In January, many people resolve to eat healthier. This year the pressure is really on: The fact that we’re all eating too much sugar is front-page news across the globe. On January 4, Public Health England (PHE) launched a major consumer-education campaign, Change 4 Life, that is designed to help UK families reduce sugar consumption. On January 7, the Obama administration released new dietary guidelines that call for a reduction in Americans’ sugar consumption. Also on January 7, Prime Minister Cameron said he would consider a tax on sugary drinks in order to reduce sugar consumption. This came a day after a study reported that a similar tax in Mexico led to a 12 percent reduction in sales of sugary beverages. To add context, we turned to Dr. Charles Alessi, a practicing GP in South West London and a Senior Advisor to PHE. He helped draft PHE’s October 2015 report “Sugar Reduction: The Evidence for Action,” which provided recommendations for reducing UK sugar consumption, and will participate in the Oliver Wyman-hosted breakfast panel Sugar, Obesity and Diabetes – The Other Global Food Crisis, to be held in Davos, Switzerland, on 20 January. Here he shares findings from the report and ideas for addressing the sugar challenge:
Oliver Wyman Health: Why is tackling sugar consumption so important to global health?
Dr. Alessi: Having too much sugar is harmful to health. It tends to lead to consuming too many calories, resulting in weight gain and obesity. We are in the midst of a global obesity epidemic. In the UK, almost two in three adults are overweight or obese, and one-third of 10- and 11-year-olds are overweight or obese. Obesity currently costs the National Health Service over £5 billion each year. In addition, sugar consumption is closely linked to tooth decay. In 2013, almost a third of five-year-olds and almost half of eight-year-olds had tooth decay. In fact, tooth decay was the most common reason for five-to nine-year-olds being admitted to hospital in the UK. The independent expert nutrition body in the UK, the Scientific Advisory Committee on Nutrition (SACN), reviewed the evidence on sugar in the diet and concluded that free sugars should form no more than 5 percent of total calorie intake. Lowering sugar consumption to that level would reduce the risk of consuming too many calories, and could help reduce overweight and obesity levels as well as tooth decay. Five percent of daily calorie intake is roughly 30 grams or seven cubes a day. Children and teenagers in the UK, however, currently consume more than three times that amount, and sugary drinks are the main source of free sugars.
OWH: Could you provide a brief explanation of the PHE “Evidence for Action” report?
Dr. Alessi: The report uses a mixed methodology to review the evidence behind interventions to help populations reduce their sugar consumption. This is the first time the international evidence on such measures has been collated and assessed. And the evidence is clear: what we see in the media, on our streets, and in shops is encouraging us to eat too much sugar. To tackle the obesity epidemic, we need a range of bold actions, including controls on the marketing, advertising, and discounting of sugary products. Other conclusions from the review include setting a clear definition of high-sugar foods; reducing added sugar in foods and drinks; and continuing to raise awareness of practical steps to reduce sugar consumption. Our research shows that education and improved food and drink labelling alone is not enough; only those who are interested in eating a healthy diet will read the labels. Ultimately, it’s not just down to individuals and families to make changes; industry and government have a role to play in helping the nation to cut back on sugar.
OWH: Among the more controversial measures outlined in the report is a “sugar tax.” Can a sugar tax be implemented in a way that does not alienate the beverage industry?
Dr. Alessi: A tax of 10 percent to 20 percent on high-sugar drinks is one of the eight possible actions proposed by PHE, and it would likely have a short-term impact on purchases. However, we would not suggest starting with a sugar tax. We believe controls on advertising, marketing, and price-discounts and reducing the sugar in processed foods and drinks would have greater long-term impact. A broad, structured programme of gradually reducing the sugar in processed food and drinks is also likely to secure significant reductions in sugar consumption.
OWH: The gulf between health advocates and industry seems so wide. How do we begin?
Dr. Alessi: There are numerous complex factors that cause obesity. The environment we live, work, and play in steers us towards overconsumption and being sedentary. Just as there are numerous factors driving up sugar consumption levels, there needs to be a range of actions to lower it. There is no single silver bullet. However, we would suggest a whole-systems approach that includes introducing controls on advertising, marketing, and price-discounts of high-sugar products, and reducing the sugar in processed foods and drink.
OWH: What are your hopes for the Davos panel discussion? What would be a good result?
Dr. Alessi: An optimal outcome would be consensus around a series of steps which would start to address the problems we all face now. It would be great to see unanimous agreement on the need for global action by governments and industry to tackle obesity through reducing sugar consumption, which is a major culprit of having too many calories in our diet.