Australian paradox: Difference between revisions

Latest revision as of 19:12, 22 March 2025

A phenomenon regarding sugar consumption and obesity in Australia

Australian Paradox[edit]

The Australian Paradox refers to the observed phenomenon in Australia where there has been a decline in sugar consumption over the past few decades, yet the prevalence of obesity has continued to rise. This paradox challenges the commonly held belief that increased sugar intake is directly responsible for rising obesity rates.

Background[edit]

The term "Australian Paradox" was popularized following a study published in 2011 by researchers from the University of Sydney. The study analyzed data on sugar consumption and obesity rates in Australia and found that, contrary to expectations, sugar consumption had decreased while obesity rates had increased.

Sugar Consumption Trends[edit]

In the late 20th century, Australians consumed high levels of sucrose, primarily from sugar-sweetened beverages and processed foods. However, data from the early 2000s onwards indicated a decline in sugar consumption. This decline was attributed to increased public awareness of the health risks associated with high sugar intake and changes in dietary guidelines.

Obesity Trends[edit]

Despite the reduction in sugar consumption, the prevalence of obesity in Australia has continued to rise. This increase in obesity rates has been attributed to a variety of factors, including increased consumption of calorie-dense foods, reduced physical activity, and changes in lifestyle and environment.

Explanations for the Paradox[edit]

Several hypotheses have been proposed to explain the Australian Paradox:

Caloric Intake and Expenditure: While sugar consumption has decreased, overall caloric intake may not have reduced significantly. Additionally, sedentary lifestyles and reduced physical activity contribute to positive energy balance and weight gain.

Substitution with Other Caloric Sources: As sugar consumption decreased, there may have been an increase in the consumption of other caloric sources, such as fats and refined carbohydrates, which can also contribute to obesity.

Metabolic and Genetic Factors: Individual metabolic and genetic factors may play a role in how the body processes and stores energy, influencing obesity rates independently of sugar consumption.

Criticism and Debate[edit]

The Australian Paradox has been the subject of significant debate and criticism. Some researchers argue that the data used in the original study was flawed or misinterpreted. Others suggest that the focus on sugar alone is too narrow and that a more comprehensive approach to understanding obesity is needed.

Conclusion[edit]

The Australian Paradox highlights the complexity of the relationship between diet and obesity. It underscores the need for a multifaceted approach to addressing obesity, considering not only sugar consumption but also overall dietary patterns, physical activity, and other lifestyle factors.

Related pages[edit]

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-The '''Australian Paradox''' is a term coined in 2011 to describe what its proponents say are diverging trends in sugar consumption and [[Obesity in Australia|obesity rates in Australia]]. The term was first used in a 2011 study published in [[Nutrients (journal)|''Nutrients'']] by Professor [[Jennie Brand-Miller]], in which she and co-author Dr Alan Barclay reported that, in Australia, "a substantial decline in refined sugars intake occurred over the same timeframe that obesity has increased."<ref name=Nutrients>{{cite journal |vauthors=Barclay AW, Brand-Miller J |title=The Australian paradox: a substantial decline in sugars intake over the same timeframe that overweight and obesity have increased |journal=[[Nutrients (journal)|Nutrients]] |volume=3 |issue=4 |pages=491–504 |date=April 2011 |pmid=22254107 |pmc=3257688 |doi=10.3390/nu3040491 }}</ref>
+{{Short description|A phenomenon regarding sugar consumption and obesity in Australia}}
-The "paradox" in its name refers to the fact that sugar consumption is often considered (for example by [[Robert Lustig]]) to be a significant contributor to rising obesity rates,<ref>{{cite web | url=https://www.newscientist.com/article/mg21228360.200-australian-paradox.html | title=Australian paradox | work=[[New Scientist]] | date=26 October 2011 | accessdate=8 April 2014 | author=Russell, Geoff}}</ref> and because [[Ecological study|ecological studies]] in the United States have found a positive relationship over certain time periods between sugar consumption and obesity prevalence,<ref name=Nutrients/> although added sugars consumption is now also declining in the United States.
+==Australian Paradox==
+The '''Australian Paradox''' refers to the observed phenomenon in Australia where there has been a decline in sugar consumption over the past few decades, yet the prevalence of [[obesity]] has continued to rise. This paradox challenges the commonly held belief that increased sugar intake is directly responsible for rising obesity rates.
-==Reaction==
+==Background==
-Some people have criticized Brand-Miller's 2011 study, such as economist Rory Robertson, who argued that "[Brand-Miller's study's] regular claim &ndash; "In Australia sugar consumption has dropped 23 per cent since 1980" &ndash; is woefully misleading, based as it is on a series that was abandoned by the [[Australian Bureau of Statistics]] (ABS) as unreliable a decade ago."<ref>{{cite web | url=http://www.smh.com.au/business/economist-v-nutritionists-big-sugar-and-lowgi-brigade-lose-20120307-1uj6u.html | title=Economist v nutritionists: big sugar and low-GI brigade lose | work=[[Sydney Morning-Herald]] | date=7 March 2012 | accessdate=8 April 2014 | author=Pascoe, Michael}}</ref> Robertson has also argued that while the paper claims that consumption of sugary soft drinks in Australia declined by 10% between 1994 and 2006, it actually increased by 30%. He cites these and other data to support calling the research "a menace to public health".<ref>{{cite web | url=http://www.abc.net.au/radionational/programs/backgroundbriefing/2014-02-09/5239418 | title=Is sugar innocent? | publisher=[[Australian Broadcasting Corporation]] | date=9 February 2014 | accessdate=8 April 2014}}</ref>
+The term "Australian Paradox" was popularized following a study published in 2011 by researchers from the University of Sydney. The study analyzed data on sugar consumption and obesity rates in Australia and found that, contrary to expectations, sugar consumption had decreased while obesity rates had increased.
-In February 2014, the [[Australian Broadcasting Corporation]] (ABC) aired a program criticizing the 2011 study proposing the existence of the paradox, based in part on Robertson's research. The CEO of the [[Australian Beverages Council]], Geoff Parker, has responded that his industry cites other studies besides Brand-Miller's 2011 study to support their view that sugar is not uniquely linked to obesity.<ref name=Safi>{{cite web | url=https://www.theguardian.com/world/2014/feb/11/soft-drink-industry-sugar-consumption-evidence | title=Soft-drink industry resists sugar consumption evidence in documentary | work=[[The Guardian]] | date=10 February 2014 | accessdate=8 April 2014 | author=Safi, Michael}}</ref> In response to Robertson's allegations, [[Sydney University]], Brand-Miller's employer, launched an investigation to determine if she is guilty of research misconduct. A spokesperson for the university said there were "...no substantiated claims against the work of any academic at the university, nor indeed has there been any finding that the complaints warrant any further investigation".<ref name=Safi/>
+==Sugar Consumption Trends==
+In the late 20th century, Australians consumed high levels of [[sucrose]], primarily from [[sugar-sweetened beverages]] and processed foods. However, data from the early 2000s onwards indicated a decline in sugar consumption. This decline was attributed to increased public awareness of the health risks associated with high sugar intake and changes in dietary guidelines.
-In July 2014, Brand-Miller and Barclay were cleared of misconduct by a six-month investigation conducted by Robert Clark of the [[University of New South Wales]].<ref>{{cite web | url=https://www.theguardian.com/world/2014/jul/21/sugar-row-nutritionists-cleared-misconduct | title=Researchers cleared of misconduct in row over sugar link to obesity | work=The Guardian | date=20 July 2014 | accessdate=24 July 2014 | author=Safi, Michael}}</ref> Following an investigation prompted by the Australian economist, two minor arithmetical errors were identified in the original manuscript of The Australian Paradox which were promptly corrected. This was the only allegation out of 8 others that was substantiated.<ref>{{cite web|url=http://sydney.edu.au/news/84.html?newsstoryid=13779|title=News - The University of Sydney|website=sydney.edu.au|accessdate=5 February 2019}}</ref>
+==Obesity Trends==
+Despite the reduction in sugar consumption, the prevalence of obesity in Australia has continued to rise. This increase in obesity rates has been attributed to a variety of factors, including increased consumption of [[calorie-dense]] foods, reduced physical activity, and changes in lifestyle and environment.
-Another study on the same topic was published in 2013 by researchers (Rikkers et al.) from the [[University of Western Australia]]. The study concluded that "The Australian Paradox assertion is based on incomplete data, as it excludes sugar contained in imported processed foods, which have increased markedly."<ref>{{cite journal |vauthors=Rikkers W, Lawrence D, Hafekost K, Mitrou F, Zubrick SR |title=Trends in sugar supply and consumption in Australia: is there an Australian Paradox? |journal=BMC Public Health |volume=13 |pages=668 |year=2013 |pmid=23866719 |pmc=3726354 |doi=10.1186/1471-2458-13-668 }}</ref> The study argued that the claim that sugar consumption had been declining in Australia relied only on production data, and that Australia gets back much of the raw sugar it exports in the form of processed foods.<ref>{{cite web | url=http://well.blogs.nytimes.com/2013/07/25/obesity-comes-to-australia/ | title=Australians Are Getting Fatter | work=[[The New York Times]] | date=25 July 2013 | accessdate=8 April 2014 | author=O'Connor, Anahad | authorlink=Anahad O'Connor}}</ref> Tom McNeill argued that Rikkers et al.'s paper was significantly flawed, writing: "Rikkers et al.'s biggest source of error is the inclusion of incorrect products in the category of "moderate to high sugar content", in violation of their study inclusion criteria. Fruit juices and fruit drinks have been added to the analysis by the authors without consideration of their actual sugar content, or the very definition of these products which must be adhered to by food manufacturers under the control of Food Standards Australia and New Zealand (FSANZ)".<ref>{{cite journal |last1=Zubrick |first1=Stephen R. |last2=Mitrou |first2=Francis |last3=Hafekost |first3=Katherine |last4=Lawrence |first4=David |last5=Rikkers |first5=Wavne |title=Trends in sugar supply and consumption in Australia: is there an Australian Paradox? (Comments) |journal=BMC Public Health |year=2013 |doi=10.1186/1471-2458-13-668/comments |url=https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-668/comments |doi-broken-date=2019-03-08 }}</ref> A narrative review of eye disease published the following year argued that the claim of the existence of an Australian paradox "is flawed as it assumes declining sugar intake, without taking into account imported foods containing sugar", quoting Rikkers et al.'s analysis as evidence.<ref>{{cite journal|last=Kearney|first=Frances M|author2=Fagan, Xavier J |author3=Al-Qureshi, Salmaan |title=Review of the role of refined dietary sugars (fructose and glucose) in the genesis of retinal disease|journal=Clinical & Experimental Ophthalmology|date=April 2014|pages=564–573|doi=10.1111/ceo.12290|volume=42|issue=6}}</ref>
+==Explanations for the Paradox==
+Several hypotheses have been proposed to explain the Australian Paradox:
-Brand-Miller and Barclay have responded that Rikkers et al. are wrong and that, in fact, the sugar consumption data they used (compiled by the United Nations [[Food and Agriculture Organization]], the Australian Bureau of Statistics and Australian beverage industry) "all incorporated data on imported products".<ref>{{cite journal |vauthors=Barclay AW, Brand-Miller JC |title=Trends in added sugar supply and consumption in Australia: there is an Australian Paradox |journal=BMC Public Health |volume=13 |pages=898 |year=2013 |pmid=24079329 |pmc=3853158 |doi=10.1186/1471-2458-13-898 }}</ref> Recent research by Levy and Shrapnel ("Quenching Australia's thirst: A trend analysis of water-based beverage sales from 1997 to 2011") has concluded that [[added sugar]] from soft drinks has continued to decline.<ref>{{cite journal|doi=10.1111/1747-0080.12108 | volume=71 | issue=3 | title=Quenching Australia's thirst: A trend analysis of water-based beverage sales from 1997 to 2011 | year=2014 | journal=Nutrition & Dietetics | pages=193–200 | author=Levy Gina S}}</ref>
+* '''Caloric Intake and Expenditure:''' While sugar consumption has decreased, overall caloric intake may not have reduced significantly. Additionally, sedentary lifestyles and reduced physical activity contribute to positive energy balance and weight gain.
-Brand-Miller's stated that per capita sales of sugar-sweetened beverages had decreased by 10%, in an interview with ABC Radio in 2014, "it might be that a key word came out. It's possible that this should be, 'While nutritively sweetened beverages ... 10 per cent sweetened beverages decreased by 10 per cent.' So I'll double-check it." Barclay, the 2011 study's other author, also said, in an email to the program, that "the 10 per cent decline could not possibly refer to per capita sales of nutritively sweetened soft drinks".<ref>{{cite web | url=https://ama.com.au/ausmed/attack-controversial-sugar-study-intensifies | title=Attack on controversial sugar study intensifies | publisher=[[Australian Medical Association]] | date=4 March 2014 | accessdate=8 April 2014 | author=Rollins, Adrian}}</ref> As mentioned previously, Brand-Miller and Barclay published a correction to their original 2011 study addressing this.<ref>{{cite journal|last=Barclay|first=Alan|author2=Brand-Miller, Jennie|title=Barclay, A.W. and Brand-Miller, J. The Australian Paradox: A Substantial Decline in Sugars Intake over the Same Timeframe that Overweight and Obesity Have Increased. Nutrients 2011, 3, 491-504|journal=Nutrients|date=12 February 2014|volume=6|issue=2|pages=663–664|doi=10.3390/nu6020663}}</ref> According to Esther Han, this correction invalidates the study's claim that soft drink consumption decreased from 1994 to 2006.<ref>{{cite web | url=http://www.smh.com.au/lifestyle/diet-and-fitness/rise-in-sugary-drinks-is-really-a-fall-says-study-funded-by-beverages-australia-20140216-32tr5.html | title=Rise in sugary drinks is really a fall, says study funded by Beverages Australia | work=Sydney Morning-Herald | date=17 February 2014 | accessdate=10 April 2014 | author=Han, Esther}}</ref>
+* '''Substitution with Other Caloric Sources:''' As sugar consumption decreased, there may have been an increase in the consumption of other caloric sources, such as [[fats]] and [[refined carbohydrates]], which can also contribute to obesity.
-Complaints about the scientific journal ''[[Nutrients (journal)|Nutrients]]'' over its publication of The Australian Paradox paper led to the [[Open Access Scholarly Publishers Association]] (OASPA) investigating ''Nutrients'' publisher, [[MDPI]]. In 2014, OASPA's investigation concluded that MDPI continued to meet its membership criteria.<ref>{{cite web|url=https://oaspa.org/conclusions-from-oaspa-membership-committee-investigation-into-mdpi/|title=Conclusions from OASPA Membership Committee Investigation into MDPI|date=11 April 2014|website=OASPA|accessdate=5 February 2019}}</ref>
+* '''Metabolic and Genetic Factors:''' Individual metabolic and genetic factors may play a role in how the body processes and stores energy, influencing obesity rates independently of sugar consumption.
-In April 2017, an update of all available Australian added sugars consumption data titled "Declining consumption of added sugars and sugar-sweetened beverages in Australia: a challenge for obesity prevention" was published in the American Journal Of Clinical Nutrition. The analysis concluded "In Australia, 4 independent data sets confirmed shorter- and longer-term declines in the availability and intake of added sugars, including those contributed by SSBs (Sugar Sweetened Beverages)."<ref>{{cite journal|title=Declining consumption of added sugars and sugar-sweetened beverages in Australia: a challenge for obesity prevention|first1=Jennie C.|last1=Brand-Miller|first2=Alan W.|last2=Barclay|journal=The American Journal of Clinical Nutrition|volume=105|issue=4|pages=854–863|doi=10.3945/ajcn.116.145318|pmid=28275129|year = 2017}}</ref>
+==Criticism and Debate==
+The Australian Paradox has been the subject of significant debate and criticism. Some researchers argue that the data used in the original study was flawed or misinterpreted. Others suggest that the focus on sugar alone is too narrow and that a more comprehensive approach to understanding obesity is needed.
-Independent analyses by Australian researchers including Ridoutt and colleagues at the Commonwealth Scientific and Industrial Research Organisation (CSIRO)<ref name="ridoutt">{{cite journal|title=Changes in Food Intake in Australia: Comparing the 1995 and 2011 National Nutrition Survey Results Disaggregated into Basic Foods|first1=Bradley|last1=Ridoutt|first2=Danielle|last2=Baird|first3=Kathryn|last3=Bastiaans|first4=Gilly|last4=Hendrie|first5=Malcolm|last5=Riley|first6=Peerasak|last6=Sanguansri|first7=Julie|last7=Syrette|first8=Manny|last8=Noakes|date=25 May 2016|journal=Foods (Basel, Switzerland)|volume=5|issue=2|pages = 40|doi=10.3390/foods5020040|pmid=28231135|pmc=5302341}}</ref> and Lei and colleagues also concluded that Australians consumed less added sugars in the years 2011-12 than they did in 1995.<ref>{{cite journal|title=Dietary intake and food sources of added sugar in the Australian population|first1=Linggang|last1=Lei|first2=Anna|last2=Rangan|first3=Victoria M.|last3=Flood|first4=Jimmy Chun Yu|last4=Louie|date=14 March 2016|journal=The British Journal of Nutrition|volume=115|issue=5|pages=868–877|doi=10.1017/S0007114515005255|pmid=26794833}}</ref>
+==Conclusion==
+The Australian Paradox highlights the complexity of the relationship between diet and obesity. It underscores the need for a multifaceted approach to addressing obesity, considering not only sugar consumption but also overall dietary patterns, physical activity, and other lifestyle factors.
-In December 2017, the Australian Bureau of Statistics published a comparison of free sugars consumption using Australia's 1995 National Nutrition Survey and 2011/2 Australian Health Survey titled "CONSUMPTION OF ADDED SUGARS - A COMPARISON OF 1995 TO 2011-12". Its main conclusion was "Between 1995 and 2011-12, Australians had a relative decrease in their consumption of free sugars, with the average proportion of dietary energy from free sugars declining from 12.5% to 10.9%."<ref>{{cite web|url=http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by+Subject/4364.0.55.011~2011-12~Main+Features~Consumption+of+Added+Sugars+-+A+comparison+of+1995+to+2011-12~20|title=Main Features - Consumption of Added Sugars - A comparison of 1995 to 2011-12|first=c=AU; o=Commonwealth of Australia; ou=Australian Bureau of|last=Statistics|date=13 December 2017|website=abs.gov.au|accessdate=5 February 2019}}</ref>
+==Related pages==
+* [[Obesity in Australia]]
+* [[Sugar consumption]]
+* [[Dietary guidelines]]
+* [[Public health]]
-==See also==
-*[[French paradox]]
-==References==
-{{Reflist}}
-[[Category:Sugar]]
 [[Category:Obesity]]
-[[Category:Obesity in Australia]]
+[[Category:Nutrition]]
-[[Category:Medical controversies in Australia]]
+[[Category:Public health]]
-[[Category:Health paradoxes]]
-{{dictionary-stub1}}