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Dur e Sameen Noman is a Professional Pharmacist.

ROLE OF SUGAR SWEETENED BEVERAGES FOR INCREASING NON COMMUNICABLE DISEASES IN PAKISTAN

 

 

 

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The consumption of sugar sweetened beverages increases in our society very rapidly especially among the youngsters, which leads to many hazardous effects on their health and are the major reason behind non communicable diseases.

According to World Health Organization (WHO) data around 2,200 individuals die every year in Pakistan due to serious non-communicable diseases.

So let’s try to understand what these SSBs (sugar sweetened beverages), how it affects your body and how the government can play its role to limit its consumption.

SUGAR SWEETENED BEVERAGES

Ssbs (Sugar sweetened beverages) are any liquid drink that is sweetened with any form of sugar, like sucrose, high fructose corn syrup, honey or molasses. Examples of SSBs are included but not limited to,

  • Regular sodas(coke, Pepsi, due etc)
  • Sports drinks (Gatorade etc)
  • Energy drinks (sting, red bull etc)
  • Fruit drinks and juices (slice, fruita vitals)
  • Pre mixed coffee and teas etc

EFFECTS OF SUGAR SWEETENED BEVERAGES ON HEALTH

Sugar can affect your body adversely if taken in excess amounts, liquid sugar is especially more harmful. Research shows that getting sugar in liquid form is much worse than getting it from solid food. This is why high sugar beverages like soda are among the worst things you can put into your body.

These are some Health concerns related to SSBs,

OBESITY

Weight gain is the major concern that is associated with sugar sweetened beverages, because they just add up to your calorie intake without making you feel full.

It’s because these sugary drinks usually contain large amounts of fructose and fructose does not lower the hunger hormone ghrelin or stimulate fullness in the same way as glucose, the sugar which forms after digestion of the starchy foods.

Studies show that people who drink sugar-sweetened beverages consistently gain more weight than people who don’t, and weight gain itself is associated with many diseases.

INSULIN RESISTANCE AND TYPE 2 DIABETES

When you have sugary drinks consistently, the cells of your body become resistant or less sensitive to insulin (the Hormone which drive glucose from bloodstream to cell) as a result pancreas have to produce more insulin to control glucose level in your body and insulin level spike in your blood stream. This condition is known as insulin resistance.

  • Animal studies demonstrate that excess fructose causes insulin resistance and chronically elevated insulin levels.
  • One study in healthy, young men found that moderate intake of fructose increased insulin resistance in the liver

This insulin resistance is the major factor that leads to type 2 diabetes that is characterized by the elevated blood sugar level, that’s why various studies linked SSBs with type 2 diabetes

SSBS AND HEART DISEASES

Cardiac health is another concern that is associated with SSBs.

Studies show that Drinking 12 ounces of sugary beverages more than once a day may lower “good” cholesterol and increase triglycerides, fat in the blood that can lead to heart disease.

Obesity and hyperglycemia caused by SSBs also affect heart health.

HIGH RISK OF CANCER

Cancer is usually associated with other chronic diseases like obesity, diabetes, and heart diseases and that’s why it’s not surprising that SSBs are linked to increased risk of cancer.

One study shows that among the 60,000 adults those who drank 2 or more sugary sodas per week were 87% more likely to develop pancreatic cancer than those who did not drink soda.

Other studies shows that Postmenopausal women who drink a lot of sugary soda may also be at greater risk for endometrial cancer, or cancer of the inner lining of the uterus.

NONALCOHOLIC FATTY LIVER DISEASE

As we discussed earlier, SSBs contain large amounts of fructose that can only be metabolized by the liver as compared to glucose that can be metabolized by every cell in your body, so when you consume a lot of fructose your liver becomes overloaded and turns fructose into fat. Some of these fats move to blood as triglycerides but some of these remain in the liver and lead to nonalcoholic fatty liver disease with the passage of time.

GOUT

Gout is a painful form of arthritis. When your body has extra uric acid, sharp crystals may form in the big toe or other joints, causing episodes of swelling and pain called gout attacks.

When you drink high fructose corn syrup-sweetened beverages, the body breaks down fructose into chemical compounds called pureness, which further break down into uric acid—the substance that forms painful crystals in the joints and causes gout.

Many large observational studies have shown strong relation between sugar-sweetened drinks and gout.

Furthermore, long-term studies linked sugary soda to a 75% increased risk of gout in women and an almost 50% increased risk in men

DEMENTIA

Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. Alzheimer’s is the most common cause of dementia.

According to one study, any gradual increase in blood sugar is strongly related with an increased risk of dementia.

To put it simply, the higher your blood sugar, the higher your risk of dementia.

By producing rapid spikes of blood sugar, SSBs are linked with increased risk of dementia

The researchers found that in the 2,664 individuals included in the study, those who consumed one to seven servings of sugar-sweetened beverages per week were 1.91 times more likely to develop Alzheimer’s disease than those who consumed no sugar-sweetened beverages.

SSBS AND DENTAL HEALTH

Everyone has harmful germs in their mouths that depend on the sugars we consume. These bacteria get energy from the sugar, but in the process produce acid which can damage teeth by causing cavities to form or erosion to occur.
SSBS has a lot of this sugar that’s why they are also not good for your dental health.

SSBS AND ADDICTION

In rats, sugar binging may cause dopamine release in the brain, giving a feeling of pleasure.

Eating sugar may have similar effects in certain people, as your brain is built in to come up with activities that release dopamine.

Indeed there are numerous studies which suggest that sugar affects your brain like hard drugs.

For people who already suffer from some kind of addiction, sugar may cause reward-seeking behavior known as food addiction.

Studies in rats demonstrate that sugar can be physically addictive.

Although it is very difficult to prove addiction in humans, many individuals consume sugary drinks in a pattern that is common for addictive, abusive substances.

REGULATION OF SSBS BY GOVERNMENT

There is convincing evidence that consumption of sugar sweetened drinks is responsible for many communicable diseases especially when they are taken frequently or in large portions. Ssbs do this by promoting excess energy intake relative to energy expenditure.

The consumption of sugar sweetened drinks has rapidly increased in many parts of the world, especially in low- and middle-income countries, contributing to rising rates of overweight and obesity.

A comprehensive package of policies is needed to limit the availability, affordability and acceptability of sugar sweetened drinks including

EDUCATION AND COUNSELING

Providing awareness to the public about SSBs effects on health, in addition to counseling, there has been an increasing effort to provide consumers with more information about the nutritional composition of what they are consuming. Starting with labeling ingredients and calories on food packages, all beverages sold in individual containers contain calorie information, as well as information about fats and sugars in the Nutrition Facts panel.

MARKETING RESTRICTIONS

Advertisements and marketing directly impact on consumer demand so certain restrictions should be applied onto the marketing of unhealthy food including SSBs.

TAXES ON SUGAR-SWEETENED BEVERAGES

Price is one of the most important factors influencing food purchasing decisions.

WHO has recommended countries to apply price policies – or taxes – that increase the retail price of SSBs by at least 20 per cent? Hoping that this step will contribute to improved diets (and health) by shifting consumer demand away from SSBs towards healthier options, including water.

On 26 may 2021 International Diabetes Federation (IDF) has urged authorities in Pakistan to double the taxes on Sugar-Sweetened Beverages (SSBs) in forthcoming budget to reduce the burden of diabetes on individuals and families affected by diabetes and to do more to prevent diabetes in the population.

On 6 June 2021 Pakistan National Heart Association (PANAH) also requested the government to impose 20 percent tax on sugar sweetened beverages as its high consumption was one of the major causes of obesity and non-communicable diseases.

Pakistan ranked 9th out of 188 countries in terms of obesity, according to the Global Burden of Disease study of 2014. The lack of awareness exacerbates the situation as the Pakistani masses have little education about nutrition and rely on myths and old wives’ tales to identify what is ‘healthy’. An increase in the cost of sugary drinks has the potential to create incentives for producers to give healthier alternatives at cheaper prices, if a policy is properly planned and executed.

CONCLUSION

Many evidence-based studies linked SSBs to weight gain and many other health issues, especially its high consumption among children and young adults. This is an alarming situation which needs to be addressed by our policy makers. They need to make such policies that limit SSBs consumption and promote the healthier options.

REFERENCES

  • https://www.healthline.com/nutrition/13-ways-sugary-soda-is-bad-for-you
  • https://www.wcrf.org/dietandcancer/limit-sugar-sweetened-drinks/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195269/
  • https://scalingupnutrition.org/news/implementing-taxes-on-sugar-sweetened-beverages-an-overview-of-current-approaches/
  • https://www.hsph.harvard.edu/nutritionsource/healthy-drinks/sugary-drinks/#:~:text=People%20who%20consume%20sugary%20drinks,in%20young%20adults%20and%20Asians.i8
  • https://thewaitingroom.karger.com/tell-me-about/what-are-the-effects-of-sugar-on-health/?gclid=Cj0KCQiA-qGNBhD3ARIsAO_o7ynMs800vv0jEV7vBfbYVGlh7MFeh-46cWolXy8AWyMViwoGt7AqVrcaAhx0EALw_wcB

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