Sugar, Politics, and Obesity

 

As Feedr‘s refined sugar-free month comes to a close, we have been reflecting on the prevalence of sugar in our society. Economies of scale, international trade agreements, and modern technology have turned this previously luxury good into a seemingly ubiquitous, and very cheap household staple. But considering we know how bad sugar is for the body, it seems strange sugar be so widespread and normalised. Here, we will explore the power of the sugar lobby, and how it has sculpted public perception of what is nutritionally sound and what isn’t. The UK levy on sugary drinks, set to come into effect next month, will also be discussed in some detail. Read on to find out more!

 

PART 1: The Current State of Affairs

 

In this generation, more people are going to die from obesity than from starvation for the first time in history. We are the first generation to die younger than our parents, because lifestyle-related diseases are shortening our predicted lifespan.

 

The bad rap the USA gets for its obesity levels can sometimes obscure the situation in other countries. But the situation here across the pond is pretty dire. Britain is the “fat man of Europe”, with 1 in 4 adults obese in 2013, compared to just 15% of French nationals. It was predicted that in 2016, £16bn of the £100bn NHS budget went directly to treating obesity-related disorders and diabetes. That is more than the £13.6 billion spend yearly on police and fire services across the UK, according to NHS England Chief Simon Stevens. What’s more, scapegoating the elderly as the reason for the strain on the NHS is simply unfounded in factual information. Leading doctors have warned that it is obese children, rather than the elderly, who are putting immense strain on NHS resources, despite there being a rise of 1 million people over the age of 65 since 2010.

 

“It’s not so much the old people getting older – because old people have always been getting older. The difference in the last 30 years is the grotesque increase in young people getting fatter and fatter,” says MP Lord McColl.

 

However, some members of the conversation around the politics of sugar have grown restless at the government’s monotonous suggestions to ‘watch your eating habits and exercise more’. Margo Wootan, the Director of Nutrition Policy at the Centre for Science in the Public Interest says in the documentary Fed Up, “We are not going to exercise our way out of the obesity crisis”. It is simply too easy to pile on the calories at a rate that is impossible to burn off to maintain a balance. For example, it would take 1h15min of biking to burn off one 570ml of Coca-Cola, or 1h12min of swimming to burn a medium portion of fries.

 

Instead, people like Margo think the answer lies in changing diet habits by changing our environmental cues and food system to promote healthy choices. As such, the responsibility and power lies with the government, it seems.

 

PART 2: The Politics of Obesity

 

In 1977, the McGovern Report was published by the US Government Committee chaired by presidential runner-up against Nixon, George McGovern. It was the first governmental guideline laying out dietary goals for Americans. The report stated the population was consuming too much fatty meat, dairy, eggs and sugar. Long story short, these four industries did not take the news well.

 

The then-president of the Sugar Research Foundation called the report “unfortunate and ill-advised”, and vilified the McGovern Committee in the press. Similarly, the president of the Salt Institute felt that there was no need for a dietary goal that called for the reduction of salt consumption, on the logic that improving nutrition will lead to longer life-spans, more old people to look after, and ultimately, higher healthcare expenditures.

 

The National Dairy Council called for the reformulation of the dietary guidelines into goals that could be endorsed by the food industry. The National Livestock and Meat Board requested the report be rewritten with phrases such as “increase consumption of lean meat” to replace “decrease meat consumption”.

 

The pressure from the lobbying of these four industries led to the report ultimately being rewritten to encourage the choices of foods low in saturated fat and cholesterol, rather than the original verbiage encouraging decreased consumption of these food groups. This push to buy leaner products sprouted the low-fat fad of the 1980s.

 

Something unforeseen at the time, however, was that low-fat products tasted awful. All the flavour is in the fat, something anyone who enjoys a juice rib-eye steak will tell you. So to compensate, food companies started adding sugar to their products to make them more palatable. Not surprisingly, Americans doubled their sugar intake from 1977-2000.

 

In 2002, the World Health Organisation (WHO) issued the now-infamous TRS-916 document. This document stated that sugar is the major, if not THE cause of chronic metabolic disease and obesity. The WHO wanted to restrict sugar intake to less than 10% of daily calories. However, the sugar lobbies and The Corn Refiners Association pushed back heavily against it, demanding the guideline be raised to 25% of daily calories from sugar.

 

These lobby groups personally intervened and asked then-Secretary of Health and Human Services Tommy Thompson to stop the report from being published on the WHO website. Thompson told the WHO that the US would withhold $406 million in funding if the document wasn’t buried, effectively extorting the organisation. To this day, you will not find the percentage of daily recommended calories from sugar on American nutritional labels, just the total number of grams.

 

Today, the US government simultaneously supports reducing sugar intake, and had provided $8.1 billion in subsidies to corn-based sweeteners since 1995. As you might have heard, high-fructose corn syrup (HFCS) is a highly refined sweetener made from corn, which has been found repeatedly to be absolutely devastating to human health, so much so that it is subject to a production quota within the EU of 303,000 tons per year. It is cheaper to make and worse for you than sugar, meaning it has found its way into pretty much every processed food in US supermarkets.

 

Food companies have been trying to influence public perception of nutrition for decades. Evidence emerged in 2016 that the Sugar Research Foundation, now called the Sugar Association, had funded Harvard scientists to carry out a literature review on the causes of heart disease, while overlooking the role of sugar. Each scientist made the equivalent of $50,000 for authoring the study, which was published in JAMA Internal Medicine in 1967.

 

Similarly, in 2015, the New York Times uncovered that Coca-Cola funneled millions into research aimed at downplaying the link between sugary drinks and obesity. The trend of junk food companies getting involved in academic research is not an uncommon one. Though the partnership terminated in 2015, The Coca-Cola Company was partnered with the American Academy of Family Physicians for several years, a controversial alignment.

 

PART 3: Obesity and Sugar

 

In Britain, campaigns warning consumers about the adverse effects of over-consuming sugar have not curbed people’s intake of the stuff. From 2012-2014, the average 4-10 year old child got 13.4% of their daily calories from added sugar, almost triple the Public Health England guideline of 5%. In fact, every age group exceeded the guideline amount, with 11-18 year olds consuming 15.2%, adults up to 65 years of age 12.3%, and those over 65, 11.1%. This is aligned with the findings by the Obesity Health Alliance and the Royal College of Paediatrics and Child Health that showed 1 in 3 10-year-olds is overweight or obese, and 1 in 3 5-year-olds has tooth decay and consumes their own weight in sugar every year.

 

An official report by Public Health England says the NHS could save £15bn and 80,000 lives in a generation by weaning us off sugar. They propose a tax on sugary drinks, excluding fruit juice, to do this, along with the following guidelines:

• A national program to reduce sugar content in everyday food and drinks
• Reducing price promotions of sugar food and drink
• Banning high-sugar foods from supermarket till areas and the end of aisles
• Clamping down on advertising sugary products on TV and online
• New rules to reduce portion sizes

 

A main focus for lots of campaigners is limiting/banning junk food adverts between prime family TV viewing times of 6-9pm. It was reported that children saw as many as 12 HFSS adverts in one hour of watching TV – including Dominoes, McDonald’s, McVities, and Oreo thins biscuits. But Ofcom stated that the UK regulations are already among the strictest in the world, and that the ASA enforces these rules rigorously.  But when children are influenced by brand recognition from the age of 18 months, we have to ask ourselves whether this is enough.

 

The controversial sugary drinks levy is set to be implemented next month. It was announced by chancellor Philip Hammond in his 2017 budget statement, and will entail a 2-tier tax. Drinks containing 5g of sugar per 100ml will be charged 18p extra per litre, and those with 8g or more of sugar per 100ml will be 24p dearer per litre. The UK Government estimates they could generate £863 million a year from the tax, all of which will allegedly be put back into the Department for Education. Whether the tax will be successful in achieving its goal of curbing obesity rates, especially in children, remains to be seen.

 

An extensive study conducted by scientists from the University of Oxford and published in the Lancet Public Health journal has found that this sugary drinks tax will greatly reduce the incidences of type 2 diabetes caused by obesity in every scenario they investigated. They mapped a realistic better and worse case scenario, by modelling 3 possible reactions the soft drinks industry would have to the levy and what the likely impact on the population would be.

 

The first is reformulating drinks to lower sugar content. Reducing sugar content of drinks by 30% could lead to 144,000 fewer children and adults with obesity each year, they predicted. Secondly, raising the price of sugary drinks by just 20% would lead to 81,600 fewer obese people per year. Finally, encouraging people to switch to lower sugar drinks was also found to lead to benefits in public health.

 

Of course this study has its limitations, for example, it doesn’t consider the effects of artificial sweeteners in place of sugar, or possible alternative scenarios that the industry could take which might actually harm those of least socio-economic standing the most.

 

This is a concern for many involved in the anti-sugary tax campaign. A similar law that went into effect in Mexico showed that this is exactly what happens when a ‘sin’ tax is implemented. The poorest families are hit hardest, and that is a crucial consideration for many regarding implementation in the UK. However, the initiative in Mexico did lead to a decrease in sugary drink consumption of 5.5% in the first year, and 9.7% in the second year, just by raising the price 4p per litre.

 

It is important to remember that a change in sales patterns is very different from impacting obesity levels, and we would be prudent to not conflate correlation and causation. The changes in spending habits might not reflect changes in obesity levels, as consumers turn to alternative sweet products to compensate for their decreased fizzy drink consumption.

 

Overall, the intersection between sugar, politics, and obesity is an interesting and complex one that merits several conversations. We’ve just touched the surface of a multi-faceted and dynamic area, and all we can do is wait and see what the tax brings in April 2018.