Monday, 8 September 2014

Don't sugar-coat it

People on the Right have been arguing that 'Dirty Politics' has been a distraction from the 'real issues' facing NZ.  For me, those 'real issues'  include: 
  • massive private and increasing public debt;  
  • loss of democratic control over national institutions and   resources;
  • increasing economic hardship among the unemployed and the working poor which is impacting on the most vulnerable, especially children;
  • appallingly high and skewed incarceration rates;
  •  increases in diseases of poverty and metabolic disorders; 
  • an over-reliance on various forms of extractive industry, the bulk of the profits from which go off shore or to a tiny proportion of the NZ population; and 
  •  an agricultural and horticultural sector that is incapable of feeding its domestic population at all, let alone cheaply.
Any intellectually and ethically rigorous examination of the dirty politics exposed in Hager's book must conclude that it is a strategy aimed at obscuring the 'real issues', masking the causes of them, and diverting people away from sensible and humane responses. 

The Right moralises like latter-day Poor Law Commissioners about the costs to the taxpayer of the 'feckless' poor but they're silent on the issue of the overt State subsidies to the likes of the owners of aged care facilities, and the covert State subsidies, via housing benefit, to employers who pay below subsistence wage.  

They also have nothing of value to say about the costs to our health care system and the loss of both productivity and potential caused by the diseases and disorders that are directly attributable to the cynical marketing of sugar-rich, nutritionally depleted foods, and of alcohol and tobacco. 

Ex-National Party MP, Katherine Rich, is Chief Executive of the NZ Food and Gocery Council, which represents manufacturers and suppliers to the grocery industry - including dairying, alcohol and tobacco companies.  In Chapter 7 of 'Dirty Politics', Hager detailed how Rich used lobbyist Carrick Graham's and blogger Cameron Slater's services to attack people who were deemed to be critical of the industry.  

In Nigel Latta's documentary about sugar, the last in the series of six excellent programmes looking at key social issues facing NZ,  Rich was interviewed by Latta.  Her responses to his questions are typical of the ethics and honesty of industry lobbyists.
  • First, attack your critics, in this instance endocrinologist Robert Lustig who, Rich claimed, 'exaggerates the role of sugar',  is 'melodramatic' and has been called 'hysterical'.
  • Second, reduce complex arguments to a simplistic parody and mock them.
  • Third, say that, in any event, it's not the industry's fault because they're only doing what the market wants them to do. 
  • Fourth, say it's people's own fault for choosing to eat too much of the wrong things and to exercise too little. 
  • Finally, say government cannot legislate to force people to make good choices in terms of what they buy or how much they exercise.
Let's first consider the question of choice.   It's insulting for a member of the affluensia like Rich to claim that, if she can make the choice not to consume junk food and can use advertising as a source of information, so can everyone.  

The reality is that there is little real consumer choice in New Zealand nor much of the vaunted competition which the Right argues ensures best value for the consumer.  Most people have to shop in one of two chains of supermarkets, both of which actively promote the consumption of certain types of foods that are high in calories and low in both essential nutrients and nutrient diversity.  

Combine that with a low wage economy and a high proportion of people who live from wage to wage, and the question of consumer choice becomes an unpleasant joke.  Add in the damaging qualities of the substance that most cheap, processed and fast food is laced with, and a lack of public knowledge of its harmful effects, and it becomes downright ugly. 

Only the terminally vacuous, the irretrievably venal or the determinedly dishonest can deny the fact that the consumers who are most at risk of the adverse effects of cheap, sugar-rich, processed foods, are those who have least choice about whether to buy them. 

The food industry hates and persistently smears Robert Lustig because he insists that it IS the industry's fault; that it knows the harm it does and, either cynically chooses to ignore it, or is deliberately doing harm; and that it uses cynical marketing techniques to encourage people to buy food that is, quite literally, killing them. 

Lustig’s argument is compelling and, unless you are a PR pro or making loads of money out of the food industry in some other way, it's impossible to ignore.  He focuses on sugar and especially on high fructose corn syrup (HFCS) for very good reasons. 

There is an epidemic of general and morbid obesity and Type 2 diabetes across much of the developed world - with all the massive health problems associated with those conditions - from kidney, liver and heart failure, to loss of limbs and sight.  The human and social costs are incalculable. Most of the victims are poor. 

The fattest nations on earth are also the largest consumers of sugar - both sugar refined from cane and beet, and more importantly, HFCS, which is sweeter and cheaper, especially in the USA. It's widely used in the production of cheaper food items and in 'low fat' items and 'health foods'.

Critics argue that the food industry laces its low-fat, low salt and its cheaper ranges of processed foods and drinks with so much sugar that the consumption of these products has created metabolic disorders of a type and severity never before known in human history.

Morbid obesity was once such a novelty that, at the turn of the 19th century, a man who weighed 50 stone became wealthy by charging people to visit him. Today 320 kg is horribly commonplace and people at the extreme end of the obesity spectrum tip the scales at 450 + kgs. 

The question is, what drives a person to consume 20,000 calories a day and eat himself into such a condition? 

The crux of the problem lies in the omnipresence of sugar in processed foods and drinks and in particular, the widespread use of HFCS. It's not just in sweets, cakes and biscuits, it's also in breads, cereals, processed meats, yoghurts, sauces, muesli bars, spreads, tinned products of all sorts and, in soft drinks.  

Some of these products are extremely high in calories but almost completely void of nutritional value.  The worst culprits are soft drinks.  The cheaper the food is, the more likely it is that it contains HFCS. 
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A 2009 report from researchers all over the world, including NZ, concluded that HFCS is a major contributor to obesity.  It noted that there may be specific issues relating to how the body breaks down fructose which does not appear naturally in high levels in most of the pre-WW2 dietary staples.  

Dietary fructose is metabolised primarily in the liver and we can only metabolise it in very small quantities. It’s laid down as visceral fat,which adheres to internal organs and even thin people may have internal fat deposits that are injurious to health.  Fructose is also known to increase the risk of atherosclerosis, cardiovascular disease, type 2 diabetes, insulin resistance and increases the levels of uric acid and LDL cholesterol. 

Some individuals and some ethnic groups may be less able to metabolise fructose just as some populations cannot metabolise alcohol. Genetics may play a part in whether an individual becomes obese and how badly. Social class certainly does.  In the NZ population Pacific Islanders have the highest levels of obesity, Maori are next, then Pakeha and Asians are the least obese but are reporting the most rapid increase in obesity. 

There is also the possibility that a person's liver may already be stressed by having to cope with the enormous range of 'toxins' we ingest (often unknowingly and involuntarily) on a daily basis - residues of the thousands of chemicals at use industrially and domestically.  There may also be a part played by the widespread use of milk solids and soya meal in food processing.

                                        * * * * * * * * *

The body naturally seeks homeostasis - equilibrium. Our metabolism - the complex chemical processes that maintain life - operates on a feedback cycle of the production of initiating and dampening hormones secreted by endocrine glands, adipose tissue and the digestive system.  

Given its fundamental importance to life, our knowledge about the subtle and complex functions of the body's hormonal messaging systems is still sketchy - in no small measure because so much research is funded by industry. (Eg. a lot of the research into obesity is funded by pharmaceutical companies looking for a drug that can control appetite.)

We didn't know about insulin resistance - the precursor to type 2 diabetes - and we didn't know about the hormones that are involved in the regulation of insulin, until the 1980s. We know now that the over-consumption of sugar, especially fructose, disrupts the feedback loops that allow our metabolism to restore homeostasis. 

In the case of appetite - there are 2 key hormones that initiate the desire to eat and, through the feeling of satiety, stop us eating.

In broad terms, leptin is slow acting hormone that regulates energy balance and suppresses appetite. It is released into the circulatory system by adipose tissue and in the stomach and crosses the blood-brain barrier. Grehlin is a fast acting hormone that plays a complex role in signaling hunger.

These hormones are linked in complex ways to the body's ability to accurately judge body fat and the appropriate production of insulin.  

Too much sugar - and in particular it seems, too much fructose - causes imbalances in the subtle and complex feedback system.  Put simply - people end up constantly feeling hungry and appetite is not switched off once they've have eaten.

Lustig argues that, in this situation, biochemistry drives behaviour. If you alter the biochemistry by flooding the system with a substance people cannot metabolise effectively and safely, eventually the metabolism becomes less and less capable of regaining and retaining equilibrium.

The outcome is the epidemic of metabolic disorders - the most visible symptom of which is a general increase in weight and a massive increase in morbid obesity and the range of serious health issues associated with it. 
The saturation of our food staples with high fructose corn syrup and other forms of sugar is the single biggest factor and the most easily remedied.  There are other social and environmental factors that may intensify and compound the ill-effects of a nutrient-poor, sugar-rich diet.

Good quality rest is essential to the balance between regulatory hormones. If you have high cortisol levels at night you will not get quality sleep and your grehlin  (the appetence hormone) levels will be higher the following day.  A high cortisol level may be a result of eating too much sugar, it may also be caused (and certainly will be exacerbated) by being in a persistent state of stress. 

For some people, a diet that is high in sugar, salt and poor quality fats, and low in nutrients, combines with their genetic blueprint and a lifestyle that is low in exercise and high in environmental, social and economic stressors.  

Imagine life as a river; downstream there's a huge whirlpool.  Some people enter the river a long way up stream and others enter it close to the whirlpool's edge.  If your life is balanced and healthy even if you enter the river close to the whirlpool you can pretty much hold your own against the current, maybe even swim upstream.  But, the more unbalanced and unhealthy your lifestyle is, the harder it is to resist the pull of the current. If you can't swim hard enough to escape you get sucked further into the vortex until you reach a point where it is impossible to break free; forces completely beyond your control are pulling you under. 

Put another way - there's a point at which restoring metabolic equilibrium is no longer possible because the metabolic processes have become chaotic.  

I asked above, what drives human beings to consume 20,000 calories a day and eat themselves into a state of complete helplessness and early death? 

You can go down the low-effort thinkers’ route and believe it's simply due to individual pathology - a sudden increase in the number of lazy, self-indulgent people who make bad choices and eat too much of the wrong things and exercise too little. 

Or, you can exercise your intellect and your humanity and see it for what it is - the gross disruption of people’s metabolism caused by a cynical, callous, profit-driven industry.

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If you're still with me, the following section provides some back ground on the changes in agriculture and food production since the 1950s.

An agricultural revolution occurred after WW2 with the use of nitrate fertilisers. A massive boom in food production took off in the 1960s in the USA with the industrial scale farming of maize, which was alternated with legumes such as soya beans and peanuts to offset the soil nitrogen depletion that occurs with intensive maize growing.

Maize fuelled the massive increase in the quantities of cheap food available to the USA's burgeoning supermarkets and fast food restaurants.  The soya meal and peanuts also found a role in food production as protein boosters and bulking agents. 

Super markets and fast food chains rely heavily on processed foods with a long shelf life.  Instead of people buying raw ingredients and cooking, preserving them etc, the food industry takes raw ingredients and makes more profit out of them by turning them into a finished product. This processing hides both the quality of the raw ingredients and the nature of the added ingredients like protein boosters, colour and flavour enhancers and artificial preservatives.

Coincidental with this was the development of technologies that allowed the vast maize surpluses to be turned into high fructose corn syrup (among other things). 

The era also saw a huge increase in cardio-vascular disease and bowel cancer that sparked a debate between those scientists who argued it was due to increased consumption of saturated fats and a sedentary lifestyle, and those who argued that the main culprit was the massive increase in the consumption of sugar.

The lobbying power of the heavily protected and heavily subsidised US maize growers and the chemical industries linked to them, ensured that saturated fats were blamed for the health problems.  

The food industry smelled a chance for even bigger profits in marketing 'healthy' low-fat foods.  Health and appearance obsessed consumers, guided by the advertisers, dutifully consumed the 'healthy' low fat and low salt alternatives.

The problem with taking fats out of food and not adding salt is that you remove a lot of the flavour so, to enhance flavour, the industry added even more HFCS which also acts as a preservative, adds calorific value and, the more people eat it, the more they want of it. In the USA, consumption of HFCS increased by 1000% between 1970 and 1990.  

Any observable reductions in heart disease and colon cancer as a result of the removal of natural fats may well have been attributable to other lifestyle changes, such an increase in exercise and dietary fibre. The startling outcome of the increase in the use of sugar from the 1970s was that people started getting fatter and Type 2 diabetes, once known as 'adult-onset' diabetes before it started appearing in children, was becoming more common, as was non-alcoholic fatty liver disease.

The 1980s' monetarist reforms resulted in the export of the American model of intensive, chemical dependent agriculture and food production to the rest of the developed world.  Public health advocates and scientists who tried to argue that the problem was the omnipresence of sugar and of HFCS in particular, were ignored, mocked or smeared.  

All attempts to control the food giants' use of sugar have failed.

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