The Guardian has an article with this headline this morning:
It also has an article with this headline:
The two between them reveal a truth that is almost wholly unspoken and little appreciated. This truth is that type 2 diabetes is a disease largely created by the consumption of too much sugar in the form of fructose and that the disease can be reversed by largely eliminating fructose from the diet of those suffering from that disease.
Fructose is like nicotine in cigarettes: it is an addictive drug hidden in a processed product (in this case, most of the ultra-processed food on sale in the UK) that has massive social consequences.
Many of those ultra-processed foods are sold to give us dopamine highs. They succeed in doing so. They also leave us wanting more. So, we go back and get it. The result is obesity. And from that follows, in too many cases, type 2 diabetes. The progression is known about, predictable, heavily researched and largely unknown because there is a massive conspiracy to hide the truth.
Those conspiring not to tell the truth are food manufacturers, food retailers and big pharma. The food industry and its retailers want to keep selling large quantities of fructose. Big pharma wants to keep us in the dark on the easy reversibility of a disease that can be straightforwardly cured without costly drug interventions that are overburdening the NHS.
How do they do that? By deliberately ensuring that misinformation is available. As the author of the second Guardian article notes:
I now realize my doctor was making an honest attempt to follow the [treatment] guidelines issued by the American Diabetes Association. I didn't ask him if he was aware that the top five funders of the ADA are the pharmaceutical companies Abbott, AstraZeneca, Eli Lilly and Co, Novo Nordisk and Regeneron.
The guidelines on treating diabetes in the USA (and so elsewhere) are created by big pharma to suit the need of big pharma to sell a lot of drugs and not to cure people of type 2 diabetes in months, which could be done by prescribing proper diets that would cost considerably less than that diabetes drugs.
I am not a fan of conspiracy theories. Far too many are just crackpot. But an open mind is also required in a case like this. We know the tobacco industry lied for decades about the impact of smoking.
We know that the Bank of England speaks nonsense when imposing its charges on society.
And the sugar-based food industry and big pharma are doing the same when it comes to fructose-based ultra-processed foods that are profoundly harmful.
There is no VAT on most food in the UK. I seriously wonder whether that should be changed now. Should the exemption just be available on non or low-processed foods? Wouldn't that make as much sense as taxes on tobacco?
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No.
First, we know this would be a highly regressive tax.
Second, we would get mired in the “is it a (VATable) cake or no-VATable biscuit” debates.
Better to use (fresh, healthy) carrot rather than stick to improve diet.
We will have to disagree on this
What is the healthy carrot?
The healthy carrot would be an SHI healthcare system, not a tax on highly processed foods which would include tofu, sliced bread but not meat.
The world can survive without tofu and sliced bread is pretty toxic stuff.
Difficult, I agree.
The first thing I would do is make cooking lessons in schools universal. If school is not about delivering skills for life then what is it for…. and what more important skill than being able to feed yourself?
I could accept food being taxed at differential rates to reflect harm they cause “in principle” (is it any different from alcohol/tobacco taxes??). I could also see that if we introduced it now we would see benefits in the long run. However, getting for “here to there” would be brutal on many of the poorest in our society…. and that is the rub.
Rates can be increased over time….
I agree about cooking lessons
I never had any. That was wrong, and reflected society at the time. Girls did, of course.
But now I am genuinely shocked by how people know how to cook, and that it is a pleasurable activity.
On the subject of cooking – the times they are a-changing. The last two times I childminded my 11 year old grandson his requests were, “Can I make some lemon drizzle cake”, and “Can I make some meringues”. Granted not the healthiest options but he has also been known to cook the family dinner. The results were perfect and along the way he taught grandma a trick or two!
Excellent
My two can cook – not Master Chef, but edible. It helped that they were fed by their dad, quite often.
Being more or less vegan, tofu is my go-to protein, not a high fructose carbohydrate.
I read that Guardian article yesterday and can’t remember reading the word fructose in it.
I have four different types of tofu in my fridge. All of them have less than 1% sugar, but 18-20% of protein. Maybe more people should eat tofu more often.
My husband had type 1 diabetes from when he was 11. I was married to him for 45 years, and in all that time it was carbohydrates that had to be controlled. If he was having a hypo, glucose tablets were useful.
The last three weeks of his life he was hardly eating or drinking. I had to give him 5 units of insulin and test his blood, then give him an inch of banana to counteract it.
Bananas contain glucose and fructose, with the fructose being converted in the body into glucose, so the glycaemic load is better for the body to cope with.
So why is fructose seen as the bad carbohydrate in all this?
I know type 1 and type 2 are different, but the carbohydrate question is the same.
Type 1 and 2 diabetes are very different as I understand it (my knowledge is based on considerable research by my wife, who was a GP and both MRCP and MRCGP as well as having six other medical post graduate qualifications).
Fructose is useful – except we on average consume 500% of what we need – and it then creates fat. Cut out that fructose and the body learns to burn fact again – and the Type 2 diabetes goes away.
Exercise does not do this – diet does. In fact, we exercise because we can absorb fat, not to absorb fat, I am told.
I do check these things.
This reply is to JenW’s query about why fructose is specifically a problem (as opposed to glucose) — it’s because of the specific digestive process for fructose, which is in the liver. In nature, fructose is only available alongside glucose and fibre, both of which trigger satiety long before damaging amounts of fructose can be consumed at any one time (which also inhibits consumption of large amounts of fructose over time). One of the principal dangers of the modern “frankenfoods” (aside from the tricks they play upon natural satiety triggers) is the high volume of fructose they can deliver at one time (which also allows for consumption of far larger quantities at one time). This is why the ubiquity of high-fructose corn syrup is implicated in increasing obesity rates.
This was discovered by Dr Robert Lustig, an American childhood obesity expert who was puzzled by the incidence of fatty liver disease in young children who were clearly NOT consuming alcohol.
Agreed
Tofu (豆腐), or as I prefer to call it “doufu”, the pinyin transcription of the characters, has been part of the staple diet of Southern China for well over 2,000 years. There is both archaeological evidence of its production and evidence of its use in the literature of the Warring States period. Admittedly this evidence is open to varying interpretations.
Doufu is hardly an ultra-processed food. In the ’70s, when both products were hard to get in the UK I used to make my own soya milk (douzhi) an doufu. To make soya milk you boil ground soya beans in water for, maybe, an hour — I can’t remember the exact time. You then strain away the grounds. To make doufu you then add a curdling agent to the soya milk. The best one to use seems to depend on the type variety of bean. I have used lemon juice, fermented black tea and several others. Commercially they seem to use Calcium Chloride and/or Magnesium Chloride. Lastly you press the curds in a press to the degree of firmness you require. The final result depends on the variety of bean, the curdling agent and the firmness of the press.
There are a lot of contradictions to the Chinese soy products trade. In parts of China doufu is seen as “poverty food”, something you eat because you can’t afford meat. But in the same areas you will find very expensive restaurants, catering mainly to Westerners, that serve traditional peasant dishes using doufu that is normally produced from local beans and guaranteed to be GMO free. At the same time vast quantities of soya beans are imported from the USA as animal food to service the increasing demand for meat. But there is another paradox. The animals used for meat production is often fed antibiotics that kill the archaea and bacteria in their stomachs that produce vitamin B12 which has the consequence that if they were not fed supplements they would become seriously ill and anyone who switched over from, say, a traditional Buddhist diet to a more western diet using meat from these animals would have less vitamin B12 in their diet than before. So where does this vitamin B12 come from? The answer is that it comes predominantly from fermented soya. The reason why the traditional diet contains more B12 is that it contains a small amount of fermented doufu.
Certain varieties of soy sauce also contain B12 because of the way they were fermented. A story is told of a hippie colony in the ’60s that decided to change to a Japanese macrobiotic diet. Everything was cheap and easy to obtain locally in the US except for the particular type of soy sauce specified. This had to be imported specially from Japan at great expense. However they concluded it was only a flavouring and substituted a much cheaper soy sauce that tasted virtually identical. After a while they all started to suffer from pernicious anaemia.
A point I had intended to make but was not quite clear about is that the vitamin B12 obtained from antibiotic-fed meat, traditional east Asian vegan diets and dietary supplements all have the same origin, namely, fermented soya. (OK, there are other ways of synthesizing B12.) So any claim that any of these diet is “naturally better” than another one on account of needing B12 supplementation are misplaced. A question worth asking anyone who insists that B12 can only be obtained from animal products is why are all B12 supplements on the market marked as vegan.
Just a small point, cooking is not enough, Domestic Science is a while lot more than simply cooking. Marguerite Patten made this point in the post war ministry of food, and again when I last heard her talk on the radio this century.
Calling it cooking was a way to regrade it to a trivial, thing that could be left to women to do. Casual mysogyny in the UK school system, incidentally.
I have been listening to BBC Radio Scotland GMS tortuously questioning politicians, from an immigration hostile perspective. Putting the case that if care workers are needed in Scotland, the numbers required should be precisely specified; and that elsewhere in the economy industries that are short of people should pay more to those already here, rather than rely on immigration.
This is a ludicrously ignorant, irresopnsible argument in Scotland. Why?
The birth rate in Scotland is 1.3 per woman. The replacement rate is 2.1 per woman; the actual rate is so catastrophic it is on a trajectory to extinction. It is unsustainable and irresponsible to continue like this. At this rate the Scots will follow the Picts; just disappear.
In the years leading up to Brexit, membership of the EU had stabilised the position, and Scotland’s population was modestly growing. We are now falling off a cliff. The BBC’s failure to recognise, and explore the real nature of the problem when they cover news is quite outrageous; it is participation in dog-whistle, right wing politics. What happened to ‘inform’, ‘educate’? It is all beyond the tawdry standards of Pacific Quay.
No. I think that is a terrible idea.
Much of your recent output has been about inequality in the tax system. I am of the opinion that this would exacerbate inequality. Like many of the “sin” taxes it creates a two tier society where the wealthy can do as they please and the poor must do as they are told.
A better approach would be proper regulation of the food industry to stop them from creating bad food. If that means higher food prices then increase the minimum wage and benefits to allow the less well off to make better/healthier food choices.
I also agree with Clive Parry that it would be a nightmare to administer re. what is subject to VAT and what isn’t
I doubt this would be a nightmare to administer.
I accept the regressiveness issue.
BUT redistribution can more than manage that, and I have shown where funds can come from. This is the Scandinavian solution to this issue.
Som the question is would you abolish tobacco and alcohol taxes because they are undoubtedly regressive. If not, how can you object to this!
Tax the fructose at source and whatever cheap nasty chemical feedstock they replace it with. Easy to administer.
That couild be done – price the additives and the sugar alone
But taxing sugar won’t happen, will it, with Victoria Atkins’ husband being managing director of British Sugar.
If we start asking it might one day.
This is a systemic problem with will require a systemic approach to tacking. We have permitted the creation of a total processed food environment. We have largely removed cooking and nutrition from the school curriculum, and with that go essential life skills. With smaller flats and houses dinning tables have been designed out. Our children have fast food relentlessly push at them though social media and other advertising (ask you lads). It’s an environment in which the supply chain has been rewarded from creating addictive products.
The resulting externalities are the degradation of health. Our bodies are literally being polluted by too much of what we eat and drink. The costs of which are overwhelming the NHS.
There is a role for tax (pricing signals). ‘Sugar tax’ on sugar laden soft drinks has been effective but was part but was part of a packages of changes and adjustments. From what I understand suppliers margins have been protected. If not you can bet we’d have heard.
This is on area where ‘carrots’ work. There have been some successful social prescribing pilots involving fresh fruit and vegetables vouchers targeted at poorer families. As with so many problems, inequality, in removing choice for some, makes them so much worse.
Thanks
I agree.
As with the sugar tax, the impact of imposing a tax on ultra-processed food is likely to involve food manufacturers making their offerings less toxic – which would be a very good thing.
It’s a mistake to regard this as only a regressive tax on poor people- the system is more dynamic than that.
I agree
The sugar tax on drinks has significantly changed what is on offer
In the EU, sugar has been largely replaced by artificial sweeteners which more and more research shows are harmful for gut bacteria. The hyper sweet taste profile remains feeding the addiction to sweet foods.
Richard I am a great fan of your posts. I would suggest an amendment to this one. Type 2 diabetes is not largely caused by over-consumption of sugar/fructose. It is primarily caused by obesity, of which there are varied dietary and social/behavioural roots. Obese patients with type 2 who return to normal bodyfat levels are able to recover from the disease. You yourself mention this later in your post.
Yes highly-processed foods can contribute to over-eating and reaching obesity, but I feel this is an important biochemical point especially as you lead with this as an opening line.
I’m sorry – but your claim that obesity is indeodnent of sugar/frctose increaased coinsumtion does not stack.
Of course there can be other factors – but to claim as you do that this is not the cause is disingenuous based on data I have seen.
To put it another way – you’re akin to claiming that because not all lung cancers are caused by smoking we should not worry about smoking.
What is your motive?
I also remember reading (sorry I don’t have the reference) that there is a worsening problem with people in the US developing type 2 diabetes/pre-diabetes that have a normal BMI.
I think the relationship between poor diet, type 2 diabetes and obesity is more complicated than suggested above.
It seems possible that obesity and type 2 diabetes are both symptoms of poor diet.
But obesity leads to type 2 diabetes
Hi Richard,
Society as a whole would undoubtedly be healthier if we reduced our overall dietary sugar/fructose intake. The food industry also indisputably uses predatory tactics and addictive properties of certain ingredients to sell more products.
The problem is energy dense food – not just fructose. It is not a single nutrient problem. The goal for public health should be to address the outstanding problem: dietary energy density in the population.
Many other people here are saying the same in the comments. We agree on the same things but disagree on a technical detail.
I do not suggest that Type 2 is independent of sugar/fructose consumption. It is a one of many factors. I am making a technical point on biology, not behaviour.
‘To claim as you do that this is not the cause is disingenuous based on data I have seen.’ You have seen the wrong data. It can be A cause. It is not THE cause. The point is small but important.
Here a small sample of data from extremely well regarded sources which have influenced my thinking. They discuss and analyse the available scientific evidence and meta-reviews.
Brad Schoenfield & James Kreiger, two of the highest regarded sports/nutrition scientists on the planet, discussing fructose – https://www.lookgreatnaked.com/blog/the-truth-about-fructose/ &
https://weightology.net/should-you-be-afraid-of-fructose/
https://biolayne.com/articles/nutrition/why-sugar-did-not-cause-the-obesity-epidemic/ – long discussion analysing many linked scientific studies from Layne Norton, a highly regarded debunker of fitness myths.
An easily digestible simple video analysing various scientific studies on sugar by Jeff Nippard – https://www.youtube.com/watch?v=9JrT84PeTgw
‘To put it another way – you’re akin to claiming that because not all lung cancers are caused by smoking we should not worry about smoking.’ I did not say we should not worry about overconsumption of fructose/sugar. We should worry about getting nutritional information correct to help us resolve our problems.
My motives – accurate dietary and health information. There are many sources of bad nutritional information and it is hard for people to sift through them. You have a large audience.
To summarise, you are saying the problem is calories, not fructose.
The evidence I have seen suggests that claim is outdated and needs to be replaced. Calories are not the issue,per se. I refer you to Robert Lustig’s work.
I would suggest that part of the problem is the manner in which retailers market some of this muck and believe me, some of it is just that. I work part-time baking some of this stuff for a major supermarket chain and it starts life as little more than frozen blobs of grease and sugar.
Doughnuts and cookies in particular are on display next to the till as they are very much an impulse purchase and because they are baked on-site they are not subject to the high fat, salt and sugar regulations which prevents similar products, not baked on-site from being similarly displayed.
The shelves are left full every day as that is a more appealing display to potential purchasers and if not everything is sold, who cares. The mark-up is so high, 20% wastage is considered acceptable. Difficult as it may be to believe (yeah, right!) but corporate greed is right up there at the top of the list of drivers for the nation’s ill health.
I was unaware of that marketing rule
I hate the bags of doughnuts on sale, often for well under £1
Obviously!
We should also remove the hidden subsidies in meat, dairy and grain production and move them to vegetable production. Fruit is not actually very good for humans as the sugar content is too high.
I have reversed my type 2 diabetes by following a keto diet – a little bit more difficult for me as I am also vegan but eminently feasible nonetheless.
Your point about fruit is little understood
Fruit is not that good for us – despite all that used to be said.
Vegetables are.
I hgave reflected this in my diet.
Glad to hear you have succeeded.
“Your point about fruit is little understood
Fruit is not that good for us –
despite all that used to be said.
Vegetables are…”
That depends on what is being defined as which in this conversation. One person’s understanding of what a fruit is can vary wildly from the next person’s.
These are all fruits that are habitually used as vegetables:
aubergines; avocados; bell peppers; courgettes; cucumbers; green beans; mangetout, or any peas eaten with the pod; okra; pumpkins; squash and tomatoes.
I’d expect there’s a a surprise, or several, in there for most people. Okra was for me.
But generally fruit as developed fir sake as such is much less good for us than vegetables
Sometimes generalities work
I must disagree that the sugar tax has been a success. It has undoubtedly been successful in reducing sugar in fizzy drinks but the result has been that they are sweetened with sugar substitutes like aspartame and stevia – substances on which there has been a vanishingly small amount of research and such that exists suggests they are implicated, at the very least, in gut inflammation….
If the tax was to work they needed to tax sweetness, not sugar.
If you read Chris Van Tulleken’s Ultra Processed People https://www.hive.co.uk/Product/Chris-van-Tulleken/Ultra-Processed-People–Why-Do-We-All-Eat-Stuff-That-Isnt/28812811 (wherein for example, he discovers that we all use the same amount of energy in a day which is why we need to exercise – otherwise that energy will probably be used elsewhere and maybe against the body itself. Exercise does not burn off any ‘extra’ calories – you’ll just use less of them when you are at rest) you start to realise that there is lot more than fructose that we have to beware of!
But I do agree that vegetables are key and that fruit is not the all round good thing that it is usually seen to be. You just have to look at an image of a peach for example before it was ‘improved’ by human breeding.
It started off as about 90% stone and 10% flesh and now the proportions have been completely reversed.
Humanity’s most consumed fruit, the Chatsworth bred Cavendish banana (hence banana republic btw https://en.wikipedia.org/wiki/Banana_republic) has gradually become sweeter and sweeter, because that’s what sells.
Just as the ‘five a day’ was not evidence based and was more a marketing plan by food producers (and a transport company!) and had nothing at all to do with nutrition.
https://www.zoeharcombe.com/2012/03/five-a-day-the-truth/
We desperately need to get corporations out of food but as that chief purveyor of empty calories, Coca-Cola, is still, I think, the only product available in every single country in the world (except, it seems North Korea) that is a long and very difficult road…
Thanks Peter
“…generally fruit as developed for sale as such is much less good for us than vegetables…”
Fair point.
I’ve been involved in horticulture (and worked in fruit and veg when I was studying it) for over 40 years. Most of the new varieties, hitting the market, tend to be sweeter than what went before.
Another thing to consider with fruit (and veg, to a lesser extent) is how its consumed. If you eat fruit in its natural state, the intrinsic sugars are released over time. If you blitz fruit into smoothies, the sugars become extrinsic and are taken up instantly.
I got a lecture on the last point over dinner, just now. I had nit realised that, although I had known for a while that fruit juices are really not good. Eat your oranges in segments. It contains two fibres, one of which lines the duodenum and prevents the harm from the fructose, apparently.
It sounds like the sale of opioids (OxyContin) by Purdue Pharma in the US, which is the subject of the Netflix docudrama “Painkiller”.
Yes, tax fructose at source.
How can you tax fructose at source, Tim? Are you discouraging the poor from eating fruit? They can’t afford to buy that quite often. Why punish them?
Twenty years ago my husband took part in a study at York University Hospital about allowing diabetics to take charge of their diabetes.
They showed photos of food with 10g of carbohydrate. Vegetarians got a bad deal out of that. However, all the foods we normally ate, like apples, oranges, peaches and pears, beans, wholemeal bread, basmati rice, were all listed as low GI, and therefore better for diabetics to eat.
Now we are told that they are not.
Baked beans on toast is a very good meal for diabetics and vegans, but it’s boring every day! It was the only meal shown in the Bites study suitable for vegans that was low GI.
You are still addressing type 1 issues and type 2 is what is being discussed.
Metabolic syndrome is a better description of type 2 diabetes.
No, the glycaemic index of food was developed by the BDA to control blood sugar in type 2 diabetes .
My mother was a type 2 diabetic, by the way, so I understand a bit about that.
Weird focus on fructose. Of course it is bad but eatung a lot of unhealthy fats (found in large amounts in meat and dairy) does raise risk of developing type 2 diabetes, as is being overweight.
Only a crazy society would tax tofu and not tax meats.
I think you need to read some evidence
https://viva.org.uk/blog/tofu-trumps-meat/
https://viva.org.uk/lifestyle/going-vegan/easy-vegan-swaps/tofu/
https://viva.org.uk/health/a-zs/foods/soya-health/
Lots more where these came from.
It would depend on how the meat was produced. Industrially produced meat with disgusting animal welfare standards and damaging the environment etc, this too should be taxed out of existence. But regeneratively produced decent meat could be produced for occasional consumption for all of us if the farming system was financed /taxed / subsidized for regenerative purposes instead for the present disastrous climate degrading diversity destroying Big Ag system now in existence.
Secondly, soya, the main ingredient is one of the most destructive monocultures in many parts of the world. And don’t say “My Tofu is Organic”…. in parts of Argentina, a country I visit every year to see my family, produces some organic soya, this is how it is sometimes done, 1) Kick some indigenous people off their land. They have no paperwork, its easy. 2) Farm without inputs for two or three years but intensively , by which time the land is degraded , but you can call the soya “organic”.
Thanks
Your last point is very good
I try tofu but still can’t get on with it.
What about the fact that most soya grown in South America is for feedstuff for cattle?
I do eat organic tofu, but here, not in Argentina. It’s from soya beans grown in the EU or Japan, not South America.
Why am I not allowed to say organic, when I have been sourcing such as a vegetarian for over 50 years? I am used to reading labels, not only because of vegetarian foods but also my husband being diabetic. I don’t need to be chastised for it.
I had a vegetarian cafe, then a guest house. I trust my sources. They would tell me if anything changes.
In fact vegetarians and vegans know far more about food and nutrition than most meat eaters. My degree included food and nutrition in the mid 70s. That’s when I discovered I didn’t need to cook meat or fish any more, so I didn’t.
As it is, vegetarian and vegan food can cost more than other foods without any extra tax on it.
Sugar tax should be really high, and advertising controls – similar to cigarette advertising bans , planning controls on junk food shops/outlets .
Massive increase in good food propaganda , cooking – stuff on media etc
On the R4 Chris van Tulliken programme about fast food – (chicken in particular – only made edible by junk sugary/fatty stuff it comes with ) https://www.bbc.co.uk/programmes/m001t2yj
a young person was saying how overwhelming is the junk advertising/messaging/ on social media and even school materials sponsorship – plus all the junk food joints on her street/ school street – so different from the shops on the ‘posh’ street not far away in London .
No conspiracy – but I tried to ask doc if I could try reducing cholesterol with diet change – not interested – just pushing drug statin. Why no publicly owned/non profit/international pharma company?
The medical profession seems largely unaware of these issues.
There are very notable exceptions.
If Labour wanted to transform the NHS changing diets is how to do it.
Look who stands to gain from this idea.
https://www.theguardian.com/business/2023/nov/09/astrazeneca-bigger-push-weight-loss-market-new-drug-deal
https://lowdownnhs.info/drugs/new-nhs-deal-too-generous-to-big-pharma-say-campaigners/
How appropriate. Today’s news.
Precisely
This is a timely piece since it seems to me that even though fats (shortenings) have been taken out of food, they have been replaced by sugars as a binding agent – our food is increasingly ‘3D printed’ – sugars are used in 3D printing to hold shapes together.
The thing is, sugar is converted into fat by our bodies so we are walking into a very unhealthy future.
My response is for Government to take control of this and basically regulate sugar out. I think sugar also acts a preservative.
There was a time when (for example) Jammie Dodgers or Wagon Wheels behaved like traditional biscuits and crumbled in your mouth. Now, with more sugar but ‘less fat’ (shortenings), it’s like eating a brittle cracker devoid of flavour (except sweetness).
The sugar lobby are laughing all the way to the bank on this.
‘Bake you own’ is the future I think.
There is no rational reason for confectionery including chocolate covered biscuits to be taxable but chocolate covered cakes (and other cakes and biscuits) are zero rated, and yet we continue this nonsense from purchase tax six decades ago. The debacle of “pastygate” shows how difficult it is to make any meaningful change in this area.
I have seen no convincing evidence that the zero rate makes food in the UK any cheaper than it is in for example France where it all bears 5.5 or 10% VAT.
This is a subject close to my heart for half a century. I too highly recommend the Chris Van Tulleken “Ultra Processed People”, and would add Joanna Blythman’s “Swallow This”, parts of which will blow your mind as to what is sold as ‘natural’ or ‘healthy’.
Yes I would totally support a tax on ultra processed food. To alleviate the problem of definition of this, use the simple rule , “If there is one ingredient in the food that is not in a home kitchen, then it is Ultra Processed”.
The biggest problem would be, as previously mentioned, is that the poorest amongst us often only have access to food shops that only sell cr*p food, and fresh veg can be expensive, and sadly they often have have little access to the know how for producing good meals cheaply from lentils beans and other cheap but nutritious ingredients. See all of Jack Munro’s writing over the years in the Guardian and beyond.
But I believe that with enlightened social policy, enlightened educational policy and enlightened financial policy this would be easy . I too don’t go in for conspiracy theories, but I believe if you actually tried to stop the processed food / Big Pharma bandwagon they would try everything dark and shady to stop such a move.
Finally, my passion is also for soil ! The extraordinary lack of nutrients in even most fruit and vegetables produced from industrial agriculture, in the past thirty plus years is another mind blower – read books about Regenerative Agriculture.
Jack Munro’s work is really good – especially on how to store foods to get maximum value. I have several of her books and will never forget a few days in Northern Ireland with her.
What about some sort of cap on the maximum amount of sugar – or the equivalent in sweeteners that is sold in the UK and gradually reducing it year on year.
I would also extend the tax on sweetened drinks to cover all forms of sweetener.
At the end of the last Labour government they demanded, without fanfare, a 10% reduction in slot in prepared foods per annum for three years. There was a significant fall in strokes as a result. The government can change things.
And if you bake use at most 2/3 of recommended sugar (or less). You won’t notice and the other flavours come to the fore.
There is a bit of confusion above between the causes of type 2 diabetes (how it arises) and risk factors for it observed in patients.
Type 2 diabetes is the name for the disorder when the hormone insulin stops carrying out its normal role properly (“insulin resistance”). The usual pattern is that when you eat, nutrients including simple sugars (monosaccharides) are released into the blood stream. Sugars are the main source of energy throughout the body, and the amount in the blood is carefully regulated such that when there is an excess some is stored for future use with insulin being the hormone signalling the relevant parts of the body to store sugar. Then some time after eating, depending on how much you ate and how much energy the body is using through exercise etc, the level of sugar (mostly glucose) in the blood will start to fall, insulin will switch off, and another hormone (called glucagon) will come into play to restore sugar levels by making stores release sugar back into the blood stream.
In a healthy person eating a balanced diet in two or three meals a day, with energy use in between such as physical work or exercise, this process alternates back and forth: taking in food and storing some of the sugar under the control of insulin, and then releasing sugar from stores to meet the energy requirements in between meals. Insulin is only produced two or three times a day, to control the storage phase.
The real cause of type 2 diabetes is insulin being produced far more of the time than that, so that eventually the normal process of responding to it starts to be overwhelmed and no longer works well. Once the body stops responding properly to insulin the amount of sugar in the blood stream rises beyond normal levels because it isn’t being diverted into storage, and most of the symptoms of diabetes are due to those high sugar levels.
That situation where insulin is called into action too often is largely down to lifestyle factors which are modifiable. With a sedentary lifestyle the sugar intake from food can be more than is used for energy, so the body spends little of its time in the “no insulin” phase of sugar release from storage; this is going to be worsened if the dietary intake is high in sugars which happens much more easily with modern processed foods. Another frequent cause is when someone snacks so that continual sugar intake again means there is no need for release of sugar from storage in between meals; sweet drinks are particularly pernicious because they don’t tend to be perceived as a snack in the same way as solid food but have a similar effect of constantly requiring insulin.
Note that all those lifestyle situations tend also to involve eating more than is needed to supply the body’s needs, with the excess then being diverted into making fat – with the consequence that being significantly overweight or obese indicates a strong risk (but not a cause) of type 2 diabetes. Fortunately unless the disease is advanced, reversing the bad lifestyle features can undo the health risk – basically not eating more than needed or food that is over-sugary, not snacking between meals, and exercising so that sugar gets released from its stores and the body gets a rest from insulin.
In principle there is no reason why fructose should be much more to blame than glucose or any other sugar which quickly passes into the blood stream; the body can convert one into another anyway. However fructose has become associated with a diabetic risk lifestyle for two reasons: first it is sensed by humans as particularly sweet so tends to promote a habitual fondness of sweet food, and second a lot of the sugar-rich processed food is sweetened with fructose rich corn syrup.
(Apologies for writing a rather long explanation, but there is often a lack of clarity which leads to rather dogmatic recommendations of fad cures as well as soundly based ones. I have tried to make it comprehensible while still not misrepresenting the science).
While I am not sure VAT is the right tax to apply, I think using taxation to drive good lifestyle habits is a good idea. Ironically the food industry’s widespread use of fructose-rich corn syrup came from just such a tax incentive (actually duty): US producers looking for a cheaper alternative when duty was put on imported cane sugar developed a sweetener based on US-produced maize, and the rest of the world has largely followed the mass-produced food technology pioneered in America.
Many thanks
I had been briefed on all that – but you put it better than I could have done.
You are also right on fructose.
Let’s just consider this: tobacco and alcohol are regulated and taxed, and other drugs are regulated. All are addictive, but sugar is not. Why not both regulated and taxed?
One reason for singling out fructose is that it is metabolised in a completely different way to glucose – in a process in the liver. I seem to remember that this process also results in fat being created.
The way that fructose is metabolised is more similar to that for alcohol than it is to the pathway for glucose.
I picked this up by watching “Sugar – The Bitter Truth” ages ago. So I apologise if that has been debunked subsequently!
You are right
I am told that is true
Standing back for a moment the real issue is that sugar is an ingredient that facilitates the production of very palatable and profitable ‘food’ from cheap, stable ingredients.
These have limited or no nutritional value, and are associated with a number of forms of diet related ill health, not just diabetes but obesity, dental decay, heart disease etc.
If we make sugar – or synthetic sweeteners more expensive and/or impose limits on sugar consumption it will make the production of these ‘ultra processed foods’ less attractive and there will be significant health benefits as a result.
I would suggest however that in addition to sugar ‘controls’ there also need to be policies put in place to ensure access to healthy food and tackle the so called ‘food deserts’ where fresh unprocessed food is unavailable.
I entirely agree
But the saving to the NHS will pay for that.
The cost of diabetes to the NHS is as big as the annual fruit and veg budget (near enough) at around £19 billion each
see what eating tofu gets you
https://www.google.com/search?q=politician+attacks+tofu+eating&rlz=1C5CHFA_enGB714GB714&oq=politician+attacks+tofu+eating&gs_lcrp=EgZjaHJvbWUyBggAEEUYOTIHCAEQIRigATIHCAIQIRigAdIBCTE1NjQ0ajBqN6gCALACAA&sourceid=chrome&ie=UTF-8#fpstate=ive&vld=cid:33d34568,vid:gTf01Dm-oBA,st:0
Fructose consumption per head appears to have peaked in the late 1990s and has been flat or declining ever since.
What is your source?
I can’t see that in data I can find
Figure 1 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3649105/ indicates a peak or plateau (if combining the two types of sugar sources) in the late 1990s.
Weird how you pop up here for the very first time, using two different identities for yourt two posts, and bith supporting the industry that I am criticising.
Me smell a rat when I can fund so many pap-ers contradiciting this eveidence?
I suggest you go and troll eslewhere
“I’m supporting the industry you’re criticising”
How bizarre and conspiratorial to think that.
Anyways, I would appreciate you sharing evidence that fructose consumption did not peak or plateau in the 1990s.
Just go and do a google search
…and the website advising us on fructose free foods is closing at the end of this month (December 2023).
https://www.fructosefreefoods.co.uk/
I think the issue is complicated, not least because there is a lot of so-called industry-funded research that is biased towards the interests of the industry. The can involve not only bad “research”, but dubious uses of statistics.
For example, Kellogg’s made the claim “Based upon independent clinical research, kids who ate Frosted Mini-Wheats cereal for breakfast had up to 18% better attentiveness three hours after breakfast than kids who ate no breakfast”. Source: https://link.springer.com/article/10.1007/s11129-021-09244-z
❌Turns out there was no evidence.
❌Even if there was evidence, the statement compares having breakfast, with not having breakfast (which is not necessarily a health benefit)
❌And “18% better attentiveness” is a relative comparison, perhaps from a tiny measured attentiveness, to a bigger, but still small measured attentiveness.
This issue not only affects food, nutrition and Big Food, but also Big Pharma. As they say, follow the money.
As a matter of interest, is there anyone else on here who has lived with a diabetic person, either type 1 or type 2? Or is all this coming from theory? Like Yvette Cooper saying that because Braverman is a vegetarian she must eat lots of tofu.
Type 1 and type 2 are not the same, as I keep saying.
Type 1 is not curable in the way type 2 is.
And I happen to think theory matters a very great deal.
I know they are not the same, as I keep saying and agreeing.
I was just asking out of interest if anyone had lived with a type 1 or type 2 diabetic.
When I told my mother I was expecting my first baby she told me I couldn’t be as diabetics were impotent. That came from her theoretical knowledge as a nurse from before the NHS came into being.
Sorry Jen, but this is getting irritating.
Your mother’s claims from the 1930s, which may or may not have been evidenced, is not current theory. Even you knew then that fell into the category of myth, so why post spurious arguments based on it here?
And let me add – if you think theory has no place and we must all have experience of something before knowing about how to address it you would eliminate almost all chance of medical advance. Is that what you want?
I don’t have time to try to work out why comments are, or are not, worthwhile posting when based on such non-scientific bases.
I absolutely hate sugar and sweet foods; even as a child I never ate biscuits and rarely ate sweets unless trying to please one of my mother’s misguided friends. What is so infuriating for me is that sugar, in some form, is snuck into almost every savory food item from mustard and mayonnaise to smoked salmon. Invariably the yucky taste of sugar is partially obscured by an equally toxic quantity of salt that produces its own especially obnoxious aftertaste and serious heartburn.
Sugar added to food has a whole slew of different names from sugar and fructose to corn syrup solids, so they need to be targeted on mass. My answer would be to tax this sugar/salt combination, which would see it reduced by manufacturers just to avoid the tax. That way you need not penalize the birthday cake or the occasional sweet treat for those who consciously choose to indulge, but you focus on removing the hidden sugar dumped in savory foods.
As I noted previously, salt can be tackled and was by the last Labour government.
Sugar is more dangerous. It could be tackled.
I used to have a quite sweet tooth. I now really struggle with sugar. I seem to have worked my way out of it. It can be done.
I gave up sugar in coffee during the Great Sugar Shortage of 1974/75. Within a few weeks I could, and still can, tell if my coffee has been stirred with a spoon previously used to stir a sugared coffee. If that tiny amount is detectable it makes you wonder why they use so much of it.
I hate it when that happens.
In fairness, I also hate it when a sppon that has been in milky coffee is used as well – because I can’t stand the taste of that either.
Americano, black, please. No sugar.
My friends know how to cook healthily. But fuel costs, minimum wages and transport problems mean that there is not enough money to buy healthy food. Microwaves foods are what they rely on plus reduced items on the bargain shelves. Christmas turkeys in one local shop are selling at “from £95”.
I am so weary of wearied and troubled victims being blamed.
Note what I have been saying this morning: we have to tackle poverty in this country and could do so. I am only blaming those who refuse to do that.
Richard, I’m type 2 diabetic. What I’d benefit from, rather than VAT on UPFs is a label on such foods warning us of the dangers. I’m vegetarian, although most of my meals are vegan, but even then I still manage to eat processed foods.
I’m a 75 year old male who was taught the basics of cooking and food preparation by my mum back in the 50s and 60s when there were less UPFs. I also have a very sweet tooth and have to fight with myself to restric my intake of chocolate, something I’ve failed to do over the last 3 years when I’ve put on 3 stones. I’d got my Hba1c down to 35 but it has crept up to 50, which I’m assured, is still within ‘safety limits’, but I’m aware I need to improve that and losing weight would definitely help.
I’ve lived alone for the last 17 years and gradually, preparing meals has become a chore to the extent that I now chose the easiest route possible to preparing and cooking.
So, rather than impose even more tax on those, like myself, who can ill afford it, labelling would be of enormous benefit.
Are the two inconsistent?
And, I stress, I would want redistrintuon to cover the costs as well
Of course not. If the product advised that VAT was included in the price that would do, but the poor would still be penalised, at least to the extent that many of them would have no idea of how to cook for themselves. Currently I find the advice on what are, and what are not UPFs, pretty inadequate. Sorry, I’m to some extent playing devil’s advocate. 🙂
So, let’s agree that labelling is vital
Hi Richard,
I seem to remember that you don’t generally like hypothecated taxes, but do you think that one could be devised to fund the part of the NHS budget attributable to bad diet via a tax on the food industry?
If properly designed it could act as a powerful carrot and stick.
Hypothecated taxes make no sense, especially in cases like this where the yield is dependent on doing harm.
Hi Richard,
I appreciate you are an expert in this field, so what I am proposing may be entirely impractical.
But what I was proposing is a tax where the total yield is targeted to pay for the amount of harm done.If harm decreases then the targeted yield decreases. The aim being to change behaviour of the food industry until perhaps no tax is required (in the very long term).
Maybe impractical but not illogical
All of the incentives for the food industry at the moment are perverse in relation to health – it would be good to find a way to incentivise them to create healthy food.
Such taxes appeal
BUT they create the idea that tax paus for spending. Ot doesmn’t. It reclaims spending and so the supposed appeal is illusory.
There are six reasons to tax:
1) To ratify the value of the currency: this means that by demanding payment of tax in the currency it has to be used for transactions in a jurisdiction;
2) To reclaim the money the government has spent into the economy in fulfilment of its democratic mandate;
3) To redistribute income and wealth;
4) To reprice goods and services;
5) To raise democratic representation – people who pay tax vote;
6) To reorganise the economy i.e. fiscal policy.
The reason for a sugar tax is (4)
I reversed diabetes 2 over the 2020-22 lockdown and kept off the excess 25-35 kg I was lugging around using time restricted eating of sensible non ultra processed plain foods and some spices and virtually no sugar. That change also assisted managing a very long term poor cardiac issue positively as well.
I found the best sources of pragmatic advise, research and experience were in the Dr Robert Lustig Books “Metabolical” & “Fat Chance” and Dr Jason Fung books “The Obesity Code” & “The Diabetes Code”.
Both doctors have had extensive practical success in treating insulin resistance disease and diabetes.
Their interviews on YouTube are a quick source but the books are more comprehensive and well worth reading.
Education about it all is always going to be the ultimate solution to spiralling out of control health and social care costs from metabolic syndrome induced poor health.
That is the conundrum though, competing against mega marketing of cheap high profit ultra processed foods. It’s not easy.
Lustig is very good