More evidence that low-calorie sweeteners are bad for your health
Studies show that artificial sweeteners can raise the risk of hypertension, metabolic syndrome, type 2 diabetes and heart disease, including stroke.
You will have seen the doomsday headlines about the recent government survey which highlighted the looming health disaster that is the average British diet.
The media furore suggested that fruit juice and cereal were nothing less than health ‘timebombs’.
We’ve certainly reports on the problems of things like the hidden sugars in fruit juice, sugary sodas and the need to get our heads around eating a wide variety of whole grains before. Indeed many natural health campaigners have worked hard to get this message across.
Given the long running battle to get us all to eat more healthily, the headlines don’t seem all that new or interesting. But do the headlines tell the whole story?
A snapshot
What is the National Diet and Nutrition Survey (NDNS) from 2008 to 2012 – and what did it really say?
The NDNS is a regular survey of the British diet, funded by the UK’s Food Standards Agency (FSA) and Public Health England.
Between 2008 and 2012 a randomly selected group of people aged 18 months or more, from 799 different postcodes, were invited to take part in the survey, via post.
Up to one adult and one child were selected from each address, and this gave a sample size of 6,828 people over the four years (3,450 adults and 3,378 children).
The adults and children were then interviewed, weighed and had their measurements taken. The family’s socioeconomic status was also determined. They were then asked to complete a four-day food and drink diary using estimated portion sizes. Those who recorded at least three days of consumption were given a £30 voucher for a high street shop.
Participants were also asked to complete a 24-hour urine collection and have a fasting blood sample taken by a nurse, alongside other measures. Around half the participants agreed to this.
The results, once tabulated were split over different age groups: children of different ages, adults aged 19 to 64 and older adults aged 65 and over.
Not a very pretty picture
Although it was only a snapshot of the British diet, taken over four days and a weekend, the survey went into a great deal of detail about the participants’ diets. Its findings were not very encouraging:
Fruit and vegetables Only 30% of adults and 41% of older adults were eating or drinking the recommended five portions of fruit or vegetables a day, and only 10% of boys and 7% of girls aged 11 to 18 got their “5-a-day”. Adults aged between 19 and 64 consumed on average 4.1 portions of fruit or vegetables per day – a portion less than the minimum amount recommended for good health.
Salt Estimated salt intake was based on the amount excreted in the urine. On average, this was higher than the recommended levels for all groups of children and adults, except girls aged 7 to 10 and older adults. Salt intake was estimated to be higher in males than females. Adults (age 11 and older) should eat no more than 6g of salt a day, children 7-10 years should have no more than 2g. Children aged 4-6 1.2 g and infants up to 3 years 0.8 g. Read more about salt here.
Fat The average intake of total fat met the recommended level (no more than 35% of food energy) in all age groups apart from men over 65, who were just over the recommendation, with 36% of their food energy coming from fat. However, the average (mean) intake of saturated fat exceeded the 11% recommendation in all age groups (coming in at 12.6% for the adults surveyed).
Of course the implications of saturated fat intake are changing faster than most of us can keep up with. But the bulk of the evidence suggests it simply is not the dietary demon it was once believed to be.
Fibre Dietary fibre for adults and older adults was 13.7-13.9g per day, which is below the recommended minimum of 18g.
Oily fish consumption was less than half the recommended one portion per week in adults.
Added sugar Average intake of non-milk added sugars (such as sugars added to some fruit juices and soft drinks) was higher than the recommended limit of 11% for all ages. The levels came in at 14.7% for children aged 4 to 10 and 15.6% in children aged 11 to 18. The main source of this sugar was soft drinks and fruit juice, which accounted for 30% of the intake for those aged 11 to 18.
Iron and minerals Average (mean) intake of iron was below the recommended levels for women and girls aged 11 to 18, and intake was below the lowest threshold in 23% of women and 46% of girls in this age group. Intake of calcium, zinc and iodine was also low. The intake of other minerals such as potassium, magnesium and selenium were below recommended levels in all age groups, except children aged under 11.
Vitamin D levels Low vitamin D was found in a proportion of all age groups, which included 7.5% of children aged 18 months to 3 years, 24.4% for girls aged 11 to 18, 16.9% in men over 65 and 24.1% in women over 65.
Blood cholesterol levels A third of adults had cholesterol levels high enough to place them at a marginally higher risk of cardiovascular disease, which is one of the main causes of death in England. A further 10% of adults had cholesterol levels that moderately increased their risk, with a further 2% having a high risk of cardiovascular disease.
Health campaigns failing – but why?
There have been numerous health campaigns stating the benefits of eating at least five portions of fruit and vegetables a day, as well as limiting sugar, salt and saturated fat.
It would seem that, based on this survey’s findings, these core messages may not have prompted dietary improvements for many people. However, they may have had impact in preventing people’s health from worsening – there is some evidence that since 2009, obesity rates have stopped rising.
The findings are concerning as the risks of an inadequate diet are well known:
The picture in the UK is similar to elsewhere in the developed world. Despite many expensive campaigns encouraging us to eat more healthily the message still has not translated into behaviour change.
According to NHS Choices, there could be numerous reasons for the public health messages failing to lead to a widespread change in eating patterns.
For example, many more people may now be aware they should be eating at least five portions of fruit and vegetables a day, but choose to ignore the message. Some commentators have also argued that some food manufacturers may be “manipulating” the 5-a-day message with confusing labelling.
Experts also confuse the 5-a-day picture given that they can’t agree amongst themselves whether we should be eating this amount or even more toe stay healthy. Recent recommendations suggest it should be 7-a-day.
Complimentary explanations include the fact that people want to eat healthily, but find many barriers to doing so, such as being unable to easily get healthy foods that are cheap and easy to prepare.
The obesogenic environment
Another explanation is that people are living in what is known an “obesogenic environment”. This is an environment that “promotes” obesity – such as working in an area that has plenty of takeaway burger and kebab shops, but no shops selling fresh fruit and vegetables.
The concept of ‘obesogens; however extends far beyond unhealthy take-aways and has shown us time and time again that a calorie isn’t just a calorie. Indeed in the US surveys have shown that calorie consumption has gone down but weight continues to go up.
Obesogens also include industrial chemicals that promote obesity, the lack of sleep culture, which greatly disturbs metabolism and leads to poor food choices and the detrimental effects of stress. Advertising that glamorises junk food should also be thrown into this mix.
What this shows is that while surveys like this are interesting and useful, they never really get to the heart of the matter of why we continue to make bad food choices.
In many ways the confusion and paralysis of average people may, in the end reflect the chaos of the policymakers and scientists who continue to look at health in very narrow parameters and therefore draw unsustainable conclusions about health.
Culture change, when it comes to food, undoubtedly needs to encompass the ‘culture’ of ‘experts’ as well.
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