the nutrition literature were reviewed in great depth, but others were not reviewed at all and significant shifts in the science were missed. The translation of the findings of literature reviews into dietary advice appeared to be compromised in two ways – by a conservatism that didn’t want to see change to long-standing messages about diet and health and an activism for change driven by environmental concerns, not by nutrition science.
As a result the Guidelines fall short scientifically in seven areas. These are reviewed below and will be considered in more depth in the weeks ahead.