Obesity has been soaring over recent decades. What are people eating to cause this obesity pandemic? Media, guru doctors, trainers, and nutritionists currently push the narrative that sugar is making people fatter. It’s in vogue to blame sugar for our expanding waistbands. Even the UK, USA, and European governments have added tax to sugar-sweetened beverages in an attempt to stop obesity.
You’d expect a correlation between rising sugar consumption rates and rising obesity rates. Is sugar really increasing obesity rates? Or is sugar the current scapegoat, the fall guy?
In this article I’ll define obesity and added sugars. I’ll then present the evidence of added sugars consumption rates and obesity rates over recent decades in both America and the UK.
What defines obesity?
The Obesity Medicine Association defines obesity as:
‘A chronic, relapsing, multifactorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences’ .
Obesity can be physically measured [19, 20, 28, 30]:
- Body mass index (BMI) at or above 30.0; severe obesity 40.0
- Body fat percentage at or above 32% for women; 25% for men
- Waist circumference to measure abdominal obesity, used in conjunction with BMI, categorised into:
- Men: desirable = <94cm (<37in); high = 94-102cm (37-40in); very high = >102cm (>40in)
- Women: desirable = <80cm (<31.5in); high = 80-88cm (31.5-34.5); very high = >88cm (>34.5in)
What are added sugars?
According to the European Food Safety Authority (EFSA), added sugars are defined as [11, 13, 15]:
‘Sugars and syrups that are added to foods during processing or preparation. They include sucrose, fructose, glucose, starch hydrolysates, glucose syrup, high-fructose syrup, and other isolated sugar preparations used as such, or added during food preparation and manufacturing. Added sugars doesn’t include naturally occurring sugars in fruits, milk, or unsweetened fruit juice or honey’.
The main sources of added sugars are:
- Sugars-sweetened drinks (including carbonated, juice, and energy drinks, squashes and cordials)
- Cereal-based products (biscuits, cakes, pastries and sweetened breakfast cereals)
- Table sugar
- Fruit juice
Sugar – and what’s happening across the pond in ‘Merica?
The US Department of Agriculture (USDA) carries out economic research that records the food availability per capita in the USA. Their data is calculated by adding total annual production, imports, and beginning stocks of a particular commodity and then subtracting exports, ending stocks, and non-food uses.
The data system provides an indication of whether Americans, on average, are consuming more or less of various foods over time. This historical data series estimates the amounts per capita per day of food energy, and 27 nutrients and dietary components (for e.g., protein, carbohydrates, fats, vitamins, and minerals) in the American food supply.
USA added fats and oils over time
Chart 1 shows that cooking oils availability per capita has significantly risen over the last 20 years from ~34 to 55lbs (15.4-25kg) per capita [1, 21]. Butter availability has been slowly rising over the last 20 years.
Chart 1: USA per capita food availability data: added fats and oils, 2000-2017 .
USA added sugars over time
Chart 2 shows that high-fructose corn syrup has continued to fall since its peak around 2000 . Cane and beet sugar has significantly dropped since its peak in 1970 (when obesity rates were globally much less than present day). In addition, cane and beet sugar has levelled off since ~1985 until 2017 (reaching 70lbs). However, the availability is overall significantly less over the last 50 years. Honey and glucose have been steady over the last 50 years .
Chart 2: USA per capita food availability data: added sugar and sweeteners, 1970-2017 .
In addition, estimated daily intake of added sugars has substantially deceased over the decades:
- From 1970-2004, average annual availability of added sugars increased by 19% (which added 76 calories to the average daily energy intake) [11, 29]
- In 2004, added sugars intake was 22 teaspoons (355 calories) [8, 11]
- In 2012, added sugars intake was 18.4 teaspoons 
- From 2003-2012, daily added sugars intake had substantially decreased by 2.6 teaspoons (11g) [8, 21]
- From 2003-2016, added sugars substantially decreased further by 4.8 teaspoons (20g) 
To summarise, from 1970-1999 total sugar consumption increased (likely from high-fructose corn syrup in beverages). Since 2000, total sugar consumption has had a steady state of decline (including high-fructose corn syrup) [18, 21]. Americans obtained 6% fewer calories from added sugars in 2014 than in 2003 . From 2003-2014, there were no differences in total grains intakes for all age groups (although these amounts were still below dietary guidelines) .
If sugar availability and consumption was highest in the 70’s, why wasn’t obesity also at its highest? If total sugar availability and consumption has been the same since the mid 80’s, why have our waistbands skyrocketed?
USA dietary recommendations for food groups: actual vs target 1970 and 2017
Chart 3 shows consumption of diary, fruit, grains, meat (eggs and nuts), and vegetables in 1970 against the percent of current dietary guidelines. In 1970 there was a 30% increased consumption of meat/eggs/nuts above dietary recommended guidelines .
Chart 3: USA per capita food availability data: consumption compared to dietary recommendations in 1970 .
Chart 4 shows consumption of diary, fruit, grains, meat (eggs and nuts), and vegetables in 2017 against the percent of current dietary guidelines. In 2017 we can see that there was over 40% increased consumption of meat/eggs/nuts and over 10% increased gains consumption compared to dietary recommended guidelines . Fatty, high calorific foods such as meat, eggs, and nuts have driven the calorie consumption above recommended daily allowances over the last 50 years. Since the 70’s, vegetable consumption has risen by approximately 10%, dairy has stayed about the same, and fruit has gone up a few percent. Dietary recommendations don’t seem to have changed the general public’s habits on consuming more fruits and vegetables over the last 50 years.
USA sugar-sweetened beverages over time
The American Heart Association (AHA) recommends limiting added sugars intake to no more than [5, 11]:
- 100 calories (25g) per day in women (equivalent to 6 teaspoons or 2 tablespoons)
- 150 calories (37.5g) per day in men (equivalent to 9 teaspoons or 3 tablespoons)
- Or 10% of total dietary energy
These recommendations are based on evidence that diets high in added sugars (such as drinking excessive amounts of sugar-sweetened beverages) are linked to a risk of cardiovascular disease (CVD), obesity, dyslipidaemia, elevated blood pressure, and chronic inflammation .
Before jumping on the bandwagon and vilifying carbs, it’s important to note that lowering saturated fats to the recommended guidelines can reduce CVD by 30%. This effect is similar to that achieved by statin treatment . Evidence from prospective observational studies indicates that carbohydrates from whole grains reduces CVD when they replace saturated fat .
The main type of added sugars that researchers link to CVD is high-fructose corn syrup (composed of 45-55% fructose). It’s artificially made from corn starch, some of whose glucose has been converted to fructose. It’s cheaper than sucrose (table sugar). It’s commonly used by the beverage industry. Excessive high-fructose corn syrup consumption may play a role in insulin resistance, obesity, hypertension, dyslipidaemia, and type 2 diabetes . Controversy exists, however, about whether the body handles high-fructose corn syrup differently to table sugar.
The caveat to note here is that a high intake of added sugars (in food or drinks) is linked to a risk of CVD and obesity, not the cause. Evidence is inconsistent regarding the positive association between sugar-sweetened beverage consumption and obesity . Interpreting the link needs to be done with caution because there can be many confounding lifestyle behaviours that influence disease and weight gain. In addition, observational data (such as epidemiological studies) show trends in eating and drinking behaviours and habits, and correlation doesn’t always equal causation. The idea that ‘correlation implies causation’ is a logical fallacy, in which two events occurring together are taken to have established a cause-and-effect relationship. This fallacy is also known by the Latin phrase ‘post hoc ergo propter hoc’ (‘after this, therefore because of this’).
Sugar-sweetened beverages include soft drinks, fruitades, sports drinks and other sugary beverages (fruit drinks, sweetened water, smoothie drinks, Frappuccino), and reduced-sugar colas. It’s been estimated that substituting one serving per day of low-calorie sweetened beverage for the same amount of sugar-sweetened beverage is associated with a 0.47kg less weight gain within a 4-year period . Hardly anything to write home about; many other life-style factors can have greater influences on body weight changes over four years.
However, the main day-to-day issue with sugar is that it often displaces nutrient-containing foods that you could be eating (sugar has no vitamins or minerals, unlike fruits and vegetables). The second issue people experience with sugar is that it causes most of the tooth decay in kids and adults.
Throughout the 90’s, calories increased approximately 35% due to soft drinks being the largest contribution of added sugars and the greatest source of calories in the US diet . However, consumption of added sugars decreased significantly during the 2000’s. In place of added sugars, the percentage of total calories from protein, fat and other carbohydrates has risen . National total energy intakes increased 13% from the 70’s to the 90’s .
The National Health and Nutrition Examination Survey (NHANES) assesses the health and nutritional status of adults and children in the US. Their surveys combine interviews and physical examinations. NHANES is part of the National Centre for Health Statistics (NCHS), which is also part of the Centres for Disease Control and Prevention (CDC). They’re responsible for producing vital health statistics for the US.
Chart 5 shows data collected by NHANES on low-calorie sweetener and sugar-sweetened beverages. It shows a decreasing trend in sugar-sweetened beverages . In 15 years, sugar-sweetened beverage intake for men and women has halved:
- In 1999, self-reported intake of sugar-sweetened beverages was 2.03 servings per day (16.2oz/d) among adults
- In 2014, this declined to 1.05 servings per day (8.6oz/d) among adults
This decline is also represented until 2016 in Chart 6. From 2003-2016, energy and sugar intake from all beverages, sugar-sweetened beverages, soft drinks, and the total sugar intake from beverages in the diet decreased for children and adults . During these years, there has been a 47% decrease in sugar-sweetened beverages among adults and children aged 2-19 years, while change in the average percentage of total sugar intake from all beverages declined 19% among adults aged >20 years, and 23% among children 2-19 years .
USA obesity statistics over time
The US ranks 1st for obesity prevalence among men and 2nd for women out of 34 countries . As a comparison, Japan has the lowest prevalence of obesity among men (4.5%) and women (3.3%) as well as the lowest prevalence of overweight (including obesity) for both men (28.9%) and women (17.6%) . Incidentally, Japan has one of the highest rice consumptions per capita on the planet.
In the early 60’s, the percentage of obese adults in the US was 13.4%. In the early 2000’s, that percentage rose to 38.2% [18, 26]. From 1960-2014, adult obesity levels increased more than 100% . From 1999-2018, obesity increased from 30.5-42.4%, and severe obesity from 4.7-9.2% .
Chart 7 shows that in 2018, an estimated 42.5% of US adults aged 20 and over were obese, including 9.2% with severe obesity, and another 31.1% overweight [19, 26].
USA diabetes over time
Diabetes is diagnosed as fasting blood sugar greater than or equal to 126mg/dL [32, 33].
- Prevalence estimates were 9.5% in 1999-2002 and 12% in 2013-2016 
- In 2011-2012, the estimated prevalence of diabetes was 12-14% among US adults 
- In 2018 it was estimated that 34.2 million people or 10.5% of the population had diabetes 
- There’s a higher prevalence among non-Hispanic black, non-Hispanic Asian, and Hispanic 
- The percentage of adults with diabetes increased with age, reaching 26.8% among those aged 65 years or older 
Risk factors for type 2 diabetes are smoking, physical activity, and overweight and obesity. 89% of individuals with diabetes are overweight or obese . 38% are physically inactive . 22-37% smoke or had been smoking . Almost 70% have high blood pressure and almost half (44%) have high cholesterol . 37% have chronic kidney disease with over half (53%) having moderate to severe kidney disease . In the US, diabetes has risen with obesity rates, yet sugar intake has been declining.
Sugar – here in ol’ Blighty
UK saturated fat consumption over time
The recommended guidelines are to consume less than 10% of total energy from saturated fats in all age groups [16, 17]. From 2016-2019, average saturated fat intake for adults was 13.3% of total energy .
UK added sugars consumption over time
The National Diet and Nutrition Survey (NDNS) provides a continuous survey of diet and nutrition in UK adults and children . Regarding sugar-sweetened beverages, these reports show :
- For children, added sugars consumption was lower between 2016-2019 compared with 2014-2016
- Since 2008, sugar-sweetened soft drinks consumed by children has significantly:
- -Dropped by 32% for 1.5-3 year olds
- Dropped by 44% for 4-10 year olds
- Dropped by 25% for 11-18 year old
Regarding added sugars consumption as a percentage of total energy [13, 16, 27]:
- <4 year olds consume 20-38%
- School children: up to 19%
- Adults: 13.5-24.6% (consumption decreases over the lifespan)
- Since 2008, consumption for adults has dropped significantly as a percentage of total energy
- For adults between 1992-2019, there’s been a significant drop: 20-12%
- Declines are similar in men and women
From 2014-2018, the largest decreases in quantities purchased have been in sugar and preserves (-9%), beverages (-5%), and bread (-5%). The largest increase has been in cheese purchases (+13%) .
UK added sugars: why 5%?
In 2010, the European Food Safety Authority (EFSA) published its scientific opinion on dietary reference values for sugar intake. It was unable to set an upper level due to insufficient evidence that sugar causes increased body weight, cardiovascular risks, or type 2 diabetes. However, the report did find evidence between an increased risk of tooth decay and frequency of – but not quantity of – sugars consumed .
These findings were consistent with the USA Institute of Medicine. They also couldn’t set an upper limit of sugar intake but suggested 25% of energy from sugar in order to avoid eating too many low nutrient foods .
However, until 2015, the UK government and the World Health Organisation (WHO) set sugar intake guidelines to:
- No more than 10% of total dietary energy for 2 year olds upwards
Then in 2015, the UK Scientific Advisory Committee on Nutrition (SACN) revised this to [13, 14, 15, 27]:
- No more than 5% of energy for 2 year olds upwards
- No more than 30g/day (e.g., 7.5 sugar cubes, at 4g/cube) of added sugars for 11 year olds to adults (13% of adults are already achieving this)
- Fruit juice limited to one 150ml glass a day
As a personal example, I drink 1.25-1.5Lt of orange per day and have near single digit body fat percentage (more on this later). Current average added sugars intake for men is 60-69g/day (e.g., 15-18 sugar cubes), and for women is 46-50g/day (e.g., 11-13 sugar cubes).
This new guideline is primarily designed to minimise tooth decay (improved dental health equals improved health), and then to manage energy intake. The previous recommended value for sugars was based on observations that tooth decay was rare in populations whose intakes were around 10% . In England, tooth decay (in the crown or root of the tooth) and added sugars consumption is common :
- 31% of adults have tooth decay (in 2018)
- 28% of 5 year olds (in 2012)
- 12% of 3 year olds (in 2013)
The new 5% sugar recommendation is also part of a broader set of dietary guidelines for carbohydrate, protein, fat, saturated fat, salt, vitamins, and minerals :
- Total carbohydrate comprising all sugars and starches should provide ~50%+ of the total energy you consume
- Dietary fibre intake (found in carbs) should be 30g per day for adults (used to be 24g/day), (most people have less than 18g/day)
- For healthy weight people, the 5% reduction in added sugars should be replaced by starches and sugars from fruits and vegetables, and from milk
- Protein: 10-15% of your total energy intake
- Fat: less than 30%
- Saturated fat: less than 10%
The key is to keep starches high and therefore keep fibre high and tooth decay low; this means at least 50% of your dietary energy intake from carbs. However, you have to draw the line somewhere with sugar intake if you want to keep your teeth and eat a nutrient-dense diet.
Halving added sugars intake from 10-5% of total dietary energy hopes to reduce energy intake across the population by an average of 100 calories per day . It’s expected to help with obesity risk reduction . If only things were that simple. The new 5% rule is arbitrary to say the least. There’s insufficient evidence to draw conclusions on the impact of sugar intake on cardio-metabolic and body weight outcomes .
SACN acknowledge that in reality lowering sugar intake by 5% (100 cals) is not easy because food can also contain fats and proteins . Also, they admit that simply reducing 100 calories per day of sugar won’t influence obesity and dental health enough to make a dent [13, 14]. Thirdly, they also admit that lowering sugar intake provides just one of many approaches to lowering the average calorie intake of the population [13, 14]. Therefore, sugar isn’t the magic bullet. Fourthly, they report there’s nothing specific about the effect of sugar on obesity when energy is held constant, apart from the health consequences of tooth decay [13, 14].
Is the 5% achievable, practical, and necessary? Probably not. Challenging – yes. UK sugar recommendations are stricter than the USA at 10% [12, 13, 14], and the average Mediterranean-style diet . Yet Italians have much less obesity rates than the UK .
European adolescents, sugar consumption and obesity
The Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS study) examined the relation between added sugars consumption and obesity in 12-17 year olds in 10 European cities (not the UK) .
In European children, the contribution of added sugars to their total energy intake is higher than recommended :
- Up to 110g/day added sugars (14-19% of total energy intake)
- The main food sources were sweetened beverages such as fruit juices and soft drinks
Although European adolescents have a high intake of sugars, it doesn’t seem to be associated with BMI in both genders. The HELENA study found no evidence that increased added sugars was associated with obesity in adolescents . This is probably because different foods have different content and not just added sugars. Therefore, there’s different impacts on the development of obesity . I suppose most people don’t eat packets of plain sugar.
Australian adolescents, sugar consumption and obesity
The Australian National Nutrition Survey (ANNS) have also reported that intakes of total, natural, and added sugars aren’t associated with BMI in adolescents or children . In a most recent study in China, researchers have observed a weak association between BMI and sugar-sweetened beverage intake . It’s interesting to note that longitudinal studies conclude that sugar, confectionery, and sweets consumption decreases after adolescence, but obesity gets worse as we age .
UK obesity statistics over time
The UK ranks 5th for obesity prevalence among men and 10th for women out of 34 countries . In comparison, the UK is 11 percentage points lower than the USA, which reports the highest obesity levels. Japan, Korea, and Italy have less than 10% obesity .
- UK obesity is increasing faster than in the USA 
- In England the overweight population has increased by 72%: from 36% in 1980 to 62% in 2013, compared to a 46% increase in the US over the same time period 
- In 2018, the majority of adults in England were overweight or obese (63%) 
- UK overweight men: 40%; overweight women: 30% 
- In 2020, 27% of adults were obese; this is up 15% since 1993 
- In 2018, 2% men and 4% women were morbidly obese; in 1993 fewer than 1% were morbidly obese 
- Highest obesity levels are between 45-74 years old for men and 45-84 years old for women . The proportion of adults who are overweight or obese increases with age among both men and women. It’s highest among men aged 55-64 (82%), and women aged 65-74 (70%). The proportion of adults who are obese also increases with age and is highest among men aged 45-54 (36%), and among women aged 55-64 (37%) .
- In 2020, 67% of men and 60% of women were classed overweight or obese. This included 26% of men and 29% of women who were obese [7, 28].
- Being overweight but not obese was more common among men than women. However, obesity (including morbid obesity) was more common in women than men .
- Obesity increased steeply between 1993-2000, with a slower rate of increase after that
Here are some of the outcomes from the National Child Measurement Programme publication for 2019 :
- For reception year, obesity prevalence was 9.7%; up from 9.5% in 2017/18
- For year 6, obesity prevalence was 20.2%; similar to 2017/18
- Obesity prevalence was higher for boys than girls in both age groups
- For children living in the most deprived areas, obesity prevalence was more than double that of those living in the least deprived areas, for both reception and year 6
- Children of obese mothers were less likely to be a healthy weight (58%) than children whose mothers were overweight but not obese (69%) or those whose mothers were neither overweight nor obese (83%). The pattern was similar for both boys and girls.
- Similarly, 22% of children of obese fathers were themselves obese, compared with 14% of children whose fathers were overweight but not obese, and 9% of children whose fathers were neither overweight nor obese
- 61% of children of obese fathers were a healthy weight, compared to 74% of children whose fathers were overweight but not obese. 81% of children were a healthy weight whose fathers were neither overweight nor obese.
Chart 8 shows obesity prevalence in England from 1993-2018 [7, 28]. Obesity is particularly rising among women. Women generally have a higher prevalence of obesity, but the gap between men and women appears to have narrowed slightly over time.
Obesity’s been rising since the 80’s and is set to climb further. The trends project 11 million more obese adults in the UK by 2030, causing an additional 6-8.5 million cases of diabetes, 5.7-7.3 million cases of heart disease and stroke, and 492,000-669,000 additional cases of cancer . There’s an estimated increase of £1.9-2 billion per year by 2030 for the combined medical costs associated with treating these preventable diseases .
It’s forecast that by 2030, male obesity will rise from 26-48%, and females from 26-43% . Every additional 5kg/m² in BMI increases a man’s risk of oesophageal cancer by 52% and colon cancer by 24%; and in women, endometrial cancer by 59%, gall bladder cancer by 59%, and postmenopausal breast cancer by 12% .
Chart 9 displays the prevalence of excess weight (overweight including obesity). Excess weight rose substantially between 1993-2002, but has increased slower in both men and women since that time. Unlike obesity, excess weight is much higher among men than women.
UK people: ‘Moi, fat?!’
Women, you’ll love this one: men are more deluded about how fat they are compared to how fat you ladies think you are.
Chart 10 displays the proportion of people in each BMI category that describe themselves as either “too heavy”, “about the right weight”, “too light” or said that they were “not sure” (perception of their own weight) [7, 28].
- Almost half of adults thought they were about the right weight
- Almost half thought they were too heavy
- Women were more likely than men to say they were too heavy (50% and 40% respectively)
- More overweight and obese women were able to identify themselves as having excess weight compared with men, despite more men than women being categorised as overweight and obese. It seems men are very deluded about their size.
- 74% of obese adults, 53% of overweight adults, and 24% of neither overweight nor obese adults, said they were trying to lose weight. It seems the popular, fashionable, fad diets just aren’t working, are they?
- 80% of obese women and 68% obese men, and 65% of overweight women and 44% of overweight men were trying to lose weight. It seems people are very confused about what to do to be successful.
Chart 11 highlights an increase in mean waist circumference among men and women from 1993-2018. The average woman’s waist has increased by 7cm from 82-89cm (32.2-35in) in 25 years . The average man’s waist has increased by 4cm from 93-97cm (36.6-38.1in) in 25 years .
Chart 12 highlights how very high waist circumference (defined as a waist size greater than 102cm/40in in men and greater than 88cm/34.6in in women) is much higher among women than men. Both sexes have seen a large increase since 1993. The number of women with waists over 88cm has increased by 22% from 26-48% over the last 25 years . The number of men with waists over 102cm has increased by 14% from 20-34% over the last 25 years .
UK diabetes over time
Diabetes is characterised by high blood glucose levels (fasting plasma glucose of <7.0mmol/L or 126mg/dL) . Diabetes has risen in conjunction with a rise in obesity, even though added sugars intake has decreased.
- Diabetes among adults has risen from 2% in 1994 to 7% in 2019 .
- In men, type 2 diabetes increased from 3.69 per 1,000 in 2000, to 3.99 per 1,000 in 2013 
- In women, it increased from 3.06 per 1,000 to 3.73 per 1,000 in 2013 
- Type 2 diabetes increases with age, between 60-69 year olds and peaking between 70-79 year olds 
- Type 2 diabetes has more than doubled from 2.39% in 2000 to 5.32% in 2013 
- Individuals from the most socially deprived areas are at greatest risk of developing the disease  (as seen with obesity)
Diabetes and other obesity related diseases are going up dramatically, yet sugars consumption is going down. This evidence also supports the unequivocal evidence that obesity is one of the main causes of diabetes, not sugar (more on this in another article).
Me as a case study
While we’re on the subject of sugar, optimal health, and body weight, you may find it interesting to look at me as a case study. It’s recommended to consume about 5-6 teaspoons (20-24g or 80-100 calories), and 9 teaspoons (36g or 145 calories) of added sugars per day for women and men, respectively. For reference, a 12oz (370g) can of sugar-sweetened soda contains ~8 teaspoons (130 calories) of added sugar.
Due to my illness, I don’t eat food. So, how can I reach optimal and athletic body fat levels living off sugary orange juice (1.25-1.5Lts per day), milk, and medical drinks (high in liquid glucose, fat and protein) every day? I consume about 50-65 teaspoons (200-250g or quarter of a kilogramme) of sugar per day, or 300-325g liquid carbs per day. That’s around 700%, or 240g more than the recommended guidelines of sugar per day. I also drink almost no water. You’d think over a decade of such high sugar intake would turn me into a morbidly obese, diseased wreck on my death bed. Yet I have low body fat. I also possess healthy belief systems. Drinking only liquids has caused me many problems, but obesity isn’t one of them. Neither do I have diabetes or CVD.
It’s a good idea to control and decrease sugar for general health, but not for my health. It’s high fat, high calorific foods, moderate to high body fat levels, and unhealthy belief systems that ultimately cause obesity and obesity-related diseases . It’s clear that obesity is so much more complex than sugar (I’m clearly a walking example of that). Overweight and obesity are complex metabolic conditions; getting fatter is a multifactorial condition.
The bottom line
Cutting out, vilifying, or bullying a single food or food group isn’t helpful to your weight loss journey, your life, other people’s lives, reality, or your psyche. Neither is arguing about things you may not fully understand.
- Illogical conversations/arguments, media influencing, and untruths about sugar and obesity don’t serve you well
- Over the past 30 years, total calorie intake has increased by an average of 200-300 calories per day. At the same time, there has been no change in physical activity .
- Kids eat much more added sugars than adults but it doesn’t lead to obesity
- People eat less added sugars as they get older, yet obesity increases with age
- Obesity has progressively increased over the decades, yet added sugars intake has decreased over the decades
- The middle of the 20th century had the highest sugar intake rates and lower obesity rates than current times
- Evidence demonstrates that added sugars intake have been primarily cut with an aim to reduce tooth decay and thus increase health (and increase taxes?), rather than stop obesity rates
- Evidence shows that added sugars don’t cause CVD, stroke, coronary heart disease, cancer, dyslipidaemia, elevated blood pressure, chronic inflammation, osteoarthritis, benign prostate hypertrophy, infertility, asthma, and sleep apnoea, but obesity does
- There’s a negative correlation between total sugar intake and BMI in children and adults 
- Evidence shows that added sugars was higher when obesity was lower. Evidence fails to support that any carbohydrate and added sugars intake changes in the food supply system are related to the current obesity epidemic . In short, sugar intakes haven’t paralleled the increase in the prevalence of obesity.
- Reducing added sugars primarily makes room for eating more nutrient-dense, high fibre foods
- Obesity is a multifactorial, vastly complicated disease. The many keys to its permanent reversal lies in changing our beliefs, biases, improving our critical thinking skills, attitudes, environments, authenticity, diet, sleep, life-style, thoughts, behaviours, emotions, identity, and habits (as addressed in my Weight Loss SOS programme). Not what Karen says on Facebook.
This blog article has focused on sugar consumption rates in relation to obesity rates over the decades. The anti-sugar, war on sugar movement is rife. The US and UK dietary guidelines recently and desperately focused on reducing added sugars in the diet. Globally however, questions remain whether total, natural, or added sugars should be the focus of public health messaging. The 2020-2025 Dietary Guidelines for Americans recommend that we limit our added sugars consumption to 10% of total calories . The UK and the World Health Organisation (WHO) recommend 5%. If you want to keep your teeth, eat less sugar. However, it’s important to note that a healthy diet includes up to 10% of energy from added sugars, making room for sugars in nutritious foods and occasional sweets and treats.
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- Economic Research Service (ERS), U.S. Department of Agriculture (USDA). Food Availability (Per Capita) Data System (2019) Food availability data: added sugar and sweeteners, 1970-2017. Available at: https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/ and https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/interactive-charts-and-highlights/#calorie (Accessed: 19 March 2019).
- Economic Research Service (ERS), U.S. Department of Agriculture (USDA). Food Availability (Per Capita) Data System (2019) Dietary recommendations and calorie consumption: consumption compared to dietary recommendations – in 1970. Available at: https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/ and https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/interactive-charts-and-highlights/#calorie (Accessed: 19 March 2019).
- Economic Research Service (ERS), U.S. Department of Agriculture (USDA). Food Availability (Per Capita) Data System (2019) Dietary recommendations and calorie consumption: consumption compared to dietary recommendations – in 2017. Available at: https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/ and https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/interactive-charts-and-highlights/#calorie (Accessed: 19 March 2019).
- Johnson, RK., Lichtenstein, AH., Anderson, CAM., Carson, JA., Despres, JP., Hu, FB., Kris-Etherton, PM., Otten, JJ., Towfighi, A., and Wylie-Rosett, J. (2018) ‘Low-calorie sweetened beverages and Cardiometabolic health: a science advisory from the American Heart Association’, Circulation, 138(9), pp. 126-140.
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