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The scientific report guiding the US dietary guidelines: is it scientific?

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4962 (Published 23 September 2015) Cite this as: BMJ 2015;351:h4962

Will “Low Sugar” Overtake “Low Fat” in Popularity as a New Year's Resolution This Year?

We read with interest the paper by Teicholz on the scientific report guiding US dietary guidelines and the ensuing online discussion regarding the relative risks and benefits of dietary fat and carbohydrates.1 Ultimately, however, dietary decisions are made by consumers, not scientists. Consumers’ perceptions of the nutritional value of various food types are probably not only shaped by scientific discussions in the BMJ, but also by numerous other influences. These perceptions are difficult to measure, but the number of views received by a recent YouTube video2 and a newspaper article3 about the perils of sugar and the broad public support for the introduction of a “sugar tax”, proposed by a well-known British naked chef4 suggest that views of the nutritional value of sugar are indeed changing.

To quantify public attitudes towards dietary fat and sugar, we used a public web facility, "Google Trends" (http://www.google.com/trends), to compare how often the phrases "low fat" and "low sugar" were entered in the world’s most popular internet search engine in preceding years (Figure 1). The term "low fat" shows a distinctive saw-tooth pattern: interest in this phrase is markedly attenuated during the holiday season, followed by a sharp rise in the number of searches at the beginning of each year. The search phrases "diet", “weight loss”, "healthy food" and "quit smoking" show a similar pattern (data not shown), suggesting that these searches are indeed a reflection of a common desire to modify unhealthy behavior at the start of the new year. Interestingly, the popularity of the search phrase "low fat" has declined gradually since at least 2004, the earliest year for which data are available. In contrast, searches for "low sugar" have become increasingly common and the phrase will probably overtake "low fat" in popularity this year (Figure 1).

A potential pitfall of this analysis is that a search phrase may have multiple meanings. For instance, the words "low sugar" may also have been entered by people worried about low blood glucose levels. However, Figure 1 shows that in recent years, the curve for "low sugar" has started to show a typical saw-tooth pattern similar to “low fat”, suggesting that the phrase is increasingly entered by people seeking to change their dietary habits as part of their new year’s resolutions rather than those with concerns about hypoglycemia.

These data suggest that the public perception of the relative health risks of dietary sugar and fat is indeed changing and that increasing numbers of people are seeking ways to limit their sugar intake at the start of the year. This is cause for modest optimism with regard to future obesity rates, as recent data indicate that a diet low in carbohydrates is probably more effective in reducing obesity and its associated cardiovascular risks than a low-fat diet.5 However, the benefits should not be overestimated: only a small minority of all new year's resolutions are actually kept.6

References
1. Teicholz N. The scientific report guiding the US dietary guidelines: is it scientific? BMJ [Internet] 2015 [cited 2015 Sep 27];351(sep23_1):h4962. Available from: http://www.bmj.com/content/351/bmj.h4962
2. Sugar: The Bitter Truth - YouTube [Internet]. [cited 2015 Dec 27];Available from: https://www.youtube.com/watch?v=dBnniua6-oM
3. Is Sugar Toxic? - The New York Times [Internet]. [cited 2015 Dec 23];Available from: http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?_r=0
4. Cameron under pressure as public backs sugar tax | Society | The Guardian [Internet]. [cited 2015 Dec 29];Available from: http://www.theguardian.com/society/2015/oct/24/sugar-tax-poll-obesity-ca...
5. Sackner-Bernstein J, Kanter D, Kaul S. Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis. PLoS One [Internet] [cited 2015 Oct 21];10(10):e0139817. Available from: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0139817
6. The Science Behind Failed Resolutions - WSJ [Internet]. [cited 2015 Dec 27];Available from: http://www.wsj.com/articles/SB10001424052748703478704574612052322122442

Figure legends
Figure 1: Comparison of the number of searches for “low fat” and “low sugar” on Google, the world’s most popular search engine. Data are publicly available on www.google.com/trends. Google Trends allows the comparison of different search terms but does not provide absolute numbers. A typical saw-tooth pattern is visible in the curve of “low fat”: interest is low during the holiday season and increases sharply at the beginning of each year. A similar pattern has emerged recently in the use of the phrase “low sugar”. The popularity of “low fat” shows a gradual decline, while “low sugar” has become more common. As a result, low sugar will probably overtake “low fat” in 2016 as a new year’s resolution

Competing interests: No competing interests

02 January 2016
Martijn R. Tannemaat
Neurologist/Clinical Neurophysiologist
N.A. Aziz
Leiden University Medical Center, department of Neurology
Albinusdreef 2, P.O. Box 9600, 2300 RC Leiden, the Netherlands