Sugar Sickness

New Zealand is, apparently, the third fattest nation in the world according to OECD statistics. Yet fighting the obesity “epidemic” is not rocket science. Apart from the very few people who have some serious metabolic disorder, all that causes obesity is taking in more calories than you burn up. Yes, it is rather more complicated than that, but not from the view of the practical outcome. If you exercise and eat fewer calories, you will always lose weight in the long run.

Notice I don’t say, if you eat less, you will lose weight. It is tragically easy to eat smaller quantities, but switch our diet to very calorie-rich products, often promoted as “health” products – but stuffed with fats and carbohydrates. Thus, I do understand where this article by Tony Falkenstein is coming from when he advocates a tax on sugar. Unfortunately nearly everything is the article is incorrect and Mr. Falkenstein’s understanding of the subject woefully deficient. A sugar tax is a very poor way of fighting obesity and a counterproductive way of fighting diabetes.

Let’s start with diabetes, a subject of which I know a considerable amount being not only a doctor but a type 2 diabetic. Diabetes is not caused by obesity. Morbidly obese people (people weighing over 50% more than their expected body weight for their height) are often diabetic, but this is because their fat renders insulin (the hormone that pushes fat and sugar into cells) less efficient. But you need a lot of excess fat to become diabetic solely due to your weight.

Type 2 diabetes is a genetic condition where insulin does not work as well as it should (unlike type 1 diabetes where the pancreas makes little or no insulin). It is found in about 50% of Pakeha and 90% of Maori, Pacific Islanders and Asians. In ancient times the gene would have been an evolutionary advantage as, during times of famine, it would have kept your blood sugar levels up. Your brain can only use sugar for energy (most of the body can burn fat). Consequently, low blood sugar makes you less able to hunt, gather or seek a mate.

Fast forward to the present day and most OECD countries have no shortage of food at all. In addition, carbohydrates are the easiest energy source to produce and therefore the most abundant in the types of food we eat.  Worse, most carbohydrates are in a form that is readily metabolised straight to glucose (so-called high glycaemic index food). Should you have the gene for insulin resistance your sugar levels will gradually rise as your poor pancreas tries to cope with the sugar load. Eventually the pancreas loses the fight and you develop diabetes (note: not everyone with this gene will develop diabetes)

Immediately one can see the absolute pointlessness of a sugar tax. Potatoes, white bread, rice and pasta become sugar in the body as fast as pure cane sugar and nearly as fast as glucose powder. Taxing sugar is like sticking your finger in the dyke when the tsunami alarm has just gone off. And taxing carbohydrates in general is just adding a tax to nearly all food.

It is the combination of plentiful food and high levels of easily accessible cheap carbohydrates that has produced both the diabetes and the obesity epidemics. This is unlikely to be easily changed because plentiful, cheap food is a GOOD thing, despite the few disadvantages. There is no famine in New Zealand and even the poorest of people should not go hungry (some, of  course, do, but that is not usually due to food being unobtainable).

Mr Falkenstein suggests we are all addicted to sugar in the same way that people are addicted to tobacco. This is a very poor analogy. We are wired to like the taste of fats and carbohydrates in our basic genes because these are the high-calories foods we need to consume in order to survive. We are not in any way wired to like burning tobacco. While I have some sympathy for the view of Mr. Falkenstein that the health industry uses false advertising techniques similar to the tobacco companies, I should point out that Mr. Falkenstein himself in the CEO of a bottled water company, surely the biggest health con of the lot!

Be that as it may, the food industry in general is merely responding to what people like to eat. We want tasty fats and carbohydrates. Therefore, that is what they provide and advertise. Unlike, tobacco, which requires a certain amount of peer pressure and brand-generated desire to produce a habit, the food industry merely has to produce something appetising. The product will then continue to sell itself.

So sugar is not an addiction, in any meaningful sense of the word. This does not entirely invalidate the argument that a tax will get us to consume less sugar (though the value of this in the war against obesity is questionable), but let us not have images of the noble government trying to save it’s addicted population. What we should be looking at with a critical eye is exactly what would be taxed in this regime proposed by Mr Falkenstein, because we are not simply talking about candy bars and coke.

• Honey 80% sugar
• Packet mixed nuts and raisins 27% (without raisins 5%)
• Tomato sauce 16% sugar (Baked beans 8.2%)
• Fruit juice 10.4%
• Peanut butter 5%
• Milk 4.2%
• Bread 2%
• Packet of Pringles 1%

Now, when you can explain to me how a packet of Pringles in a child’s lunchbox is somehow better than a packet of nuts and raisins, I will agree that a tax on sugar is a good thing. Until then, let me leave you with this gem from the article:

“Last month, Denmark, which has one of the lowest obesity rates (one-third of the New Zealand rate) introduced the world’s first fat tax, levied on foods, including butter and bacon, that contain more than 2.3 per cent saturated fat. [emphasis mine]”

And there you have it in a nutshell. Denmark has one of the lowest obesity rates in the first world and yet simply has to introduce a new tax. The correct question here is not Mr. Falkenstein’s “why not here?” but “When will they stop interfering?”

The answer is never in our lifetime.

“First they came for the sugar
Then they came for the fat
Then they came for carbonated bubbles
and made the coke quite flat

“Then they came for the beef, the chicken and the lamb
Suddenly there was nothing with a taste worth a damn
Finally they came for everything left that was nice
We were left with spinach, asparagus and rice

“All because we were timid, silent mice.”

(Apologies to Martin Niemöller)

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