7 April 2016

How sugar, skewed science and bad politics created a public health disaster

By

If you haven’t read Ian Leslie’s work before, then you are in for a treat if you buy a copy of today’s Guardian (what do you mean you don’t buy the Guardian?). Ian Leslie’s background is in the advertising industry and his latest book is Curious: The Desire to Know & Why Your Future Depends On It. I rarely miss one of his pieces. But even by his high standards, the long read he has produced on sugar and nutrition is a humdinger.

In essence, a good deal of what we have all been taught in the West about diet and the relative risks from fat and sugar, seems to have been based on at best a misreading and at worst a conspiracy perpetuated by well-meaning people who could not countenance the idea they may be wrong. The truth has been leaking into the public consciousness gradually in recent years. Don’t eat too many eggs! Eggs are fine now. I can’t believe you’re still eating butter! Actually, real butter is ace and better for you. Too much olive oil, which we think of as good thing when we’re in Italy, where they live longer, is bad for you the moment you get off the plane at Heathrow! No, use proper olive oil rather than the low-fat alternatives that have been pushed our way for decades now. Fat is the enemy! No, it seems sugar is the bigger enemy.

Someone did warn early on about sugar and for his trouble was trashed. Like most of us, I’m sure, I had never heard of British scientist John Yudkin until Ian Leslie mentioned him. More than forty years ago he was turned into a pariah for arguing that sugar – and not high fat – should be the focus of the most concern. Obesity levels in the West have sky-rocketed in recent decades, despite many consumers eating products labelled as healthy and worrying about cholesterol.

As Ian Leslie writes: “If, as seems increasingly likely, the nutritional advice on which we have relied for 40 years was profoundly flawed, this is not a mistake that can be laid at the door of corporate ogres. Nor can it be passed off as innocuous scientific error. What happened to John Yudkin belies that interpretation. It suggests instead that this is something the scientists did to themselves – and, consequently, to us. We tend to think of heretics as contrarians, individuals with a compulsion to flout conventional wisdom. But sometimes a heretic is simply a mainstream thinker who stays facing the same way while everyone around him turns 180 degrees. When, in 1957, John Yudkin first floated his hypothesis that sugar was a hazard to public health, it was taken seriously, as was its proponent. By the time Yudkin retired, 14 years later, both theory and author had been marginalised and derided. Only now is Yudkin’s work being returned, posthumously, to the scientific mainstream.”

You can read the whole piece here.

Several observations from me:

1) This is a genuinely shocking story, unlike the Panama papers, which generally seem to involve rich people obeying the law but offending the Guardian and others by being extremely rich. I’m usually pretty hard to convince on this health nut stuff. I like sugar. I detest being told what to do by Jamie Oliver and puritanical government health ministers. Sometimes, however, vague prejudices only get us so far in understanding the extent and complexity of a problem. Sometimes we need to put the mantras down and turn on our brains.

2) The sugar conspiracy, or cock-up, call it what you will, should at least give all of us pause for thought on the science of climate change and the many claims made on its behalf. I mean it should make those on both sides of the argument stop for a second and consider if they might in making their case have fallen into the trap that many nutritionists fell into, of advocating their favoured orthodoxy and shutting out the possibility that it is at least partially wrong, and for understandable career reasons (most of us have mortgages or bills to pay) banishing doubts if they popped into their minds. With the gift of hindsight we tend to assume we are inherently more sophisticated than our ancestors: “How could they ever believe that?” And yet for forty years, an enormous machine whirred away, operated by the scientific Establishment, governments and supra-national bodies such as the WHO. All pushing an orthodoxy about which there are now, at the very least, major doubts.

3) This story should have major implications for how we think about regulation and what it can achieve well beyond nutrition. In banking, some of the most exciting work is being done by Charles Calomiris at Columbia and his colleagues. He’s a leading expert on bank crashes and the regulatory response. A lot of what we think we know turns out to be wrong. Introducing deposit insurance (protecting your deposits) must make banks and the system safer logically? It must do? Nope. There is a large amount of evidence that it can make banks more likely to be reckless because their senior staff know government stands ready to rescue them. Yet we have built an entire architecture of regulation over the course of the last century on the fallacy of making finance “safer” while actually making it more dangerous. You think bank crashes are a universal phenomenon? Again, nope, simply not true. The US has had more than a dozen serious banking crises since the country’s rapid industrialisation, all the time building in ever greater implicit subsidy and support for the system. Canada next door has had no banking crises in the same period, or nothing of comparable seriousness. The Canadian approach to banking and regulation was historically entirely different from the US approach. It’s not somehow “in the water”. Contrasting outcomes are the product of different approaches to regulation.

4) One common lesson from banking and the nutrition scandal is that it is folly to try to do too much when it comes to regulation. As Calomiris says, keep it as simple as possible and design rules with clear incentives in mind to encourage less harmful behaviour and reduce the risk of disaster. Similarly, the effort to harmonise food nutrition and regulation all built on a largely unquestioned consensus, that we believed because the scientists were almost all in agreement, turns out to have contributed to a public health disaster in the form of obesity. Cooperation is a nice word and it is all very well. But the tendency inherent in officials and leaders seeking to respond to globalisation is to seek common standards, which by require an underpinning “big” theory and an easily communicated problem. This can have appalling unintended consequences. It amplifies mistakes and via government and the media the effects are then endlessly transmitted across borders. That leads to hundreds of millions of people shopping and eating according to a consensus that turns out to be wrong. This seems increasingly likely to have happened with fat v sugar.

5) Everything these days turns into a legal row and a class action. Why won’t this sugar story highlighted so well by Ian Leslie end up going the same way? Answers, please, on a post-card or in a letter to CapX.

Iain Martin is Editor of CapX