The sugar-fat seesaw: Sugar focus undermines fat threat posed in obesity fight

Concentrating health advice only on sugar is likely to misinform consumers and downscale the urgent need to also reduce fat-derived calories, a paper has suggested.

The findings, published in the International Journal of Epidemiology, suggest that initiatives such as the sugar tax, coupled with research that highlights the dangers of excess sugar on health, have overshadowed the contribution fat makes to overall calorie intake.

The research includes evidence suggesting individuals who focus on reducing one type of food, compensate by eating more of another type rather than reducing their overall calories, an effect known as the ‘sugar-fat seesaw’.

Overweight and obesity rates have nearly doubled over thirty years, with recent health questionnaires placing more than half the adult population in Europe as overweight or obese.

The study

weight-fat-obese-BMI.jpg
Body mass index (BMI) is seen as one of the most reliable markers of obesity. ©iStock (Sirikorn)

Scientists from the University of Glasgow looked at data from 132,479 subjects from the UK, who filled in diet questionnaires and had body measurements taken. Of the subjects involved in the study, 66% of men and 52% of women were overweight or obese.

Of these individuals, there was a weak link between energy from sugar and fat; 13% of those in the highest quintile for sugar were in the lowest for fat, and vice versa.

Compared with normal BMI, obese subjects had 11.5% higher total energy intake and 14.6%, 13.8%, 9.5% and 4.7% higher intake from fat, protein, starch and sugar, respectively.

This meant the proportion of energy derived from fat was higher (34.3% vs 33.4%) but from sugar was lower (22.0% vs 23.4%).

“People who are overweight and obese consume more calories than those who are normal weight. But they consume a smaller proportion of these calories from sugar and a larger proportion from fat,” said Dr Jason Gill, from the Institute of Cardiovascular and Medical Sciences and co-lead author.

“Thus it is important not to simply focus on reducing sugar intake; we need to emphasise reductions in fat intake as well.”

The study also looked at body mass index (BMI) - a strong measure of obesity. Here, BMI was strongly associated with total energy and energy derived from fat rather than sugar. Here, researchers found the sugar value became negative after adjustment for total energy.

Too much sugar still bad

fat_sugar_reduction.jpg
The sugar tax has hit the headlines of late but efforts to reduce fat in foods have not received equal exposure. ©iStock

The association between sugar intake and obesity has been well-documented with sugar’s contribution much condemned by health campaigners.

While not dismissing the dangers of an excess of dietary sugar, this study attempts to further define the relationships between macronutrients, including sugar, with degrees of adiposity in the general population.

The majority of macronutrients contribute to overall energy intake and the study’s researchers believed that focusing on sugar in isolation may not be the best approach to reducing overall energy intake.

In discussing the results, the researchers thought the association between sugar intake and obesity was due to the contribution of sugar to overall energy consumption, rather than a specific effect of sugar.

They believed that reduction of sugar consumption would only be effective at reducing obesity if associated with a reduction in overall energy intake.

However, the team thought that the ‘sugar-fat seesaw’ remained the critical factor in the current global obesity epidemic.

“The critical message is that people need to reduce their overall calories. If focusing attention on sugar results in people compensating by eating more crisps then we will fail to combat obesity,” Jill Pell, director of the Institute of Health and Wellbeing and co-lead author concluded.

 

Source: International Journal of Epidemiology

Published online ahead of print, doi: 10.1093/ije/dyw173

“Adiposity among 132 479 UK Biobank participants; contribution of sugar intake vs 5 other macronutrients.”

Authors: J.P. Pell et al.