High death tolls and sugar sweetened beverages

You may be aware of the Sugar by Half initiative launched recently. It is a call to action for Australians to reduce their sugar consumption by half in a combined effort by Dr. Peter Bruckner (the Australian Cricket team doctor), Dr. Rosemary Stanton, Dr. Rob Moodie, Catherine Freeman, Shane Watson, and many others including our own, Damon Gameau.

And taking action on reducing added sugar intake is very much needed.

According to a 2015 report published in Circulation journal, our overconsumption of the sweet stuff – especially in the form of sugar-sweetened beverages (SSB) – is seriously hurting us and our healthcare system.

The review

Existing evidence from meta-analyses has established links between SSB and negative health outcomes such as type 2 diabetes and obesity-related cardiovascular disease, type 2 diabetes, and cancer.

Considering this, researchers from Tufts University gathered data to report on the global impact of disability and death due to consumption of sugar-sweetened beverages.¹

Taking dietary data from around the world between 1980-2010, the group analyzed intake of soft drink, sports and energy drinks, sweetened iced teas, or homemade sugary drinks by nation, age, and sex. The beverages contained at least 50 kcal per 230ml serving, though 100% fruit juice was excluded.

The researchers found 184,000 deaths in 2010 could be due to knocking back too much of the sugary drink.

“Many countries in the world have a significant number of deaths occurring from a single dietary factor, sugar-sweetened beverages. It should be a global priority to substantially reduce or eliminate sugar-sweetened beverages from the diet,” said Dr. Dariush Mozaffarian, senior author of the study.

They came to this conclusion by analyzing 62 dietary surveys from 51 different countries, alongside data on sugar availability. The geographical, gender and age information captured showed varying levels of consumption across the groups.

The researchers found that SSB consumption contributed to 133,000 deaths from diabetes, 45,000 deaths from cardiovascular disease, and 6,450 deaths from cancer. And about 76% of the deaths occurred in lower or middle-income countries.

“Among the 20 countries with the highest estimated sugar-sweetened beverage-related deaths, at least 8 were in Latin America and the Caribbean, reflecting the high intakes in that region of the world,” said Gitanjali Singh, lead author of the study.

Over-consumption of SBB is making us seriously sick. And alongside the individual impact, there is also increased burden on healthcare systems and national economies, especially as younger folk are more likely than older to suffer a chronic disease attributed to SSB consumption.

“The health impact of sugar-sweetened beverage intake on the young is important because younger adults form a large sector of the workforce in many countries, so the economic impact of sugar-sweetened beverage-related deaths and disability in this age group can be significant. It also raises concerns about the future. If these young people continue to consume high levels as they age, the effects of high consumption will be compounded by the effects of aging, leading to even higher death and disability rates from heart disease and diabetes than we are seeing now,” Singh said.

Will a soft drink tax help?

The report highlights a strong need for global prevention programs. So, how do we begin to attempt cut down on knocking back the sweet stuff as a population?

There are a number of initiatives getting information and education out there about the issues of consuming too much sugar – including Sugar By Half and That Sugar!

Some are advocating for a tax on sugary drinks, to help curb the rise in obesity and its related health issues.

Whilst a tax on sugary drinks isn’t the only answer, it could contribute to lowering intake and creating a revenue stream that could be poured back into the healthcare system or subsidizing fresh vegetables and fruit, making them accessible and affordable for all.

The WHO recently released a report recommending that increasing or introducing a tax on SSB could make serious in-roads to discouraging added sugar overconsumption. This may be particularly important for lower-middle income countries, where the sweet stuff is consumed more, but access to and affordability of fresh, whole foods should be prioritized.²

What we can do

Proposed tax aside, we could all do ourselves a favour by simply taking a moment to find out if we are consuming a good chunk of added sugar.

Here are our top tips to help you identify where the added sugar lies, and ways to deal with it sneaking into your everyday:

1. Understand added vs natural sugar
   Added sugars are ingredients added to a food or drink. Natural sugars, like those in fruit, vegetables, whole grains and dairy, occur naturally as part of a whole food, and are a normal part of the diet.
2. Reading the label
   Remember, 4.2g of sugar is 1 teaspoon, and we want to limit added sugar intake to 6 teaspoons (25g) per day.
3. Shop from the supermarket perimeter
   Focus your regular supermarket shop on these areas to supply most of your daily whole food needs – including fresh vegetables, fruit and other produce like dairy and meat. Staple yummies like nuts, seeds and good fat olive and coconut oils may require an occasional middle aisle adventure!
4. Mostly eat real food
   If a majority of the food you consume each day is real, whole food, there leaves little room for the heavily processed, sugar-laden junk food. But if you have something junky, do not be hard on yourself.
5. Occasional processed food is okay
   Our bodies are amazingly resilient, so when cutting back on the added sugars, you don’t need to be extreme. A little dessert when out with friends, or some birthday cake at a workplace afternoon tea ain’t going to break the health bank!
6. Limit the sugary drinks
   Replace a bubbly soft drink with soda water infused with citrus or berries and fresh herbs or spices like cinnamon and vanilla. And if you really want a juice, enjoy one that is freshly pressed and water it down.

 By Angela Johnson (BHSc Nut. Med.)

References:

1. Singh, GM, Micha, R, Khatibzadeh, S, Lim, S, Ezzati, M, & Mozaffarian, D 2015, ‘Estimated global, regional, and national disease burdens related to sugar-sweetened beverage consumption in 2010’, Circulation, no. 8, p. 639.
2. WHO 2016, Fiscal policies for diet and the prevention of noncommunicable diseases, viewed 13 October 2016, <http://www.who.int/dietphysicalactivity/publications/fiscal-policies-diet-prevention/en/>