The 2003 Australian Dietary Guidelines are nearing the close of their formal review process, which commenced in December 2011. As the end point draws near, the beverages industry is questioning whether they miss the mark.
Undoubtedly, the current review process has been hotly contested. Many industry lobby groups and individual companies have worn a path to Canberra and elsewhere staking their individual or collective cases. The beverages industry, through the Australian Beverages Council, has held over 20 meetings with key stakeholders in and around the Guidelines ‘space’.
The main issue for non-alcoholic beverages in the 2011-12 review has been Guideline 2 (c). In 2003, guidance around added sugars proposed ‘consume in moderation’, which at the time was supported by the evidence base, reasonable and aligned with broader nutrition advice. Since then the industry has taken this message on board and engrained it into top line messaging, advising people to 'consume in moderation'.
Under the current draft 2 (c) however, the prior theme of moderation has moved to ‘limit consumption of sugar-sweetened beverages’ and over the course of the last 12 months, has moved even further to ‘limit consumption of sugar-sweetened soft drinks, cordials, fruit drinks, vitamin waters, energy and sports drinks’. A significant shift indeed! The Guidelines suggest that the evidence has changed to warrant the new guideline’s inclusion. But has it?
In its lobbying, industry opened all meetings with a statement that it acknowledges sugar is a hot topic and it isn’t afraid of science. Indeed, if it wasn’t for the regular rebuttal from anti-industry campaigners whenever industry funds reputable scientific papers with sound methodology and repeatable results, there’d be more of it. But what industry is afraid of is weak science being interpreted incorrectly and then used as the basis of guideline decisions.
Within the Guidelines review period, there were a total of 31 scientific papers published that related to sugar-sweetened beverages and weight gain. Interestingly, the Guidelines Working Committee only took into account 14 of these, or 45 per cent. So why less than half? If the other 55 per cent of papers on the topic had been included, it would have pointed to an even weaker evidence base for the inclusion of 2 (c). And within the 45 per cent, the results - associating consumption with weight gain - were far from convincing.
Now before the critics jump in to discuss different standards for assessing papers, let me say that the Beverages Council did a full systematic literature review of all the papers and used the same process for assessing quality of the research as the Guidelines Working Committee did.
Anther perplexing aspect was that the Guidelines review occurred some mere months before the Australian Health Survey (AHS) results were due for release. The first such survey in 17 years, it looked at the diet and biomedical markers for 55,000 Australians. Industry is a little flummoxed as to why the Guidelines, being reviewed for the first time in almost a decade, couldn’t wait for new data from such a large survey instead of relying on information that is a generation old. Confusing or what?
So let’s turn the table around. If industry went to the government and asked for a significant policy change based on a weak assessment of only 45 per cent of the total papers published and relied on 17-year-old data with a new improved data set only months away, what would the reply be?
Australians are being thrown simplistic messages to address a serious, complex and multi-factorial problem in overweight and obesity. The emphasis should be on improving the health literacy for everyone that needs it. The concept of the total diet should be the focus – energy in versus energy out. People lose weight by burning more energy than they consume, from all foods and beverages. ‘Limit consumption of x’ means nothing in the concept of everyday life and doesn’t address the bigger problem. Remember ‘eat less fat’? Since that narrow-focussed push from public health advocates, the nation’s waistline has continued to expand. Now sugar is in the firing line. Striving for panaceas means other important issues are being missed.
