Cardiovascular disease, type 2 diabetes, cancer and respiratory disease kill 35 million per year globally.

In 2012, the UN advocated a new health goal of reducing avoidable deaths from non-communicable diseases by 25 per cent by 2025. It identified tobacco, alcohol and poor diet as central risk factors.

The first two have been regulated by governments, but poor diet is actually responsible for more disease and death than smoking, alcohol and physical inactivity all put together.

The evidence for regulating sugar is now overwhelming. At a basic level, it offers no nutritional value. Contrary to what the food industry wants us to believe, we do not need carbohydrates from added sugar for energy.


Sugar fulfils four criteria that justify it being regulated:

  • The first is toxicity. As Professor of dentistry and co-founding member of Action on Sugar, the late Aubrey Sheiham told me ‘sugar is directly corrosive to teeth enamel’. Tooth decay is the most common cause of admission to hospital for UK children, and also the number one cause of chronic pain in kids. Excess consumption triggers type 2 diabetes, high blood pressure and cardiovascular disease. Insulin resistance is the number one risk factor for heart attack. Preventing insulin resistance is key to reducing cardiovascular disease.
  • Secondly, it’s unavoidable. Sugar is now added to over 80 per cent of junk and processed foods. Much is hidden, making it almost impossible for individuals to exercise choice.
  • Thirdly, sugar has the potential for abuse, and consumption encourages subsequent intake. By interfering with biological pathways and hormones involved with controlling hunger, it effectively stimulates appetite.
  • And fourthly, it has a negative impact on society. The economic effects of diseases associated with sugar are colossal. Take type 2 diabetes, an almost entirely preventable and potentially reversible condition. The direct costs to the NHS, and indirect costs to the economy from lost productivity, are close to £20bn. This will double by 2035 if we fail to act.

There’s nothing wrong with the occasional treat and a teaspoon of sugar won’t kill you. It’s the effects of chronic exposure and excess consumption that have been far worse than the impact of any class A drug on population health.

The World Health Organisation recommends a maximum limit of 6 tea spoons of free sugar a day for the average adult. This includes any added sugar and sugar from fruit juice, honey and syrups. US guidelines recommend a maximum of 3 tea spoons for children under 8 years old. A typical chocolate bar or can of cola has almost triple that amount!

So what’s the best dietary pattern to follow when it comes to improving your cardiovascular health and reducing insulin resistance?

Having researched this and published in this area in academic journals myself I’ll tell you what I follow and what I advise my patients.

  • Firstly cut out all refined carbohydrates. That includes all added sugars and starchy carbohydrates such as potatoes, white rice, white bread and go easy on the white pasta. See these foods more as treats, not a necessary part of a healthy diet. There is overwhelming evidence that when it comes to reducing the risk of heart attack, stroke, dementia, death and possibly even cancer a high fat Mediterranean diet is the best to adopt. This means lots of vegetables, at least 4 table spoons of extra virgin olive oil per day, a daily handful of nuts, and at least 2-3 portions of oily fish a week.There is very compelling evidence from recent Cambridge Medical Research Council studies that a moderate consumption of full fat dairy in the form of cheese and yoghurt actually protects against the development of type 2 diabetes and heart disease.
  • Avoid cooking in vegetable oils such as sunflower and corn oil. Not only do they produce toxic chemicals called aldehydes which have been linked to cancer, heart disease and dementia when heated to a high temperatures but recent studies have revealed that a high intake of omega 6 polyunsaturated fatty acids makes LDL cholesterol prone to oxidation. This in effect means it’s more likely to damage the inner lining of coronary arteries. Much better to cook in coconut oil, butter or extra virgin olive oil.
  • Ultimately think about eating foods that will do good to your body. Up to 75% of all calories we burn happens from doing nothing. This is the energy that’s required for cell division, keeping your heart beating, maintaining the right body temperature. You want to providing those cells with the right foods and nutrients, not junk food that will make you fat, sick or both.

What about Exercise?

Exercise has many health benefits but is quite ineffective when it comes to weight loss and you can’t outrun a bad diet. A 30-minute brisk walk daily will do wonders to your health. But when it comes to activity, do what you enjoy whether it’s dancing, cycling, having regular sex or all three.

In the meantime, when you’re next in the supermarket, instead of counting calories, count your sugar tea spoons and instead of picking up that low fat spread, pick up some butter or even better still a bottle of extra virgin olive oil. Your heart will thank you for it.

About the Author

Dr Aseem Malhotra is a Consultant Cardiologist.

He is a world renowned expert on the prevention, diagnosis and treatment of heart disease. He has been the leading figure in the UK raising awareness around the harms of excess sugar consumption and the rapid impact of dietary changes on cardiovascular health. He was recently ranked by software company Onalytica as the number 1 doctor in the World in influencing Obesity thinking. In addition to being a member of the London Food Board Dr Malhotra is adviser to the National Obesity Forum and a founding member of campaign group Action On Sugar.

He has published extensively in international academic journals and regularly writes in the mainstream press.

Dr Malhotra is a vocal campaigner for greater transparency in medical research so that doctors and patients can be better informed when making decisions on medical and surgical treatments.

He also argues that over diagnosis and over treatment represents one of the greatest threats to our health and the sustainability of the NHS.

Last year Dr Malhotra became the youngest member to be appointed to health think tank, The King’s Fund and was recently named in the Debretts 500 list of 19 most influential people in science and medicine in Britain.

Dr Malhotra is available for private consultations at ROC Private Clinic. If you wish to make an appointment to see Dr Malhotra please click here.

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