Sugar-sweetened beverages are in the sights of public health nutritionists, especially in relation to obesity. But there is some good news: a fundamental shift from sugar-sweetened to non-sugar soft drinks is underway and the amount of sugar entering the national diet from these beverages is in long-term decline.

Despite all the interest in sugar in recent years Australian nutritionists don’t really know for sure whether sugar intake in Australia is going up, going down or staying the same. Unlike American nutritionists who have the findings from the ongoing NHANES series of nutrition surveys to go on, we have been hamstrung by the poor quality of our nutrition data. There are few national nutrition surveys to guide us.

In 2011, Dr Alan Barclay and Professor Jennie Brand-Miller collated the available Australian data and concluded that per capita consumption of sugar had decreased by 16% in Australia between 1980 and 2003. Their work was attacked with uncommon vigour. Apparently, this was not a message that some people wanted to hear. One concern expressed about their work was that Barclay and Brand-Miller had partly relied on ‘apparent consumption’ data, which the Australian Bureau of Statistics ceased publishing in 1998/99.

In a subsequent analysis by the commodity firm Green Pool, the apparent consumption data were updated and analysed, and again suggested a long-term fall in sugar consumption in Australia was underway. There were more howls of protest. Unfortunately, when the quality of the available data is ordinary this sort of debate ensues and we end up with lots of heat but little light.

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Fructose has been accused of being the root of all dietary evil but at a symposium in Sydney this week Canadian researcher John Sievenpiper argued that fructose has been misjudged.

John Sievenpiper knows a fair bit about dietary carbohydrates and health. His team in Toronto recently conducted systematic reviews and meta-analyses evaluating the effects of fructose on body weight, blood pressure and glycemic control in humans. He discussed some of the findings at the ‘Sweet Symposium’ on 2 December.

The fructose-centric view

Sievenpiper reviewed the rapid evolution of what he called the ‘fructose-centric view’ in modern nutrition, which positions fructose as a central driver of the obesity epidemic and cardiometabolic risk. Certainly several lines of evidence had raised suspicions about fructose – apparent increases in fructose consumption were associated with increases in obesity in population studies; animal studies showed fructose had adverse metabolic effects; there were similar findings in some human studies; and an articulate anti-fructose champion, Robert Lustig, emerged and took his simple ‘fructose is toxic’ message to the general public. And the media loved it – even the ABC’s ‘science’ program Catalyst jumped on the bandwagon and pushed the idea around. In less than a decade the fructose hypothesis became an anti-fructose doctrine with a chanting chorus of true believers.

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