So, what about these calls to reduce sugar intake? “The guidelines appear to have taken a step backward in light of more than 40 years of modern research… Guidelines like these, not backed by the best evidence available, are troubling, especially given they are coming from an organisation with such an important mission.” That was the view of the US Sugar Association. Senior Advisor for the European Committee of Sugar Manufacturers, Emile Majster, was similarly dismissive. He said: “We are glad that [there are] calls for a debate and discussion before the recommendations are turned into policy. Keeping added sugars to 5% of daily calories is unrealistic.”
And no, we’re not talking about the recent Governmental report which recommended we radically reduce the sugar in our diets. This was the reaction to the World Health Organisation’s report in March, which called on us to initially reduce our free sugar intake to at least below 10% of energy intake, with an ideal figure of 5% and below. At the time, the WHO’s Director of Nutrition for Health and Development, Dr Francesco Branca, said: “We have solid evidence that keeping intake of free sugars to less than 10% of total energy intake reduces the risk of overweight, obesity and tooth decay. Making policy changes to support this will be key if countries are to live up to their commitments to reduce the burden of noncommunicable diseases.”
The report from the Government’s Scientific Advisory Committee on Nutrition went even further than the WHO’s initial recommendation of less than 10%, calling for free sugars intake to be 5% or less of daily energy intake. It is widely believed that this measure will have an overwhelmingly positive effect on the nation’s health, from tooth decay and obesity to diabetes and heart disease.
The British Dental Association launched an online petition calling directly on David Cameron to implement the recommendations from this report. To date, it has 1,681 signatures. Chair of the BDA, Mick Armstrong said: “If David Cameron wants to give some meaning to his pledges on prevention he can start today, by finally acknowledging the huge burden sugar is placing on the NHS.” Action on Sugar also directly called on the Government to do more to reduce the heavy burden of sugar on our health and wellbeing. Chairman Professor Graham McGregor called on the policy to be “enforced by a strong independent agency.” Professor Simon Capewell, an Action on Sugar advisor, laid down the gauntlet, asking: “Can the UK Government now show that they are also genuinely committed to promoting our children’s health, rather than supporting industry’s profits?”
Food and Drink Federation director general, Ian Wright, wasn’t happy at the recommendation to reduce our daily intake of free sugars to below 5% of energy intake. He said: “Sensationalist commentaries on this everyday ingredient that are not based in science should now be relegated to the past. Demonising any one ingredient in the obesity debate isn’t helpful.” The British Soft Drinks Association director general, Gavin Partington, wholeheartedly agreed. He said: “Some people do need to reduce their sugar intake and eat a more balanced diet, but today’s recommendations make little sense and will further confuse people.”
The dental reaction
The reaction among the dental community was one of overwhelming support for reduction in sugar. Being on the frontline, as it were, of seeing the effect that sugar can have, the dental industry is delighted that measures may finally be taken in what had previously been a war of treatment, rather than prevention.
Mick Horton, Dean of the FGDP (UK) said: “It is without doubt that a reduction in sugar intake to the level proposed by the SACN would have a major impact on reducing the development of dental caries in the population. We now call on the Government to work with Public Health England and other stakeholders to develop a robust and effective strategy to help support this goal.”
Dr Nigel Carter OBE, Chief Executive of the British Dental Health Foundation, commented: “The evidence surrounding the harm caused by sugars is overwhelming and has been recognised for decades – this recommendation, while being long overdue, is most welcome and can make a significant difference to the lives of millions of people in the UK. The recommendations laid out by SACN give the government an opportunity to lower the sugar intake as advised and help put an end to our addiction and habitual behaviours and attitudes towards sugar.”
Claire Stevens, spokesperson for the British Society of Paediatric Dentistry, said: “We need to combat the high caries levels in children in all ways possible. We would like consistent and clear labelling to be mandatory on all food and drink products and we would like to see more preventive programmes along the lines of Scotland’s Childsmile.”
The dental community, more than most, see the debilitating effects of sugar on children’s teeth, especially, and seem to be united in their anticipation into what measures will be implemented to reverse current trends.
So can this be done?
A political will is essential. Industry participation is vital. And the general public need to adapt and change also. Currently, free sugars constitute almost twice the amount of our free sugars intake daily, so it will need to be a combination of strong political implementation of policy, getting the food industry on board, and getting consumers to accept these changes.
Katherine Jenner, Campaign Director of Action on Sugar, said: “These recommendations are all well and good in theory, but our current sugar intakes are so high because the food industry adds large amounts of completely unnecessary sugar to our everyday foods, which all adds up.”
Despite their criticism of the recommendation, the food and drinks industry have nevertheless indicated that they are willing to support the measures, with Ian Wright saying “We will continue to engage with Government and other partners and to be part of the solution to tackling obesity,” while Gavin Partington added: “Manufacturers have reduced sugar intake from all soft drinks by more than 8% since 2012. Our ongoing work will do more to reduce sugar intake than the setting of unrealistic targets that do not consider overall diet and lifestyle.”
Health groups, however, continue to criticise the food and drinks industry for not doing enough, and being more focussed on profits than their consumer’s health. Professor Graham McGregor, for example, isn’t convinced by the food industry’s promises. He told the Guardian: “The food industry walks all over us. It is seen as untouchable. The government knows it can enforce [change] if it wants to. We did it with tobacco; you can easily take out up to 50% of the sugar without anybody noticing, if you do it slowly.” Mick Armstrong emphasised the importance of Governmental intervention, highlighting “the government now has the evidence and a clear duty to send the strongest possible signal to the food industry that while added sugar might be helping their sales, it is hurting their customers.”
It certainly seems that these efforts will be a process. It cannot happen overnight. Industry pledges are all well and good, but the first step needs to be Governmental action, through a clear, coherent policy and strong enforcement. Only then will the positive steps that the industry says it’s already taking can be unified into concrete action. It may hurt their profits in the long-term but the Government must surely acknowledge that the damaging effect that sugar has on the population’s wellbeing as well as the strain that it places on an already overloaded NHS is completely unacceptable. Once these two measures of the process have been implemented, the onus will then be on the consumer to accept these changes and get on with their life.
And that it, it seems, is a challenge that certain sections of the food industry are already planning for.
Marketing Sciences Unlimited, an independent market research agency based in Winchester, are being employed by the food industry to test methods of sugar reduction in their products on normal consumers. It is by no means an easy process, according to Anna Heron, a director at the company. She told the Guardian: “But a lot of food and drink is about habit. Changing habits is quite difficult. But it’s also the fact that you can change one ingredient, or the amount of that ingredient, and it affects so much else about the product. Humans enjoy fat and sugar and things that are bad for us. All our research shows that consumers don’t want to change but do feel that it’s the manufacturers’ responsibility to reduce the sugar in their food and drink. It’s clearly what a lot of companies are thinking.”
Consumers may not want to change, but accepting change is another matter entirely. Going to the shop for lunch and a choice between fruit or chocolate may be a battle that ends with choosing the latter, but that chocolate bar was to have a greatly reduced sugar content, then the consumer’s choice for the less healthy option would mean inflicting far less damage on their long-term health. Change cannot happen overnight, it must be gradually implemented and consumers are much more likely to accept these changes, an example of which was found with a recent survey by the British Dental Health Foundation which found that over half of us would support a tax on sugary drinks, in order to curb its wide intake.
Similarly, the decrease in salt levels among the population has led to vast falls in blood pressure, which contributed to the decreases in stroke and heart disease, according to a study published by the British Medical Journal. Salt was gradually reduced in products and had clear health benefits. There is no reason why the same can’t be done with sugar.
If, in fact, companies are doing their bit to incrementally decrease sugar content in their products, as Tesco have begun to do in their own-brand soft drinks, then the final hurdle would be consumer acceptance and, as the gradual reductions in salt have shown, when it comes to health matters consumers are ready and willing to accept these measures rather than opting for the healthy option, when unhealthy, tasty options are still available.
The Government certainly has a unique opportunity to implement policies that will have a trickle-down effect that will, ultimately, benefit the health and wellbeing of the nation and reverse the growing trends of tooth decay and obesity in children, a blight which can have a negative impact on them right through to their adult lives.
The health groups have successfully lobbied, an independent report has highlighted the great need for it to happen, and, despite a certain degree of unwillingness, the food industry seems to be on board with implementing changes (especially if they are compelled to) so the ball seems to have fallen squarely in the court of Messrs Cameron, Hunt and colleagues. They have promised that a strong, one-party Government can take the important decisions. They have pledged to implement a preventive approach to the nation’s healthcare. Now it’s time to prove it. Taking strong measures to curb sugar intake (via a sugar tax, clear labelling, or outright banning of excess sugar levels) will provide the nation with a platform to greatly reduce the economic, social and personally negative effects of a high sugar diet.