The rise of sugar is a fascinating piece of our social history – from its discovery in India to an expensive luxury added in small quantities to some foods and drinks and now to the astronomical amounts we consume today. Its story includes establishing it as a crop in the New World, the development of slavery to fulfil the market in Europe, blockades in the Napoleonic War preventing its transatlantic shipment and the development of rival sugar beet manufacture in Europe. Is the latest part of the story that it is making us ill?

It’s uncommon to find someone who doesn’t like sugar. Although people vary in how much sweetness they enjoy, most of us gain pleasure from sweet foods and drinks. Sugar is quickly absorbed and the sweetness triggers the “reward centre” in our brain, making us feel good. Many of us turn to sweet things when we feel a bit low and in need of comfort or perking up; and sweet snacks such as chocolates or biscuits are often shared amongst friends or given as gifts.

But recently sugar has been getting some bad press. You have probably seen the headline accusation that sugar is “the new tobacco”, suggesting that sugar, like smoking, is the cause of widespread disease. Certainly, a large part of the population is now designated “obese”, which is worrying as a large amount of body fat increases the chance of major diseases such as diabetes, heart disease and stroke.

Others have countered by saying that it’s not specifically sugar that has led to the current levels of obesity and diabetes, but people eating too many calories from all types of food and drink.

So does our sugar consumption matter? The simple and straight answer is “yes”.

In fact, the subject has become so important that a consortium of Britain’s leading doctors and scientists have formed a group – Action on Sugar – to publicise the problem and what’s to be done about it.

Although defenders of sugar are right that there is no decisive evidence yet that sugar alone leads to obesity and disease, there can be no doubt it is a major contributing factor. The attractive taste of sweet food and drinks makes it easy to consume too many calories. And it is possible, as some doctors think, that fructose – which makes up half of the main type of sugar we eat – is not handled well by our bodies and is turned into fat that is linked with diseases*.

These days sugar seems to be in everything. The amount of sugar sold each year is truly stunning. It’s not just the sugar we buy for home use and the sugar you’d expect to find in desserts and confectionary. Processed food often sells more on taste than on nutritional quality, and added sweetness can make all sorts of food seem more appetising. This means sugar can be found in a huge variety of savoury foods, from ham to curries, soups to ready meals, pizzas to tins of beans. And there’s the large quantities of sugar that go into soft drinks, particularly fizzy drinks and so-called “sports drinks”, where one can may contain the equivalent of many teaspoons of sugar. Many people see these drinks as a major health hazard, and several states in the USA are taking steps to limit their sales.

Our bodies do not need sugar – however much we want it! It fulfils no nutritional need, and cutting back on added sugar makes a lot of sense. (Most nutritionists agree that there is no need to worry about the sugar naturally occurring in whole fruit and vegetables.) Reducing the sugar in your diet is a great help to achieving and maintaining a healthy body weight, and the health advantages of doing so are immense.

For all our sakes let’s wish Action on Sugar every success.

 

*We explain how your body processes fructose in our book, How to Live to 110: Your comprehensive guide to a healthy life

 

Microbes have a bad name. Most people just think of them as carriers of disease. Indeed, bacteria and other microscopic organisms are often pictured in TV adverts as tiny evil humans that every home-loving person should buy powerful antiseptics to eradicate.

Of course, a few microbes are the cause of major diseases, and some others bring less serious upsets. But it’s unfair of us to think of all microbes as harmful. Many of them fulfil useful purposes in the environment, such as breaking down waste to release chemicals for plants and animals to re-use. And some are vital for our health.

Each of us carries around a whole personal environment of different microbes ¬¬ –on our skin and inside our body. Researchers have coined the term ‘Human Microbiome’ for this, and recently they have been showing how individual it can be and exploring how it affects our health.

We acquire our first microbes as we are born, and our exposure to them increases rapidly over the first few years of life and continues into adulthood. As adults we carry around 10 microbial cells for every one of our own cells. That’s about 100 trillion microbe cells! Our gut alone contains about 2 kg of microbes.

These are not causing us any harm, and many are more than just passive passengers, coming along for the ride. We have learned a lot about the gut microbes, for example. They produce anti-inflammatories, pain killers and some vitamins as well as beneficial antioxidants. Recent research* has shown that people with cancer developing in their colons have a different microbial makeup in their colons to healthy people, which suggests some microbes may be protective against this. And fascinating laboratory work in mice** has suggested that some microbes might be implicated in body fatness, with other interesting work*** opening up about their association with metabolic changes related to type 2 diabetes.
With much of this work it’s far too early to suggest that actively changing gut microbes might be beneficial for humans. But these are interesting findings, and they undermine the simplistic view that microbes are there to be eradicated.

*Link to study on the Human Gut Microbiome and Risk of Colorectal Cancer  http://dx.doi:10.1093/jnci/djt300

**Link to study on the gut microbiome and obesity in mice  http://dx.doi.org/10.1126/science.1241214

***Link to study of the human gut microbiome and metabolic markers  http://dx.doi.org/10.1038/nature12506

Link to study on dietary intervention impact on gut microbial gene richness  http://dx.doi.org/10.1038/nature12480

 

Great news for over-60s who like gardening! And for DIY enthusiasts and people who enjoy similar activities around the home and garage.

A recent study* from Stockholm, Sweden, showed that men over 60 who did these activities daily were nearly a third less likely to suffer from diseases such as coronary heart disease, stroke and diabetes than men who were less active. Indeed, these men gained almost as much benefit as those who were more vigorously active.

The study followed 4,000 men aged over 60 for twelve years, and obtained their results by repeatedly questioning the participants about 12 different activities and through laboratory tests.

These findings are valuable because many people as they get older find that they can’t fully achieve the recommended levels of physical activity – or are disinclined to do so. The research shows how everyone can derive significant benefit from the activities they can do and enjoy doing.

Activities like gardening and DIY entail standing, using upper and lower limb muscles and walking, and this increases metabolic rate, maintains muscle power, preserves bones and affects body metabolism. Though everyday activities may not involve more than moderate levels of exercise, these effects have been shown to be of clear benefit.

This doesn’t mean that greater levels of physical activity are unnecessary. Part of the study showed those who were even more active gained an even greater reduction in risk of the diseases.

Our society has become increasingly sedentary both at work and in leisure time. Sitting for long periods is one of the riskiest things anyone can do, and yet many older and retired people – and, indeed, many younger people – spend much of their day sitting. This study helps confirm the advice that we should all reduce sitting to a minimum and find something we like doing instead.

 

*Link to study abstract:  http://bjsm.bmj.com/content/early/2013/10/08/bjsports-2012-092038

 

 

We’re told the NHS is strapped for cash and it might get worse before it gets better. So, is there anything we can do as individuals? Actually, yes there is. Better still, it may even bring us financial benefits too.

A recent report* from Nuffield Health and the London School of Economics called “12 minutes more…” makes a strong economic case for taking more exercise. It is an approachable document well worth browsing through.

The health benefits of activity have been shown repeatedly: increased physical activity reduces the risk of heart disease and stroke, helps control type 2 diabetes, reduces blood pressure and body fat, improves aspects of mental health and much more. As a result, governments around the world – including our own – have recommended we all do at least 150 minutes of moderately physical activity a week.

Unfortunately, the report concludes that the majority of us don’t achieve this level. But it goes a stage further by looking at what this means economically for individuals and for the country.

First, there’s the personal burden when someone contracts one of the long-term diseases that physical activity might have helped prevent. Quite apart from the unpleasantness of the disease itself, there is the potential for loss of earnings and the impact this has on one’s own life and the lives of family members.

Secondly, there’s the less obvious but even greater burden illness puts on society as a whole through the loss of economic activity and the demands placed on the NHS and other organisations. The sums involved are quite staggering. If everyone did the recommended amount of exercise, the report authors calculate this would save the NHS £257 million per year. Mental health savings – taking account of savings for the NHS, earnings and welfare – would be over £6.3 billion.

On an individual level, the report estimates that the average household income of those that do moderate sports is more than £6,500 a year higher than inactive households. These people are also more likely to be employed.

This report contains a lot of detail establishing how all these figures were calculated. But even if only a proportion of these staggering amounts could be saved it shows that we can all do our bit by increasing our activity levels.

Many economists believe that if something doesn’t hit our own pocket directly we tend to ignore it – and that certainly seems true for physical activity. It’s only when a report like this spells it out to us that we can see clearly the enormous cost inactivity is having.

And the solution is hardly a drastic one. The report’s title “12 minutes more…” comes from its bottom line finding: that all it would take to improve our health and personal finances, and to relieve the financial pressure on the NHS, is an increase in the amount of activity we do on average of just 12 minutes a day.

 

 

*Link to the report: http://www.nuffieldhealth.com/sites/default/files/inline/Nuffield%20Health_%20LSE_Low-Fitness_Report.pdf

 

If you have type 2 diabetes, as so many people do these days, then going for a walk after eating may help.

Were you told you should rest after meals? If you are over a certain age, it’s quite likely you have been following this advice since childhood – but it may be wrong.

After a meal, the level of glucose – a type of sugar – increases in your blood. One of the problems with diabetes is controlling this raised glucose level. Now there is some objective evidence from a small study* showing the benefit of low level physical activity after a meal.

The study involved 10 people older than 60 years who were asked to walk in a laboratory for 45 minutes at roughly 2½ mph either in one sustained session or as 15-minute sessions after each of their three main meals. Researchers compared their glucose levels afterwards. Both regimes improved the overall control of glucose levels over the whole day, but walking for 15 minutes after eating was better at controlling the rise in glucose after meals.

This was a small study, but it suggests that even a relatively modest amount of walking after meals – which is within the capability of older people and those less physically able or active – is beneficial for those with type 2 diabetes. Higher levels of activity might bring even greater benefit, but it is good to know that even this low level of exercise helps.

 

*Link to a summary of the study:

http://www.jwatch.org/fw107607/2013/06/13/short-walks-after-meals-could-help-control-glucose-levels

Link to the study abstract:

http://care.diabetesjournals.org/content/early/2013/06/03/dc13-0084.abstract

 

There have long been health warnings over eating too much red meat. Initially the concern was over its fat content, and more recently there has been interest in whether the way red meat is broken down in the body might be behind an increase in the risk of heart disease and, to a lesser extent, stroke. Eating red meat has also been shown to have links with bowel cancer.

Now it may be the turn of type 2 diabetes, a rapidly increasing disease that not only brings its own problems but also contributes to the risk of heart disease.

Researchers* have used health data collected in nearly 150,000 American men and women who were followed up over more than 7 years. Among these, there were 7,450 new cases of type 2 diabetes.

In addition to the already known factors that might have explained these new cases, the researchers looked changes in the amount of red meat the participants ate. Those who increased their consumption by an average of half a serving of red meat a day for a four year period were more likely to get diabetes during the subsequent four years than those who didn’t. And those who cut their red meat consumption over the first four years were then less likely to go on to develop diabetes.

This wasn’t the whole story as there were changes in body weight – which is known to be a factor in diabetes – to take account of. But there was enough evidence to suggest red meat played a part in these people developing the condition.

However, a word of caution is needed. A study of this sort that looks retrospectively through data that wasn’t specifically collected for the purpose is not enough to establish cause and effect, or to say how such an effect arises.

For researchers, it raises interesting questions about red meat and how it might have led to this finding. For the rest of us, it is a useful reminder that we should be conscious of what we eat and of maintaining an appropriate body weight, and that those of us who consume a lot of red meat might consider the already current advice to replace some of it with fish, chicken, pulses or vegetables.

*Link to the study abstract: http://archinte.jamanetwork.com/article.aspx?articleid=1697785

 

 

There’s compelling evidence that keeping active has very great health benefits, helping to prevent many of today’s common diseases. But how much do you need to do? And does it matter what activity you choose?

A recent study* has provided some interesting evidence. Over a 6-year period, researchers compared 16,000 walkers with 33,000 runners to see what difference physical activity made to their risk of high blood pressure, diabetes and level of blood cholesterol – factors linked with heart disease.

They grouped the walkers and runners according to the average amount of activity they did. To do this, they used a measure (“metabolic equivalent”) that took account of the weight of each person and the calories they burnt. This allowed the amount of activity done by the walkers and the runners to be compared directly. The highest-activity group was doing the equivalent of an hour or so of brisk jogging every day (or a couple of hours of brisk walking), while the lowest-activity group was averaging around an hour of gentle walking a day in total (or the equivalent in jogging). There were two categories in between these, and all four levels were compared with people who did little activity at all.

The results showed that, broadly, the more activity people did, the greater the benefits in terms of high blood pressure, diabetes and blood cholesterol levels.

What was particularly interesting, though, was that the results for walking and running were very similar. A given amount of activity – whether running or a longer period of walking which expended the same energy – seemed to result in similar health benefits.

This study offers encouragement to those unable (or unwilling!) to get into higher levels of exercise. And it backs up all the previous research showing that even some physical activity is certainly more beneficial than none.

 

*Link to the study abstract: http://atvb.ahajournals.org/content/early/2013/04/04/ATVBAHA.112.300878.

 

 

Almost everyone likes sugar. Many people like it a lot – a fact that hasn’t escaped food manufacturers.

No longer is sugar simply something to be added at table or used in cakes, biscuits and jams. It has become ubiquitous: you now find it in all sorts of unexpected places – sauces and salad dressings, cured meats, breakfast cereals, curries and ready meals. And, of course, large quantities are added to many fizzy drinks.

There is currently a debate about how much sugar people consume in the industrialised nations. The sugar industry would like us to think it is modest; but – based on the amount of raw and refined sugar produced per year, supported by surveys of populations – it seems that over the past 45 years there has been at least a threefold increase in sugar consumption. In recent years, the increase has been even faster at about 4 to 5 percent per year.

Bangladesh appears to be the country with the lowest sugar consumption at 8 kg per person per year and Israel the highest with an astonishing 66 kg per person per year. Given that this is an average figure, some Israelis must be consuming considerably more – virtually the equivalent of their entire body weight in sugar!

With rising levels of obesity in industrialised and emerging nations alike, and an alarming increase in type 2 diabetes around the world, the question arises of whether these alarming health trends have anything to do with our bodies becoming swamped by sugar.

Recent studies have been examining this. In one*, data from 175 countries showed that levels of diabetes increased with increased availability of sugar, even after taking into account body weight and physical activity levels. The researchers therefore concluded that there was a probable relationship between diabetes levels and sugar consumption, but stressed that their methodology could not prove it. (Reaching secure conclusions about cause and effect requires vast long-term studies.)

In an unrelated study**, the American Heart Association has estimated that sugar-sweetened drinks are responsible worldwide for around 180,000 deaths per year: 133,000 from diabetes, 44,000 from heart disease and 6,000 from cancer. The researchers expressed concern; but again commentators have cautioned about drawing premature conclusions about cause and effect.

Evidence is certainly mounting that sugar consumption at today’s levels may be a major contributor to poor health. Indeed, some communities in the United States are already considering ways of reducing sales of sugary drinks through taxation or banning large portion sizes. Perhaps we should be doing the same on this side of the Atlantic.

Certainly, though, we could each do with a hard look at the stunning amount of sugar we may be consuming. Cutting down will do us no harm, and may prove to be great for our health.

 

*Link to the diabetes and sugar study: http://dx.doi.org/10.1371/journal.pone.0057873

**Multimedia resources, including taped interviews with an AHA expert offering perspective on the science, are available on the right column of this link http://newsroom.heart.org/news/180-000-deaths-worldwide-may-be-associated-with-sugary-soft-drinks?preview=b39f71c47418e98ba6ebd2660b859f96

 

 

“Non-communicable diseases” are those – such as heart disease, diabetes, cancer and lung disease – which arise from lifestyle and environmental factors rather than from germs and infections. Before the 20th Century, most deaths were due to infectious diseases. Now, nearly two-thirds of deaths worldwide are due to non-communicable diseases.

Tackling this presents an enormous challenge globally. A United Nations meeting in New York in 2011 identified the four major factors that we all need to address: poor diet, physical inactivity, tobacco use and alcohol intake.

But persuading adults to change their lifestyle is far from the whole picture. There is growing evidence that we also need to focus attention on children – and even on babies before they are born!

Some of these diseases have their roots in childhood. Coronary artery disease is one that has been extensively investigated. Many of the risk factors can be shown to have their onset in childhood, when dietary and other habits begin to form under the influence of family members and childhood friends. Parents need better information on the importance of encouraging physical activity and a good diet in their children.

A recent article in The Lancet* goes further and suggests that disease in later life can be affected by what happens to us before we are born. For example, if the mother is poorly nourished or has diabetes, this is associated with her unborn child being at greater risk of developing non-communicable diseases when it reaches adulthood.

There is also some evidence that if a pregnant mother or infant is exposed to certain pollutants in the atmosphere or in food, this too may have an impact on the child in the long term, potentially affecting its immune responses and its neurological and reproductive functions when adult. How this happens probably relates to changes in the way the baby’s DNA is processed during its development, when substantial changes can be passed from cell to cell as they divide and grow. These changes can last and have a knock-on effect in adult life.

These findings add to the urgent need for worldwide action to curb environmental pollution from harmful chemicals.

 

 

*Link to article: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61609-2/fulltext?rss=yes

 

Exercise is seen as important for people who have type 2 diabetes and for those who may not have it yet but are heading in that direction. These people are often overweight, but it now seems that physical activity is doing more than simply helping them burn calories.

Recent studies have shown that resistance training – physical activity such as weight training, where you exercise your muscles against a resistance – brings greater benefit than expected in the fight against diabetes. This type of exercise burns far fewer calories than aerobic activities such as running, swimming, cycling and so on. That suggests the benefit must come in some other way.

Researchers have now analysed the activities of 32,000 US men over an 18 year period*. Those who engaged for more than 150 minutes per week in either aerobic or weight training had a 54% or 34% lower risk respectively of developing diabetes. Those who did both types of exercise had an even greater reduction of 59%.

These findings are interesting in several respects. First, some people prefer resistance training to aerobic activities and it is good to know they are deriving worthwhile benefit. Second, it’s valuable to have further confirmation that combining different types of exercise brings even greater benefits. And then there’s the intriguing scientific question of what process is actually bringing the benefit.

It seems that increasing muscle mass and power alters sensitivity to insulin, the substance that controls the level of glucose in your blood. Aerobic exercise changes how oxygen is handled and the activity of the enzymes that metabolise fat, whereas resistance exercise changes muscle type and the ability to metabolise glucose. That might be why these different types of activity both have benefits – and why combining them is even better.

If you aren’t able to manage the full amount of exercise recommended, don’t despair. A further finding is that lower levels of activity still bring some benefit, although not as much.

 

*Link to the study: http://archinte.jamanetwork.com/article.aspx?articleid=1307571

 

Professor Brian Kirby, co-author of How to Live to 110: Your comprehensive guide to a healthy life

 

© 2012 How to Live to 110 Suffusion theme by Sayontan Sinha