Runner's World - A Spoonful of Sugar Keeps the Advertisers Happy

 I have been a subscriber to Runner’s World for about 12 years now. Over the years it has provided much-needed advice and motivation, a little monthly run-envy and the occasional journalistic howler.  Lately the howlers have started to become louder and a little more grating, to the point where my wife, a successful fitness business owner, now regularly asks why we bother with our subscription.  My answer is that I care what the running world looks like, even if I don't always agree with it.

So many promises

This month’s edition includes a six-page blockbuster about the role of sugar in a runner’s diet by the respected coach and nutritional expert Matt Fitzgerald entitled “Sweet Truth”,  and it has really got my goat!

The devil is in the detail!

After a first scan of the article, which reads a lot like like a sales piece for Gatorade, I thought “I wonder who pays his wages”;  but then I saw that actually the article was really just being all things to all people. It rambled around the usual sugar debates and concluded by saying “Don’t worry about sugar, you need it, but you are a runner and you will burn it off”.  Typical stuff, but 6 pages, really?

Unsurprisingly Matt’s article promised to “cut through the hype with a set of Science-Backed Sugar Rules”. I am always intrigued by the term science-backed, particularly in Runners World where the studies quoted are often ridiculously out of tune with the conclusions drawn by scatterbrain journalists. But Matt is chock-full of experience, surely we can expect some hard truths from a top guy like him. Sadly not.

There was a hollow criticism of Gary Taubes (the author of The Case Against Sugar) for "not being a scientist". It would be childish in the extreme of anyone to read this article and simply conclude that Mr Taubes is not qualified to speak on the matter. Character assassination is an ugly thing and Matt seems to have joined the happy brigade who attempt to gain kudos for slagging off other people. 

Then suddenly the RW article was tempered with recognition that overeating sugar can actually lead to insulin sensitivity and type 2 diabetes - the precise point that Taubes et al. are trying to make.  There was  criticism of certain diets but a recognition that we need to watch what we eat – most people call that dieting.  Mostly though there was the ever present implication that what is good for elite runners should be good for the rest of us.

The readers of Runners World are not elite athletes. If a bunch of elite Kenyans eat 20% of their energy from sugar this should not be used to justify the mass-marketing and magazine articles like this that tell the average runner that they should power every training effort and race with gels, PowerAde and carb-loaded snacks. The article did not mention the effect of this marketing on children, who most certainly do not need to consume sugar to power their sport and yet our schools and leisure centres are subsidised by selling energy drinks to kids.

Recognise this?

Matt then asks “If the best runners in on earth are amongst the heaviest sugar consumers then can it be so bad?”  The simple answer is Yes. The best runners in the world will be burning off this sugar on their morning run. The rest of us will not. This ‘Kenyan  paradox’ is hardly surprising, but Fitzgarald’s conclusion “They ate fewer calories than they burned” is simplistic. Maybe they ate less than they burned because there was a very real chance that by doing so they might become rich. Did the researchers ask how much time they spent feeling hungry? This is not a reasonable guideline for normal runners or the public in general.  The best way to eat less than you burn is to control your hunger. Traditional diets fail at this point; eating carbohydrate based diets does not allow you to control hunger unless you are very highly motivated – an elite runner perhaps. Eating a fat-based diet is crucially different here. People who eat a lower percentage of carbohydrates and a higher percentage of natural fats feel hungry less often and hence consume less. This is why LCHF diets consistently out-perform high carb diets in randomised controlled trials. And this is how intermittent fasting works, your body gets used to fuelling on fat and you do not feel hungry so often.

It should also be mentioned that type 2 diabetes does not normally develop quickly. Insulin resistance grows over decades and the more insulin you have to make the more resistance you are likely to develop. Has anyone measured the incidence of type 2 diabetes in retired Kenyan runners? I doubt it, as we are only interested in how they run so fast. Steve Redgrave may have developed hereditary type 2 diabetes, or it may be the result of consuming very high amounts of carbohydrates over a long and illustrious sporting career.

"Don’t worry about fructose says" Matt. The Harvard study he refers to concludes that eating certain whole fruits can be better for preventing weight gain than some vegetables; he doesn’t mention which fruits. The answer is blueberries and apples, but the implication and matts Rule #1 (Don’t worry about natural sugars) is that fructose is therefore good for you. The study does not say this.  Bad use of science Matt!   Most people don’t know the difference between fructose and sucrose and they don’t know the difference between whole fruit and fruit juice; they gorge on orange juice or smoothies thinking that they are healthy.

Lovely fattening smoothies!

Matt says “eat refined sugar in moderation”. Again this statement is problematic because most people do not know what it means; they don’t know what the recommended amounts are, and so what exactly is moderation? For a Runner's World audience fixated by timeings, measurements, performance improvement and measurability, what does “moderation” mean?  Meanwhile every petrol station, office or shop we go to is bombarding us with sugary temptations and saying ”let me be the one to supply your moderate amount of sugar today”.   If we want people to understand how low the World health organisation recommendation on daily sugar intake is, then we need show them. Give them a glossy picture of one large apple; and make it clear that sugar in general is bad for you.

When you consider that it is not very difficult for runners to switch to burning fat instead of sugar it is a wonder that Runners World covers the subject so little – there is a lot of mileage in the subject! 

Matt is not right when he says that you will not perform at your very best if you skip sugar; some people will and some won’t. But I would suggest that most runners would be somewhat richer, a lot healthier, rather happier, and would enjoy their running a whole lot more if they were to exchange those few extra seconds from  their marathon PB for life of running without sugar.  I simply don’t have to think about refuelling when I run a marathon and I finish happier and stronger than anyone I know (well there might be the odd sub-3 exception here!). I am also a little faster at 51 than I was at 45 having recently knocked 6 minutes off my off-road marathon PB.

Matt also provides an anecdote about Julie Benson and her difficulties with the No Sugar No Grain diet which left her feeling drained of energy during her training. This sounds to me like a typical simple case of not having enough energy; in other circumstances this is known as starving. I could be wrong here, but I don’t see references to replacing your energy intake with healthy fats on NSNG diet web sites. Yes it is true that some people do not adapt to fat burning as well as others but these people are certainly a minority of the readers of Runners World.

He introduces stress as a performance inhibitor and suggests that the worry associated with strictly following a formula diet is a common thing. This can be true. But there is nothing particularly stressful about a Real Food diet and no reason to worry if you accidentally fall off the waggon and eat slice of cake. The LCHF waggon is much easier to jump back onto than most for the simple reason that the food is very tasty! Contrast that with the constant warnings from sports nutritionists like Matt whose “Rules” say we MUST replace energy as we run and we MUST follow every run with the right amount of a mixture of carbs and protein. What if we forget, or get the mixture wrong? Will all our effort be wasted? Worry, worry, worry! 

In fact the “science” behind this post-run recovery advice does not support this widely held conclusion; it is based on runners performing in a fasted state, so of course their bodies needed energy and protein after a run. Most people do not run in a fasted state, do they?  And following this advice is precisely why so many runners put on weight during their marathon training. Personally I never feel hungry after a 3-hour run (although a creamy coffee is nice) and I generally recover fast enough to spend the afternoon gardening and run again the next day should I wish to. No stress there then.

Fitzgerald's declaration that runners fear an insulin spike after consuming sugar while running is interesting. I have never heard of this idea before. As far as I am aware most runners have never experienced an insulin spike and wouldn’t recognise one if it hit them in the head; people who fear consuming sugar during exercise are generally referring to the sugar that they will consume in their life and the possibility that it might lead to long-term weight gain or insulin sensitivity.  Yes, consuming sugar delays fatigue, but teaching your body to burn fat will delay it a lot longer.

Finally the article admits that eating sugar can become addictive, and that effort is required to overcome the affliction of having a “sweet tooth” is non-trivial, and may require the assistance of a qualified nutritionist.  Try to square this with the general advice of “eat less and move more” and you will be left with a head-ache.

Eat less more more?

So much of the advice we read neglects the simple fact that we are all habit-based creatures. Matt presumably finds it easier than most people to train hard and eat well because it has become a habit, part of his lifestyle and there are clear incentives for him to retain these habits.  For most people their lifestyle is far more sedentary and revolves around a constant stream of temptations to eat badly. Cakes in the kitchen, sweets in the jar by the door, coffee (and cake) with friends etc.  These habits are hard to break and nutritionists are bonkers if they think that it is a simple thing to adopt a philosophy of "all things in moderation" as Matt and so many others suggest. If it were that easy we would not have an obesity epidemic. 

I would prefer to call a spade a spade; use simple statements. Smoking is bad for you, so avoid it. Drinking alcohol is bad for you so avoid it. Sugar is bad for you, so avoid it. Un-refined food is good for you, eat it.   I am not saying that that this is easy to do, but having commonly agreed guidelines would be a good start. 

For many it takes a compelling event (such as the doctor telling them they have heart disease or type 2 diabetes) to force them to confront the truth and alter their life-long habits.  These days we all seem to want the moon on a stick, but life is harder than that. People should see LCHF as a way  of life, not a dietary fad. 

I do not have diabetes or heart disease. My compelling event came when I read that I could run faster for longer if I changed my diet. That was three years ago and it worked; my improved health (weight stable and all blood markers improved) is a rather nice side-effect of my competitiveness!

I have only ever read one article on running on fat in Runners World. A journalist took up the diet for a few months to see what effect it would have on her marathon time. She found it hard, but lost weight and did rather well; she then gave it up because she missed beer and pizza !  Desperate to get a sub-four-hour time she introduced carbs back into her diet for the last 3 weeks of training, just as she was reducing her weekly milage she confused her body with un-needed carbs. This was a big mistake and as a result she hit some kind of wall at 16 miles, and despite getting a big PB she was disapointed at missing her target. It's OK to race on carbs, although I have never needed to; but you mustn't undo all that good work by carb-loading.

The benefits of LCHF on running do not come as cheaply as this; over time we adapt to oxidise a steadily higher volume of fat per minute, and our performance improves.Runner's World feeds us with a deluge of expert advice like Matt’s telling us that we will not run like a champion unless we eat like a champion.  The science here is desperately poor and generally financed by sports nutrition companies. I know that a lot of RWs advertising income is from big sugar producers like SIS and Lucozade but I would like to see RW place a stronger emphasis on public health, after all most of its readers seem to have taken up running to become more healthy, not to run a sub-2:30 marathon.


PS - 22nd November 2017.
I thought that this article in The Times today was interesting. If you've read this far then so might you.

A spoon-full of sugar helps each mouthful go down!

The latest from Robert Lustig on the fight against dietary sugar.

Read more here: http://www.sacbee.com/2014/07/23/6574928_viewpoints-dont-believe-industry.html#storylink=cpy

http://www.sacbee.com/2014/07/23/6574928_viewpoints-dont-believe-industry.html

There is whole lot of money being spent on persuading us that sugar is harmless. It is incredible to think that some people are employed solely to write reports to make sugar look respectable.

"It is difficult to get a man to understand something when his salary depends on his not understanding it"

Things are little different in this country, every manufacturer of food with added sugar (that includes just about all processed food) argues that their food has it's place in a "healthy balanced diet" - even Coca Cola!. When you combine this with the ubiquitous phrase "everything in moderation", you will get a big pile of sugar on our places every day.

They can't all be right, can they? Not when the World Health Organisation are recommending a maximum of 6 teaspoons of sugar per day. http://www.telegraph.co.uk/health/healthnews/10677712/World-Health-Organisation-advises-halving-sugar-intake.html

However Action on Sugar is gaining ground (they want to persuade industry to gradually lower the unnecessary sugar content in processed foods), and the new guidelines for school food and drink are also good to see  (http://www.bbc.co.uk/news/education-27869411).

But I wait to see whether our local school will actually remove any more of the wide array of sugary drinks from the counter and start promoting water as the drink of choice. After a minor improvement 2 months back they have stopped replying to my emails since this change was announced; they have until January to change or I will be after them.

So things are starting to change. The biggest danger I see ahead is with the attitudes of parents. So many people argue that they should be allowed to choose for themselves if they want to drink a 2 liter bottle of cheap cola every day; they don't want to be nannied by me or the state.

The trouble is the nation is getting fatter and the Nanny Health Service is getting poorer; and these same people appear to expect nanny to be there to tuck them in and cure them when they need drugs or a gastric band. They cant have it both ways!

Dietary Advice and the Big-Food Wolf

The Big-Food Wolf is lurking in the corridors of Westminster disguised as government advisors but paid by food and drug companies. The wolf owns the lobbyists, paid solely to prevent our government from passing laws or making recommendations that might lower the dividends for the shareholders of their companies but might actually make our nation more healthy. 

The World Wide Wolf is spending 500 times as much on marketing its products as the World Health Organisation has to spend on dietary advice. The wolf is all around us; sponsoring the England Football Team, sponsoring and controlling ‘Our’ Olympics and educating our children to associate rubbish food with sporting success. 

I'd like to put it to the current and shadow chancellors and health secretaries that if they are brave enough to stand up to the big-food wolf and listen to the truth about the effects of sugar and carbohydrates upon diabetes, obesity and metabolic syndrome, then they could save tens of billions from future NHS spending and spend it on creating more jobs and better schools instead.

There is growing evidence to suggest that this level of saving truly could be made.

Dr Aseem Malhorta who is on the board of the Action On Sugar Group certainly thinks so. He points out that "Added sugar has no nutritional value whatsoever and causes no feeling of satiety”. So we should all ask ourselves why it is there in such great quantities in our food when it has proven links with causing diabetes and other diseases (http://www.lowcarbdietnews.com/evaluate-lchf-treatment-diabetes/)

Action on Sugar aims to work with the food companies to lower sugar levels. They hope that a gradual lowering of the levels of added sugar would not actually be noticed by consumers and would cause a significant lowering of illness.

The typical response of the food companies is that obesity is not their fault as there are so many other factors involved. Coke is not the enemy if used as part of a “Healthy Balanced Diet”.  They also quote the nasty-ubiquitous line: ‘Anything is OK in moderation”. Would that also be true for cocaine I wonder?

The food companies also say that they are already helping to educate us about food choices. Perhaps someone should devise a test on the subject and see what percentage of the population passes it. 

At the same time, each food company thinks it’s alright to suggest that there is room on our ‘healthy’ plate for their unhealthy food. Just how big is that plate? His critics like to portray Dr Malhorta as a bit a “quack”, which is a shame as he brings evidence to the debate where the food industry just brings childish excuses.

Despite getting fatter and less healthy the British public doesn’t like being told what to eat, do we?

I for one have found that since I have been on a LCHF diet I no longer need much sugar at all to get a taste of sweetness in food should I want that. My favorite dish of Greek yogurt and full cream with crushed nuts and preserved ginger tastes sweet to me, and yet it only has about half a teaspoon of sugar in it. Compare that to the 7 teaspoons in a can of Coca-Cola or the 6 teaspoons in a serving of Jordan’s Granola (this is a normal 100g serving mind you, not the paltry 45g recommended on the box that is clearly not big enough for normal people). 

Sugar is addictive and like most drugs we can reduce our dependency on it if we try hard enough. So perhaps Action On Sugar are taking the most pragmatic approach possible.

A Calorie is NOT a Calorie

According to NHS Choices website (http://www.nhs.uk/Livewell/Goodfood/Pages/eatwell-plate.aspx) the key to a “healthy balanced diet” is

• ·       Eating the right amount of food for how active you are
• ·       Eating a range of foods – this is what balanced means

The first line of their advice contains a major assumption - "calories in = calories out".

The second line of advice is of no practical use at all. What range of foods? What balance?

After just a simple level of research into 'calories in=calories out'  you will learn that it is not how many calories you eat but WHAT YOU EAT that impacts on the body’s response to storing energy as fat. But still our conditioned response to fat people who say “I really do not eat that much” is to say we do not believe them.

The human body is a complicated machine, and our genetic make-up ensures that we all have many differences, and so the suggestion that if we all ate the same food and moved the same amount then we would all weigh the same is simplistic nonsense. But most of us, myself included I admit, have peddled that nonsense for years.

Tim Noakes (https://www.facebook.com/pages/Tim-Noakes/363196263770926 ) has suggested that we all have different levels of Carbohydrate Intolerance, and that our propensity to put on weight is related to our level of intolerance. Now this sounds simple enough to me, just in the same way that some of us are more or less tolerant of say wheat, lactose or alcohol.

So, repeat after me; “Not All Calories Are The Same!”

  

So what is a Healthy Balanced Diet? (or rather What Isn’t?)

Here is the NHS healthy eating plate:

As you can see there appears to be room on this plate (at the bottom) for a can of coke or a mars bar (albeit a rather small one).  The precence of this purple segment gives all sugary food manufacturers license to say that their product can be used as part of a “healthy balanced diet”. The flood gates are open!

Our school canteens (and the food outlets in our teaching hospitals!) are half-full of fizzy sugary drinks and fruit drinks. Look! It’s there at the bottom of the healthy eating plate, so surely this means that it is OK to have a sugary drink with every meal? Along with the fruit from the green segment of the place. And yet there as absolutely no need for it. There is more than enough energy being delivered by that huge yellow slice of carbohydrates. "But we're following the government guidelines", say the canteens.

While we are on that topic, there is nothing BUT energy being delivered by those carbohydrates, they have absolutely no nutritional value; that scares me and is the main reason I have chosen to try living on a LCHF diet. Why eat lots of something that does you no good?

So, sugary and fruity drinks are nutritionally redundant. Why not recommend drinking water instead? Why include these drinks on that plate at all? Unless perhaps the food industry lobbyists had some hand in designing the contents of the plate? This would not surprise me at all as most of the members of the government’s health advisory panels are either on the boards of or have received lots of funding from companies in the food and drugs industries. Many of them are professors, but can we rely on them to be impartial? Money talks. And it writes reports.

It took the moral colossus of our times Jeremy Paxman to get the chairman of Coca-Cola Europe to admit that perhaps the 44 teaspoons of sugar in a large sized Cinema cup of Coke might be too much. (See 2 mins 20 seconds into this https://www.youtube.com/watch?v=ugFock3p2xE).

Now lots of folks would argue that they never drink fizzy drinks anyway, so what’s the problem? We should all be allowed to make our own choices. Well, we are constantly being advised to eat foods that are low in fat, and you don’t have to look very hard to see that most low-fat foods have a tasty hidden ingredient to compensate for the loss of fat; sugar.

Look on the label of most processed foods and you will see one or more of the following in the list of ingredients.

So one way or another most of us end up consuming too much sugar.

In the WH Smiths in Edinburgh Airport half of the shop was dedicated to sweet snacks. The only item that I could find that did not have some sugar in it was water. Even the healthy-looking sandwiches had a teaspoon of sugar in them. Why?

Here is the specific NHS advice on sugary drinks: 

"Instead of sugary, fizzy drinks and juice drinks, go for water or unsweetened fruit juice (remember to dilute these for children, to further reduce the sugar)"

If we are not fond of water then we should be drinking fruit juice (fructose). At least they suggest watering it down, but does anyone ever do that?

So, we should drink fructose, should we?  If our livers have already had their fill of the carbs on that healthy plate and topped up our glycogen supplies then that fructose can do nothing but turn straight into fat and stay that way.  What is that fruity drink on our ‘healthy’ plate for exactly? Vitamin C perhaps? Nope; there is more than enough of it and all the other nutrients we need in the vegetables and meat that ought to be on that plate. There is simply no need for it to be there. Sorry, that’s not fair; it tastes nice. But so does Coca-Cola.

I think that this conflicts hugely with the picture that most of us have in our minds of a healthy meal, with a nice glass of orange juice to wash it down.

Regulation?
Another quote from my superstar of the month Aseem Malhotra comes from this fascinating article http://www.theguardian.com/commentisfree/2014/mar/16/big-food-in-denial-about-harm-of-sugar.  The compelling sentence in this article is this: “Regulation to protect consumers and children is clearly needed.”

The food industry say they would like to work with ministers and the NHS to provide even better education about food choices, and it seems clear that there is a general reaction against ‘The Nanny State’ telling us what to eat and what not to eat; but I suspect that this ‘education’ will not change a thing. For example, acording to the dietary advice on a tasty looking pot of breakfast yogurt in WH Smiths advertised with no added sugar, it has just 2 teaspoons of sugars (fruit based) in each portion. Read the smaller print and you see that the suggested potion size is riduculously small, just over one third of the pot. Clearly the pot is aimed at a single perrson (there is only one spoon); I could easily eat two of them. When we are making choices about take-away food we look at the item, not some portion of it. So we will be eating 6 teaspoons of sugar for breakfast, not 2. This is not education, it is obfuscation.

History tells us that legal intervention is the only way to get results.

In Helena, Montana a ban on smoking in public places was followed by a significant decrease in coronary heart disease. The ban was overturned after 6 months and the rates of CHD rose back to their previous levels. (http://www.bmj.com/content/328/7446/977)

Consider the recent change in the law on smoking. Up until a few years ago the tobacco industry dragged their heels to stop change. As recently as 1994 the CEOs of every major tobacco company in the USA testified to Congress under oath that they were convinced that smoking did not have an effect on heart disease. They lied in order to protect their shareholders. And so will the CEOs of Tate and Lyle and Kellogg’s if they have to.  

Since the ban on smoking in public was intruduced in the UK there has been a significant reduction in Asthma and premature births (http://www.bbc.co.uk/news/health-26770009).

The key here is that interventions can quickly show significant effects. I think that it is likely that only a change in the law on food labeling will have a significant effect on our health. Or preferrably a fundamental review of the advice being given to the British public about healthy eating.

So, who is afraid of the big-food wolf? Are the lambs in the fields of Westminster just waiting to be flattered, paid-off and slaughtered when the time comes?

Many people think that over the last 20 years politicians in this country have emulsified into a center-ground of quivering, fatty, homogeneous sludge. But what they do get excited about is our votes. If we demand a change in dietary advice, and they can see that their chances of re-election depend upon it then perhaps they will be prepared to stand up to the wolf in sweet clothing and demand a change. So we need to raise the profile of the issue; and that, in a small way, is what I have hoped to do today.

If you want to learn more about the bitter truth about sugar, then this is the best place to start. https://www.youtube.com/watch?v=dBnniua6-oM

Credits: Some of the information in this article was presented by Dr Asseem Malhotra in his lecture at the College of Medicine on May 1^st 2014.