On Monday night Four Corners investigates the power of Big Sugar and its influence on public policy.
“How did the entire world get this fat, this fast? Did everyone just become a bunch of gluttons and sloths?” Doctor
The figures are startling. Today, 60% of Australian adults are classified as overweight or obese. By 2025 that figure is expected to rise to 80%.
“It’s the stuff of despair. Personally, when I see some of these young people, it’s almost hard to imagine that we’ve got to this point.” Surgeon
Many point the finger at sugar – which we’re consuming in enormous amounts – and the food and drink industry that makes and sells the products fuelled by it.
Tipping the scales, reported by Michael Brissenden and presented by Sarah Ferguson, goes to air on Monday 30th of April at 8.30pm. It is replayed on Tuesday 1st of May at 1.00pm and Wednesday 2nd at 11.20pm.
It can also be seen on ABC NEWS channel on Saturday at 8.10pm AEST, ABC iview and at abc.net.au/4corners.
” In 2012-13, Aboriginal and Torres Strait Islander people 2 years and over consumed an average of 75 grams of free sugars per day (equivalent to 18 teaspoons of white sugar)1. Added sugars made up the majority of free sugar intakes with an average of 68 grams (or 16 teaspoons) consumed and an additional 7 grams of free sugars came from honey and fruit juice. “
“Amata was an alcohol-free community, but some years earlier its population of just under 400 people had been consuming 40,000 litres of soft drink annually.
The thing that I say in community meetings all the time is that, the reason we’re doing this is so that the young children now do not end up going down the same track of diabetes, kidney failure, dialysis machines and early death, which is the track that many, many people out here are on now,”
NACCHO Post : Mai Wiru, meaning good health, and managed by long-time community consultant John Tregenza.
“This isn’t about, as the food industry put it, people making their own choices and therefore determining what their weight will be. It is not as simple as that, and the science is very clear.” Surgeon
Despite doctors’ calls for urgent action, there’s been fierce resistance by the industry to measures aimed at changing what we eat and drink, like the proposed introduction of a sugar tax.
“We know about the health impact, but there’s something that’s restricting us, and it’s industry.” Public health advocate
On Monday night Four Corners investigates the power of Big Sugar and its influence on public policy.
“The reality is that industry is, by and large, making most of the policy. Public health is brought in, so that we can have the least worse solution.” Public health advocate
From its role in shutting down debate about a possible sugar tax to its involvement in the controversial health star rating system, the industry has been remarkably successful in getting its way.
“We are encouraged by the government here in Australia, and indeed the opposition here in Australia, who continue to look to the evidence base and continue to reject this type of tax as some sort of silver bullet or whatnot tosolve what is a really complex problem, and that is our nation’s collective expanding waistline.” Industry spokesperson
We reveal the tactics employed by the industry and the access it enjoys at a time when health professionals say we are in a national obesity crisis.
“We cannot leave it up to the food industry to solve this. They have an imperative to make a profit for their shareholders. They don’t have an imperative to create a healthy, active Australia.” Health advocate
NACCHO post – Sixty-three per cent of Australian adults and 27 per cent of our children are overweight or obese.
“This is not surprising when you look at our environment – our kids are bombarded with advertising for junk food, high-sugar drinks are cheaper than water, and sugar and saturated fat are hiding in so-called ‘healthy’ foods. Making a healthy choice has never been more difficult.
The annual cost of overweight and obesity in Australia in 2011-12 was estimated to be $8.6 billion in direct and indirect costs such as GP services, hospital care, absenteeism and government subsidies.1 “
OPC Executive Manager Jane Martin
BACKGROUND
” This campaign is straightforward – sugary drinks are no good for our health. It’s calling on people to drink water instead of sugary drinks.’
Aboriginal and Torres Strait Islander people in Cape York experience a disproportionate burden of chronic disease compared to other Australians.’
‘Regular consumption of sugary drinks is associated with increased energy intake and in turn, weight gain and obesity. It is well established that obesity is a leading risk factor for diabetes, kidney disease, heart disease and some cancers. Consumption of sugary drinks is also associated with poor dental health.
Water is the best drink for everyone – it doesn’t have any sugar and keeps our bodies healthy.’
Apunipima Public Health Advisor Dr Mark Wenitong
Read over 48 NACCHO articles Health and Nutrition HERE
“A cheeky, graphic counter-campaign taking on cheap frozen drink promotions like $1 Slurpees and Frozen Cokes has hit Victorian bus and tram stops to urge Australians to rethink their sugary drink.
Rather than tempt viewers with a frosty, frozen drink, the “Don’t Be Sucked In” campaign from LiveLighter and Rethink Sugary Drink, an alliance of 18 leading health agencies, shows a person sipping on a large cup of bulging toxic fat. “
Craig Sinclair, Chair of Cancer Council Australia’s Public Health Committee, said while this graphic advertisement isn’t easy to look at, it clearly illustrates the risks of drinking too many sugary drinks.
“Frozen drinks in particular contain ridiculous amounts of added sugar – even more than a standard soft drink.”
“A mega $3 Slurpee contains more than 20 teaspoons of sugar.
That’s the same amount of sugar as nearly eight lemonade icy poles, and more than three times the maximum recommended by the World Health Organisation of six teaspoons a dayi.”
“At this time of year it’s almost impossible to escape the enormous amount of advertising and promotions for frozen drink specials on TV, social media and public transport,” Mr Sinclair said.
“These cheap frozen drinks might seem refreshing on a hot day, but we want people to realise they could easily be sucking down an entire week’s worth of sugar in a single sitting.”
A large frozen drink from most outlets costs just $1 – a deal that major outlets like 7-Eleven, McDonald’s, Hungry Jacks and KFC promote heavily.
LiveLighter campaign manager and dietitian Alison McAleese said drinking a large Slurpee every day this summer could result in nearly 2kg of weight gain in a year if these extra kilojoules aren’t burnt
“This summer, Aussies could be slurping their way towards weight gain, obesity and toxic fat, increasing their risk of 13 types of cancer, type 2 diabetes, heart and kidney disease, stroke and tooth decay,” Ms McAleese said.
“When nearly two thirds of Aussie adults and a third of kids are overweight or obese, it’s completely irresponsible for these companies to be actively promoting excessive consumption of drinks completely overloaded with sugar.
“And while this campaign focuses on the weight-related health risks, we can’t ignore the fact that sugary drinks are also a leading cause of tooth decay in Australia, with nearly half of children aged 2– 16 drinking soft drink every day.ii
“We’re hoping once people realise just how unhealthy these frozen drinks are, they consider looking to other options to cool off.
“Water is ideal, but even one lemonade icy pole, with 2.7tsp of sugar, is a far better option than a Slurpee or Frozen Coke.”
Mr Sinclair said a health levy on sugary drinks is one of the policy tools needed to help address the growing impact of weight and diet-related health problems in Australia.
“Not only can a 20% health levy help deter people from these cheap and very unhealthy drinks, it will help recover some of the significant costs associated with obesity and the increasing burden this puts on our public health care system,” he said.
This advertising will hit bus and tram stops around Victoria this week and will run for two weeks. #
FROZEN DRINKS: More FACTSiii
About LiveLighter: LiveLighter® is a public health education campaign encouraging Australian adults to lead healthier lives by changing what they eat and drink, and being more active.
In Victoria, the campaign is delivered by Cancer Council Victoria and Heart Foundation Victoria. In Western Australia, LiveLighter is delivered by Heart Foundation WA and Cancer Council WA.
About Rethink Sugary Drink: Rethink Sugary Drink is a partnership between the Apunipima Cape York Health Council, Australian Dental Association, Australian Dental and Oral Health Therapists’ Association, Cancer Council Australia, Dental Health Services Victoria, Dental Hygienists Association of Australia, Diabetes Australia, Healthier Workplace WA, Kidney Health Australia, LiveLighter, The Mai Wiru Sugar Challenge Foundation, Nutrition Australia, Obesity Policy Coalition, Stroke Foundation, Parents’ Voice, the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) and the YMCA to raise awareness of the amount of sugar in sugar-sweetened beverages and encourage Australians to reduce their consumption.
“Part of our healthy food strategy is looking at reducing sugary drinks because consumption of sugary drinks across the whole population, but particularly in remote communities, is very high and high intake of sugary drinks has been linked to obesity, diabetes, heart disease, poor oral health and kidney disease.”
“Amata SA was an alcohol-free community, but some years earlier its population of just under 400 people had been consuming 40,000 litres of soft drink annually.
The thing that I say in community meetings all the time is that, the reason we’re doing this is so that the young children now do not end up going down the same track of diabetes, kidney failure, dialysis machines and early death, which is the track that many, many people out here are on now,”
Mai Wiru, meaning good health, and managed by long-time community consultant John Tregenza.
A nutrition strategy to reduce the portion size and availability of soft drink has reduced the consumption of sugary drinks in a remote Indigenous community.
Outback Stores, which provides retail services to more than 30 remote stores on behalf of Indigenous communities across the Northern Territory, Western Australia and South Australia, found its strategy decreased the sale of soft drinks by 10 per cent in six months.
Outback Stores health and nutrition manager, Jen Savenake, an Advanced Accredited Practising Dietitian, says the store joined forces with one local community to trial the implementation of extra measures on top of its usual healthy food strategy.
Ms Savenake says the usual policy features measures such as stocking at least half of its fridges with water and diet drinks, with the remainder comprising sugary drinks.
“Our standard policy around sugary drinks includes things like – we always have the water fridges at the front of the store, where you have to go searching for the sugary drink at the back of the store,” she says.
“We have a special deal on water so that we get Mt Franklin water at $1 and the sugary drinks are 25 per cent more expensive than the diet drinks, and the diet drinks are more expensive than the water.
“We don’t promote sugary drinks ever, so we’ll do promotions on water and diet drinks but never promoting the sugary drinks, so you never see them on the end of the aisle and on discount.”
Despite the existing measures, Ms Savenake says sugary drinks remain a “really big problem”.
“Part of our healthy food strategy is looking at reducing sugary drinks because consumption of sugary drinks across the whole population, but particularly in remote communities, is very high and high intake of sugary drinks has been linked to obesity, diabetes, heart disease, poor oral health and kidney disease.”
As part of the trial, the store stopped selling sugary drinks on school days between 8.30am and 2pm, and also reduced the soft drink portion size.
“We never stock bottles more than 1.25 litres so we haven’t got any 2 or 2.5 litre bottles but what we looked at was reducing the size of the bottle,” she says.
“So now we stock the biggest selling line in our 1 litre bottle rather than 1.25 (litre) so you get a 25 per cent reduction immediately for all of those.
“We also changed from stocking a 375ml can to a 250ml can and from a 600ml bottle to a 390ml bottle.”
Ms Savenake, who presented the preliminary results of the trial at the recent Dietitians Association of Australia’s (DAA) 34th National Conference, says the remote Indigenous community is now experiencing “some big changes” in the amount of sugary drinks being consumed.
Burunga NT in store promotion
“We still actually need some more time to see what the total results are going to be, but we’re getting at least a 10 per cent reduction in sugary drinks over the comparable period.”
Early indications also show an increase in sales of water, dietary drinks, fruit juices and milk drinks.
While different strategies may be needed in different communities, particularly communities with easy access to other stores, Ms Savenake says dietitians working at the food supply level can have an impact on consumption but they also need to work with all their stakeholders to ensure there is community support for these strategies.
“To do this project in the community, we had the support of the whole community…this is not Outback Stores imposing these conditions on the community, this is the community saying – what can we do to improve the health of our people,” she says.
“So we worked with them to develop that and that’s probably one of the most important things that we got out of it, that yes – we can implement the strategies at the food supply level but we need to make sure that people are on board.
“There is actually a case study where one community banned sugary drinks and what happened was they just set up a huge black market, so people would bring boot loads of the stuff and sell it for $10 a can out of the back of the car, and so it didn’t achieve the desired outcomes because people were just spending a whole lot of money on sugary drinks on their alternative supply route.”
Ms Savenake says Outback Stores will continue to examine the strategies in the community and may expand some of the measures, including smaller portion sizes, to more stores in a bid to assist communities to improve their health.
“I’ve been doing this for 20 years but there’s almost like a tipping point where suddenly there’s a broader community awareness that we all need to get involved in doing something to improve our health and working towards healthier food,” she said.
“We’re still providing choice – you can still get it. It might be just a little bit harder to get, the shop is not open all the time so it’s still your choice around what you want to consume but we’re just providing a few incentives to mean that it’s a little bit more expensive, it’s a little bit less available, but if you really want it, it’s still there.”
“Young Australians, people in Aboriginal and Torres Strait Islander communities and socially disadvantaged groups are the highest consumers of sugary drinks.
These groups are also most responsive to price changes, and are likely to gain the largest health benefit from a levy on sugary drinks due to reduced consumption ,
A health levy on sugary drinks is not a silver bullet – it is a vital part of a comprehensive approach to tackling obesity, which includes restrictions on children’s exposure to marketing of these products, restrictions on their sale in schools, other children’s settings and public institutions, and effective public education campaigns.
We must take swift action to address the growing burden that overweight and obesity are having on our society, and a levy on sugary drinks is a vital step in this process.”
Rethink Sugary Drink campaign Download position statement
“Amata SA was an alcohol-free community, but some years earlier its population of just under 400 people had been consuming 40,000 litres of soft drink annually.
SBS will be showing That Sugar Film this Sunday night 2 April at 8.30pm.
There will be a special Facebook live event before the screenings
” The UK’s levy on sugar sweetened beverages will start in 2018, with revenue raised to go toward funding programs to reduce obesity and encourage physical activity and healthy eating for school children.
We know unhealthy food is cheaper and that despite best efforts by many Australians to make healthier choices price does affect our decisions as to what we buy.”
” Alarmingly, with overweight becoming the perceived norm in Australia, the number of people actively trying to lose weight is declining. A recent report by the Australian Institute of Health and Welfare found that nearly 64 per cent of Australians are overweight or obese. This closely mirrors research that indicates around 66 per cent of Americans fall into the same category.
With this apparent apathy towards personal health and wellbeing, is it now up to food and beverage companies to combat rising obesity rates?
Ten of Australia’s leading health and community organisations have today joined forces to call on the Federal Government to introduce a health levy on sugary drinks as part of a comprehensive approach to tackling the nation’s serious obesity problem.
The 10 groups – all partners of the Rethink Sugary Drink campaign – have signed a joint position statement calling for a health levy on sugary drinks, with the revenue to be used to support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.
This latest push further strengthens the chorus of calls in recent months from other leading organisations, including the Australian Medical Association, the Grattan Institute, the Australian Council of Social Services and the Royal Australian College of General Practitioners.
Craig Sinclair, Chair of the Public Health Committee at Cancer Council Australia, a signatory of the new position statement, said a health levy on sugary drinks in Australia has the potential to reduce the growing burden of chronic disease that is weighing on individuals, the healthcare system and the economy.
“The 10 leading health and community organisations behind today’s renewed push have joined forces to highlight the urgent and serious need for a health levy on sugary drinks in Australia,” Mr Sinclair said.
“Beverages are the largest source of free sugars in the Australian diet, and we know that sugary drink consumption is associated with increased energy intake and in turn, weight gain and obesity. Sugary drink consumption also leads to tooth decay.
“Evidence shows that a 20 per cent health levy on sugar-sweetened beverages in Australia could reduce consumption and prevent thousands of cases of type 2 diabetes, heart disease and stroke over 25 years, while generating $400-$500m in revenue each year to support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.
“The Australian Government must urgently take steps to tackle our serious weight problem. It is simply not going to fix itself.”
Ari Kurzeme, Advocacy Manager for the YMCA, also a signatory of the new position statement, said young Australians, people in Aboriginal and Torres Strait Islander communities and socially disadvantaged groups have the most to gain from a sugary drinks levy.
The Rethink Sugary Drink alliance recommends the following actions to tackle sugary drink consumption:
• A public education campaign supported by Australian governments to highlight the health impacts of regular sugary drink consumption
• Restrictions by Australian governments to reduce children’s exposure to marketing of sugar-sweetened beverages, including through schools and children’s sports, events and activities
• Comprehensive mandatory restrictions by state governments on the sale of sugar-sweetened beverages (and increased availability of free water) in schools, government institutions, children’s sports and places frequented by children
• Development of policies by state and local governments to reduce the availability of sugar-sweetened beverages in workplaces, government institutions, health care settings, sport and recreation facilities and other public places.
Rethink Sugary Drink is a partnership between major health organisations to raise awareness of the amount of sugar in sugar-sweetened beverages and encourage Australians to reduce their consumption. Visit www.rethinksugarydrink.org.au for more information.
The 10 organisations calling for a health levy on sugary drinks are:
Stroke Foundation, Heart Foundation, Kidney Health Australia, Obesity Policy Coalition, Diabetes Australia
the Australian Dental Association, Cancer Council Australia, Dental Hygienists Association of Australia, Parents’ Voice, and the YMCA.
Every day we read or hear more about the so-called ‘sugar tax’ or, as it should be more appropriately termed, a ‘health levy on sugar sweetened beverages’.
We have heard arguments from government and health experts both in favour of, and opposed to this ‘tax’. As CEO of one the state’s leading health charities I support the state government’s goal to make Tasmania the healthiest population by 2025 and the Healthy Tasmania Five Year Strategic Plan, with its focus on reducing obesity and smoking.
However, it is only one tool in the tool box to help us achieve the vision.
Our approach should include strategies such as restricting the marketing of unhealthy food and limiting the sale of unhealthy food and drink products at schools and other public institutions together with public education campaigns.
Some of these strategies are already in progress to include in our toolbox. We all have to take some individual responsibility for the choices we make, but as health leaders and decision makers, we also have a responsibility to create an environment where healthy choices are made easier.
This, in my opinion, is not nannyism but just sensible policy and demonstrated leadership which will positively affect the health of our population.
Manufacturers tell us that there are many foods in the marketplace that will contribute to weight gain and we should focus more on the broader debate about diet and exercise, but we know this is not working.
A recent Cancer Council study found that 17 per cent of male teens drank at least one litre of soft drink a week – this equates to at least 5.2 kilograms of extra sugar in their diet a year.
Evidence indicates a significant relationship between the amount and frequency of sugar sweetened beverages consumed and an increased risk of developing type 2 diabetes. We already have 45,000 people at high risk of type 2 diabetes in Tasmania.
Do we really want to say we contributed to a rise in this figure by not implementing strategies available to us that would make a difference?
I recall being quite moved last year when the then UK Chancellor of the Exchequer George Osborne said that he wouldn’t be doing his job if he didn’t act on reducing the impact of sugary drinks.
“I am not prepared to look back at my time here in this Parliament, doing this job and say to my children’s generation… I’m sorry. We knew there was a problem with sugary drinks…..But we ducked the difficult decisions and we did nothing.”
The UK’s levy on sugar sweetened beverages will start in 2018, with revenue raised to go toward funding programs to reduce obesity and encourage physical activity and healthy eating for school children. We know unhealthy food is cheaper and that despite best efforts by many Australians to make healthier choices price does affect our decisions as to what we buy.
In Mexico a tax of just one peso a litre (less than seven cents) on sugary drinks cut annual consumption by 9.7 per cent and raised about $1.4 billion in revenue.
Similarly, the 2011 French levy has decreased consumption of sugary drinks, particularly among younger people and low income groups.
The addition of a health levy on sugar sweetened beverages is not going to solve all problems but as part of a coordinated and multi-faceted approach, I believe we can effect change.
Caroline Wells, is Diabetes Tasmania CEO
3. Who is responsible for Australia’s waistlines? from here
Alarmingly, with overweight becoming the perceived norm in Australia, the number of people actively trying to lose weight is declining. A recent report by the Australian Institute of Health and Welfare found that nearly 64 per cent of Australians are overweight or obese. This closely mirrors research that indicates around 66 per cent of Americans fall into the same category.
With this apparent apathy towards personal health and wellbeing, is it now up to food and beverage companies to combat rising obesity rates?
Unfortunately it is not clear cut. While Big Food and Big Beverage are investing in healthier product options, they also have a duty to shareholders to be commercially successful, and to expand their market share. The reality is that unhealthy products are very profitable. However companies must balance this against the perception that they are complicit in making people fatter and therefore unhealthier with concomitant disease risks.
At the same time, the spectre of government regulation continues to hover, forcing companies to invest in their own healthy product ranges and plans to improve nutrition standards.
The International Food and Beverage Alliance (a trade group of ten of the largest food and beverage companies), has given global promises to make healthier products, advertise food responsibly and promote exercise. More specific pledges are being made in developed nations, where obesity rates are higher and scrutiny is more thorough.
However companies must still find a balance between maintaining a profitable business model and addressing the problem caused by their unhealthy products.
An example of this tension was evident when one leading company attempted to boost the sale of its healthier product lines and set targets to reduce salt, saturated fat and added sugar. The Company also modified its marketing spend to focus on social causes. Despite the good intentions, shareholders were disgruntled, and pressured the company to reinstate its aggressive advertising.
What role should governments play in shaping our consumption habits and helping us to maintain healthier weights? And should public policy be designed to alter what is essentially personal behaviour?
So far, the food and beverage industry has attempted to avoid the burden of excessive regulation by offering relatively healthier product lines, promoting active lifestyles, funding research, and complying with advertising restrictions.
Statistics indicate that these measures are not having a significant impact. Subsequently, if companies fail to address the growing public health burden, governments will have greater incentive to step in. In Australia, this is evident in the increased political support for a sugar tax. The tax has been debated in varying forms for years, and despite industry resistance, the strong support of public health authorities may see a version of the tax introduced.
Already, Australia’s food labelling guidelines have been amended and tightened, and a clunky star rating system introduced to assist consumers to make healthier choices. Companies that have worked to address and invest in healthy product ranges must still market them in a responsible way. Given the sales pressure, it is tempting for companies to heavily invest in marketing healthier product ranges. However they have an obligation under Australian consumer law to ensure products’ health claims do not mislead.
We know that an emboldened Australian Competition and Consumer Commission (ACCC) is taking action against companies that deliberately mislead consumers. The food industry is firmly in the its sights, with a case currently underway against a leading food company over high sugar levels in its products. This shows that the Regulator will hold large companies to account, and push for penalties that ‘make them sit up and take notice.’
At a recent Consumer Congress, ACCC Chair Rod Sims berated companies that don’t treat consumers with respect. He maintains that marketing departments with short-term thinking, and a short-sighted executive can lead to product promotion that is exaggerated and misleading. All of which puts the industry on notice.
With this in mind, it is up to Big Food and Big Beverage to be good corporate citizens. They must uphold their social, cultural and environmental responsibilities to the community in which they seek a licence to operate, while maintaining a strong financial position for their shareholders. It is a difficult task, but there has never been a better time for companies to accept the challenge.
“The high costs of transporting food and groceries to remote communities mean that Aboriginal and Torres Strait Islander people in these areas are already paying inflated prices for these types of products, and all other grocery items.
“These communities are also less able to pay higher costs and have limited access to alternatives, particularly fresh fruit and vegetables – which, because of the long distances they need to be transported, are often past their prime and overpriced when they arrive,”
“Reducing sugar consumption is critical to reducing chronic health conditions, including diabetes; however, there needs to be more work done on how these issues would be overcome before NACCHO could support any tax-based approach such as a sugar tax.”
Chair Matthew Cooke from peak Indigenous health body, National Aboriginal Community Controlled Health Organisation (NACCHO) has expressed reservations about the tax to MJA InSight.
Senator Scullion said he has been working with remote stores to restrict the sale of larger bottles of soft drink.
“I’ve been trying to negotiate the two litre and 1.5 litres off the shelves completely,”
“It’s a difficult thing but the evidence shows that whatever portion you buy, a child will drink one–and-a-half litres.”
More recently he went to a community store where water was free, but despite trying to “hide the full-strength coke” it was the popular choice.
He gave one example where a remote community store was drawing half of its total profits from soft drink sales.
“It was the most expensive liquid in that store and everyone went straight there,”
Indigenous affairs minister, Nigel Scullion,
” TAXES on unhealthy foods, not subsidies on fruit and vegetables, are effective at reducing the burden of obesity, new research suggests, amid renewed clamour for a sugary drinks tax.
Researchers at the University of Melbourne have found that a subsidy on fresh fruit and vegetables would not on its own produce health gains, because it would lead to an undesirable increase in sodium and energy intake.”
However, adding a subsidy to a package of taxes on sugar, fat, salt and sugar-sweetened beverages could be effective, they wrote. The combination of taxes plus the subsidy could avert 470 000 disability-adjusted life years and save $3.4 billion from the health budget, the modelling study found.
The study drew on detailed New Zealand price–elasticity data – which track variations in product uptake with changes in product prices – to quantify disease risk reductions associated with each change in risk factor exposure.
A sugar tax would be most cost-effective, the study found, followed by a salt tax, a saturated fat tax and a sugar-sweetened beverages tax.
Writing in the journal PLOS Medicine, Dr Linda Cobiac and colleagues said that their findings added to the “growing evidence of large health benefits and cost-effectiveness of using taxes and regulatory measures to influence the consumption of healthy foods”.
The findings about the subsidy might at first appear counterintuitive, they said.
“However, using price subsidies or discounts as an incentive to purchase more fruits and vegetables may have the effect of increasing real income available to buy food, including unhealthy products, and could therefore lead to an overall increase in dietary measures such as saturated fat, sodium, or total energy intake,” they wrote.
Writing in the MJA, the University of Sydney’s Professor Stephen Colagiuri urged the government to make the tax a priority as part of a multicomponent strategy against obesity.
In his MJA article, Professor Colagiuri cited the introduction of Mexico’s sugary drinks tax in 2014, which was followed by a 12% decline in the consumption of taxed beverages and a spike in bottled water consumption.
“The ongoing impact of [Mexico’s] tax has been challenged with new data suggesting a small increase in sales of SSBs [sugar-sweetened beverages] in 2015, but still lower than the increase in pre-tax sales,” he wrote.
“Arguments that an SSB tax is an ineffective means to reduce consumption are inconsistent with food industry claims of potential damage and job losses, which instead may point to the industry believing that a tax would substantially impact consumption.”
Professor Colagiuri noted that Australia was among the largest global markets for sugar-sweetened beverages, with males aged 4–30 years drinking an average 750 mL (two cans) per day.
“Government pays for health services and consequently has a right and duty to address externalities to promote and protect public health,” he wrote.
However, the federal government last week continued its resistance to any form of sugar tax, with health minister Greg Hunt commenting: “We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer.”
David Butt, CEO of the National Rural Health Alliance told MJA InSight that his organisation supported “the possibility of taxing sugar-sweetened beverages and using the revenue to subsidise access to healthier food options”.
Professor Andrew Wilson, director of the Menzies Centre for Health Policy at the University of Sydney, said that compared with taxing sugar per se or salt, the proposed tax on sugary drinks had “the virtue of being fairly easy to define”.
“However, these drinks are so cheap to make that the tax will need to be substantial,” he added.
A recent report by the Grattan Institute recommended that sugar-sweetened beverages be taxed at a rate of 40 cents per 100 grams of sugar, increasing the price of a 2-litre bottle of soft drink by 80 cents. This would raise about $500 million a year, according to the Grattan Institute, which predicted a resultant 15% drop in consumption of sugary drinks and a small decrease in obesity rates.
Professor Wilson stressed that any taxation approach should be “part of a package that includes education and support for good nutrition, promotion and facilitation of physical activity, with particular focus on school-aged and older teens, planning considerations and, possibly for some areas and groups, subsidies for fruit and vegetables”.
Dr Cobiac agreed, commenting: “Our modelling shows that the potential health benefits of using taxes and subsidies to improve dietary choices and the nutritional quality of our foods in Australia are huge, but ultimately, they are just one of a number of measures that are needed to tackle obesity.”
Dr Cobiac noted that 13 other countries had announced taxes on unhealthy foods or sugar drinks in the past 5 years.
“It was true that Denmark had revoked its policies,” she said; however, she added that it was likely that as early initiators “they did not fully foresee or plan for dealing with the resulting backlash from the food industry”.
“We will never know what effect the taxes would have had in Denmark; they were repealed before there was a chance to properly evaluate them,” Dr Cobiac said.
“While many people want to eat better and lose weight, it is not easy to sustain the changes in behaviour when we live in an environment where unhealthy foods are widely available, heavily marketed and cheap.
“That environment is unlikely to change without a really comprehensive strategy to tackle the obesity problem.”
This debate has been going around and around for far too long. In the meantime, overweight and obesity rates are increasing. Public health advocates need to change tack and get on with their ‘real’ jobs to make a positive difference. Scrap the idea of additional taxes on processed foods. And as for ‘modelling studies’ to underpin an evidence base to guide action. We know what to do: listen to people demonstrating ‘Lived Experience’.
I second the previous comment. “Modelling” is not evidence. Let’s see real world evidence first — does a tax on sugar actually reduce obesity rates? That is the only evidence that counts.
As a side point, imposing a “sugar tax” will cause food manufacturers to substitute sugar with other sweeteners, e.g. stevia. The long term health implications of stevia (and other additives) are unknown. Of course public health “experts” love to pretend that they are omniscient and infallible, but some caution is warranted. Let’s not repeat the massive public health failures of the past, such as the notorious food pyramid which was based on the flimsiest of evidence.
We do know what to do, but the political power of the processed food industry means we get obstruction to anything that might decrease sales of its products. Junk food and drinks contribute 35% of adults’ and over 40% of children’s energy intake. That is the elephant in the room and we need multiple actions to tackle it. A sugar tax is one that is simple to implement, especially applied to drinks.
Even more importantly, we need to stop promoting junk food and drinks. That means stopping advertising these products during TV programs that children watch. It means sporting teams and sports heros not acting as walking billboards. It needs bans on advergames for children where product placement of junk foods and drinks are visible for the time spent playing the game – which may be 30 minutes. It needs schools to stop selling children junk food and drinks from the school canteen (which negates anything they might learn in the classroom).
We also need to talk about foods rather than nutrients. The Dietary Guidelines talk about foods. Sadly, almost no one follows them – as shown by the fact that less than 7% eat even the minimal amount of vegetables and fruit recommended, and junk food consumption is so high.
Oh great, another tax and it worked so well on cigarettes!. We are one of the most highly taxed countries in the world! We need a new paradigm to tackle this problem and we doctors should be able to come up with one. What about tax deductions for people who loose weight?
Lot’s of salient comments from Rosemary and Roger. I do not believe that drinks alone are the major cause of obesity. As always if you put more calories in than you need or use in exercise the extra calories are stored as fat, period! We need to return to the era of good home cooking and stop eating out at expensive restaurants and quick take away options which are loaded with fat and sugar. Then and only then can we begin to tackle the problem of obesity.
What will the food industry use to replace ingredients that are taxed? Instead of sugar in foods will they use starches and intense sweeteners? Metabolically very little difference between starch and sugar. Will saturated fat be replaced with unsaturated fats that may be less heat stable and produce byproducts may have other health risks? Will consumers go back to adding more salt during cooking and at the table to processed foods with lower salt levels? Research needs to be on the whole diet outcomes if some processed foods carry an additional tax. We know that how the food industry meet consumer demand for low cholesterol and low saturated fat foods did not always result in a “healthy” food. Perhaps as a community we need improved cooking and gardening skills so we rely less on highly processed foods.
Education, education, education!! Where is ‘health’ on the syllabus at our schools? What public education is there on nutrition despite the valiant efforts of the likes of Rosemary Stanton. We might as well tax cars even more more as we kill lots of people with them! And it has been well pointed out that sugar alone is not responsible for our health woes. Logically we need more put GST on food, however no government would seriously consider this
” JUNK food would be banned from schools and sports venues, and a sugar drink tax introduced, under a new blueprint to trim the nation’s waistline.
The 47-point blueprint also includes a crackdown on using junk food vouchers as rewards for sporting performance and for fundraising.
State governments would be compelled to improve the healthiness of foods in settings controlled by them like hospitals, workplaces and government events.
And they would have to change urban planning rules to restrict unhealthy food venues and make more space for healthy food outlets. “
” In 2014-15, 63.4% of Australian adults were found by the National Health Survey to be overweight or obese. In response to Australia climbing up the ladder of the most obese countries in the world, professor Stephen Colagiuri, a diabetes expert at the University of Sydney, has urged the government to introduce a sugar tax to dissuade people from consuming sugary foods.”
But what if you live in a place where you don’t have easy access to fresh food? What if the Macca’s down the road is within walking distance, but you have to jump in the car and drive for miles to get to the nearest supermarket? That’s called a food desert, and the sugar tax could have a bigger impact on people who live in those areas.
What is the sugar tax?
At this point, it is a recommendation from some health experts, which would place a levy on sugary drinks in order to mitigate obesity rates.
A report from the World Health Organization (WHO) says that a tax of 20% or more results in the drop of soft drink sales, which they say would also cut healthcare costs if it succeeded in improving health outcomes.
The Grattan Institute has suggested a tax of 40 cents per 100 grams of sugar, and calculated that obesity costs Australians $5.3 billion a year. The savings they have projected would mean an extra $500 million for the budget.
Is there support for the sugar tax?
The WHO called for a tax on sugary drinks across the world in October 2016 to curb the effects of sugary drinks on health.
The Greens have released a statement saying that if the government doesn’t act on the issue, they will draft a private senator’s bill and introduce it to the Senate by the end of 2017.
Who is against it?
The Turnbull government, Labor, and senators Pauline Hanson and Derryn Hinch have all rejected the idea of imposing a sugar tax.
Minister for Health Greg Hunt has said the government was taking action in other ways: “We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer.”
Pauline Hanson said she would not support the tax because she believes it’s high time people take responsibility for what they put in their mouths, and Derryn Hinch said the tax would be unfair and unworkable.
Labor leader Bill Shorten said the opposition had no plans for a sugar tax, but said it was probably time to “toughen up advertising restrictions around junk food at peak periods when the little eyeballs are on the TV and getting all the wrong messages about food and healthy eating”.
What is a food desert?
A food desert is an area where there are no fresh fruit or vegetable outlets within a 500-metre radius. They are also defined by limited access to shops that sell healthy foods, coupled with an abundance of fast-food takeaway options within easy walking distance. These areas leave people disenfranchised by lack of access to affordable, healthy food and at a greater risk of obesity and the development of diabetes.
There have been a number of food deserts identified in Australia: Braybrook, Maidstone and West Footscray/Kingsville have been identified in Victoria, areas of western Sydney including Blacktown (where residents are three times more likely to develop diabetes) and Mount Druitt and even in wealthy areas of Canberra. Research commissioned by Anglicare and Red Cross showed that there was insufficient access to affordable and nutritionally adequate food in inner suburbs such as Kingston, Red Hill and Fyshwick, as well as Narrabundah Longstay Caravan Park, Belconnen, Weston Creek and newer suburbs in the Gungahlin region.
How would the sugar tax affect people living in food deserts?
“It is astonishing that the government is pressing ahead with this pernicious tax when the evidence clearly suggests that it will simply not affect consumption in any meaningful way. As with any regressive tax, this will only raise living costs for hard-pressed families, already struggling with big tax bills. Politicians must look at the evidence and ignore the High Priests of the Nanny State in the public health lobby, and abolish the Sugar Tax before it is too late.”
Food deserts are, in particular, an issue for people of low socio-economic status (SES) and where there are people with mobility issues in the community. The tax will undeniably hit the poor and those living in food deserts harder because more of their income goes towards poor quality food, but there is evidence from studying the effectiveness of the tax in Mexico that it does decrease spending on unhealthy food products for everyone.
“We note that Australians of low SES are disproportionately affected by high rates of diet-related illnesses and are therefore likely to experience greater dietary improvements as a result of a tax on SSBs. Inequitable aspects are likely to be further ameliorated if revenue was used to support healthy eating initiatives and subsidies on healthy foods for low-SES households.”
This means the sugar tax could actually be beneficial to low-SES households in food deserts, as a result of both a shift in eating habits, and a freeing up of space in the health budget to rectify access issues in relation to cost and geography.
” The Australian Chronic Disease Prevention Alliance recommends that the Australian Government introduce a health levy on sugar-sweetened beverages, as part of a comprehensive approach to decreasing overweight and obesity, and with revenue supporting public education campaigns and initiatives to prevent chronic disease and address childhood obesity.
A health levy on sugar-sweetened beverages should not be viewed as the single solution to the obesity epidemic in Australia.
Rather, it should be one component of a comprehensive approach, including restrictions on children’s exposure to marketing of these products, restrictions on their sale in schools, other children’s settings and public institutions, and effective public education campaigns[42].
Health levy on sugar-sweetened beverages
ACDPA Position Statement
Key messages
The Australian Chronic Disease Prevention Alliance (ACDPA) recommends that the Australian Government introduce a health levy on sugar-sweetened beverages (sugary drinks)i, as part of a comprehensive approach to decreasing overweight and obesity.
Sugar-sweetened beverage consumption is associated with increased energy intake and in turn, weight gain and obesity. Obesity is an established risk factor for type 2 diabetes, heart disease, stroke, kidney disease and certain cancers.
Beverages are the largest source of free sugars in the Australian diet. One in two Australians usually exceed the World Health Organization recommendation to limit free sugars to 10% of daily intake (equivalent to 12 teaspoons of sugar).
Young Australians are the highest consumers of sugar-sweetened beverages, along with Aboriginal and Torres Strait Islander people and socially disadvantaged groups.
Young people, low-income consumers and those most at risk of obesity are most responsive to food and beverage price changes, and are likely to gain the largest health benefit from a levy on sugary drinks due to reduced consumption.
A health levy on sugar-sweetened beverages in Australia is estimated to reduce consumption and potentially prevent thousands of cases of type 2 diabetes, heart disease and stroke over 25 years. The levy could generate revenue of $400-$500 million each year, which could support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.
A health levy on sugar-sweetened beverages should not be viewed as the single solution to the obesity epidemic in Australia. Rather, it should be one component of a comprehensive approach, including restrictions on children’s exposure to marketing of these products, restrictions on their sale in schools, other children’s settings and public institutions, and effective public education campaigns.
i ‘Sugar-sweetened beverages’ and sugary drinks are used interchangeably in this paper. This refers to all non-alcoholic water based beverages with added sugar, including sugar-sweetened soft drinks and flavoured mineral waters, fortified waters, energy and electrolyte drinks, fruit and vegetable drinks, and cordials. This term does not include milk-based products, 100% fruit juice or non-sugar sweetened beverages (i.e. artificial, non-nutritive or intensely sweetened). 2
About ACDPA
The Australian Chronic Disease Prevention Alliance (ACDPA) brings together five leading non-government health organisations with a commitment to reducing the growing incidence of chronic disease in Australia attributable to overweight and obesity, poor nutrition and physical inactivity. ACDPA members are: Cancer Council Australia; Diabetes Australia; Kidney Health Australia; National Heart Foundation of Australia; and the Stroke Foundation.
This position statement is one of a suite of ACDPA statements, which provide evidence-based information and recommendations to address modifiable risk factors for chronic disease. ACDPA position statements are designed to inform policy and are intended for government, non-government organisations, health professionals and the community.
Chronic diseases are the leading cause of illness, disability, and death in Australia, accounting for around 90% of all deaths in 2011[1]. One in two Australians (i.e. more than 11 million) had a chronic disease in 2014-15 and almost one quarter of the population had at least two conditions[2].
However, much chronic disease is actually preventable. Around one third of total disease burden could be prevented by reducing modifiable risk factors, including overweight and obesity, physical inactivity and poor diet[2].
Overweight and obesity
Overweight and obesity is the second greatest contributor to disease burden and increases risk of type 2 diabetes, heart disease, stroke, kidney disease and some cancers[2].
The rates of overweight and obesity are continuing to increase. Almost two-thirds of Australians are overweight or obese and one in four Australian children are already overweight or obese[2]. Children who are overweight are also more likely to grow up to become overweight or obese adults, with an increased risk of chronic disease and premature mortality[3].
The cost of obesity in Australia was estimated to be $8.6 billion in 2011-12, comprising $3.8 billion in direct costs and $4.8 billion in indirect costs[4]. If no further action is taken to slow obesity rates in Australia, the cost of obesity over the next 10 years to 2025 is estimated to total $87.7 billion[4].
Free sugars and weight gain
There is increasing evidence that high intake of free sugarsii is associated with weight gain due to excess energy intake and dental caries[5]. The World Health Organization (WHO) strongly recommends reducing free sugar intake to less than 10% of total energy intake (equivalent to around 12 teaspoons of sugar), or to 5% for the greatest health benefits[5].
ii ‘Free sugars’ refer to sugars added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.
In 2011-12, more than half of Australians usually exceeded the recommendation to limit free sugar intake to 10%[6]. There was wide variation in the amounts of free sugars consumed, with older children and teenagers most likely to exceed the recommendation and adults aged 51-70 least likely to exceed the recommendation[6]. On average, Australians consumed around 60 grams of free sugars each day (around 14 teaspoons)[6]. Children and young people were the highest consumers, with adolescent males and females consuming the equivalent of 22 and 17 teaspoons of sugar each day respectively [6].
Beverages contribute more than half of free sugar intake in the Australian diet[6]. In 2011-12, soft drinks, sports and energy drinks accounted for 19% of free sugar intake, fruit juices and fruit drinks contributed 13%, and cordial accounted for 4.9%[6]. 3
Sugar-sweetened beverage consumption
In particular, sugar-sweetened beverages are mostly energy-dense but nutrient-poor. Sugary drinks appear to increase total energy intake due to reduced satiety, as people do not compensate for the additional energy consumed by reducing their intake of other foods or drinks[3, 7]. Sugar-sweetened beverages may also negatively affect taste preferences, especially amongst children, as less sweet foods may become less palatable[8].
Sugar-sweetened beverages are consumed by large numbers of Australian adults and children[9], and Australia ranks 15th in the world for sales of caloric beverages per person per day[10].
One third of Australians consumed sugar-sweetened beverages on the day before the Australian Health Survey interview in 2011-12[9]. Of those consuming sweetened beverages, the equivalent of a can of soft drink was consumed (375 mL)[9]. Children and adolescents were more likely to have consumed sugary drinks than adults (47% compared with 31%), and consumption peaked at 55% amongst adolescents[9]. Males were more likely than females to have consumed sugary drinks (39% compared with 29%)[9].
Australians living in areas with the highest levels of socioeconomic disadvantage were more likely to have consumed sugary drinks than those in areas of least disadvantage (38% compared with 31%)[9]. Half of Aboriginal and Torres Strait Islander people consumed sugary drinks compared to 34% of non-Indigenous people[9]. Amongst those consuming sweetened beverages, a greater amount was consumed by Aboriginal and Torres Strait Islanders than for non-Indigenous people (455 mL compared with 375 mL)[9]. 4
The health impacts of sugar-sweetened beverage consumption
WHO and the World Cancer Research Fund (WCRF) recommend restricting or avoiding intake of sugar-sweetened beverages, based on evidence that high intake of sugar-sweetened beverages may increase risk of weight gain and obesity[7, 11]. As outlined earlier, obesity is an established risk factor for a range of chronic diseases[2].
The Australian Dietary Guidelines recommend limiting intake of foods and drinks containing added sugars, particularly sugar-sweetened beverages, based on evidence of a probable association between sugary drink consumption and increased risk of weight gain in adults and children, and a suggestive association between soft drink consumption and an increased risk of reduced bone strength, and dental caries in children[3].
Type 2 diabetes
Sugar-sweetened drinks may increase the risk of developing type 2 diabetes[3]. Evidence indicates a significant relationship between the amount and frequency of sugar-sweetened beverages consumed and increased risk of type 2 diabetes[12, 13]. The risk of type 2 diabetes is estimated to be 26% greater amongst the highest consumers (1 to 2 servings/day) compared to lowest consumers (<1 serving/month)[13].
Cardiovascular disease and stroke
The consumption of added sugar by adolescents, especially sugar-sweetened soft drinks, has been associated with multiple factors that can increase risk of cardiovascular disease regardless of body size, and increased insulin resistance among overweight or obese adolescents[14].
A high sugar diet has been linked to increased risk of heart disease mortality[15, 16]. Consuming high levels of added sugar is associated with risk factors for heart disease such as weight gain and raised blood pressure[17]. Excessive dietary glucose and fructose have been shown to increase the production and accumulation of fatty cells in the liver and bloodstream, which is linked to cardiovascular disease, and kidney and liver disease[18]. Non-alcoholic fatty liver disease is one of the major causes of chronic liver disease and is associated with the development of type 2 diabetes and coronary heart disease[18].
There is also emerging evidence that sugar-sweetened beverage consumption may be independently associated with increased risk of stoke[19].
Chronic kidney disease
There is evidence of an independent association between sugar-sweetened soft drink consumption and the development of chronic kidney disease and kidney stone formation[20]. The risk of developing chronic kidney disease is 58% greater amongst people who regularly consume at least one sugar-sweetened soft drink per day, compared with non-consumers[21].
Cancer
While sugar-sweetened beverages may contribute to cancer risk through their effect on overweight and obesity, there is no evidence to suggest that these drinks are an independent risk factor for cancer[7]. 5
A health levy on sugar-sweetened beverages
WHO recommends that governments consider taxes and subsidies to discourage consumption of less healthy foods and promote healthier options[22]. WHO concludes that there is “reasonable and increasing evidence that appropriately designed taxes on sugar-sweetened beverages would result in proportional reductions in consumption, especially if aimed at raising the retail price by 20% or more”[23].
Price influences consumption of sugar-sweetened beverages[24, 25]. Young people, low-income consumers and those most at risk of obesity are most responsive to food and beverage price changes, and are likely to gain the largest health benefit from a levy on sugary drinks due to reduced consumption[23]. While a health levy would result in lower income households paying a greater proportion of their income in additional tax, the financial burden across all households is small, with minimal differences between higher- and lower-income households (less than $5 USD per year)[26].
A 2016 study modelled the impact of a 20% ad valorem excise tax on sugar-sweetened beverages in Australia over 25 years[27]. The levy could reduce sugary drink consumption by 12.6% and reduce obesity by 2.7% in men and 1.2% in women[27]. Over 25 years, there could be 16,000 fewer cases of type 2 diabetes, 4,400 fewer cases of ischaemic heart disease and 1,100 fewer strokes[27]. In total, 1,600 deaths could potentially be prevented[27].
The 20% levy was modelled to generate more than $400 million in revenue each year, even with a decline in consumption, and save $609 million in overall health care expenditure over 25 years[27]. The implementation cost was estimated to be $27.6 million[27].
A separate Australian report is supportive of an excise tax on the sugar content of sugar-sweetened beverages, to reduce consumption and encourage manufacturers to reformulate to reduce the sugar content in beverages[28]. An excise tax at a rate of 40 cents per 100 grams was modelled to reduce consumption by 15% and generate around $500 million annually in revenue[28]. While a sugary drinks levy is not the single solution to obesity, the introduction of a levy could promote healthier eating, reduce obesity and raise revenue to combat costs that obesity imposes on the broader community.
There is public support for a levy on sugar-sweetened beverages. Sixty nine percent of Australian grocery buyers supported a levy if the revenue was used to reduce the cost of healthy foods[29]. A separate survey of 1,200 people found that 85% supported levy revenue being used to fund programs reducing childhood obesity, and 84% supported funding for initiatives encouraging children’s sport[30].
An Australian levy on sugar-sweetened beverages is supported by many public health groups and professional organisations.
“Let’s be honest, most countries and communities (and especially Aboriginal and Torres Strait Islanders ) now face serious health challenges from obesity. Even more concerning, so do our kids.
While no single mission will be the panacea to a complex problem, using 2017 to set a new healthy goal of giving sugar the kick would be a great start.
Understand sugar, be aware of it, minimise it and see it for what it is – a special treat for a rare occasion.
This New Year’s, make breaking up with sugar your planned resolution.
“Hey sugar – it’s not me, it’s you…”
Alessandro R Demaio Global Health Doctor; Co-Founded NCDFREE & festival21; Assoc. Researcher, University of Copenhagen and NACCHO supporter
Download NACCHO Healthy Futures Report Card Here 20178
As we come to the end of 2016, many of us start to look back – and reflect. The year has been defining – even redefining – in many ways. Politics, technology and culture have all seen major leaps and in some cases, hurdles. In public health, it’s been a big year for sugar.
Global recognition is building for the very real health concerns posed by large and increasing quantities of hidden sugar in our diets. This near-ubiquitous additive found in products from pasta sauces to mayonnaise has been in the headlines and in our discussions. The seemingly innocuous sweet treat raises eyebrows from community groups to policy makers – and change is in the air.
Let’s review some of the sugar-coated headers from the past 12 months:
The global obesity epidemic continued to build while more than two-in-three Australian adults faced overweight or obesity – and almost one in four of our children.
Australians were estimated to consume a staggering 76 litres of sugary drinks each since January alone, and new reports highlighted that as much as 15% of the crippling health costs associated with obesity could result from sugary drinks consumption.
Meanwhile around the planet, more countries took sound policy measures to reduce sugar consumption in their citizens. France, Belgium, Hungary, Finland, Chile, the UK, Ireland, South Africa and many parts of the United States implemented, continued or planned the implementation of pricing policies for sugary drinks.
In short, the over-consumption of sugar is now well recognised as a public health challenge everywhere.
With all this in mind and a New Year ahead, it’s time to put big words into local action. With resolutions brewing, here are seven helpful tips to breaking up with sugar in 2017.
1. Understand sugar
When it comes to sugar, things can get pretty confusing. Below, I shed some light on the common misunderstandings, but let’s recheck sugar itself – in simplest terms.
Sugar is a type of refined carbohydrate and a source of calories in our diet. Our body uses sugar and other sources of calories as energy, and any sugar that is not used is eventually stored as fat in our liver or on our bellies.
“Free sugars” are those added to products or concentrated in the products – either by us or by the manufacturer. They don’t include sugars in whole fruits and vegetables, but more on that later. For a range of health reasons, the World Health Organization recommends we get just 5% of our daily calories from free sugars. For a fully grown man or woman, this equates to a recommended limit to sugar consumption of roughly 25 grams – or 6 teaspoons. For women, it’s a little less again.
Consume more than this, and our risk of health problems rises.
2. Quit soft drinks
With 16 teaspoons of sugar in a single bottle serving – that’s more than 64 grams – there’s nothing “soft” about soft drinks. Including all carbonated drinks, flavoured milks and energy drinks with any added sugars, as well as fruit drinks and juices, sugary drinks are a great place to focus your efforts for a healthier 2017. Sugary drinks provide no nutritional value to our diets and yet are a major source of calories.
What’s more concerning, evidence suggests that when we drink calories in the form of sugary drinks, our brains don’t recognise these calories in the same way as with foods. They don’t make us feel “full” and could even make us hungrier – so we end up eating (and drinking) more. In this way, liquid calories can be seen as even more troubling than other forms of junk foods. Combine this with studies that suggest the pleasure (and sugar spike) provided by sugary drinks may make them hard to give up – and it’s not difficult to see why many of us are drinking higher amounts, more often and in larger servings. This also makes cutting down harder.
The outcome is that anything up to one-seventh of the entire public cost of obesity in Australia could now result from sugary drinks. In other words, cut out the sugary drinks and you’ll be doing your own health a favour – and the health of our federal and state budgets.
3. Eat fruit, not juice
When it’s wrapped in a peel or a skin, fruit sugars are not a challenge to our health. In fact, the sugars in fruit are nature’s way of encouraging us to eat the fruit to begin with. Fruits like oranges, apples and pears contain important fibres. The “roughage” in our foods, this fibre is healthy in many ways but there are three in particular I will focus on. First, it slows our eating down; it is easy to drink a glass of juice squeezed from 7 apples, but much harder to eat those seven pieces whole. Second, it makes us feel full or satiated. And third, it slows the release of the sugars contained in fruit into our blood streams, thus allowing our bodies to react and use the energy appropriately, reducing our chances of weight gain and possibly even diabetes.
Juice, on the other hand, involves the removal of most of those fibres and even the loss of some of the important vitamins. What we don’t lose though, is the 21 grams or more than five teaspoons of sugar in each glass.
In short, eat fruit as a snack with confidence. But enjoy whole fruit, not juice.
4. Sugar by any other name
High-fructose corn syrup, invert sugar, malt sugar and molasses – they all mean one thing: sugar.
As the public awakens to the health challenges posed by sugar, the industry turns to new ways to confuse consumers and make ‘breaking up’ more difficult. One such way is to use the many alternative names for sugar – instead of the ‘s’ word itself. Be on the lookout for:
Evaporated cane juice, golden syrup, malt syrup, sucrose, fruit juice concentrate, dextrose and more…
5. Eat whole foods where possible
Tomato sauce, mayonnaise, salad dressings, gravies, taco sauces, savoury biscuits and breakfast cereals – these are just some of the many foods now often packed with hidden, added sugars.
A study found that 74% of packaged foods in an average American supermarket contain added sugars – and there is little evidence to suggest Australia would be dramatically different. Added to food to make it more enjoyable, and moreish, the next tip when avoiding such a ubiquitous additive is to eat whole foods.
It’s hard to hide sugar in plain flour, or a tomato, or frozen peas. Buying and cooking with mostly whole foods – not products – is a great way to ensure you and your family are not consuming added sugars unaware.
6. See beyond (un)healthy claims
Words like “wholesome”, “natural” and “healthy” are clad on many of our favourite ingredients. Sadly, they don’t mean much.
Even products that are full of sugar, like breakfast cereals and energy bars, often carry claims that aim to confuse and seduce us into purchase. Be wary – and be sure to turn the package over and read the ingredients and nutrition labelling where possible (and if time permits).
7. Be okay with sometimes
The final but crucial message in all of this is that eating or drinking sugar is not a sin. Sugar is still a part of our lives and something to enjoy in moderation. The occasional piece of cake, or late night chocolate – despite the popular narrative painted by industry to undermine efforts for true pricing on sugar – these occasional sweet treats are not the driving challenge for obesity. The problem is that sugary drinks, and sugar in our foods, have become every day occurrences.
With this in mind, let’s not demonise sugar but instead let’s see it for what it is. Enjoy some juice or bubbles from time to time but make water the default on an everyday basis. With the average can of cola containing 39 grams or 9 teaspoons of sugar, be OK with sometimes.
Bitter truth
Let’s be honest, We now face serious health challenges from obesity.
“Amata was an alcohol-free community, but some years earlier its population of just under 400 people had been consuming 40,000 litres of soft drink annually.
The thing that I say in community meetings all the time is that, the reason we’re doing this is so that the young children now do not end up going down the same track of diabetes, kidney failure, dialysis machines and early death, which is the track that many, many people out here are on now,”
Mai Wiru, meaning good health, and managed by long-time community consultant John Tregenza.
” With most complex issues, you start somewhere. You come up with evidence-informed policies and you try them out. You rigorously evaluate their performance, and learn by doing.
But not with obesity. “Complexity” is the new enemy of action. Since the causes of obesity are complex, every “single” policy advanced in response can be dismissed as a dangerously simplistic solution to a complex problem.
Welcome to obesity, the problem we’re not allowed to start to fix.
Except with personal responsibility, of course.!!!
A tax on sugary drinks will get National Party politicians in trouble with sugar producers, and Liberal Party politicians in trouble with big food.
The real problem is that it might work. Based on the experience of Mexico, a sugary drinks tax will very likely cause consumers to purchase fewer sugary drinks.
Despite batting it away, a tax on sugary drinks is on the public agenda, and it’s here to stay. I don’t see the sugary drinks industry winning on this issue indefinitely.
Partly because Australian health researchers will keep it on the agenda.”
“We need a national healthy weight strategy which includes a comprehensive approach to tackle overweight and obesity in all parts of Australia.
“While there’s no silver bullet for reducing overweight and obesity rates, there are key policies which we know can make a significant difference to the health of all Australians.”
The Obesity Policy Coalition recommends four key actions by government to address the obesity problem:
Develop and implement a long-term, comprehensive, integrated strategy to address obesity.
Take action to substantially reduce children’s exposure to unhealthy food marketing.
Introduce a 20 per cent tax on sugar-sweetened beverages and use the money raised to offer healthy food subsidies for people on low incomes and to support obesity prevention initiatives.
Make the Health Star Rating System mandatory, to ensure it is displayed on all packaged food products.
The Healthy Communities: Overweight and obesity rates across Australia, 2014-15 report finds that in 2014-15:
The percentage of overweight or obese adults ranged from 53% in Northern Sydney to 73% in Country SA
Overweight and obesity rates were generally higher in regional PHN areas than in metropolitan PHN areas
After excluding adults who were overweight, the percentage of obese adults ranged from 16% in Central and Eastern Sydney to 38% in Country SA
The obesity rate was 25% or higher in 18 of the 28 PHN areas for which results were available.
When I looked up from marking exams and saw the look on Barnaby Joyce’s face, I just knew he was seeing red about the Grattan Institute’s proposal for a sugary drinks tax, levied at a rate of 40 cents per 100 grams of sugar.
The Grattan Institute report estimates that such a tax would reduce the consumption of sugary drinks by about 15% and generate up to half a billion dollars that could help to pay for a broad array of obesity-related programs.
Imagine! A public health policy that fights obesity, diabetes and tooth decay AND generates revenue.
The National Party hate the idea. Deputy Prime Minister and Leader of the Nationals, Barnaby Joyce told reporters: Pictured here with the Asst Minister for Rural Health Dr David Gillespie
“If you want to deal with being overweight, here’s a rough suggestion: stop eating so much, and do a bit of exercise. There’s two bits of handy advice and you get that for free. The National Party will not be supporting a sugar tax”.
Well that’s what he said.
But here’s what I heard: “We know that obesity and diabetes are out of control. But we have ideological objections to being part of the solution”.
The same day that Minister Joyce shared these thoughts with reporters, the Australian Food and Grocery Council issued a press release saying that it was seeking a “constructive response to obesity”.
“Obesity is a serious and complex public health issue with no single cause or quick-fix solution”, explained the AFGC, but “it is not beneficial to blame or tax a single component of the diet”.
Personal responsibility…the answer to obesity, traffic accidents, terrorism, Zika virus, perhaps everything?
In a limited sense, Barnaby Joyce is right.
The only cure for personal obesity is personal responsibility.
But personal responsibility has turned out to be a spectacularly poor solution to “societal obesity”.
By societal obesity, I am referring to the trend towards overweight and obesity that has arisen over the past few decades and now affects the majority of adult men and women (and more than one in four children).
Since each of us is an individual, and because we live in a culture that prizes individual autonomy, it’s easy to fall into the trap of believing that individual effort, personal motivation, is the solution to the world’s ills.
But just as the global epidemics of obesity and diabetes were not caused by a catastrophic, global melt-down in personal responsibility, personal responsibility is equally unlikely to provide the magic solution.
That’s where public policies come in.
Governments know all this, but with the exception of tobacco control, they seem reluctant to apply their knowledge in the area of preventive health.
The fact is, from road traffic accidents to terrorism, smart governments:
acknowledge the complexity of the factors that contribute to societal problems;
They acknowledge that multiple interventions are needed, in many settings;
They acknowledge that possible solutions need to be trialled now, under conditions of uncertainty, instead of handing the problem to future generations.
They monitor the actions they take, because healthy public policy is a dynamic, ongoing process; and finally
They give a damn. Meaning that they recognise they are accountable to the community for helping to solve difficult, societal problems, and for the performance of the public policies they administer.
Imagine if Australia’s government took that approach with obesity.
The debate about a sugary drinks tax is here to stay: it will never go away
A tax on sugary drinks will get National Party politicians in trouble with sugar producers, and Liberal Party politicians in trouble with big food.
The real problem is that it might work. Based on the experience of Mexico, a sugary drinks tax will very likely cause consumers to purchase fewer sugary drinks.
Despite batting it away, a tax on sugary drinks is on the public agenda, and it’s here to stay. I don’t see the sugary drinks industry winning on this issue indefinitely.
Partly because Australian health researchers will keep it on the agenda.
It will come back, and back. Especially as evidence of its success accumulates overseas.
One conversation worth having is how revenues from a sugary drinks tax might support agricultural producers in rural Australia, helping to cushion them from the adverse effects (if any) of the tax and creating incentives for the production of a sustainable and healthy food supply.
That is simply one question worth considering during the process of developing a national nutrition policy (which we don’t currently have).
In the meantime, Australian health advocates need to broaden their base.
Advocacy for public policy action on obesity needs to become more closely integrated with advocacy on food security. And advocacy in both areas needs to be linked more closely to action on reducing health inequalities.
But enough about all that. You really came here for Barnaby, didn’t you?
Personal responsibility, not the Australian Tax Office, should determine how much sugar Australians consume, says Barnaby Joyce. Often as not, Barnaby’s recovery program involves half a packet of Marlboros, which he calls bungers.
Barnaby was much agitated on Wednesday about the suggestion by the Grattan Institute that a tax on high-sugar fizzy drinks might go some way towards alleviating Australia’s obesity problem.
“This is one of the suggestions where right at the start we always thought was just bonkers mad,” he declared, adding his party would not be supporting a sugartax.
This shouldn’t knock you cold with surprise. Barnaby is the leader of the Nationals. Name a sugar-growing area and you’ll find a Nationals or a Liberal National Party member at the local school fete knocking back a mug of raw sugar-cane juice and proclaiming it God’s food.
But Barnaby wasn’t simply stopping at political solidarity with his northern MPs.
He had some Barnaby-advice on how you might lose weight without taxingsugar.
“People are sitting on their backside too much, and eating too much food and not just soft drinks, eating too many chips and other food,” he lectured.
“Well, so the issue is take the responsibility upon yourself. The Australian Taxation Office is not going to save your health, right. Do not go to the ATO as opposed to go to your doctor or put on a pair of sandshoes and walk around the block and…go for a run.
The ATO is not a better solution than jumping in the pool and going for a swim.
The ATO is not a better solution than reducing your portion size.
“So get yourself a robust chair and a heavy table and halfway through the meal, put both hands on the table and just push back. That will help you lose weight.”
Note 1: The Federal electorates of Lyne which takes in Taree and Port Macquarie has been identified at the Number One stroke ‘hotspot’ in Australia.Refer
Note 2 : The Minister is not to be confused with David Gillespie Author of How Much Sugar and Sweet Poison : Why Sugar makes us fat .
In the wake of the progress report on Closing the Gap, the Indigenous Affairs Minister Nigel Scullion has declared sugary soft drinks are “killing the population” in remote Indigenous communities.
Key points:
Closing the Gap report found worst health outcomes found in remote communities
One remote community store drawing half of total profits from soft drink sales, Senator Scullion says
Senator Scullion says he thinks attitudes to soft drink are changing
According to evidence provided to Senate estimates today, at least 1.1 million litres of so-called “full sugar” soft drink was sold in remote community stores last financial year.
The sugary drinks tax revenue could be spent on obesity programs that benefit the disadvantaged, reducing the regressivity of the tax.
While the beverage and sugar industries are strongly opposed to any tax on sugar, their concerns are overblown.
A sugar-sweetened beverages tax will reduce domestic demand for Australian sugar by around 50,000 tonnes, which is only about 1% of all the sugar produced in Australia. And while there may be some transition costs, this sugar could instead be sold overseas (as 80% of Australia’s sugar production already is).
A tax on sugary drinks is a public health reform whose time has come.
Obesity not only affects an individual’s health and wellbeing, it imposes enormous costs on the community, through higher taxes to fund extra government spending on health and welfare and from forgone tax revenue because obese people are more likely to be unemployed.
We propose the government put a tax on sugar-sweetened beverages to recoup some of the third-party costs of obesity and reduce obesity rates. Such a tax would ensure the producers and consumers of those drinks start paying closer to the full costs of this consumption – including costs that to date have been passed on to other taxpayers. There is the added benefit of raising revenue that could be spent on obesity-prevention programs.
The scope of our proposed tax is on non-alcoholic, water-based beverages with added sugar. This includes soft drinks, flavoured mineral waters, fruit drinks, energy drinks, flavoured waters and iced teas.
While a sugary drinks tax is not a “silver bullet” solution to the obesity epidemic (that requires numerous policies and behaviour changes at an individual and population-wide level), it would help.
Why focus on sugary drinks?
Sugar-sweetened beverages are high in sugar and most contain no valuable nutrients, unlike some other processed foods such as chocolate. Most Australians, especially younger people, consume too much sugar already.
People often drink excessive amounts of sugary drinks because the body does not send appropriate “full” signals from calories consumed in liquid form. Sugar-sweetened beverages can induce hunger, and soft drink consumption at a young age can create a life-long preference for sweet foods and drinks.
We estimate, based on US evidence, about 10% of Australia’s obesity problem is due to these sugar-filled drinks.
Many countries have implemented or announced the introduction of a sugar-sweetened beverages tax including the United Kingdom, France, South Africa and parts of the United States. The overseas experience is tax reduces consumption of sugary drinks, with people mainly switching to water or diet/low-sugar alternatives.
There is strong public support in Australia for a sugar-sweetened beverages tax if the funds raised are put towards obesity prevention programs, such as making healthier food cheaper. Public health authorities, including the World Health Organisation and the Australian Medical Association, as well as advocates such as the Obesity Policy Coalition, support the introduction of a sugar-sweetened beverages tax.
What the tax would look like
We advocate taxing the sugar contained within sugar-sweetened beverages, rather than levying a tax based on the price of these drinks, because: a sugar content tax encourages manufacturers to reduce the sugar content of their drinks, it encourages consumers to buy drinks with less sugar, each gram of sugar is taxed consistently, and it deters bulk buying.
The tax should be levied on manufacturers or importers of sugar-sweetened beverages, and overseas evidence suggests it will be passed on in full to consumers.
We estimate a tax of A$0.40 per 100 grams of sugar in sugary drinks, about A$0.80 for a two-litre bottle of soft drink, will raise about A$400-$500 million per year. This will reduce consumption of sugar-sweetened beverages by about 15%, or about 10 litres per person on average. Recent Australian modelling suggests a tax could reduce obesity prevalence by about 2%.
Low-income earners consume more sugar-sweetened beverages than the rest of the population, so they will on average pay slightly more tax. But the tax burden per person is small – and consumers can also easily avoid the tax by switching to drinks such as water or artificially sweetened beverages.
People on low incomes are generally more responsive to price rises and are therefore more likely to switch to non-taxed (and healthier) beverages, so the tax may be less regressive than predicted. Although a sugar-sweetened beverages tax may be regressive in monetary terms, the greatest health benefits will flow through to low-income people due to their greater reduction in consumption and higher current rates of obesity.
The revenue could also be spent on obesity programs that benefit the disadvantaged, reducing the regressivity of the tax.
While the beverage and sugar industries are strongly opposed to any tax on sugar, their concerns are overblown. Most of the artificially sweetened drinks and waters, which will not be subject to the tax, are owned by the major beverage companies.
A sugar-sweetened beverages tax will reduce domestic demand for Australian sugar by around 50,000 tonnes, which is only about 1% of all the sugar produced in Australia. And while there may be some transition costs, this sugar could instead be sold overseas (as 80% of Australia’s sugar production already is).
A tax on sugary drinks is a public health reform whose time has come.
This debate has been going around and around for far too long. In the meantime, overweight and obesity rates are increasing. Public health advocates need to change tack and get on with their ‘real’ jobs to make a positive difference. Scrap the idea of additional taxes on processed foods. And as for ‘modelling studies’ to underpin an evidence base to guide action. We know what to do: listen to people demonstrating ‘Lived Experience’.