The Great Doughnut Debate

by Tracy Purbrick
Primary Care Dietitian

Is a doughnut intrinsically evil, or should we only ever judge it by the company it keeps? Or to put it another way, should foods be labelled good, bad or indifferent, as per the Multiple Traffic Light (MTL) system or blandly described with panels of percentages, as per the Guideline Daily Amounts (GDAs) approach?

The battle between GDA’s and the MTL system has been fought so vociferously that rather than educate the masses, the public has been left more bemused than enlightened. Incredibly, whilst the government was chief instigator of the MTL approach, it has displayed either monumental impotence or apathy in not standing by its own brainchild and making it law.

Whatever the MTL’s shortcomings (all eminently ‘tweakable’) it is quite scandalous that rogue elements of the food industry have been left blithely to do their own thing and thereby seriously undermine it. And whilst the two rivals are now being given some sort of showdown – with the promise to see which version the public prefers – exposure to GDAs is inevitably going to be greater.

After all, Tescos (the chief GDA rabble rouser) holds over 30 percent of the supermarket share, almost double its nearest rival. Whilst my fingers will be tightly crossed for a victory of common-sense and the emergence of a hybrid of colours and percentages, maybe this is also an opportunity to take the debate one stage back. What was the wisdom of the chosen nutrients selected in the first place: total fat, saturated fat, sugar and salt.

So to kick things off, why was total fat selected rather than energy? Scratch beneath the surface of most epidemiological studies and evidence relating disease to total fat intake is pretty flimsy. Just look to the Cretans, glugging back 40 percent of their calories as fat, yet keeling over with even fewer coronaries than the infamously more austere Japanese. On the other hand, evidence relating an increasing number of diseases to obesity is overwhelming, and obesity in turn hinges upon calories – regardless of which macronutrient they’ve come from, which is why people have been able to achieve weight loss on diets as diverse as the Atkins and Pritikins.

Next, whilst labelling saturated fat – a fat consistently linked with heart disease – is laudable, why is there no red light reserved for trans fats: saturated fat’s bigger, badder brother? Of course, there shouldn’t actually be any significant level of unnatural trans fats in the UK diet, since no level of intake from industrial partial hydrogenation is deemed safe.

Denmark has led the world in tackling trans fats, introducing such strict regulations that even if a Dane were to live off ready meals (something us Brits sadly excel in) they’d struggle to eat even 1g of the stuff per day. If the UK government hasn’t got the gumption to do the same, it should at least name and shame via food labelling those food products in which they lurk. At present, trans fats have no special billing of their own, making their appearance by stealth amongst the considerably larger total fat.

The other questionable nutrient is sugar (do I hear grumbles of dissent?). In the era of the glycaemic index and more importantly glycaemic load, sugar becomes little more than a red herring. We must surely ask ourselves why people want to know how much sugar a product contains and then question whether sugar labelling actually achieves that end.

If it is to enable better blood sugar control, then highlighting dietary sugar could actually be woefully misleading. How many patients with diabetes do we already see who’ve ditched the All Bran (17 percent sugar but low GI) in favour of Weetabix (only 4.4 percent sugar, but high GI)?

Science has long moved beyond the complex and simple carbohydrate paradigm, but Jo public still hasn’t and never will if we perpetuate this myth via labelling. If denouncing sugar is for our dental welfare, then again, sugar is only one part of the story. Other factors, such as stickiness of a food, acidity and frequency of consumption are also important. Yes – raisins are far healthier than sweets, but frequently chewed, they could both leave you edentulous.

And whilst switching from standard Pepsi to diet cola will certainly spare some caries and calories (the latter easily flagged up by my aforementioned calorie traffic light), the acid bath could still erode the smile off your face. The main problem with sugar is that it is frequently, but by no means always, a marker for nutrient poor food, AKA junk. So why don’t we aim our labelling at identifying just that, by not just flagging up foods with health claims, but those with health shames too.

The food industry has had things all their own way for far too long. They’ll happily brag that something’s good for your heart and print little heart icons to hammer the message home, but there’s a strange absence of warnings on foods that might actually be detrimental to health. I’ve yet to see an icon of a fat belly or someone clutching their heart having a coronary on a packet of crisps.

But that brings us back to the good food/bad food debate. The food industry’s position on this is clear: ‘there is no such thing as a bad food, only bad diets’, which underpins their main argument against the MTL system. But if there is no such thing as bad foods then how can there be any such thing as good foods.

The truth, as they well know, is that the ‘no bad food’ mantra has served our appetites for junk food and their pockets well. Perhaps it is time to admit that a doughnut actually isn’t very healthy and deserves all of the red lights it gets. And of course we’ll all continue to eat them, but as a treat on top of our otherwise healthy diet, rather than pretending it’s an integral part of it.

So without further ado, my proposed list for the eventual labelling victor: calories, saturated fat, trans fat (hopefully a category requiring a brief existence) glycaemic load and salt. Then, in tandem with nutritional claims, let’s make manufacturers own up to the nutritional underperformers too.

Maybe the image of a dustbin on any nutrient poor junk and sensible warnings on all cariogenic drinks of the particular dangers of frequent swilling. But whatever the eventual food labelling outcome, we should never lie in order to simplify.