Canada has been fighting a war on obesity for decades. Yet obesity now affects four in 10 of us, often leading to serious complications such as heart disease, stroke and diabetes.
Perhaps that’s because we’ve been targeting the wrong enemy.
Until recently, efforts were focused on fat intake, but research is now pointing to excessive sugar as one of the main culprits. Recent revelations show this misinformation was intentional, with the sugar industry putting forth significant, long-term efforts to hide this connection that are reminiscent of the tobacco industry’s efforts to deny the health impacts of smoking.
Refined sugars are in most of the food we eat—soda, cereals, canned soup, and fast food just to name a few. Sugar-sweetened beverages such as pop, fruit drinks, sports drinks and the like are particularly damaging, as they have minimal nutritional value and, despite the calories, don’t quench an appetite. Drinking just one sugar-sweetened beverage a day has been linked to increased weight gain, a 20 percent increase in the risk of heart disease and a 26 percent increase in the risk of diabetes.
An eye-opening report published this year in JAMA Internal Medicine revealed that as early as 1954, the Sugar Research Foundation—a lobby group for the sugar industry—targeted researchers studying the links between sugar, fat, and health. It paid researchers to produce reviews in prestigious medical journals. Those reviews downplayed sugar’s contributions to obesity, while not disclosing the Sugar Research Foundation as a funder or participant. The goal, ostensibly, was to overstate the role of fat and exonerate sugar as a cause of obesity and related diseases.
Their success had an immense impact, even shifting Canada’s nutrition guidelines. Low fat became synonymous with healthy for decades. The industry continues to steer research even today: a study found that while 83 percent of industry-funded research found no link between soda consumption and weight gain, 83 percent of independently-funded research did find a link.
Today, sugar has saturated our food system. Addressing it will require a comprehensive approach, including a tax on sugar-sweetened beverages. Such taxes have been introduced in France, the UK, Philadelphia, Berkeley, and Mexico. The cities of Boulder, Oakland, San Francisco and Albany have also recently enacted a tax.
Mexico’s story echoes our own—it has an obesity burden similar to Canada’s, and even higher rates of diabetes. A 10 percent tax on sugar-sweetened beverages was passed in 2014, and consumption per capita dropped by six percent in 2014 and 12 percent in 2015. While Mexicans haven’t seen an impact on obesity yet, these changes in consumption could result in up to 1,700 fewer deaths per year from diabetes and heart disease.
Sugar taxes have been championed by the World Health Organization and World Medical Association. They have endorsed a sugar-sweetened beverage tax because it’s easy and low-cost to implement, and steers consumers toward healthier choices. Recent leaked documents highlighting in-depth strategies by the beverage industry to prevent or repeal these taxes also demonstrate that a tax works. These taxes are cutting into their bottom line.
While the tax is a smart move, it’s not a silver bullet. As we saw with tobacco, taxes have a moderate effect on consumption but are only effective as part of a suite of sustained policies and initiatives that create cultural change.
Indeed, smoking rates have gone down because of a shift in social views around smoking, not just because cigarettes are more expensive. This success was compounded by using the profits from cigarettes to fund anti-tobacco initiatives. Sugar should be no different. Indeed, part of Mexico’s success was due to a concurrent Bloomberg public awareness campaign around sugar.
A sugar tax allows consumers to make more informed choices around the true costs of food by building long-term health costs into the purchase price, and encouraging healthier beverage choices. Funding and momentum from the tax can be used for pro-health policies, including improving school nutrition, effective marketing restrictions and exercise programs. It will also augment existing initiatives including the recent redevelopment of nutrition and food labelling guidelines.
A recent Senate report recommended a sugar tax as one of 21 measures to address obesity. We must take this recommendation seriously. Advocates, policymakers, researchers and the public need to collaborate and make such a tax a reality.
The authors have written this article on behalf of the Public Health Physicians of Canada & Public Health Physician’s Resident’s Council.