Possibly the most prevalent “addiction” of all, one that starts early in life and is linked to excessive weight gain, dental decay, chronic diseases like diabetes and even some cancers, is the addiction to sugar. About 15% of our total caloric intake in Canada comes from sugar, despite World Health Organization recommendations that sugar be limited to no more than 10%, or about seven teaspoons for children and 12-13 teaspoons per adult per day. Although it is debatable whether sugar meets all the criteria to be classified as an addiction, there is no doubt that people love the taste of sweetness, and adding colour, bubbles, brand names and even caffeine, leads to the desire for soft drinks.
According to Marion Nestle, author of the book “Soda Politics”, soda companies produced and sold 220 billion litres of carbonated beverages in 2012. About 21% of that was diet soda and the rest was sugar-sweetened. A single can of sugar-sweetened soda contains up to 10 teaspoons, with no health benefits, and lots of potential harms. It shouldn’t come as a surprise that Peterborough’s Healthy Kids Community Challenge will be encouraging all of us to drink more water as a healthier choice, starting this month. And thanks to the recent acquisition of the PTBO H2O Mobile Drinking Water Station we will all be able to enjoy cold, natural, municipal water at community events as a calorie-free way to stay hydrated.
It doesn’t take long for young children to develop a hankering for sugar. Many parents who have offered their young child juice to drink can tell you that before long, milk and water are shunned, and only sweetened beverages willingly consumed. Besides displacing more nutritious choices, sugar-sweetened beverages (SSB) contribute to childhood obesity. Animal studies demonstrate that consuming sugars as liquids bypasses the physiological regulatory systems that control appetite and food intake. Given the link to obesity and diabetes, several countries have introduced a tax on these beverages as a way to discourage consumption. Could that work here in Ontario and what do we know of its impact? After all, we know that taxation of alcohol and tobacco is one strategy that helps to discourage price-sensitive youth and lower-income Canadians from indulging more than they already do, so might it work with sugar? Or would it be ineffective, intrusive and downright regressive, hurting low-income individuals more than others?
On the “pro” side is data from countries like Mexico, where a 10% excise tax was followed by a 6-12% decline in the consumption of soft drinks and an increase in water consumption across all socio-economic groups. Excise taxes are levied before the point of purchase and are reflected in the sale price of a product. Economic modelling has shown that this price increase can decrease sugar-sweetened beverage purchase and consumption and show improvements in body mass index (BMI), specifically in high-income countries. SSBs are considerably cheaper than healthier beverages (e.g. 1L of milk in Canada in 2015 was $2.47 compared to $1.94 for 2L bottle of cola). Increasing the cost of SSBs would lessen the price difference between the two products, which might make milk a more accessible choice.
Taxation measures, if implemented, should be combined with other policy interventions, e.g. increasing access to healthy foods while decreasing access to unhealthy foods in schools, daycares, and recreation facilities; restricting the marketing of foods and beverages to children; and effective, long-term educational initiatives. Subsidizing nutritious foods, such as vegetables and fruits, and milk, could also help to turn empty calories into healthier ones. Promoting water as a beverage, as is being done here in Peterborough, can help make a difference as well.
An estimated 180,000 deaths are caused each year, globally, by the consumption of SSBs, including 133,000 from diabetes, 44,000 from cardiovascular disease, and 6,000 from cancer. The Heart and Stroke Foundation is calling on Canadian and provincial governments to introduce a tax as a component of a comprehensive strategy to save lives. Now, that’s what I call “sweet”!
By Dr. Rosana Salvaterra, Medical Officer of Health, Peterborough Public Health
