Eight steps to reverse the diabetes epidemic

The sugary food tax debate is back in professor Grant Schofield's latest research. Photo: Lynn Grieveson

A high-profile, pro-fat nutrition advisor says the key to reducing type-two diabetes lies in a special eight-point plan, centred around reducing sugar consumption. Teuila Fuatai speaks to Professor Grant Schofield about his latest research.

The Ministry of Education’s special health advisor is proposing a new plan to reduce New Zealand’s type-two diabetes epidemic within three years.

Grant Schofield, a public health professor at AUT and the inaugural chief health and nutrition advisor at the ministry, sets out the anti-sugar plan in a newly published article in the Journal of Insulin Resistance.

Co-authored with two leading international nutrition experts, Schofield and his colleagues hone in on the role of the processed food industry in the increasing rates of diabetes.

“To them, it is about energy balance, gluttony and sloth, diet and exercise, and if you are overweight it is your fault,” the trio write.

“Yet, when weight and calories are factored out, the correlation between sugar consumption and type two diabetes is much stronger. Furthermore, there are countries where diabetes rates are high, yet obesity rates are low, such as India, Pakistan and China – while their sugar consumption has increased by 15 percent in the past six years alone.”

Schofield, who advocates a low-carb, high-fat diet, is adamant New Zealand is at a turning point in its attitude and understanding of the health impacts of sugar.

“If you look at the sort of damage sugar does - [for example], when you’ve got four-year-olds getting anaesthetised to get half their teeth taken out because they’re rotten - and people say parents should know better, if we just made widespread change on how much sugar was floating around then we’d probably be better off.”

New Zealanders are sick of being “the third-fattest country in the world” and having some of the worst dental decay for young people, especially among Māori and Pacific people, he says.

While the highly-debated taxes on sugary drink and food form one of the plan's eight recommendations, the What the Fat! and What the Fast! co-author maintains a realistic perspective on how this could play out in New Zealand.

“[This Government] might not do a tax right away, but they can certainly start….with any of the points in our paper that we’ve suggested.”

Anti-tobacco laws over the years are used by Schofield and his co-authors to show the importance of Government intervention in making sugary foods less available and affordable in shops. Changes at the supermarket, ensuring sugary food and drink are not “loss-leading” and easy, end-of-aisle temptations, are among the recommendations.

Organisations providing dietary advice should also be banned from accepting money or endorsing products that market processed food, Schofield says. If they do accept or promote companies that have processed food, that should be publicly declared to show a conflict of interest.

Research modelling in the paper shows after three years of the such a plan being implemented, the prevalence of type-two diabetes begins to reduce.

Schofield: "We could reverse the trend in three years, and then it could start going down again. It’s taken 50 years to get to where it is now, so three years is not a long time to wait at all."

He also points out that anti-sugar policies could be tacked on to current “infrastructure” restricting sale and advertising of alcohol and tobacco.

“We’ve got quite strict controls [over alcohol and tobacco sale]. I know people enjoy them, but they cause harm. It’s exactly the same with sugar and junk food.

“We already have all the infrastructure to do that with alcohol and tobacco, so let’s just chuck sugar in there as well.

Schofield also uses tobacco to rebut “industry arguments” regarding potential loss of business.

“At every point [when changes were made], there was interference. When smoking was stopped in bars and pubs, the industry… said it was going to be the end of everything and there would be people out of business. Actually the exact opposite happened. The country was just a better place.”

Overall, the public health problems stemming from excess sugar consumption are not too different from those associated with tobacco.

“You can say there is no safe level of tobacco, but there is a safe level of sugar,” Schofield admits.

“But there’s no nutritional value for sugar. I’m not saying we’ll ban it, it will still be in society, but we’ve got to change its availability - it’s pretty obvious.”