Intended for healthcare professionals

Feature Sugar

Sugar: spinning a web of influence

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h231 (Published 11 February 2015) Cite this as: BMJ 2015;350:h231

Re: Sugar: spinning a web of influence

Gornall alleges that the scientists he names in his series are influenced by the food industry to work against the cause of public health but produces no evidence of this. Instead, he collects quotes from people to suggest that the current policies are not working, which he attributes to the malign operations of the food industry, working at least partly through these scientists.

The opposite appears to be the case. For example, the SACN report proposed that no more than 5% of a person’s energy intake should be in the form of sugar. In the UK, the average child consumes about 15% and the average adult about 12% of their energy as sugars. The SACN target is much lower than current UK intake. It is hard to see how policy actions would be different if the target had been set lower, say to 3%., if Gornall is correct and that SACN target was pulled upwards by industry-influenced scientists. The problem of nutrition is not what we should eat but how we persuade ourselves to eat it.

There is broad consensus in public health that we need wholesale shifts in the food environment that put the sugary treats we like to eat out of consciousness. There is no chance of imposing this change on politicians or the public who currently neither share nor want this vision. We need instead to build consensus that such change is necessary. The gains in tobacco control that regulated the market were achieved by patient consensus building. Attacking scientists leading this work damages this cause because it undermines the trust of public and professionals in the science that underpins these recommendations. Arguing for a more radical vision than the Responsibility Deal could ever deliver does not require commentators to be blind to or criticise the gains achieved by it.

There is a strong tide of sanctimony in British public health and riding this tide is a luxury more easily enjoyed by commentators than those who are actively involved in improving health. The reality is that the scientists named in Gornall’s reports deserve to sleep the sleep of the just. I am privileged and proud to work with Susan Jebb, one of the scientists named. The sadness of this kind of attack is that I have seen the very real personal toll. It is just one more way that this BMJ series has harmed health.

Competing interests: I am working on two current trials of weight management in primary care in which commercial weight loss companies (Slimming World, Rosemary Conley, and Weight Watchers) donate free 12-week treatment courses to the NHS that that NHS would otherwise have paid for. This is not a benefit to me personally or my department. I have given and received hospitality on a few occasions to members of these companies. I have also worked with the pharmaceutical industry on smoking cessation. Once in the past three years I gave a day's consultancy to Pfizer on general topics related to smoking cessation that led to payments to me and the University of Oxford.

12 February 2015
Paul Aveyard
Professor of behavioural medicine
University of Oxford
Nuffield Depatment of Primary Care Health Sciences, Woodstock Road, Oxford OX2 6GG