M. Nouman : Sugar is one of the simple forms of carbohydrates that contain monosaccharides, such as fructose and galactose, and disaccharides, such as sucrose and lactose.
Simple carbohydrates are also in candy, soda, and syrups. However, these foods and beverages are made with processed and refined sugars and do not have vitamins, minerals, or fiber. They are called “empty calories” and can lead to weight gain. Free sugars include monosaccharides and disaccharides added to foods and beverages by the manufacturer, culinarian, or consumer, and sugars naturally present in honey, syrups, fruit juices, and fruit juice concentrates.
Food and beverages high in sugar are perceived to be among the leading risk factors for nutrition-related non-communicable diseases. The thriving presence of ultra-processed food producers has resulted in reversals to diets that are correlated with noncommunicable diseases and which incorporate sugar-sweetened beverages.
Diets high in sugar are linked to obesity and overweight, both of which increase the probability and chance of diabetes. There is a powerful link below obesity and mortality. In the Region, both men and women suffer from being overweight and obese. It is estimated that over 50% of women are overweight. Roughly half of overweight women are obese. In the case of children and adolescents the picture is even more alarming. The overindulgence in high calorie food and indoor leisure activities, such as watching television, surfing the net and playing games, all contribute to childhood obesity.
Regionally, overweight and obesity in children under-five years of age has increased from 5.8% to 8.1% between 1990 and 2012, which is above the global average of 6.7%. Overweight and obesity in adolescents (13–15 years) are highly prevalent.
Benefits of reducing sugar intake:
Everyone has a role in facilitating a deduction in sugar consumption – governments, the private sector and civil society. Reducing sugar intake reduces particularly the risk of developing overweight and obesity, and in turn in developing diabetes. It also has a substantial effect on reducing dental caries. The proof for the health benefits of population-wide reduction in sugar intake is strong.
Governments can reduce population sugar consumption!
- To ameliorate population sugar intake/consumption, government can enforce the evidence-based interventions.
- Reformulate sugar-rich foods and drinks to lower sugar intakes.
- Set criteria for all food and drink served by government-sponsored institutions.
- Restrict advertising of sugar-enriched products, particularly drinks.
- Impose constraints on marketing, advertising and sponsorship of all sugar-enriched foods and drinks across all media platforms.
- Use nutritional profiling to ascertain precise definitions of foods and drinks high in sugar.
- Eradicate sugar subsidies provided by national governments and instruct progressive taxes initially on sugary drinks and then on all foods and drinks with added sugar.
- Enhance accredited training on diet and health for individuals with opportunities to influence population food choices.
Consumption of Sugary Drinks Is a Major Cause of Obesity
Excessive sugar consumption is a major cause of obesity and its related diseases, increasing the risks of type 2 diabetes, hypertension, liver and kidney damage, heart disease, and some cancers. The guidelines of the World Health Organization and the World Cancer Research Fund state that added sugars should comprise no more than 10% of an individual’s total calorie intake and preferably less than 5%.
Sugary drinks often have no nutritional value and are exceptionally harmful to the body. The liver absorbs sugar in liquid form more rapidly than in solid form and therefore cannot efficiently process and release it.
The surplus is stored in the liver as fat or glycogen deposits. This can lead to fatty liver disease and increased risks for diabetes and other NCDs. Consuming sugar in liquid form, be it from 100% fruit juice or from sugar-sweetened beverages, does not decrease food intake.
Sugary drinks contribute to undernutrition when they replace foods or drinks with greater micronutrient densities. For example, in some Asian, African, American, and Caribbean countries numerous infants consume sugary drinks as weaning foods, which can exacerbate undernutrition and stunting. Infants with stunting confront a vastly greater risk of high visceral fatness, hypertension, and type 2 diabetes.
It is hard to counteract sugary beverage consumption with physical activity. For instance, to offset consumption of an 8-ounce (oz) (237-milliliter) regular soft drink requires 16 minutes of running or 1.0 mile of walking. To offset the normal intake of 20 oz (591 ml)
requires 40 minutes of running or 2.5 miles of walking.
As per WHO, 58 percent of total deaths were rendered by non-communicable diseases (NCDs). In other terms, approximately 2,200 people die each day due to these fatal diseases in Pakistan.
According to the Steps Survey of Pakistan (2014-15), more than four out of 10 adults (41.3 percent) were obese or overweight, while 37 percent had hypertension.
Every 4th adult (26 percent) was suffering from type two diabetes as per second National Diabetes Survey of Pakistan conducted in 2016-17.
According to the International Diabetes Federation 2019, Pakistan has the fourth highest burden of type two diabetes worldwide with more than 19 million cases.
Solution: Tax on Sugary Drinks
Sugary drink taxes are among the promising decisions for governments, because such taxes decrease sugary drink consumption while increasing earnings to fund other government services and initiatives.
Sugar-sweetened beverage taxation exemplifies an opportunity to prevent noncommunicable diseases but it comes with challenges.
Pakistan National Heart Association on this situation:
PANAH asks government to introduce 20% tax on sugar sweetened beverages, it is a good action towards stopping disease like obesity and related NCDs like heart disease, hypertension, diabetes, liver and kidney diseases, some types of cancers, and tooth decay.
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- Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015
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- Healthy diet, Fact sheet N°394. Geneva: World Health Organization; 2015
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- Sugar supply (kcal/capita/d) in Northen Africa and Western Asia between 1970 and 2010. In
- FAO/Statistics Division. Italy; Food and Agriculture Organization of the United Nations; 2013
- WHO Global Health Observatory data repository. Geneva: World Health Organization.