Sugar, the new tobacco
There’s an industry selling a product that is bad for one’s health.
A generation ago that industry was tobacco and its product was cigarettes.
Today it is the food and beverage industry and its product is sugar – sugar that is being added to food and drink.
After 20 years working in tobacco control, Jane Martin, executive manager of the Obesity Policy Coalition, a policy think tank of the Cancer Council Victoria, has taken up the battle against sugar-laden food and drinks.
She charges that the food industry has borrowed the corporate playbook of the tobacco industry to fend off regulation.
“The sugar industry has been very similar to the tobacco industry in how they work,” she says.
“They fund their own research studies and criticise research they see as harmful. They focus on personal responsibility, saying it’s up to parents and the individual.”
But the parallels don’t stop there.
“The tobacco industry pushed self-regulation over legislation. And now we have self-regulation around marketing to children of junk food and drinks, which is exactly what the tobacco industry got away with.”
Added sugar – not natural sugars that exist in fruits and vegetables – is everywhere.
One of the largest sources is beverages such as soft drinks, energy drinks and fruit drinks.
But a stroll though the supermarket shows that there is added sugar in bread, yoghurt, peanut butter, soup, wine, sausages – indeed, in nearly any processed food.
A single tablespoon of tomato sauce can contain a teaspoonful of sugar. This ‘invisible sugar’ comes under many names.
For example, there are more than 40 different names for sugar listed on food labels in Australia, New Zealand and Singapore, ranging from ‘agave nectar’ to ‘high-fructose corn syrup’ and ‘molasses’, along with a whole host of names you will have never heard of.
According to Lisa Renn, an accredited practising dietitian, sugar has a range of purposes in food manufacturing.
“It’s not only used as a sweetener, it’s used as a colouring for food consistency and as something to hold the ingredients together,” she explains.
“Having small amounts of sugar in moderation is OK. But large amounts every day are not good. Soft drinks have become the new water.”
Dr Robert Lustig, a paediatric endocrinologist at the University of California, San Francisco, and a world leader in the anti-sugar campaign, points out that sugar consumption worldwide has tripled in the past half-century.
“Our food supply now contains so much added sugar that our metabolic (energy-processing) systems just can’t handle it,” he says.
“Your body does different things with different types of calories. Fructose (added sugar) in quantities eaten today primarily gets stored as fat. Usually, that fat will go to your belly.”
And the danger to our health is not just obesity: there is evidence linking sugar to liver disease, type 2 diabetes, heart disease and tooth decay.
Nevertheless the food and beverage industry continues to promote sugar with extensive advertising of its sugary products.
It also spends large sums of money opposing clearer labelling of its products, as well as fighting increased taxation on sugary foods and drink.
Hundreds of millions of dollars is spent each year promoting unhealthy foods – those high in sugar and/or fat.
As well as advertising in conventional media, the industry also invests heavily in sponsoring sports events, product placements on TV shows and Facebook marketing – all the places likely to reach children.
World Health Organisation's stance on sugar
In 2015, the World Health Organization (WHO) reaffirmed its previous recommendation that ideally our intake of sugar – except that naturally occurring in fruits and vegetables – should not exceed ten per cent of total energy intake, and that less than five per cent would bring additional health benefits.
The WHO presented strong data linking the consumption of sugar to rates of obesity and, as type 2 diabetes is linked to obesity, to this disease as well.
In the average diet, ten per cent of total energy intake would work out to be about 50 g, or 12 teaspoons of sugar per day.
A single 375 ml can of soft drink typically contains around 35 g of added sugar.
The Australian Health Survey found that in 2011-2012, Australians were consuming an average of 60 g of sugars each day, or the equivalent of 12 teaspoons of white sugar.
Soft drinks, energy and sports drinks, as well as fruit and vegetable juices made up more than a third of these added sugars.
“Sugar-sweetened soft drinks and juices are the dietary version of the cigarette,” says Professor Merlin Thomas, NHMRC Senior Research Fellow at the Baker IDI Heart and Diabetes Institute.
“They may provide a short-term kick, but in the long term they contribute to a range of diseases and ultimately premature mortality.”
It’s not just that soft drinks represent a major source of unnecessary kilojoules, increasing our risk of diabetes, heart disease and some cancers, Thomas says.
“In fact, our expanding waistlines may represent a risk as grave as smoking.”
Thomas points out that sugars in soft drinks are absorbed fast, requiring an equally fast response in the body and putting extra demands on the pancreas, the job of which is to regulate our metabolism.
Some studies suggest that regularly drinking soft drinks can thin your bones, and all soft drinks cause tooth decay. An industry group, the Australian Food & Grocery Council (AFGC), brushed aside the WHO report.
“The WHO recommendation relates to dental caries, not weight issues or diabetes,” says AFGC deputy chief executive Dr Geoffrey Annison.
He says the recommendation covers dietary ‘free’ sugars and not ‘added’ sugars, in line with the Australian Dietary Guidelines.
“This is consistent with the industry’s view that healthy eating requires moderation, variety and balance.”
Meanwhile, the advertising of sugary foods continues.
Overweight and obesity in children, and the amount of sugary food children continue to eat and drink, are of particular concern to health professionals as well as parents.
One area where experts see that a difference can be made is in reducing or stopping TV advertising of sugary foods and beverages around children’s programming.
A recent study by the Cancer Council and the National Heart Foundation of Australia found that teenage boys who watched more TV were more likely to eat junk food, and were more likely to be obese.
“We thought obesity was high in people with high TV viewing habits because they may not be as active, but most studies show that it’s about what they are watching and how that’s impacting on the foods they are consuming,” says Kathy Chapman, chair of Cancer Council Australia’s Nutrition and Physical Activity Committee.
Despite voluntary industry guidelines that say junk food and soft drinks cannot be advertised directly to children, these guidelines are not mandatory and the manufacturers set their own criteria of what they deem to be healthy or unhealthy, Chapman says.
“Advertising works, that’s why these companies spend a lot of money on it. It is up to parents to teach their children about safety, but it doesn’t stop us having a pedestrian crossing.”
The Canadian province of Quebec has been a leader in this regard, restricting such ‘junk food’ TV advertising to children since 1978. Quebec now has substantially lower obesity rates than the rest of Canada.
Other countries that have restricted commercials for sugary drinks, cereals and other junk food during times when kids watch TV include Norway, Sweden, Denmark, Mexico and the UK.
Another area of food and beverage advertising that anti-sugar campaigners strongly oppose is the association of products with athletes, a tactic used by the tobacco industry just over 50 years ago when both celebrities and athletes were employed to endorse cigarettes.