Downsizing

by Tom Watson

  What I’ve learned over the years is that the food labelling system in the UK is broken, particularly in relation to sugar. Having been hoodwinked by misleading packaging myself, I’ve done my utmost to publicly highlight the dangers of hidden sugars in our food. Even if you forgo the obvious culprits – sweets, cakes and biscuits – you’re still being exposed to huge amounts in products where you’d perhaps least expect it, such as cereals, soups and sauces. Indeed, I’ve found that everything from pizzas to sandwiches, and from ‘energy’ bars to ‘health’ drinks, contains more sugar than you’d ever imagine. All too often, where foods are labelled ‘low-fat’ (think yoghurts, ice cream or salad dressings), extra sugar has been added to make up for the loss of taste. Food production is all based on a sugar economy. Even trying to avoid sugar is difficult.

  Dr Robert Lustig addressed this in his seminal book, Fat Chance: The Hidden Truth about Sugar, Obesity and Disease:

  By using different forms of sugar in any given product, the food industry can add many different sugars to one product. The grams don’t change, but the order on the label does. The food industry has over forty other names for sugar in an effort to hide it on the label, but a discerning eye can often spot them.

  He then cited the various names that are used on food labels to describe sugar, including fructose, dextrose and maltodextrin, as well as the deceptively wholesome-sounding barley malt, agave nectar and blackstrap molasses. The sugar content is hidden in plain sight behind complicated names; to be a health-conscious shopper these days, it seems you need a GCSE in biology to decipher the nutritional information.

  In November 2018 I penned an article for the Daily Mail (the newspaper resumed contact with me following editor Paul Dacre’s departure) in which I exposed the misleading labels found on brands in our high-street supermarkets. I discovered high-sugar juice drinks (being heralded as ‘one of your five-a-day’) that were made ‘partially from concentrate’. The sugar content was not immediately obvious, but the mandatory labelling elsewhere on the 200ml carton confirmed there was 10.5g sugar per 100ml. By including just one such drink in their child’s lunchbox, parents would be giving them 21g of sugar, three grams shy of the daily recommended intake of sugar for a seven-to-ten-year-old. As for baby rusks – a staple of infant diets for generations, and once marketed as teething aids – I found that sugar was often the main ingredient after flour. Even the reduced-sugar varieties contained 3.4g per rusk, meaning that an older child who consumed three or four per day could easily hit half their recommended sugar intake.

  ‘Is it any wonder that kids of eight years old are being diagnosed with type 2 diabetes?’ I said to Barbara Hearn, a member of my team who’d assisted me with the research.

  ‘It’s shocking,’ she replied, as we wandered down a central London supermarket aisle. ‘All these hidden sugars in food meant for kids. Cereals. Pizza. Even sausages, for goodness sake. Retailers and manufacturers need to be more responsible. We can’t just blame parents.’

  Barbara and I came across scores of products aimed at youngsters that had little or no nutritional value, food that would arguably make them unwell. It was a hugely dispiriting experience.

  Some food for grown-ups was just as bad. In one supermarket I came across a ham and cheese sandwich that contained 15.1g of sugar (or four teaspoons, half the recommended daily allowance). Throw in a packet of crisps and a can of pop to qualify for the discounted ‘meal deal’, and you’d be over your daily sugar limit in one sitting. In another high-street food store, I found countless chilled chicken products containing honey, dextrose or molasses.

  The manufacturers, no doubt, would argue that these additional ingredients are essential as a preservative, or for flavour, but I don’t buy it. Foods that don’t normally contain sugar shouldn’t have it added, and consumers buying a piece of chicken shouldn’t expect it to be laden with the stuff. It is thoroughly disingenuous. Maple-roasted, honey-basted, sweet chilli… it’s all sugar. Pure and simple.

  The way we market food, especially to young consumers, has to undergo radical change, too. The people who sell us our food have immense power over what we end up eating, and we need to tackle the way in which these retailers influence our choices, whether it’s McDonald’s running Monopoly-themed promotions that encourage kids to supersize their already deeply unhealthy meal, or supermarkets running BOGOF offers on meals saturated with fat and sugar. A particularly insidious example is Coca-Cola’s Christmas truck tour, which targets children in various UK towns and cities by handing out free cans from red lorries festooned with fairy lights. In 2018 it was forced to scale back its schedule following opposition from local authorities and public health organisations, all rightly concerned that this flagrant marketing stunt had no benefit to their communities, many of which had significant problems with obesity and tooth decay. I shared their indignation and fired off an angry letter to Coca-Cola Great Britain, stating in no uncertain terms that this festive sampling of sugary drinks was wholly unacceptable.

  I had the world of advertising in my sights, too, and in January 2019 delivered a speech to its trade body, the Advertising Association, calling on the industry to stop using cartoon characters on cereal packets to promote sugary products to children. I may not have been the most popular person in the conference hall that morning, but some home truths needed telling.

  ‘We face a public health crisis in the UK, and one of the main causes is refined sugar in our foods and drinks,’ I said. ‘The results are horrific: 26,000 children hospitalised with rotten teeth. The worst obesity rates in Western Europe. And the catastrophe of type 2 diabetes, taking lives and costing the NHS £10 billion a year. I’m making it my political mission to change this.’

  I then projected up some images of various Kellogg’s cereal packets, complete with garish colours and grinning characters: Tony the Tiger, the Honey Monster, the Coco Pops monkey.

  ‘Before anyone tells me this is packaging and not advertising, let me tell you what they are: they are advertising billboards on tabletops aimed at tiny tots. And, because of that, they should be included in the self-regulatory arrangements for the industry.

  ‘These products are packed full of sugar, with little nutritional value. Even if a child had the recommended portion of Frosties, they’d be eating more than half their daily allowance of sugar before they’ve even got to school. And if they ate a bowl the size of the one that’s depicted on the front of the pack, they’d be exceeding their daily sugar allowance in one sitting. For children under ten, cereal is their single biggest source of free sugar intake. When we have a third of children leaving primary school overweight or obese, when teenage diabetes is rising by seventy per cent, we’ve got to ask ourselves is this still acceptable? I don’t think it is.

  ‘The unpalatable truth for the Advertising Association, which represents the interests of the industry to government, is that some sectors of the advertising industry have played a part in getting us here. Advertising has contributed to making us a nation overweight, unhealthy and addicted to sugar, and the industry has got to play a part in getting us out of this mess. So when it comes to high-sugar products like Coco Pops, my argument to you today is: get that monkey off our packs. I want you to find a way to help us get healthier. Get cartoon characters off adverts for high-sugar foods. Help us kick our sugar habit.

  ‘Everywhere our citizens look, on TV, online, on buses, on billboards, they are surrounded by adverts for foods laced with sugar. Those ads work. They’ve sold us the idea that breakfast means a bowl of sugary cereal. They’ve sold us the thought that thirst can only be truly quenched by a sugary, fizzy drink. So, today, I want you to think deeply about how advertising could help transform the lives of Britain’s 3.4 million identified type 2 diabetics. How changes in your industry could contribute to stopping kids leaving school obese. How we can get two million type 2 diabetics off their meds. How we can save the NHS ten per cent of its budget.’

  The harsh fact is that food packag
ing laws allow manufacturers to be unacceptably unclear about how much sugar a product contains. A claim such as ‘one of your five-a-day’ can convince a consumer that the product is healthy, and can distract from the heaps of sugar it actually contains. It doesn’t seem right that we allow the sale of ‘child-friendly’ products with bright colours and jolly illustrations when their contents are close to the recommended daily sugar limit for youngsters. It is not fair to parents or to children.

  If we are serious about dealing with our obesity and diabetes epidemics, we’ve got to get a grip on this issue. At the moment it’s like the Wild West. Local trading standards are supposed to have an overview on packaging, but what can they do against a food giant? TV food advertisements are regulated by the Advertising Standards Authority, while nutrition and allergen labelling is monitored by the Food Standards Agency. Too many products fall through the gap and instead of truthful packaging, we are getting packets of lies. Today, when we are reminded of the terrible consequences of diabetes on our personal and national health, we must resolve to do something about it. With all the hidden sugar, conflicting health advice, ultra-processed food and misleading labels, people who want to get healthy barely have a chance.

  We can’t afford to continue as we are. The scale of the public health crisis that already costs our NHS £10 billion a year is clear. I don’t want to live in a society in which people get ill from the food they eat, and then have to fight like hell to regain their health. I don’t want my children and grandchildren to go through what I and millions of other people have. These future generations will suffer greatly if we fail to get a grip.

  But there are things that my colleagues and I can do to help remedy this. Tackling Big Sugar and fighting the obesity crisis is a massive issue for public policy, and there comes a time when politicians of all sides must join forces to enact change. We need to tackle the global sugar giants who peddle poisons to our children. We need to crack down on junk food adverts on TV and on the high street. We need to ban firms from using children’s characters on food packaging if the contents within are loaded with sugar. We need to make laws – like the sugar tax – to enforce change where the industry has palpably failed to show any responsibility. We need to arrive at the point where it’s socially unacceptable to drink sugar in pop, where it’s considered a little bit dirty and unsavoury. I would like us to replicate what has happened with tobacco, whereby smokers are made to feel shameful and guilty, with products hidden behind screens or under counters. We need to stop tolerating those brands which seek to rake in billions at the expense of our nation’s health, and we need to shame them into changing ingredients and clarifying labels.

  Encouragingly, however, I do think there is an increasing number of people who are quitting sugar for health reasons (particularly millennials, I reckon, who seem to be relatively food-savvy) and the more that do, the more their cautionary tales and personal testimonies will be heard. If we are to have any hope of forging a healthier society, though, we cannot depend on individuals all enjoying their own epiphany before it’s too late. We need to tear down the walls that Big Sugar has built to protect its products and its profits.

  Finally, nutritionists may argue about the merits of various diets, but they nearly all agree on two fundamental principles: firstly, that the one-size-fits-all approach no longer works and, secondly, that sugar is extremely bad for you. The sooner we all wise up to this, the sooner we can start building a better, healthier, more nutritious world for everyone.

  CHAPTER EIGHT

  Remission for All

  By 2025 it is estimated that there will be five million people in the UK – nearly five times the population of Birmingham – with a diagnosis of diabetes. Five million of us living with this debilitating disease, searching for answers and seeking a healthier life. The cost to the individual is well known, as is the price paid by society. The National Health Service ploughs £10 billion a year into the treatment of diabetes and that outlay will only rise as the number of sufferers grows.

  £10 billion. More than the entire policing budget for England and Wales. Most of that money is spent on treating diabetes-related complications: the increased risk of dementia, sight loss and kidney disease, for example, not forgetting the circulatory problems that can lead to nerve damage and amputation. However, if we can arrest the development of diabetes, we will be able to massively improve people’s lives and prevent the next generation from getting sick like we did. And, while lifting millions of people out of the misery and hopelessness of a diabetes diagnosis, we can save the taxpayer a fortune. The good news is that we can stem the flow. The solution is surprisingly simple and shockingly straightforward. I call it Remission for All. And I want it to become a reality in the UK.

  Look at it this way. If five million people in our country contracted leprosy – a truly horrendous condition that rots your body from the outside in – we’d hear an awful lot about it. Legions of people losing their lives and limbs to this disease would prompt a national crisis. There would be urgent questions tabled in parliament, our government would face a public outcry and citizens wouldn’t be able to move for action plans and emergency investment. Yet with diabetes – a condition that rots from the inside out – nobody seems to lift a finger. The number of patients rises, and more of us suffer and die, but the response from the corridors of power is slow, muted and lacking in any sense of urgency. And it’s not as if we’re waiting on some miracle cure or some billion-pound research to fix this, either. Type 2 diabetes can be stopped and reversed for millions of people, thanks to simple dietary changes and a modest increase in exercise; I’m living proof of that. Experience has shown me that, with the right advice and the right encouragement, we can – every one of us – keep our condition in check. So why isn’t this message being heralded by those who govern us? It is a question that makes me angrier than almost any other posed in the modern political arena.

  Now that I’ve come out the other side, relatively unscathed, I believe it’s my duty to address this conundrum. It is time for a frank and honest conversation about diabetes in this country, and for radical action to tackle this burgeoning epidemic. My burning ambition, in this context, is to establish a Remission for All movement. A nationwide initiative, propelled by people power, it would be driven by two principal objectives: firstly, to support the estimated 3.4 million UK citizens with type 2 diabetes in trying to regain control of their body and reverse their diagnosis. Secondly, to pressure the government into implementing policy changes that may liberate patients from their condition, and help them to transform their lives. The UK’s diabetes crisis is a ticking time-bomb, and we require strong leadership to help us tackle the food corporations, to implement changes to the dietary advice doled out to us and to fund new technology to arm people in their battle against diabetes.

  But for so long it’s been too easy for the decision-makers to ignore us. So let’s make some noise. Let us rise up, join together and form a five-million-strong Remission for All movement – a trade union of diabetics, if you will – to demand the answers and the action that we need. My privileged position means that I can act on others’ behalf, not just my own, but I want you to stand up and be counted, too. Because it is only when you speak up, and when we all speak up, that our private tragedies will become a priority for our politicians. We have got to stop feeling guilty, and start getting angry.

  Over the past few years, as I’ve attempted to manage my treatment, I’ve faced a number of barriers. They certainly aren’t unique to me, though. These issues and frustrations are widespread and they are holding diabetics back from getting better. One of the main obstructions faced by type 2 diabetes sufferers, I believe, is a deep-rooted culture of shame. Being diagnosed with T2D is embarrassing. It shouldn’t be, but it is. It is wrapped up with a real sense of self-loathing, coupled with a genuine belief that you have brought all this upon yourself, and that you are entirely to blame for the lifestyle choices you’ve made, the behaviours y
ou’ve exhibited and the warning signs you’ve ignored. When you’re consumed with so much guilt about your illness, you often find yourself feeling sheepish about asking for the help that you need. Sometimes, your self-esteem is so low that you don’t even feel like you deserve that help.

  Before I turned my corner, I spent a long time in denial about my diabetes. Like many middle-aged men who are faced with fading youth and failing health, I felt extremely vulnerable. I tried to maintain some kind of equilibrium by managing my illness with drugs and by trying (albeit half-heartedly) to monitor the damage it was doing to me. But I didn’t own type 2 diabetes, nor did I fight it; I merely suppressed it. I surrendered to its terrible, inevitable progress. It took me a while to properly understand, and then to fully accept, that I had a life-threatening, life-reducing, life-debilitating condition.

  Only after furthering my knowledge with reading and research – especially the work of Dr Michael Mosley and Professor Roy Taylor – did the gravity of this disease begin to hit home. However, while I was able to discuss my subsequent health concerns with Dr Nazeer and Maggie, my diabetes nurse, I was unable to open up to others. I simply couldn’t find the inner strength, or the right language, to broach the subject with loved ones. Instead, I continued to carry my guilty little secret around with me, shielding my illness from close friends and family for fear that they’d perceive me as weak-willed and lily-livered. In the cold light of day, I didn’t want them to see me how I saw myself: as an abject failure.

  The same was true at work. I kept mum about my battle with diabetes in Westminster and West Bromwich, worried that my standing among colleagues, voters and constituents would diminish if news filtered out that I had an illness that was commonly seen as self-inflicted. Society also dictated that MPs should be strong and robust, and wise and responsible, and in my mind, being a diabetes sufferer just didn’t fit that mould.