Role of Sugar-Sweetened Beverages in Increasing Non Communicable Diseases in Pakistan
Maryam Ishtiaq, student
According to WHO in 2008, 57 million people worldwide died from various causes and 63% of
them died from non-communicable diseases. The highest proportion of premature deaths (under
60 years) due to NCDs were reported from low- and middle-income countries. In Pakistan,
NCDs are among the top ten causes of illness and death. According to the 2014-15 NCDS
STEPS study, 41.3% of Pakistanis are overweight or obese and 37% of people have hypertension
problems. According to the National Diabetes Survey 2016-17, 26% of people have type 2
diabetes. Excessive consumption of sugary drinks is one of the leading causes of obesity and
related NCDs such as heart disease, high blood pressure, diabetes, kidney and liver problems and
certain types of cancer.
SSBs refer to any beverage with added sugar or other artificial sweeteners, such as carbonated
beverages, fruit punch, energy and sports drinks as well. Carbonated beverages, soda or soft
drinks, SSBs are widely used in Pakistan. Another study of household income costs in Pakistan
shows that carbonated beverages make up about 60-70% of the household consumption rate of
non-alcoholic beverages. Several studies indicate the growing trend in the use of SSBs in recent
years. Demand for Cola carbonated beverages is growing rapidly in Pakistan.
The use of SSBs is directly related to less healthy behavior. Adults and adolescents who smoke,
do not get enough sleep, do not exercise much, eat fast food and do not eat fruit regularly are
more likely to become regular consumers of SSBs. Teens who regularly take SSBs also have
extra screen time e.g. with televisions, cell phones, computers and video games.
Consumption of sugar-sweetened beverages (SSBs), especially cold-carbonated beverages, may
have a major impact on the epidemic of obesity and obesity, due to these drinks, high sugar
content, low saturation, and incomplete total energy compensation. Experimental studies have
suggested that the potential for sugary drinks that can lead to weight gain is low saturated
carbohydrate intake and the effect of incomplete energy compensation on subsequent diets.
Specifically, the fraction of fructose in sugar causes the formation of lipid and carbohydrate
metabolism. Indirectly, sugar promotes good energy balance, thus weight gain and fat gain,
which in turn leads to the formation of lipid and carbohydrate metabolism.
Sweetened beverages, especially soda, provide small amounts of healthy food and increase
obesity and the risk of diabetes, fractures, and tooth decay. People who consume sugary drinks
regularly, 1 to 2 cans a day or more are 26% more likely to develop type 2 diabetes than people
who are less likely to have such drinks. The risks are even greater for young people and Asians.
Strong evidence indicates that cold sugary drinks contribute to the development of diabetes.
When you eat anything, your pancreas releases insulin. But when you eat too much sugar and
your body stops responding properly to insulin, your pancreas begins to absorb more insulin.
Eventually, your active pancreas will go down and your blood sugar levels will go up, setting
you up for type 2 diabetes.
If you have diabetes, too much sugar can lead to kidney damage. Kidneys play a vital role in
filtering your blood. When the blood sugar level reaches a certain level, the kidneys begin to
pump excess sugar into your urine. If left unmanaged, diabetes can damage the kidneys,
preventing them from doing their job of filtering the waste products from your bloodstream. This
can lead to kidney failure.
If you eat too much sugar, the extra insulin in your blood can affect your arteries throughout your
body. It causes their walls to swell, grow stronger and stronger, this stresses your heart and
damages it over time. This can lead to heart disease, such as heart failure, heart failure, and
stroke. Too much extra sugar may contain fructose or high fructose corn syrup. Fructose is a
process in the liver and in large quantities can damage the liver.
1- Non-alcoholic fatty liver disease (NAFLD): This is seen as excess fat in the liver.
2- Non-alcoholic steatohepatitis (NASH): Fatty liver, inflammation and “steatosis,” which are
Different countries reduce the use of SSBs by making separate interventions. New York Mayor
Michael Bloomberg’s proposal to ban the sale of any beverage of more than 16 ounces of city
restaurants, delis, cinemas and street carts may be well-intentioned, but Connie Diekman, RD,
former president of the American Dietetic Association, believes that. it will do little to reverse
the US obesity epidemic. Changing people’s behavior related to alcohol consumption is an
important public health step; however, Diekman notes that restricting certain sizes may make
drinks as a “forbidden fruit” even more desirable.
For those who want to reduce their sugary drink, Diekman recommends the following:
• Dip slices of lemon, lemon or orange in carbonated water.
• Switch to fruit juice instead of fruit juices to improve nutrition.
• Choose sweetened beverages with unhealthy sweeteners instead of sugar.
• And if you have to deal with sugary drinks, speed them up throughout the day and drink less.
Caffeine may be a greater source of sugar than some people. Diet may need to be reduced
slightly if the reason for drinking caffeine is in cola drinks. To help with your craving for
caffeine, limit your intake of foods, speed up fluids, and use low-sugar sugary foods.
To reduce the cost of health care and NCDs in Pakistan, it is important to prevent the use of these
SSBs. Raising taxes on SSBs is a proven first step in reducing obesity and disease burden on
related NCDs, and increasing national income.
Strategies for reducing SSB use have been identified in each important obesity prevention
setting. The strategies for reducing SSB usage are presented below. Strategies that apply to all
important settings are listed first, followed by strategies that are specific.
Strategy 1: Ensuring optimal access to drinking water
Strategy 2: Limit access to sugary drinks
Strategy 3: Encourage access to and use of healthy alternatives to sugary drinks
Strategy 4: Reduce the sale of sugary drinks and reduce the marketing impact on children
Strategy 5: Reduce the estimated cost of other healthy drinks by using different amounts of
Strategy 6: Include testing and counseling on sugary drinks as part of general health care
Strategy 7: Extend the knowledge and skills of health care providers to assess nutrition and
advice on the use of sugary drinks